This website is the digital version of the 2014 National Climate Assessment, produced in collaboration with the U.S. Global Change Research Program.

For the official version, please refer to the PDF in the downloads section. The downloadable PDF is the official version of the 2014 National Climate Assessment.

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Welcome to the National Climate Assessment

The National Climate Assessment summarizes the impacts of climate change on the United States, now and in the future.

A team of more than 300 experts guided by a 60-member Federal Advisory Committee produced the report, which was extensively reviewed by the public and experts, including federal agencies and a panel of the National Academy of Sciences.

Explore the effects of climate change
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Human Health

Climate change threatens human health and well-being in many ways, including through more extreme weather events and wildfire, decreased air quality, and diseases transmitted by insects, food, and water.

Explore human health.



Climate change is increasing the risks of respiratory stress from poor air quality, heat stress, and the spread of food-borne, insect-borne, and waterborne diseases. Extreme weather events often lead to fatalities and a variety of health impacts on vulnerable populations, including impacts on mental health, such as anxiety and post-traumatic stress disorder. Large-scale changes in the environment due to climate change and extreme weather events are increasing the risk of the emergence or reemergence of health threats that are currently uncommon in the United States, such as dengue fever.

Key weather and climate drivers of health impacts include increasingly frequent, intense, and longer-lasting extreme heat, which worsens drought, wildfire, and air pollution risks; increasingly frequent extreme precipitation, intense storms, and changes in precipitation patterns that can lead to flooding, drought, and ecosystem changes; and rising sea levels that intensify coastal flooding and storm surge, causing injuries, deaths, stress due to evacuations, and water quality impacts, among other effects on public health.

Key Message: Wide-ranging Health Impacts

Climate change threatens human health and well-being in many ways, including impacts from increased extreme weather events, wildfire, decreased air quality, threats to mental health, and illnesses transmitted by food, water, and disease-carriers such as mosquitoes and ticks. Some of these health impacts are already underway in the United States.

Key Message: Most Vulnerable at Most Risk

Climate change will, absent other changes, amplify some of the existing health threats the nation now faces. Certain people and communities are especially vulnerable, including children, the elderly, the sick, the poor, and some communities of color.

Key Message: Prevention Provides Protection

Public health actions, especially preparedness and prevention, can do much to protect people from some of the impacts of climate change. Early action provides the largest health benefits. As threats increase, our ability to adapt to future changes may be limited.

Key Message: Responses Have Multiple Benefits

Responding to climate change provides opportunities to improve human health and well-being across many sectors, including energy, agriculture, and transportation. Many of these strategies offer a variety of benefits, protecting people while combating climate change and providing other societal benefits.

Air Quality

Wildfire Smoke has Widespread Health Effects Wildfire Smoke has Widespread Health Effects Details/Download

Climate change is projected to harm human health by increasing ground-level ozone and/or particulate matter in some locations. Ground-level ozone (a key component of smog) is associated with many health problems, such as diminished lung function, increased hospital admissions and emergency room visits for asthma, and increases in premature deaths.4,5,6,7 Factors that affect ozone formation include heat, concentrations of precursor chemicals, and methane emissions, while particulate matter concentrations are affected by wildfire emissions and air stagnation episodes, among other factors.8,9

Ragweed Pollen Season Lengthens Ragweed Pollen Season Lengthens Details/Download

Warmer and drier conditions have already contributed to increasing wildfire extent across the western United States, and future increases are projected in some regions.10,11,12,13,14,15 Long periods of record high temperatures are associated with droughts that contribute to dry conditions and drive wildfires in some areas.16 Wildfire smoke contains particulate matter, carbon monoxide, and other compounds, which can significantly reduce air quality, both locally and in areas downwind of fires.17,18,19,20,21 Smoke exposure increases respiratory and cardiovascular hospitalizations, emergency room visits and medication for asthma, bronchitis, chest pain, and other ailments.17,22,23 It has been associated with hundreds of thousands of deaths globally each year.2,17,22,24,25 Future climate change is projected to increase wildfire risks and associated emissions, with harmful impacts on health.13,26,27,28,29,30,31

Allergies and Asthma

Heavy Downpours are Increasing Exposure to Disease Heavy Downpours are Increasing Exposure to Disease Details/Download

Climate change, as well as increased CO2 by itself, can contribute to increased production of plant-based allergens.13,3,32,33,34,35,36 Higher pollen concentrations and longer pollen seasons can increase allergic sensitizations and asthma episodes,37,38,39,40 and diminish productive work and school days.3,40,41 Simultaneous exposure to toxic air pollutants can worsen allergic responses.42,43,44,45 Extreme rainfall and rising temperatures can also foster indoor air quality problems, including the growth of indoor fungi and molds, with increases in respiratory and asthma-related conditions.46,47,48,49

Food and Waterborne Diarrheal Disease

Diarrheal disease is a major public health issue in developing countries and while not generally increasing in the United States, remains a persistent concern nonetheless. Exposure to a variety of pathogens in water and food causes diarrheal disease. Air and water temperatures, precipitation patterns, extreme rainfall events, and seasonal variations are all known to affect disease transmission.50,51,52 In the U.S., children and the elderly are most vulnerable to serious outcomes, and those exposed to inadequately or untreated groundwater will be among those most affected.

In general, diarrheal diseases including Salmonellosis and Campylobacteriosis are more common when temperatures are higher,53,54,55,56,57,58,59 though patterns differ by place and pathogen. Diarrheal diseases have also been found to occur more frequently in conjunction with both unusually high and low precipitation.60,61 Sporadic increases in streamflow rates, often preceded by rapid snowmelt62 and changes in water treatment,63 have also been shown to precede outbreaks. Risks of waterborne illness, and beach closures resulting from heavy rain and rising water temperatures are expected to increase in the Great Lakes region due to projected climate change.64,65,66,67

Extreme Heat

Extreme heat events are the leading weather-related cause of death in the United States.68 Many cities, including St. Louis, Philadelphia, Chicago, and Cincinnati have suffered dramatic spikes in death rates during heat waves. Deaths result from heat stroke and related conditions,69,70,71,72,73 but also from cardiovascular disease, respiratory disease, and cerebrovascular disease.74,75 Heat waves are also associated with increased hospital admissions for cardiovascular, kidney, and respiratory disorders.75,76,77,78,79

The Hottest Days Will Get Hotter

Projected Temperature Change of Hottest Days

Rapid Emissions Reductions (RCP 2.6)Continued Emissions Increases (RCP 8.5)

The maps show projected increases in the average temperature on the hottest days by late this century (2081-2100) relative to 1986-2005 under a scenario that assumes a rapid reduction in heat-trapping gases (RCP 2.6) and a scenario that assumes continued increases in these gases (RCP 8.5). The hottest days are those so hot they occur only once in 20 years. Across most of the continental U.S., those days will be about 10ºF to 15ºF hotter in the future under the higher emissions scenario, increasing health risks. (Figure source: NOAA NCDC / CICS-NC).

man wiping forehead ©Richard Drew/AP/Corbis

Extreme summer heat is increasing in the United States. The effects of heat stress are greatest during heat waves lasting several days or more. As human-induced climate change causes temperatures to continue to rise, heat waves are projected to increase in frequency, intensity, and duration.80,81,82,83,84

Some of the risks of heat-related sickness and death have diminished in recent decades, possibly due to better forecasting, heat-health early warning systems, and/or increased access to air conditioning for the U.S. population.85,86 However, extreme heat events remain a cause of preventable death nationwide. Urban heat islands, combined with an aging population and increased urbanization, are projected to increase the vulnerability of urban populations, especially the poor, to heat-related health impacts in the future.87,88,89

While deaths and injuries related to extreme cold events are projected to decline due to climate change, these reductions are not expected to compensate for the increase in heat-related deaths.90,91,92

Diseases Carried by Vectors

Climate is one of the factors that influences the distribution of diseases borne by vectors (such as fleas, ticks, and mosquitoes, which spread pathogens that cause illness).94,95,96,97,98,99,100,101,102,103,104 The geographic and seasonal distribution of vector populations, and the diseases they can carry, depend not only on climate, but also on land use, socioeconomic and cultural factors, pest control, access to health care, and human responses to disease risk, among other factors.95,96,105,106,107

North Americans are currently at risk from numerous vector-borne diseases, including Lyme, dengue fever, West Nile virus, Rocky Mountain spotted fever, plague, and tularemia.98,108,109,110,111 112,113,114,115,116,117,118,119,120,121 Vector-borne pathogens not currently found in the U.S., such as chikungunya, Chagas disease, and Rift Valley fever viruses, are also threats. Climate change effects on the geographical distribution and incidence of vector-borne diseases in other countries where these diseases are already found can also affect North Americans, especially as a result of increasing trade with, and travel to, tropical and subtropical areas.97,107

Lyme Disease

The development and survival of blacklegged ticks, their animal hosts, and the bacterium that causes Lyme disease, are strongly influenced by climatic factors, especially temperature, precipitation, and humidity. Potential impacts of climate change on the transmission of Lyme disease include: 1) changes in the geographic distribution of the disease due to the increase in favorable habitat for ticks to survive off their hosts;122 2) a lengthened transmission season due to earlier onset of higher temperatures in the spring and later onset of cold and frost; 3) higher tick densities leading to greater risk in areas where the disease is currently observed due to milder winters and potentially larger rodent host populations; and 4) changes in human behaviors, including increased time outdoors, which may lead to a higher risk of exposure to infected ticks.

Projected Changes in Tick Habitat

Projected Changes in Tick Habitat

Drag the slider to view time series effect

The maps show the current and projected (for 2080) probability of establishment of tick populations (Ixodes scapularis) that transmit Lyme disease. The projected expansion of tick habitat includes much of the eastern half of the country by 2080. For some areas around the Gulf Coast, the probability of tick population establishment is projected to decrease by 2080. (Figure source: adapted from Brownstein et al. 200593 ).


Multiple Benefits

Policies and other strategies intended to reduce carbon pollution and mitigate climate change can often have independent influences on human health. For example, reducing CO2 emissions through renewable electrical power generation can reduce air pollutants like particles and sulfur dioxide. Efforts to improve the resiliency of communities and human infrastructure to climate change impacts can also improve human health. There is a growing recognition that the magnitude of health “co-benefits,” like reducing both pollution and cardiovascular disease, could be significant, both from a public health and an economic standpoint.123,124,125

Innovative urban design could create increased access to active transport (such as walking and biking).66 The compact geographical area found in cities presents opportunities to reduce energy use and emissions of heat-trapping gases and other air pollutants through active transit, improved building construction, provision of services, and infrastructure creation, such as bike paths and sidewalks.126,127 Urban planning strategies designed to reduce the urban heat island effect, such as green/cool roofs, increased green space, parkland, and urban canopy, could reduce indoor temperatures and improve indoor air quality, and could also produce additional societal co-benefits by promoting social interaction and prioritizing vulnerable urban populations.126,128


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The National Climate Assessment summarizes the impacts of climate change on the United States, now and in the future.

A team of more than 300 experts guided by a 60-member Federal Advisory Committee produced the report, which was extensively reviewed by the public and experts, including federal agencies and a panel of the National Academy of Sciences.

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