Extreme Heat and Wildfire Smoke: Consequences for Communities

More Extreme Weather Leads to More Public Health Emergencies

Extreme heat and wildfire smoke both pose significant and worsening public health threats in the United States. Extreme heat causes the premature deaths of an estimated 10,000 people in the U.S. each year, while more frequent and widespread wildfire smoke exposure has set back decades of progress on air quality in many states. Importantly, these two hazards are related: extreme heat can worsen and prolong wildfire risk, which can increase smoke exposure. 

Extreme heat and wildfire smoke events are independently becoming more frequent and severe, but what is overlooked is that they are often occurring in the same place at the same time. Emerging research suggests that the combined impact of these hazards may be worse than the sum of their individual impacts. These combined impacts have the potential to put additional pressure on already overburdened healthcare systems, public budgets, and vulnerable communities. Failing to account for these combined impacts could leave communities unprepared for these extreme weather events in 2025 and beyond.

To ensure resilience and improve public health outcomes for all, policymakers should consider the intersection of wildfire smoke and extreme heat at all levels of government. Our understanding of how extreme heat and wildfire smoke compound is still nascent, which limits national and local capacity to plan ahead. Researchers and policymakers should invest in understanding how extreme heat and wildfire smoke compound and use this knowledge to design synergistic solutions that enhance infrastructure resilience and ultimately save lives. 

Intersecting Health Impacts of Extremely Hot, Smoky Days

Wildfire smoke and extreme heat can each be deadly. As mentioned, exposure to extreme heat causes the premature deaths of an estimated 10,000 people in the U.S. a year. Long-term exposure to extreme heat can also worsen chronic conditions like kidney disease, diabetes, hypertension, and asthma. Exposure to the primary component of wildfire smoke, known as fine particulate matter (PM2.5), contributes to an additional estimated 16,000 American deaths annually. Wildfire smoke exacerbates and causes various respiratory and cardiovascular effects along with other health issues, such as asthma attacks and heart failure, increasing risk of early death. 

New research suggests that the compounding health impacts of heat and smoke co-exposure could be even worse. For example, a recent analysis found that the co-occurrence of extreme heat and wildfire smoke in California leads to more hospitalizations for cardiopulmonary problems than on heat days or smoke days alone. 

Extreme heat also contributes to the formation of ground-level ozone. Like wildfire smoke, ground-level ozone can cause respiratory problems and exacerbate pre-existing conditions. This has already happened at scale: during the 2020 wildfire season, more than 68% of the western U.S. – about 43 million people – were affected in a single day by both ground-level ozone extremes and fine particulate matter from wildfire smoke.

Impacts on Populations Most Vulnerable to Combined Heat and Smoke

While extreme heat and wildfire smoke can pose health risks to everyone, there are some groups that are more vulnerable either because they are more likely to be exposed, they are more likely to suffer more severe health consequences when they are exposed, or both. Below, we highlight groups that are most vulnerable to extreme heat and smoke and therefore may be vulnerable to the compound impacts of these hazards. More research is needed to understand how the compound impacts will affect the health of these populations.

Housing-Vulnerable and Housing-Insecure People

Access to air conditioning at home and work, tree canopy cover, buildings with efficient wildfire smoke filtration and heat insulation and cooling capacities, and access to  smoke centers are all important protective factors against the effects of extreme heat and/or wildfire smoke. People lacking these types of infrastructure are at higher risk for the health effects of these two hazards as a result of increased exposure. In California, for example, communities with lower incomes and higher population density experience a greater likelihood of negative health impacts from hazards like wildfire smoke and extreme heat. 

Outdoor Workers

Representing about 33% of the national workforce, outdoor workers — farmworkers, firefighters, and construction workers — experience much higher rates of exposure to environmental hazards, including wildfire smoke and extreme heat, than other workers. Farmworkers are particularly vulnerable even among outdoor workers; in fact, they face a 35 times greater risk of heat exposure death than other outdoor workers. Additionally, outdoor workers are often lower-income, making it harder to afford protections and seek necessary medical care. Twenty percent of agricultural worker families live below the national poverty line.

Wildfire smoke exposure is estimated to have caused $125 billion in lost wages annually from 2007 to 2019 and extreme heat exposure is estimated to cause $100 billion in wage losses each year. Without any changes to policies and practice, these numbers are only expected to rise. These income losses may exacerbate inequities in poverty rates and economic mobility, which determine overall health outcomes.

Pregnant Mothers and Infants

Extreme heat and wildfire smoke also pose a significant threat to the health of pregnant mothers and their babies. For instance, preterm birth is more likely during periods of higher temperatures and during wildfire smoke events. This correlation is significantly stronger among people who were simultaneously exposed to extreme heat and wildfire smoke PM2.5.

Preterm birth comes with an array of risks for both the pregnant mothers and baby and is the leading cause of infant mortality. Babies born prematurely are more likely to have a range of serious health complications in addition to long-term developmental challenges. For the parent, having a preterm baby can have significant mental health impacts and financial challenges.

Children

Wildfire smoke and extreme heat both have significant impacts on children’s health, development, and learning. Children are uniquely vulnerable to heat because their bodies do not regulate temperatures as efficiently as adults, making it harder to cool down and putting their bodies under stress. Children are also more vulnerable to air pollution from wildfire smoke as they inhale more air relative to their weight than adults and because their bodies and brains are still developing.  PM2.5 exposure from wildfires has been attributed to neuropsychological effects, such as ADHD, autism, impaired school performance, and decreased memory. 

When schools remain open during extreme weather events like heat and smoke, student learning is impacted. Research has found that each 1℉ increase in temperature leads to 1% decrease in annual academic achievement. However, when schools close due to wildfire smoke or heat events, children lose crucial learning time and families must secure alternative childcare.

Low-income students are more likely to be in schools without adequate air conditioning because their districts have fewer funds available for school improvement projects. This barrier has only been partially remedied in recent years through federal investments.

Older Adults

Older adults are more likely to have multiple chronic conditions, many of which increase vulnerability to extreme heat, wildfire smoke, and their combined effects. Older adults are also more likely to take regular medication, such as beta blockers for heart conditions, which increase predisposition to heat-related illness.

The most medically vulnerable older adults are in long-term care facilities. There is currently a national standard for operating temperatures for long-term care facilities, requiring them to operate at or below 81℉. There is no correlatory standard for wildfire smoke. Preliminary studies have found that long-term care facilities are unprepared for smoke events; in some facilities the indoor air quality is no better than the outdoor air quality.

Challenges and Opportunities for the Healthcare Sector

The impacts of extreme heat and smoke have profound implications for public health and therefore for healthcare systems and costs. Extreme heat alone is expected to lead to $1 billion in U.S. healthcare costs every summer, while wildfire smoke is estimated to cost the healthcare system $16 billion every year from respiratory hospital visits and PM2.5 related deaths. 

Despite these high stakes, healthcare providers and systems are not adequately prepared to address wildfire smoke, extreme heat, and their combined effects. Healthcare preparedness and response is limited by a lack of real-time information about morbidity and mortality expected from individual extreme heat and smoke events. For example, wildfire smoke events are often reported on a one-month delay, making it difficult to anticipate smoke impacts in real time. Further, despite the risks posed by heat and smoke independently and when combined, healthcare providers are largely not receiving education about environmental health and climate change. As a result, physicians also do not routinely screen their patients for health risk and existing protective measures, such as the existence of air conditioning and air filtration in the home. 

Potential solutions to improve preparedness in the healthcare sector include developing more reliable real-time information about the potential impacts of smoke, heat, and both combined; training physicians in screening patients for risk of heat and smoke exposure; and training physicians in how to help patients manage extreme weather risks. 

Challenges and Opportunities for Federal, State, and Local Governments 

State and local governments have a role to play in building facilities that are resilient to extreme heat and wildfire smoke as well as educating people about how to protect themselves. However, funding for extreme heat and wildfire smoke is scarce and difficult for local jurisdictions in need to obtain. While some federal funding is available specifically to support smoke preparedness (e.g., EPA’s Wildfire Smoke Preparedness in Community Buildings Grant Program) and heat preparedness (e.g. NOAA NIHHIS’ Centers of Excellence), experts note that the funding landscape for both hazards is “limited and fragmented.” To date, communities have not been able to secure federal disaster funding for smoke or heat events through the Public Health Emergency Declaration or the Stafford Act. FEMA currently excludes the impacts on human health from economic valuations of losses from a disaster. As a result, many of these impacted communities never see investments from post-disaster hazard mitigation, which could potentially build community resilience to future events. Even if a declaration was made, it would likely be for one “event”, e.g. wildfire smoke or extreme heat, with recovery dollars targeted towards mitigating the impacts of that event. Without careful consideration, rebuilding and resilience investments might be maladaptive for addressing the combined impacts.

Next Steps

The Wildland Fire Mitigation and Management Commission report offers a number of recommendations to improve how the federal government can better support communities in preparing for the impacts of wildfire smoke and acknowledges the need for more research on how heat and wildfire smoke compound. FAS has also developed a whole-government strategy towards extreme heat response, resilience, and preparedness that includes nearly 200 recommendations and notes the need for more data inputs on compounding hazards like wildfire smoke. Policymakers at the federal level should support research at the intersection of these topics and explore opportunities for providing technical assistance and funding that builds resilience to both hazards.

Understanding and planning for the compound impacts of extreme heat and wildfire smoke will improve public health preparedness, mitigate public exposure to extreme heat and wildfire smoke, and minimize economic losses. As the overarching research at this intersection is still emerging, there is a need for more data to inform policy actions that effectively allocate resources and reduce harm to the most vulnerable populations. The federal government must prioritize protection from both extreme heat and wildfire smoke, along with their combined effects, to fulfill its obligation to keep the public safe.

Federation of American Scientists Unveils Federal Policy Agenda for Tackling Extreme Heat; Supported by 60+ Organizations

Announcement Comes as 2024 is Officially Declared Hottest Year on Record; Lingering Effects of Extreme Heat Fuel Catastrophic Wildfires in California

Washington, D.C. – January 13, 2025 – The Federation of American Scientists (FAS), a non-partisan, nonprofit science think tank dedicated to developing  evidence-based policies to address national threats, today released the 2025 Heat Policy Agenda. This strategy provides specific, actionable policy ideas to tackle the growing threat of extreme heat in the United States – an issue that now affects all 50 states and costs the country more than $160 billion annually. The Heat Policy Agenda was co-signed by more than 60 labor, industry, health, housing, environmental, academic and community associations and organizations.

“The 2025 Heat Policy Agenda lays out a comprehensive strategy for how to build U.S. resilience to extreme heat using science, technology, and evidence-based solutions,” says Daniel Correa, CEO of the Federation of American Scientists. “These ideas are also designed to increase government efficiency, protect critical infrastructure, and secure our Nation’s economy. We look forward to helping political leaders pursue rapid implementation of this critical agenda with the ultimate goal of protecting the health and wellbeing of people across the nation.”

Rollout of the Heat Policy Agenda comes as the National Oceanic and Atmospheric Administration (NOAA) confirms 2024 as the hottest year on record, continuing a sustained trend. The 10 warmest years in modern history have all occurred during the past decade. 

Rollout also comes as catastrophic wildfires around Los Angeles provide a stark reminder of the lingering effects of extreme heat, and the interconnected nature of climate effects.

“Prolonged summer heat left vegetation in southern California bone-dry, making it that much easier for wildfires to explode unchecked,” explains Dr. Hannah Safford, FAS Associate Director of Climate and Environment. “Summer heat also depleted water resources critical for firefighting, and made it difficult to safely reduce fuel loads. The crisis we’re seeing around Los Angeles this winter underscores that we have to think about heat year-round – not just when it’s hot outside.”

The Heat Policy Agenda presents clear and specific actions the federal government can take to protect people, places, and the economy from the effects of extreme heat. These include:

“As a Nation, we’ve underinvested in extreme heat relative to other natural hazards – but heat kills more people each year than hurricanes, tornadoes, and floods combined,” observes Grace Wickerson, FAS Health Equity Policy Manager. “Our 2025 Heat Policy Agenda addresses this emerging public health crisis from the ground up, with an emphasis on protecting children, the elderly, and other vulnerable populations.”

The 2025 Heat Policy Agenda represents insights and perspectives from hundreds of practitioners, technical experts, and community leaders. The full list of organizations co-signing the Agenda and urging immediate policy action on extreme heat is listed below. Please fill out this form if your organization would like to be added to this list.

Signatories Urging Policy Action on Extreme Heat

Alliance of Nurses for a Healthy Environment
American Federation of State, County, and Municipal Employees
American Forests
American Lung Association
Arizona State University’s Knowledge Exchange for Resilience
Association of Farmworker Opportunity Programs
Association of State and Territorial Health Officials
Atlantic Council’s Climate Resilience Center
C40 Cities Climate Leadership Group
California ReLeaf
Center for American Progress
Center for Biological Diversity
Center for Energy Poverty and Climate
Center for Invasive Species Prevention
Children’s Environmental Health Network
Climate Mayors
Climate Power
Climate Resolve
Dade County Street Response
Earth Ethics, Inc.
Elevate
Energy Equity Project
Farmworker Association of Florida
Federation of American Scientists
Food Tank
Green Roofs for Healthy Cities
Grid Alternatives
Groundwork USA
ICLEI – Local Governments for Sustainability
Institute for Market Transformation
King County, Washington
Korey Stringer Institute
La Isla Network
League of Conservation Voters
MetroLab Network
Moms Clean Air Force
National Center for Healthy Housing
National Coalition for the Homeless
National Consumer Law Center
National Council on Occupational Safety and Health
National Employment Law Project
National Energy Assistance Directors Association
National Partnership for Women & Families
National Recreation and Parks Association
National Young Farmers Coalition
Natural Resources Defense Council
New America Future of Land and Housing Program
Next100
Organizing Resilience
Physicians for Social Responsibility
Rebuild by Design
SafeWork Washington
Smart Growth America
Smart Home America
Smart Surfaces Coalition
Southeast Sustainability Directors Network
Ten Across Resilience Network
The CLEO Institute
The New Buildings Institute
The Passive House Network
Toxic Free NC
Trust for Public Land
Undaunted K12
Union of Concerned Scientists
Urban Sustainability Directors Network
We Act for Environmental Justice
WeCount!
Women with Broken Heals
Workplace Fairness
Yale Center on Climate Change and Health



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ABOUT FAS

The Federation of American Scientists (FAS) works to advance progress on a broad suite of contemporary issues where science, technology, and innovation policy can deliver dramatic progress, and seeks to ensure that scientific and technical expertise have a seat at the policymaking table. Established in 1945 by scientists in response to the atomic bomb, FAS continues to work on behalf of a safer, more equitable, and more peaceful world. More information about FAS work at fas.org.

ABOUT THIS COALITION

More than 60 labor, health, industry, environmental, and community organizations join with the Federation of American Scientists to support the 2025 Heat Policy Agenda, a comprehensive, common-sense strategy to tackle the growing threat of extreme heat in the United States. This call for action comes as 2024 is officially declared the hottest year on record, continuing a sustained trend. Extreme heat now affects tens of millions of Americans each year, and costs the country more than $160 billion annually in health costs, lost productivity, and other impacts. Rapid implementation of the 2025 Heat Policy Agenda will mitigate heat impacts, boosting the U.S. economy and making it safer for all Americans to live, work, and play.

RESOURCES

Extreme Heat Policy Agenda

2025 Heat Policy Agenda

It’s official: 2024 was the hottest year on record. But Americans don’t need official statements to tell them what they already know: our country is heating up, and we’re deeply unprepared.

Extreme heat has become a national economic crisis: lowering productivity, shrinking business revenue, destroying crops, and pushing power grids to the brink. The impacts of extreme heat cost our Nation an estimated $162 billion in 2024 – equivalent to nearly 1% of the U.S. GDP.

Extreme heat is also taking a human toll. Heat kills more Americans every year than hurricanes, floods, and tornadoes combined. The number of heat-related illnesses is even higher. And even when heat doesn’t kill, it severely compromises quality of life. This past summer saw days when more than 100 million Americans were under a heat advisory. That means that there were days when it was too hot for a third of our country to safely work or play.

We have to do better. And we can.

Attached is a comprehensive 2025 Heat Policy Agenda for the Trump Administration and 119th Congress to better prepare for, manage, and respond to extreme heat. The Agenda represents insights from hundreds of experts and community leaders. If implemented, it will build readiness for the 2025 heat season – while laying the foundation for a more heat-resilient nation.

Core recommendations in the Agenda include the following:

  1. Establish a clear, sustained federal governance structure for extreme heat. This will involve elevating, empowering, and dedicating funds to the National Interagency Heat Health Information System (NIHHIS), establishing a National Heat Executive Council, and designating a National Heat Coordinator in the White House.
  2. Amend the Stafford Act to explicitly define extreme heat as a “major disaster”, and expand the definition of damages to include non-infrastructure impacts.
  3. Direct the Secretary of Health and Human Services (HHS) to consider declaring a Public Health Emergency in the event of exceptional, life-threatening heat waves, and fully fund critical HHS emergency-response programs and resilient healthcare infrastructure.
  4. Direct the Federal Emergency Management Agency (FEMA) to include extreme heat as a core component of national preparedness capabilities and provide guidance on how extreme heat events or compounding hazards could qualify as major disasters.
  5. Finalize a strong rule to prevent heat injury and illness in the workplace, and establish Centers of Excellence to protect troops, transportation workers, farmworkers, and other essential personnel from extreme heat.
  6. Retain and expand home energy rebates, tax credits, LIHEAP, and the Weatherization Assistance Program, to enable deep retrofits that cut the costs of cooling for all Americans and prepare homes and other infrastructure against threats like power outages.
  7. Transform the built and landscaped environment through strategic investments in urban forestry and green infrastructure to cool communities, transportation systems to secure safe movement of people and goods, and power infrastructure to ready for greater load demand.

The way to prevent deaths and losses from extreme heat is to act before heat hits. Our 60+ organizations, representing labor, industry, health, housing, environmental, academic and community associations and organizations, urge President Trump and Congressional leaders to work quickly and decisively throughout the new Administration and 119th Congress to combat the growing heat threat. America is counting on you.

Executive Branch

Federal agencies can do a great deal to combat extreme heat under existing budgets and authorities. By quickly integrating the actions below into an Executive Order or similar directive, the President could meaningfully improve preparedness for the 2025 heat season while laying the foundation for a more heat-resilient nation in the long term. 

Streamline and improve extreme heat management.

More than thirty federal agencies and offices share responsibility for acting on extreme heat. A better structure is needed for the federal government to seamlessly manage and build resilience. To streamline and improve the federal extreme heat response, the President must:

Boost heat preparedness, response, and resilience in every corner of our nation.

Extreme heat has become a national concern, threatening every community in the United States. To boost heat preparedness, response, and resilience nationwide, the President must:

Usher in a new era of heat forecasting, research, and data.

Extreme heat’s impacts are not well-quantified, limiting a systematic national response. To usher in a new era of heat forecasting, research, and data, the President must:

Protect workers and businesses from heat.

Americans become ill and even die due to heat exposure in the workplace, a moral failure that also threatens business productivity. To protect workers and businesses, the President must:

Prepare healthcare systems for heat impacts.

Extreme heat is both a public health emergency and a chronic stress to healthcare systems. Addressing the chronic disease epidemic will be impossible without treating the symptom of extreme heat. To prepare healthcare systems for heat impacts, the President must:

Ensure affordably cooled and heat-resilient housing, schools, and other facilities.

Cool homes, schools, and other facilities are crucial to preventing heat illness and death. To prepare the build environment for rising temperatures, the President must:

Promote Housing and Cooling Access

Prepare Schools and Other Facilities

Legislative Branch

Congress can support the President in combating extreme heat by increasing funds for heat-critical federal programs and by providing new and explicit authorities for federal agencies.

Treat extreme heat like the emergency it is.

Extreme heat has devastating human and societal impacts that are on par with other federally recognized disasters. To treat extreme heat like the emergency it is, Congress must:

Build community heat resilience by readying critical infrastructure.

Investments in resilience pay dividends, with every federal dollar spent on resilience returning $6 in societal benefits. Our nation will benefit from building thriving communities that are prepared for extreme heat threats, adapted to rising temperatures, and capable of withstanding extreme heat disruptions. To build community heat resilience, Congress must:

Leveraging the Farm Bill to build national heat resilience.

Farm, food, forestry, and rural policy are all impacted by extreme heat. To ensure the next Farm Bill is ready for rising temperatures, Congress should:

Funding critical programs and agencies to build a heat-ready nation.

To protect Americans and mitigate the $160+ billion annual impacts of extreme heat, Congress will need to invest in national heat preparedness, response, and resilience. The tables on the following pages highlight heat-critical programs that should be extended, as well as agencies that need more funding to carry out heat-critical work, such as key actions identified in the Executive section of this Heat Policy Agenda.

The U.S. Needs to Build More Houses in Future Receiving Cities

After a 50-year population boom, migration to the Sun Belt is skidding to a halt. Instead, the scorching heat and devastating storms increasingly common across the southern (and coastal) United States are prompting Americans to consider moving to more geographically resilient regions. New America estimates that 20 million Americans will relocate in the coming decades to escape extreme heat, drought, sea-level rise and natural disasters such as tropical storms, flooding, and wildfires. Many of them are likely to end up in “Receiving Cities” in the Midwest, Northeast, and the northern Great Plains.

Many anticipated “Receiving Cities” – places like Cincinnati, Duluth, Buffalo and Detroit – could benefit from the economic stimulus and revitalization that often accompany population inflows. These cities have a large carrying capacity but have suffered from deindustrialization, disinvestment, and population outflows in the last half century.

Yet at present, many Receiving Cities aren’t positioned to support an influx of residents. The rapid and unplanned arrival of transplants could overwhelm housing supply (which is already in shortfall across much of the country), increase housing insecurity and displacement, and place additional stress on federal and local rental and homeowner assistance programs, legal aid clinics, and other housing-related services. 

Because weather-related migration is not presently occurring en masse, the new administration has an opportunity to (i) increase the preparedness and socioeconomic appeal of Receiving Cities, in large part through production and preservation of housing for all income levels; and then (ii) encourage and support American households in relocating to these communities. The federal government should designate “Receiving Cities” to which it will allocate funds and tax incentives aimed at producing and preserving affordable housing, in anticipation of population inflows. 

Challenge and Opportunity

How will the Sun Belt Exodus Unfold?

Over the last 50 years, Florida, Texas, Arizona, and other Sun Belt states have experienced a boom of residents seeking affordable housing, low taxes, and balmy weather. These population inflows have had a significant positive impact on local economies by creating jobs, boosting housing markets, and stimulating small businesses. 

Yet extreme weather and natural disasters are starting to reverse this trend. A study published in July 2024 by the Federal Reserve Bank of San Francisco shows that the U.S. population is starting to migrate away from areas increasingly exposed to extreme heat toward historically colder areas, which are becoming more attractive as extreme cold days become increasingly rare. Meanwhile, analysis from First Street Foundation suggests that 3.2 million Americans have already relocated from areas with high flood risk. As extreme weather events become more frequent and severe, and as Southern cities become hotter, New America estimates that 20 million Americans will relocate by 2100. 

As Americans move, however, many are relocating to nearby communities that are often no less vulnerable than the ones they had left. A report from Rice University on government buyouts of flood-prone houses, for example, found that 58 percent of participating homeowners relocated within a 10-mile drive of their previous property. And, even as some Americans are leaving the Sun Belt, others are continuing to move there. Census Bureau data from 2023 shows that 11 of the 15 fastest-growing cities in the U.S. are located in Arizona, Texas, and Florida: states at increasing risk of various natural hazards, including sea-level rise, extreme heat, drought, flooding, and tropical storms.

Alongside negative effects on physical safety and quality of life, decisions to remain in geographically vulnerable areas have major economic consequences for residents, local and state governments, and the federal government. Residents and local governments risk hundreds of billions of dollars in financial losses from property damage and lost local tax revenues. State and regional actors increase the fallout of an all-but-certain collapse of real estate, mortgage lending, and homeowners insurance markets. Additionally, the federal government faces multi-billion dollar losses each year from post-disaster assistance payouts and from administering the already-insolvent National Flood Insurance Program. 

In order to minimize these losses, the U.S. must support the steady relocation of American households to more geographically resilient regions, including the Midwest, Northeast, and the northern Great Plains. And it must ensure that “Receiving Cities” in these regions have the housing and infrastructure to support and benefit from population inflows – just as Sun Belt metros have over the last half century – without displacing existing residents.

An Opportunity for Receiving Cities 

For many Receiving Cities, transplants from the Sun Belt and elsewhere offer a chance for socioeconomic revitalization and growth. Population increases can boost demand for goods and services, fill gaps in the local labor market, and increase the municipal tax base. Transplants will bring a diverse range of professional experience, skills, and educational backgrounds that can complement the existing workforce within their new community.

But without additional investment, many of these cities are unprepared to absorb population inflows. Post-industrial cities in the Midwest and Northeast theoretically possess the urban carrying capacity to accommodate new residents, but have persistently underinvested in housing, along with other community needs. For instance, Detroit, with its thousands of vacant and abandoned buildings, was actually short 24,000 habitable homes after blight was taken into account, according to a 2020 study from the University of Michigan. Similarly, a 2022 report from Duluth, Minnesota, often cited as the most geographically resilient city in the U.S., shows that the community requires 2,400 additional units to keep pace with its current rate of growth.

Consequently, the rapid and unplanned arrival of transplants in receiving cities could possibly overwhelm a local housing sector, exacerbate unaffordability, displacement, and homelessness, and place additional stress on rental and homeowner assistance programs, legal aid clinics, and other housing-related services. Recent experience in Chico, California is emblematic: following sudden population growth due to the 2018 Camp Fire, housing prices in Chico increased 21 percent while many Housing Choice Voucher beneficiaries struggled to find rentals. Smaller and mid-sized municipalities can especially struggle with the abrupt arrival of many displaced persons or transplants. A shortfall of financial and technical resources creates barriers to preparedness, and many local governments do not possess the staffing and expertise to access the federal funding and professional assistance that is crucial for planning.

Access to affordable and quality housing will be foundational for any successful revitalization or growth. Through a Receiving Cities Housing Program, the U.S. government can support future receiving cities to prepare local housing markets for expected population increases due to weather change. As this population movement is not presently occurring en masse, there is opportunity for the incoming administration to (i) help increase the preparedness and socioeconomic appeal of future receiving cities, in large part through production and preservation of affordable housing; and then (ii) encourage and support American households in relocating in the near future to receiving cities, in order to increase individual, community, and national resilience.

Burdens for unprepared communities

Although out of scope for this memo, it is worth mentioning that without proper planning, large population inflows could also place increased strain on existing infrastructure and public services in receiving communities, including health care, transportation, education, water and sanitation, electricity, and waste management. Unprepared localities may experience new or additional challenges in basic amenity provision, service disruptions, and/or increased cost of living for both newcomers and long-time residents as a result.

Plan of Action

Upon taking office, the President should sign an Executive Order to boost housing supply nationwide, with a focus on housing supply in Receiving Cities via a Receiving Cities Housing Program. The Executive Order will establish an Interagency Policy Committee (IPC) focused on housing risk reduction in Receiving Cities, stewarded by the Domestic Policy Council or the National Economic Council.

In parallel, the new administration must work to frame domestic relocation and the Receiving Cities Housing Program as an opportunity instead of a crisis or burden. American viewpoints are evolving on weather and disaster-related relocation, previously a political and social “third rail.” A 2021 survey found that 57 percent of participants believed climate change will force them to consider a move in the next decade. According to a similar survey from the real estate firm Redfin in 2021, nearly half of respondents that planned to relocate in the next year cited climate change as a deciding factor. 

To further depoliticize weather-related migration, the President should publicly position extreme weather as a risk to be managed similar to cyber risk and national security risk. He could do so in a speech to the American people and to Congress, such as the 2025 State of the Union. The President can also direct their Communications Director and Press Secretary, along with relevant agencies such as the Federal Emergency Management Agency (FEMA) and the Department of Housing and Urban Development (HUD), to communicate on the risks to households of remaining in vulnerable regions, and of the Receiving Cities Housing Program as a tool for revitalization and economic growth.

Overall, the Receiving Cities Housing Program should be guided by the following recommendations:

Recommendation 1. Expand federally supported research and data collection on geographic resilience, weather-related migration projections, and urban carrying capacity to inform designation of “Receiving Cities.”

Improved understanding of (i) geographic resilience; (ii) likely domestic weather-related relocation patterns; and (iii) urban carrying capacity is essential for informed and data-driven decision-making regarding the designation of “Receiving Cities.” The Executive Order should: 

Recommendation 2. Designate a set of “Receiving Cities” based on clearly articulated criteria and in consultation with prospective Receiving Cities.

The Receiving Cities Housing Program must consider geographic resilience, projected demographic growth, and urban carrying capacity (including potential carrying capacity of adjacent federal lands) during its selection process. Criteria should include a desire from the Receiving City to be included in the program. In order to ensure buy-in, potential Receiving Cities should also tangibly demonstrate a long-term commitment to affordable housing development, resilient urban planning, and socioeconomic equity amid weather-related migration. The IPC should develop and announce a set of measurable housing-related preconditions for designation of a city as a “Receiving City.” Program requirements could include, but is not limited to:

Recommendation 3. Develop a Receiving Cities Housing Program that supports production and preservation of affordable housing in designated “Receiving Cities.”

Once the Receiving Cities Housing Program selects participant cities, it must support these communities to (a) build new units, via a New Home Program, and (b) rehabilitate and preserve existing units, via a Home Restoration Program.

The Receiving Cities New Homes Program will include the following assistance:

The Receiving Cities Home Restoration Program will be responsible for making older and vacant homes market-ready, and will include the following assistance:

Recommendation 4. Secure long-term federal financing for the Receiving Cities Housing Program.

Major legislation such as the American Rescue Plan Act, the Infrastructure Investment and Jobs Act (IIJA), and the Inflation Reduction Act (IRA) demonstrate that the federal government can direct significant and flexible resources towards adaptation and resilience. Prioritization of these needs must continue via the Receiving Cities Housing Program, as effective preparation in receiving cities for weather-related migration is a long-term effort.

Concurrently, IPC member agencies should coordinate with relevant federal financing departments, agencies, and offices to increase funding for the production and preservation of affordable housing in designated “Receiving Cities,” with the following actions:

Recommendation 5. Create a pilot program that offers incentives for American households to relocate from high-risk areas to “Receiving Cities.”

As a supplement to the Receiving Cities Housing Program, HUD, in collaboration with FEMA and DOT, should pilot a resilient relocation program that provides tax breaks, housing vouchers, and/or direct payouts for households to relocate to Receiving Cities. The pilot could also incorporate workforce training or reskilling programs. 

At the local, state, and federal level, there are existing programs that provide incentives or support for people to relocate, such as Tulsa Remote; the ThinkVermont Innovation Initiative; and the Biden Administration’s recently established WelcomeCorps. A similar federal initiative for weather-related migration should leverage knowledge and expertise from existing programs. 

Conclusion

Led by the incoming administration, a new Receiving Cities Housing Program should incorporate a whole-of-government approach and emphasize coordination with local leaders, civil society, and the private sector. Implementation of this program will help provide projected receiving cities with increased resources to plan for and receive new arrivals, and also ensure that relocation to geographically resilient regions is a logical and appealing choice for Americans voluntarily relocating in part or whole due to weather.

Ultimately, with sufficient planning, technical assistance, resource allocation, and communications, the federal government can shape weather-related migration into an opportunity for economic revitalization and growth in geographically resilient communities, and also ensure equitable and high quality-of-life for both new arrival and long-time residents.

This action-ready policy memo is part of Day One 2025 — our effort to bring forward bold policy ideas, grounded in science and evidence, that can tackle the country’s biggest challenges and bring us closer to the prosperous, equitable and safe future that we all hope for whoever takes office in 2025 and beyond.

PLEASE NOTE (February 2025): Since publication several government websites have been taken offline. We apologize for any broken links to once accessible public data.

Frequently Asked Questions
What is a receiving community?

Broadly, a “receiving community” is any U.S. community that receives an influx of new residents due to weather-related migration. Some receiving communities are labeled as “geographically resilient,” which means that they are towns and cities in relatively less geographically vulnerable parts of the U.S.

When will most weather-related transplants move?

Despite broad consensus that climate change will result in greater displacement and migration in the U.S., it is difficult to determine a “tipping point” for very large population movements. Several scholars and journalists believe that the indirect economic impacts of natural disasters will spur a mass movement. Within this century, negative effects on sectors such as construction and real estate, manufacturing, tourism and recreation, and agriculture could lead to economic downturns, job loss, and then migration. At the same time, in many geographically vulnerable regions, the lack of access to traditional 30-year mortgages, increasingly unaffordable or unavailable homeowners insurance, or unsustainable repair costs following repeat disasters may cause real estate prices to crash and convince Americans to relocate.

How many Americans will become weather-related transplants?

Estimates vary widely on the number of future weather-related transplants in the U.S., and are often contingent on specific geographies or natural hazards. Research from the University of Southern California, for example, projects that sea-level rise alone will displace 13 million people in the country by 2100. Another study suggests that one in 12 residents from the U.S. South will relocate towards California, the Rockies, or the Pacific Northwest. Yet another academic article predicts that geographically resilient cities in the Northwest and Northeast should expect to grow in population by roughly 10 percent. Findings from the First Street Foundation indicate that 3 million Americans have already relocated due to increased flooding and flood risk.


Larger estimates also exist: Tulane University professor Jesse Keenan has predicted that 50 million Americans could relocate due to climate change. Reporter Abrahm Lustgarten writes that as many as 1-in-2 Americans, or approximately 162 million people, could eventually move due to natural disasters and environmental degradation.

Why does the U.S. federal government need to designate “Receiving Cities?”

For the last several years, New America has studied the dynamics of domestic weather-related migration, including the reasons why so many Americans are actively moving into vulnerable areas and also why those displaced by natural hazards often relocate to communities no less vulnerable than the places left behind. In part, we discern an oversimplified narrative that presents coastal regions of the United States as dangerous and inland areas as safe. Yet, as the impact of Hurricane Helene in western North Carolina demonstrates, this misinformation has the potential to threaten the well-being of millions of Americans and hampers adaptation efforts. Instead of relying on the media, the real estate sector, and others to designate geographically resilient cities, the federal government and its partners must leverage the resources and expertise at their disposal to designate “receiving cities” through rigorous quantitative analysis.

Federation of American Scientists (FAS) Celebrates 2nd Anniversary of the Inflation Reduction Act

The Inflation Reduction Act (IRA) is the largest climate investment in history. FAS scientists offer policy ideas to maximize the impacts of this investment on U.S. competitiveness, energy security, resilience, and more.

Washington, D.C. – August 16, 2024 – The Federation of American Scientists (FAS), the non-partisan, nonprofit science think tank dedicated to using evidence-based science for the public good, is celebrating the two-year anniversary of the signing of the Inflation Reduction Act (IRA) by sharing policy ideas to drive continued successful implementation of this landmark legislation.

The IRA is a United States federal law which aims to reduce the federal government budget deficit, lower prescription drug prices, and invest in domestic energy production while promoting clean energy. It was passed by the 117th United States Congress and it was signed into law by President Biden on August 16, 2022. The IRA has catalyzed $265 billion in new clean energy investments and created hundreds of thousands of jobs in the United States, putting us on a path to achieving climate goals while boosting the economy. 

“In just two years, the Inflation Reduction Act has driven down costs of energy and transportation for everyday Americans while reining in catastrophic climate change” says Hannah Safford, Associate Director of Climate and Environment. “This legislation proves that when we invest in a better future, everyone wins.”

“The IRA enables the country to move toward ambitious climate goals. We already see the effects with new policy proposal ideas that could supercharge pursuit of these goals,” says Kelly Fleming, Associate Director of Clean Energy. “The Department of Energy finds that with the Inflation Reduction Act and Bipartisan Infrastructure Law, we can double the share of clean electricity generation to 80% in 2030.”

FAS, one of the country’s oldest science policy organizations, works with scientists and technologists to propose policy-ready ideas to address current and emerging threats, including climate change and energy insecurity.  

On today’s two-year anniversary of the IRA, FAS is highlighting policy proposals that build on the IRA’s successes to date and suggest opportunities for continued impact. Examples include:

Geothermal 

Geothermal technologies became eligible for tax credits under IRA.

Breaking Ground on Next-Generation Geothermal Energy The Department of Energy (DOE) could take a number of different approaches to accelerating progress in next-generation geothermal energy, from leasing agency land for project development to providing milestone payments for the costly drilling phases of development.

Low-Carbon Cement 

The IRA provides $4.5B to support government procurement of low-carbon  versions of this cornerstone material.

Laying the Foundation for the Low-Carbon Cement and Concrete Industry Cement and concrete production is one of the hardest industries to decarbonize. Using its Other Transactions Authority, DOE could design a demand-support program involving double-sided auctions, contracts for difference, or price and volume. 

Critical Minerals and Energy Manufacturing

Supply chains necessary for battery technologies are being built out in the U.S. thanks to IRA incentives. The new Manufacturing and Energy Supply Chain Office (MESC) has implemented and unveiled programs to retool existing facilities for EV manufacturing, and rehire existing work, and provide tax incentives for clean energy manufacturing facilities with funding provided in the IRA. The office supports the development and deployment of a domestic clean energy supply chain, including for critical minerals needed for batteries and other advanced technologies.

Critical Thinking on Critical Minerals: How the U.S. Government Can Support the Development of Domestic Production Capacity for the Battery Supply Chain Batteries for electric vehicles, in particular, will require the U.S. to consume an order of magnitude more lithium, nickel, cobalt, and graphite than it currently consumes.

Nature Based Solutions

Billions of dollars have been invested into nature based solutions, including $1 billion in urban forestry, that will make communities more resilient to climate change.

A National Framework For Sustainable Urban Forestry To Combat Extreme Heat. To realize the full benefits of the federal government’s investment in urban forestry, there will need to be a coordinated, equity-focused, and economically validated federal plan to guide the development and maintenance of urban forestry that will allow the full utilization of this critical resource.

Submit Your Science and Technology Policy Ideas

The IRA is one lever to make real-world change; good ideas can come from anyone, including you.

FAS is soliciting federal policy ideas to present to the next U.S. presidential administration through the Day One 2025 project, which closes soon. Interested parties can submit science and technology related policy ideas year-round at FAS’s Day One website page.

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ABOUT FAS

The Federation of American Scientists (FAS) works to advance progress on a broad suite of contemporary issues where science, technology, and innovation policy can deliver dramatic progress, and seeks to ensure that scientific and technical expertise have a seat at the policymaking table. Established in 1945 by scientists in response to the atomic bomb, FAS continues to work on behalf of a safer, more equitable, and more peaceful world. More information at fas.org.

The Federation of American Scientists (FAS) Applauds the Newly Announced Board Selected to Lead the Foundation for Energy Security and Innovation (FESI)

FAS eager to see the Board set an ambitious agenda that aligns with the potential scale of FESI’s impact

Washington, D.C. – May 9, 2024 – Earlier today Secretary of Energy Granholm took the first official step to stand up the Department of Energy-affiliated non-profit Foundation for Energy Security and Innovation (FESI) by appointing its inaugural board. Today the “Friends of FESI” Initiative of the nonpartisan, non-profit Federation of American Scientists (FAS) steps forward to applaud the Secretary, congratulate the new board members, and wish FESI well as it officially begins its first year. The Inaugural FESI Board consists of 13 accomplished members whose backgrounds span the nation’s regions and communities and who have deep experience in innovation, national security, philanthropy, business, science, and other sectors. It includes:

Since the CHIPS and Science Act authorized FESI in 2022, FAS, along with many allies and supporters who collectively comprise the “Friends of FESI,” have been working to enable FESI to achieve its full potential as a major contributor to the achievement of DOE’s vital goals. “Friends of FESI” has been seeking projects and activities that the foundation could take on that would advance the DOE mission through collaboration with private sector and philanthropic partners.

“FAS enthusiastically celebrates this FESI milestone because, as one of the country’s oldest science and technology-focused public interest organizations, we recognize the scale of the energy transition challenge and the urgency to broker new collaborations and models to move new energy technology from lab to market,” says Dan Correa, CEO of FAS. “As a ‘Friend of FESI’ FAS continues our outreach amongst our diverse network of experts to surface the best ideas for FESI to consider implementing.” The federation is soliciting ideas at fas.org/fesi, underway since FESI’s authorization.

FESI has great potential to foster the public-private partnerships necessary to accelerate the innovation and commercialization of technologies that will power the transition to clean energy. Gathering this diverse group of accomplished board members is the first step. The next is for the FESI Board to pursue projects set to make real impact. Given FESI’s bipartisan support in the CHIPS & Science Act, FAS hopes the board is joined by Congress, industry leaders and others to continue to support FESI in its initial years. 

“FESI’s establishment is a vital initial step, but its value will depend on what happens next,” says David M. Hart, a professor at George Mason University’s Schar School of Policy and Government and leader of the “Friends of FESI” initiative at FAS. “FESI’s new Board of Directors should take immediate actions that have immediate impact, but more importantly, put the foundation on a path to expand that impact exponentially in the coming years. That means thinking big from the start, identifying unique high-leverage opportunities, and systematically building the capacity to realize them.”


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ABOUT FAS

The Federation of American Scientists (FAS) works to advance progress on a broad suite of contemporary issues where science, technology, and innovation policy can deliver dramatic progress, and seeks to ensure that scientific and technical expertise have a seat at the policymaking table. Established in 1945 by scientists in response to the atomic bomb, FAS continues to work on behalf of a safer, more equitable, and more peaceful world. More information at fas.org.


Resources

Building a Firm Foundation for the DOE Foundation: It All Starts with a Solid Board
https://fas.org/publication/fesi-board-launch/

FAS use case criteria:
https://fas.org/publication/fesi-priority-use-cases/

FAS open call for FESI ideas:
https://fas.org/publication/share-an-idea-for-what-fesi-can-do-to-advance-does-mission/

DOE announcing FESI board:
https://www.energy.gov/articles/doe-appoints-inaugural-board-directors-groundbreaking-new-foundation

DOE release announcing FESI:
https://www.energy.gov/articles/doe-launches-foundation-energy-security-and-innovation



Climate Change Challenges and Solutions in Forestry & Agriculture

Climate change is already impacting agriculture and forestry production in the U.S. However, these sectors also hold the key to adaptation and mitigation. The United States Department of Agriculture (USDA) is at the forefront of addressing these challenges and developing solutions. Understanding the implications of climate change in agriculture and forestry is crucial for our nation to forge ahead with effective strategies and outcomes, ensuring our food and shelter resources remain secure.

Currently, the atmosphere contains more key greenhouse gasses (nitrous oxides, carbon dioxide, methane) than ever in history thanks to human activities. Industrial, agricultural, and deforestation practices add to the abundance of these critical gasses that are warming our planet. This has become more noticeable through more frequent severe weather and natural disasters with record heat waves, droughts, tornadoes, and rainfall. In 2023, global climate records of temperatures were broken and hit the highest in the last 174 years. Ocean temperatures are reaching record levels, along with major melts in ice sheets. All these changes will affect forestry and agriculture in profound ways. Crop damaging insects and diseases, along with other stresses caused by extreme changes, will also have cascading effects.

Adjustments or adaptations in response to climate change have progressed globally, with planning and implementation across multiple sectors and regions. While much attention is being paid to reforestation and reducing deforestation, gaps still exist and will need continued attention and financial input to address current and future challenges. Agriculture and forestry are two sectors worth exploring as they can open up climate adaptation and mitigation solutions that have positive cascading benefits across regions.

Challenges in the Agriculture and Forestry Sector

Agriculture contributes to greenhouse gas emissions through several activities, such as burning crop residues, soil management and fertilization, animal manure management, and rice cultivation. In addition, agriculture requires significant amounts of energy for vehicles, tractors, harvest, and irrigation equipment. Agriculture involves complex systems that include inputs of fertilizers and chemicals, management decisions, social factors, and interactions between climate and soil.

Most agriculture operations need fertilizers to produce goods, but the management and specific use of fertilizers need further focus. According to the Inventory of Greenhouse Gas Emissions and Sinks, agriculture contributes 9.4% of total greenhouse gas emissions in the United States.

Agriculture is particularly vulnerable to climate change because many operations are exposed to climatic changes in the natural landscape. There has been widespread economic damage in agriculture due to climate change. Individuals and farms have been affected by flooding, tornadoes, extreme wildfires, droughts, and excessive rains. Loss of property and income, human health, and food security is real for agriculture producers. Adverse impacts will continue to be felt in agricultural systems, particularly in crop production, water availability, animal health, and pests and diseases.

Forestry is a major industry in the U.S. and plays a key role in regulating the climate by transferring carbon within ecosystems and the atmosphere.. Forests remove carbon dioxide (CO2) from the atmosphere and store it in trees and soils. Forestry has seen a decline in the last few decades due to development and cropland expansion. The decline in forestry acres affects essential services such as air purification, regulating water quantity and quality, wood products for shelter, outdoor recreation, medicines, and wildlife habitat. Many Indigenous people and Tribal Nations depend on forest ecosystems for food, timber, culture, and traditions. Effective forest management is crucial for human well-being and is influenced by social and economic factors.

Land cover types and distribution of the United States. Forest lands have decreased in the last two decades. (Source: Fifth National Climate Assessment)

Forests are affected by climate change on local or regional levels based on climate conditions such as rainfall and temperature. The West has been significantly affected, with higher temperatures and drought leading to more wildfires. Higher temperatures come with higher evaporation rates, leading to drier forests that are susceptible to fires. The greater amount of dry wood causes extensive fires that burn more intensely. Fire activity is projected to increase with further warming and less rain. Since 1990, these extensive fires have produced greater greenhouse gas emissions of carbon dioxide (CO2). Other regions of the country with forests that typically receive more rain, like the southeast and northeast, are challenging to predict fire hazards. Other climate change effects include insects, diseases, and invasive species, which change forest ecosystems’ growth, death, and regeneration. Various degrees of disruption can impact a forest’s dynamics.

Current Adaptation Approaches in Agriculture and Forestry

Since agriculture’s largest contribution to greenhouse gas emissions is agriculture soil management, emphasis is being placed on reducing emissions from this process. Farmers are tilling less and using cover crops to keep the ground covered, which helps soils perform the important function of carbon storage. These techniques can also help lower soil temperatures and conserve moisture. In addition, those working in the agriculture sector are taking measures to adapt to the changing climate by developing crops that can withstand higher temperatures and water stress. Ecosystem-based solutions such as wetland restoration to reduce flooding have also been effective. Another potential solution is agroforestry, in which trees are planted, and other agricultural products are grown between the trees or livestock is grazed within a forestry system. This system provides shade to the animals and enhances biodiversity. It protects water bodies by keeping the soil covered with vegetation throughout the year. The perennial vegetation also stores carbon in above-ground vegetation and below-ground roots.

In the forestry space, land managers and owners are developing plans to adapt to climate challenges by building adaptations in key areas such as relationships and connections of land stewardship, research teamwork, and education curriculum. Several guides, assessments, and frameworks have been designed to help private forest owners, Tribal lands, and federally managed forests. Tribal adaptation plans also include Tribal values and cultural considerations for forests. The coasts will be adapting to more frequent flooding, and relocation of recreation areas in vulnerable areas is being planned. In major forestry production areas in the West, forestry agencies are developing plans for prescribed burning to keep dead wood lower, eliminate invasive species, and enable fire-adapted ecosystems to thrive, all while reducing severe wildfires. Thinning forests and fuel removal also help with reducing wildfire risk.      

While both sectors have made progress in quickly adjusting their practices, much more needs to be done to ensure that land managers and affected communities are better prepared for both the short-term and long-term effects of climate change. The federal government, through USDA, can drive adaptation efforts to help these communities.

Current Policy

The USDA created the Climate Adaptation and Resilience Plan in response to Executive Order 14008, Tackling the Climate Crisis at Home and Abroad, which requires all federal agencies to develop climate adaptation plans in all public service aspects, including management, operations, missions, and programs. 

The adaptation plan focuses on key threats to agriculture and forestry, such as:

Many USDA agencies have developed actions to address the impacts of climate change in different mission areas of USDA. These adaptation plans provide information for farmers, ranchers, forest owners, rural communities, trade and foreign affairs on ways to address the impact of climate change that affects them the most. For example, farm and ranch managers can use COMET Farm, a user-friendly online tool co-developed by Colorado State University and USDA that helps compare land management practices and account for carbon and greenhouse gas emissions.

USDA has invested $3.1 billion in Partnerships for Climate-Smart Commodities, encompassing 141 projects that involve small and underserved producers. The diverse projects are matched financially with non-federal funds and include over 20 tribal projects, 100 universities, including 30 minority-serving institutions, and others. The goals of the federal and private sector funding include:

The USDA Forest Service has also developed its own Climate Adaptation Plan that comprehensively incorporates climate adaptation into its mission and operations. The Forest Service has cultivated partnerships with the Northwest Climate Hub, National Park Service, Bureau of Land Management, University of Washington, and the Climate Impacts Group to develop tools and data to help with decision-making, evaluations, and developing plans for implementation. One notable example is the Sustainability and Climate website, which provides information on adaptation, vulnerability assessments, carbon, and other aspects of land management. 

Conclusion

While sustained government incentives can help drive adaptation efforts, it is important for everyone to play a role in adapting to climate change, especially in the agriculture and forestry sectors. Purchasing products that are grown sustainably and in climate-smart ways will help protect natural resources and support these communities. Understanding the significance of resilience against climate changes and disruptions is crucial, both in the short and long term. These challenges require collaborators to work together to creatively solve problems in addressing greenhouse gas contributions. Climate models can help solve complex problems and test different scenarios and solutions. As the Fifth National Climate Assessment of the United States notes, greenhouse gas concentrations are increasing, global warming is on the rise, and climate change is currently happening. The choices we make now can have a significant impact on our future.

The Federation of American Scientists values diversity of thought and believes that a range of perspectives — informed by evidence — is essential for discourse on scientific and societal issues. Contributors allow us to foster a broader and more inclusive conversation. We encourage constructive discussion around the topics we care about.

Enhancing Public Health Preparedness for Climate Change-Related Health Impacts

The escalating frequency and intensity of extreme heat events, exacerbated by climate change, pose a significant and growing threat to public health. This problem is further compounded by the lack of standardized education and preparedness measures within the healthcare system, creating a critical gap in addressing the health impacts of extreme heat. The Department of Health and Human Services (HHS), especially the Centers for Medicare & Medicaid Services (CMS), the Health Resources and Services Administration (HRSA), and the Office of Climate Change and Health Equity (OCCHE) can enhance public health preparedness for the health impacts of climate change. By leveraging funding mechanisms, incentives, and requirements, HHS can strengthen health system preparedness, improve health provider knowledge, and optimize emergency response capabilities. 

By focusing on interagency collaboration and medical education enhancement, strategic measures within HHS, the healthcare system can strengthen its resilience against the health impacts of extreme heat events. This will not only improve coding accuracy, but also enhance healthcare provider knowledge, streamline emergency response efforts, and ultimately mitigate the health disparities arising from climate change-induced extreme heat events. Key recommendations include: establishing dedicated grant programs and incentivizing climate-competent healthcare providers; integrating climate-resilience metrics into quality measurement programs; leveraging the Health Information Technology for Economic and Clinical Health (HITECH) Act to enhance ICD-10 coding education; and collaborating with other federal agencies such as the Department of Veterans Affairs (VA), the Federal Emergency Management Agency (FEMA), and the Department of Defense (DoD) to ensure a coordinated response. The implementation of these recommendations will not only address the evolving health impacts of climate change but also promote a more resilient and prepared healthcare system for the future.

Challenge

The escalating frequency and intensity of extreme heat events, exacerbated by climate change, pose a significant and growing threat to public health. The scientific consensus, as documented by reports from the Intergovernmental Panel on Climate Change (IPCC) and the National Climate Assessment, reveals that vulnerable populations, such as children, pregnant people, the elderly, and marginalized communities including people of color and Indigenous populations, experience disproportionately higher rates of heat-related illnesses and mortality. The Lancet Countdown’s 2023 U.S. Brief underscores the escalating threat of fossil fuel pollution and climate change to health, highlighting an 88% increase in heat-related mortality among older adults and calling for urgent, equitable climate action to mitigate this public health crisis.

Inadequacies in Current Healthcare System Response

Reports from healthcare institutions and public health agencies highlight how current coding practices contribute to the under-recognition of heat-related health impacts in vulnerable populations, exacerbating existing health disparities. The current inadequacies in ICD-10 coding for extreme heat-related health cases hinder effective healthcare delivery, compromise data accuracy, and impede the development of targeted response strategies. Challenges in coding accuracy are evident in existing studies and reports, emphasizing the difficulties healthcare providers face in accurately documenting extreme heat-related health cases. An analysis of emergency room visits during heat waves further indicates a gap in recognition and coding, pointing to the need for improved medical education and coding practices. Audits of healthcare coding practices reveal inconsistencies and inaccuracies that stem from a lack of standardized medical education and preparedness measures, ultimately leading to underreporting and misclassification of extreme heat cases. Comparative analyses of health data from regions with robust coding practices and those without highlight the disparities in data accuracy, emphasizing the urgent need for standardized coding protocols.

There is a crucial opportunity to enhance public health preparedness by addressing the challenges associated with accurate ICD-10 coding in extreme heat-related health cases. Reports from government agencies and economic research institutions underscore the economic toll of extreme heat events on healthcare systems, including increased healthcare costs, emergency room visits, and lost productivity due to heat-related illnesses. Data from social vulnerability indices and community-level assessments emphasize the disproportionate impact of extreme heat on socially vulnerable populations, highlighting the urgent need for targeted policies to address health disparities.

Opportunity

As Medicare is the largest federal source of Graduate Medical Education (GME) funding (Figure 1), the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) play a critical role in developing coding guidelines. Thus, it is essential for HHS, CMS, and other pertinent coordinating agencies to be involved in the process for developing climate change-informed graduate medical curricula.

  Figure 1: Graduate Medical Education Funding Streams

By focusing on medical education enhancement, strategic measures within HHS, and fostering interagency collaboration, the healthcare system can strengthen its resilience against the health impacts of extreme heat events. Improving coding accuracy, enhancing healthcare provider knowledge, streamlining emergency response efforts, and mitigating health disparities related to extreme heat events will ultimately strengthen the healthcare system and foster more effective, inclusive, and equitable climate and health policies. Improving the knowledge and training of healthcare providers empowers them to respond more effectively to extreme heat-related health cases. This immediate response capability contributes to the overarching goal of reducing morbidity and mortality rates associated with extreme heat events and creates a public health system that is more resilient and prepared for emerging challenges. 

The inclusion of ICD-10 coding education into graduate medical education funded by CMS aligns with the precedent set by the Pandemic and All Hazards Preparedness Act (PAHPA), emphasizing the importance of preparedness and response to public health emergencies. Similarly, drawing inspiration from the Health Information Technology for Economic and Clinical Health Act (HITECH Act), which promotes the adoption of electronic health records (EHR) systems, presents an opportunity to modernize medical education and ensure the seamless integration of climate-related health considerations. This collaborative and forward-thinking approach recognizes the interconnectedness of health and climate, offering a model that can be applied to various health challenges. Integrating mandates from PAHPA and the HITECH Act serves as a policy precedent, guiding the healthcare system toward a more adaptive and proactive stance in addressing climate change impacts on health.

Conversely, the consequences of inaction on the health impacts of extreme heat extend beyond immediate health concerns. They permeate through the fabric of society, widening health disparities, compromising the accuracy of health data, and undermining emergency response preparedness. Addressing these challenges requires a proactive and comprehensive approach to ensure the well-being of communities, especially those most vulnerable to the effects of extreme heat.

Plan of Action

The following recommendations aim to facilitate public health preparedness for extreme heat events through enhancements in medical education, strategic measures within the Department of Health and Human Services (HHS), and fostering interagency collaboration.

Recommendation 1a. Integrate extreme heat training into the GME curriculum. 

Integrating modules on extreme heat-related health impacts and accurate ICD-10 coding into medical education curricula is essential for preparing future healthcare professionals to address the challenges posed by climate change. This initiative will ensure that medical students receive comprehensive training on identifying, treating, and documenting extreme heat-related health cases. Sec. 304. Core Education and Training of the PAHPA provides policy precedent to develop foundational health and medical response curricula and training materials by modifying relevant existing programs to enhance responses to public health emergencies. Given the prominence of Medicare in funding medical residency training, policies that alter Medicare GME can affect the future physician supply and can be used to address identified healthcare workforce priorities related to extreme heat (Figure 2).

Figure 2: A model for comprehensive climate and medical education (adapted from Jowell et al. 2023)

Recommendation 1b. Collaborate with Veterans Health Administration Training Programs. 

Partnering with the Department of Veterans Affairs (VA) to extend climate-related health coding education to Veterans Health Administration (VHA) training programs will enhance the preparedness of healthcare professionals within the VHA system to manage and document extreme heat-related health cases among veteran populations.

Implementation plan
Agency/Department InvolvementAction StepsEvaluation
HHS; CMS, NCHS, Health Resources and Services Administration (HRSA), Office of Climate Change and Health Equity (OCCHE): Coordinates efforts to integrate extreme heat training into medical education.Needs Assessment: OCCHE within HHS collaborates with VA to assess climate-related health coding education needs within VHA and GME training programs.Curriculum Integration: Assess the extent to which modules on extreme heat-related health impacts and ICD-10 coding are integrated into medical school curricula.
VA: Implements climate-related health coding education initiatives within VHA.Curriculum Development: OCCHE, CMS, NCHS, HRSA collaborate with medical accrediting bodies and subject matter experts to develop modules on extreme heat health impacts and ICD-10 coding for inclusion in medical education curricula.Student Performance: Evaluate medical students’ performance on assessments related to extreme heat-related health impacts and coding practices.
VHA: Participates in training programs and integrates education into its curriculum.Accreditation Standards Integration: Accrediting bodies revise accreditation standards to include requirements for teaching extreme heat-related health topics and coding practices. Work with CMS to update Conditions of Participation to include climate mitigation and resilience. Training Participation: Monitor the number of healthcare professionals, including those in the VHA, participating in climate-related health coding education and assess their level of engagement.
The Joint Commission (TJC); Healthcare Facilities Accreditation Program (HFAP): Accrediting bodies responsible for setting standards for climate competent healthcare facility accreditation.Faculty Training: HHS supports faculty training programs to ensure educators have the necessary knowledge and skills to teach extreme heat topics effectively. VHA incorporates climate-related health coding education into existing training programs for healthcare professionals, including physicians, nurses, and other staff.Faculty Feedback:
Solicit feedback on the effectiveness of training and support provided for delivering the new curriculum.
Environmental Protection Agency (EPA), National Oceanic and Atmospheric Administration (NOAA), Department of Homeland Security (FEMA), Assistant Secretary for Preparedness and Response (ASPR): Provide subject matter expertise on extreme heat and support curriculum development.Funding: Titles VII and VIII of the Public Health Service Act (PHSA) provide funding for programs to improve the healthcare workforce and support public health initiatives.Impact on Patient Care: Assess the impact of enhanced climate-related health coding education on patient care outcomes within participating hospitals and within the VHA system.
Title VII: Health Professions Education Programs can be used to support medical education programs focused on climate-related health impacts, including curriculum development, faculty training, and student scholarships or stipends.
Title VIII: Nursing Workforce Development Programs can support the integration of climate-related health content into nursing education programs, including undergraduate, graduate, and continuing education initiatives.
Evaluation and Feedback: Continuous evaluation of curriculum integration and feedback mechanisms are established to assess the effectiveness of training and make improvements as needed. Research funding provided through PHSA Titles VII and VIII can support studies evaluating the effectiveness of educational interventions on climate-related health knowledge and practice behaviors among healthcare providers.

Recommendation 2. Collaborate with the Agency for Healthcare Research and Quality (AHRQ) 

Establishing a collaborative research initiative with the Agency for Healthcare Research and Quality (AHRQ) will facilitate the in-depth exploration of accurate ICD-10 coding for extreme heat-related health cases. This should be accomplished through the following measures:

Establish joint task forces. CMS, NCHS, and AHRQ should establish joint research initiatives focused on improving ICD-10 coding accuracy for extreme heat-related health cases. This collaboration will involve identifying key research areas, allocating resources, and coordinating research activities. Personnel from each agency, including subject matter experts and researchers from the EPA, NOAA, and FEMA, will work together to conduct studies, analyze data, and publish findings. By conducting systematic reviews, developing standardized coding algorithms, and disseminating findings through AHRQ’s established communication channels, this initiative will improve coding practices and enhance healthcare system preparedness for extreme heat events.

Develop standardized coding algorithms. AHRQ, in collaboration with CMS and NCHS, will lead efforts to develop standardized coding algorithms for extreme heat-related health outcomes. This involves reviewing existing coding practices, identifying gaps and inconsistencies, and developing standardized algorithms to ensure consistent and accurate coding across healthcare settings. AHRQ researchers and coding experts will work closely with personnel from CMS and NCHS to draft, validate, and disseminate these algorithms.

Integrate into Continuous Quality Improvement (CQI) programs. Establish collaborative partnerships between the VA and other federal healthcare agencies, including CMS, HRSA, and DoD, to integrate education on ICD-10 coding for extreme heat-related health outcomes into CQI programs. Regularly assess the effectiveness of training initiatives and adjust based on feedback from healthcare providers. For example, CMS currently requires physicians to screen for the social determinants of health and could include level of climate and/or heat risk within that screening assessment.

Allocate resources. Each agency will allocate financial resources, staff time, and technical expertise to support collaborative activities. Budget allocations will be based on the scope and scale of specific initiatives, with funds earmarked for research, training, data sharing, and evaluation efforts. Additionally, research funding provided through PHSA Titles VII and VIII can support studies evaluating the effectiveness of educational interventions on climate-related health knowledge and practice behaviors among healthcare providers.

Recommendation 3. Leverage the HITECH Act and EHR.

Agency/Department InvolvementAction StepsEvaluation
HHS: Coordinates efforts to integrate climate-related health coding education into HITECH Act programs.Integrate ICD-10 Coding Training in EHR Adoption Programs: HHS, NCHS and CMS coordinate with ONC to include specific modules or training components related to ICD-10 coding for extreme heat-related health outcomes within the educational programs facilitated under HITECH Act incentives. This ensures that healthcare professionals adopting EHR systems receive comprehensive training on coding practices relevant to climate-related health challenges.Integration Success: HHS regularly evaluates the extent to which ICD-10 coding education and climate-related health data collection are integrated into CMS-funded GME programs and EHR systems.
CMS: Implements incentives and requirements for EHR integration and coding education.Customize EHR Templates: ONC provides guidance to EHR vendors and developers to create customized templates or modules within EHR systems that facilitate accurate documentation of extreme heat-related health cases.Coding Accuracy: Assess the accuracy of ICD-10 coding for extreme heat-related health outcomes in electronic health records and reporting systems.
Office of the National Coordinator for Health Information Technology (ONC): Provides technical assistance and guidance on EHR integration.Incorporation into Meaningful Use Criteria: CMS and ONS to oversee the integration of the accurate coding of climate-related health outcomes into the Meaningful Use/Promoting Interoperability Programs criteria outlined by the HITECH Act.Provider Feedback: Solicit feedback from healthcare providers on the effectiveness of training modules and EHR integration efforts.
Establish Reporting Requirements: Use the HITECH Act to establish reporting requirements for climate-related health data, encouraging the inclusion of ICD-10 codes for extreme heat-related health outcomes in electronic reporting systems supported by EHRs.
Incentives for Climate-Ready EHR Implementation:
Expanding incentives within the HITECH Act to healthcare providers integrating climate-related health coding into HER systems could enhance healthcare management. The 2009 program allocated $27 billion to promote EHR adoption. Aligning incentives with climate-related coding fosters a more comprehensive approach. This incentivizes EHR and climate-related ICD-10 coding practices, advancing the capacity to address climate-related health challenges.

Recommendation 4. Establish climate-resilient health system grants to incentivize state-level climate preparedness initiatives

HHS and OCCHE should create competitive grants for states that demonstrate proactive climate change adaptation efforts in healthcare. These agencies can encourage states to integrate climate considerations into their health plans by providing additional funding to states that prioritize climate resilience.

Within CMS, the Center for Medicare and Medicaid Innovation (CMMI) could help create and administer these grants related to climate preparedness initiatives. Given its focus on innovation and testing new approaches, CMMI could design grant programs aimed at incentivizing state-level climate resilience efforts in healthcare. Given its focus on addressing health disparities and promoting preventive care, the Bureau of Primary Health Care (BPHC) within HRSA could oversee grants aimed at integrating climate considerations into primary care settings and enhancing resilience among vulnerable populations.

Conclusion

These recommendations provide a comprehensive framework for HHS — particularly CMS, HRSA, and OCCHE— to bolster public health preparedness for the health impacts of extreme heat events. By leveraging funding mechanisms, incentives, and requirements, HHS can enhance health system preparedness, improve health provider knowledge, and optimize emergency response capabilities. These strategic measures encompass a range of actions, including establishing dedicated grant programs, incentivizing climate-competent healthcare providers, integrating climate-resilience metrics into quality measurement programs, and leveraging the HITECH Act to enhance ICD-10 coding education. Collaboration with other federal agencies further strengthens the coordinated response to the growing challenges posed by climate change-induced extreme heat events. By implementing these policy recommendations, HHS can effectively address the evolving landscape of climate change impacts on health and promote a more resilient and prepared healthcare system for the future.

This idea of merit originated from our Extreme Heat Ideas Challenge. Scientific and technical experts across disciplines worked with FAS to develop potential solutions in various realms: infrastructure and the built environment, workforce safety and development, public health, food security and resilience, emergency planning and response, and data indices. Review ideas to combat extreme heat here.

Frequently Asked Questions
What are the expected outcomes of these recommended policy actions?

  1. Improved Accuracy in ICD-10 Coding: Healthcare providers consistently apply accurate ICD-10 coding for extreme heat-related health cases.

  2. Enhanced Healthcare Provider Knowledge: Healthcare professionals possess comprehensive knowledge on extreme heat-related health impacts, improving patient care and response strategies.

  3. Strengthened Public Health Response: A coordinated effort results in a more effective and equitable public health response to extreme heat events, reducing health disparities.

  4. Improved Public Health Resilience:

    1. Short-Term Outcome: Healthcare providers, armed with enhanced knowledge and training, respond more effectively to extreme heat-related health cases.

    2. Long-Term Outcome: Reduced morbidity and mortality rates associated with extreme heat events lead to a more resilient and prepared public health system.



  5. Enhanced Data Accuracy and Surveillance:

    1. Short-Term Outcome: Improved accuracy in ICD-10 coding facilitates more precise tracking and surveillance of extreme heat-related health outcomes.

    2. Long-Term Outcome: Comprehensive and accurate data contribute to better-informed public health policies, targeted interventions, and long-term trend analysis.



  6. Reduced Health Disparities:

    1. Short-Term Outcome: Incentives and education programs ensure that healthcare providers prioritize accurate coding, reducing disparities in the diagnosis and treatment of extreme heat-related illnesses.

    2. Long-Term Outcome: Health outcomes become more equitable across diverse populations, mitigating the disproportionate impact of extreme heat on vulnerable communities.



  7. Increased Public Awareness and Education:

    1. Short-Term Outcome: Public health campaigns and educational initiatives raise awareness about the health risks associated with extreme heat events.

    2. Long-Term Outcome: Informed communities adopt preventive measures, reducing the overall burden on healthcare systems and fostering a culture of proactive health management.



  8. Streamlined Emergency Response and Preparedness:

    1. Short-Term Outcome: Integrating extreme heat preparedness into emergency response plans results in more efficient and coordinated efforts during heatwaves.

    2. Long-Term Outcome: Improved community resilience, reduced strain on emergency services, and better protection for vulnerable populations during extreme heat events.



  9. Increased Collaboration Across Agencies:

    1. Short-Term Outcome: Collaborative efforts between OCCHE, CMS, HRSA, AHRQ, FEMA, DoD, and the Department of the Interior result in streamlined information sharing and joint initiatives.

    2. Long-Term Outcome: Enhanced cross-agency collaboration establishes a model for addressing complex public health challenges, fostering a more integrated and responsive government approach.



  10. Empowered Healthcare Workforce:

    1. Short-Term Outcome: Incentives for accurate coding and targeted education empower healthcare professionals to address the unique challenges posed by extreme heat.

    2. Long-Term Outcome: A more resilient and adaptive healthcare workforce is equipped to handle emerging health threats, contributing to overall workforce well-being and satisfaction.



  11. Informed Policy Decision-Making:

    1. Short-Term Outcome: Policymakers utilize accurate data and insights to make informed decisions related to extreme heat adaptation and mitigation strategies.

    2. Long-Term Outcome: The integration of health data into broader climate and policy discussions leads to more effective, evidence-based policies at local, regional, and national levels.



Combating Extreme Heat with a National Moonshot

Extreme heat is the leading cause of weather-related deaths in the United States and has been for the past 30 years. Low-income communities and many other vulnerable populations are disproportionately affected by heat risk. As the climate continues to warm, the threat to public health will correspondingly increase. Through a presidential directive, the White House Climate Policy Office (WHCPO) should establish the National Moonshot to Combat Extreme Heat, an all-of-government program to harmonize and accelerate federal efforts to reduce heat risk and heat illness, save lives, and improve the cost-effectiveness of federal expenditures. 

The goals of the Moonshot are to:

  1. Reduce heat deaths by 20% by 2030, 40% by 2035, and 60% by 2050. 
  2. Build 150 heat-resilient communities by 2030 by facilitating access to funding and uplifting social infrastructure actions prioritizing at-risk, vulnerable populations.
  3. Increase visibility and awareness of federal efforts to protect residents from extreme heat. 

The Moonshot will be overseen by a new, high-level appointee at WHCPO to serve as the Executive Officer of the White House Interagency Work Group on Extreme Heat (WHIWG). 

Challenge and Opportunity

The threat to public health and safety from extreme heat is serious, expansive, and increasing as the planet continues to warm. According to Heat.gov, “Extreme heat has been the greatest weather-related cause of death in the U.S. for the past 30 years — more than hurricanes, tornadoes, flooding or extreme cold.” The number of deaths from extreme heat is difficult to accurately determine and is frequently undercounted. More recently, during the Heat Dome of 2021, the state of Washington reported 1,231 heat deaths in just one month. Further, heat-related illness includes a broad spectrum of diseases, from mild heat cramps to life-threatening heat stroke. Heat exposures have been linked to mental health illnesses and adverse birth outcomes, such as preterm births and low birth weights. Extreme heat disproportionately impacts marginalized people, including those that are low-income, BIPOC, seniors, veterans, children, the unhoused, and those with compromised health status, among others. All heat illnesses and deaths are considered preventable.

Extreme heat is an all-of-society problem that requires an all-of-government response. As the frequency, intensity, duration, and breadth of heat waves have increased dramatically over the past four years, officials and leaders at all levels have begun taking action. 

The federal government has launched new programs for addressing extreme heat over the last few years as heat waves have become a front-page issue. Recent programs initiated by the Biden Administration are providing a variety of resources and increasing awareness of this threat. Key examples are:

Actions are needed to remedy the deficit in attention to extreme heat by uplifting the role of extreme heat in the federal response to climate impacts and give greater emphasis to social infrastructure actions. 

Several bills to address extreme heat through federal legislation have been introduced in Congress, though none have advanced. Most notable are:

  1. S. 2645: Senator Edward Markey’s Preventing HEAT Illness and Deaths Act of 2023 would authorize NIHHIS to prescribe actions and provide funding. 
  2. HR 3965: Representative Ruben Gallego’s “Extreme Heat Emergency Act of 2023” would amend the Stafford Act by adding “extreme heat” as a natural disaster for which response aid is authorized.
  3. H.R. 2945: Representative Ruben Gallego’s Excess Urban Heat Mitigation Act of 2023” would require the Department of Housing and Urban Development (HUD) to establish a grant program to fund activities to mitigate or manage heat in urban areas. The Senate version of this bill, S. 1379, is led by Senator Sherrod Brown.

Even with this momentum, actions are dispersed across many departments and agencies. Plus, many local and state governments tend to apply for federal funding on a program-by-program, agency-by-agency basis and must navigate a complicated landscape with limited funding explicitly earmarked for heat resilience. Further, most “infrastructure” and capacity-building funding is based on mitigating or restoring economic loss of property, leading to financial relief that has gone primarily to built infrastructure and natural infrastructure projects. Communities need social infrastructure: social cohesion, policy and governance, public health, communications and alerts, planning, etc., to respond to extreme heat. This requires a pathway for communities to access funds to combat extreme heat in a comprehensive and coordinated way and bring social infrastructure actions up to a level equal to built and natural infrastructure interventions. 

There is a need to improve the coordination of heat actions across the federal government, align heat resilience activities with Justice40 mandates, and promote community-based interventions to reduce heat deaths. A National Moonshot to Combat Extreme Heat can do this by leveraging several new community-focused programs to accelerate the protection of at-risk populations from heat-related death and illness. The challenge, and therefore the opportunity, for the Moonshot is to identify, integrate, and accelerate existing resources in a human-centric framework to reduce preventable deaths, promote cool and healthy communities, and deliver value nationwide. 

Plan of Action 

The WHCPO should appoint a new Deputy Director for Heat to serve as the Executive Officer of the WHIWG and coordinate the National Moonshot to Combat Extreme Heat – an all-of-government program to accelerate federal actions to address extreme heat. The goals of the Moonshot are to:

  1. Reduce heat deaths by 20% by 2030, 40% by 2035, and 60% by 2050; 
  2. Build 150 heat-resilient communities by 2030 by facilitating access to funding and uplifting social infrastructure actions prioritizing at-risk, vulnerable populations. Social infrastructure encompasses a variety of actions in four categories: social cohesion, policy, communications, and planning.  Social infrastructure centers the needs of people in resilience.  This target aligns with the U.S. goal to reduce greenhouse gas emissions by 50% by 2030. 
  3. Improve visibility and awareness of federal efforts to protect residents from extreme heat.

The Moonshot will capitalize on existing policies, programs, and funding and establish a human-centric approach to climate resilience by uplifting extreme heat. The Moonshot will identify and evaluate existing federal activities and available funding, including funds from the Inflation Reduction Act (IRA) and the Bipartisan Infrastructure Law (BIL), as well as agency budgets, including Federal Emergency Management Agency’s funding for the Building Resilient Infrastructure and Communities (BRIC) and the Hazard Mitigation Grant Program (HMGP). The Moonshot will integrate actions among the many existing programs dispersed across the government into a well-coordinated, integrated inter-agency initiative that maximizes results and will support cool, safe, and healthy communities

Recommendation 1. Enhance the visibility, responsibility, and capacity of the WHIWG. 

Signaling high-level support through a presidential directive, the WHCPO should appoint a Deputy Director for Heat as the Executive Officer of the WHIWG to lead the Moonshot. Two additional staff positions will be established to support the assessment, stakeholder engagement, and planning processes. The WHIWG and the Deputy Director will design and implement the Moonshot working with the Department of Health and Human Services Office of Climate Change and Health Equity. A lead contact will be designated in each agency and department participating in the NIHHIS program. 

Recommendation 2. Assess and report current status. 

The Moonshot should identify, evaluate, and report on existing programs addressing heat across the federal government, including those recently launched by the White House, to establish a current baseline, identify gaps, and catalog opportunities for integration within the federal government. The Moonshot will generate a database of existing programs and a budget cross-cut analysis to identify current funding levels. The report will incorporate the NIHHIS Extreme Heat Strategy and identify existing funding opportunities, including those in the IRA, Bipartisan Infrastructure Law, and agency programs. The Moonshot will also work with CDC and NIHHIS to develop a method to identify heat deaths to establish a baseline for tracking progress on the goals. 

Recommendation 3. Build broad community support.

The Moonshot should convene conversations and conduct regional extreme heat workshops with state, local, and tribal government personnel; external experts and stakeholders; Justice40 community leaders; professional associations; private sector representatives; and philanthropies. Topics should span the spectrum of social infrastructure, including social cohesion, public health, insurance, infrastructure, communications, and more. Based on input, the Moonshot will establish an advisory committee of non-government participants and develop pathways to connect stakeholders with federal community-focused climate resilience programs, including the White House’s Justice 40 program, EPA’s Environmental Justice Thriving Communities Technical Assistance Centers Program, and the Department of Transportation’s Thriving Communities Network, and other relevant federal programs identified in Recommendation 2. The Moonshot would add extreme heat as a covered issue area in these programs.

Recommendation 4. Make a plan.

The Moonshot should expand upon the NIHHIS Extreme Heat Strategy and make a heat action plan uplifting human health and community access to harness the potential of federal heat programs. The plan would assign roles, responsibilities, and deadlines and establish a process to track and report progress annually. In addition, the Moonshot would expand the NCR Framework to include an implementation plan and establish a human-centric approach. The Moonshot will evaluate co-benefits from heat reduction strategies, including the role cool surfaces play in protecting public health while also decreasing smog, reducing energy use, and solar radiation management. And, consistent with the Biden Administration’s 2025 priorities, the Moonshot will support research and development on emerging technologies such as microfiber fabrics that keep people cool during heat waves, temperature-sensitive coatings, and high-albedo reflective materials that can reduce the need for mechanical air-conditioning. Innovation is especially needed related to resurfacing the nation’s aging roadways.

The Moonshot will also include a communications plan to increase awareness of federal programs and funding opportunities to combat extreme heat. This should all be in place in nine months to prepare for the FY 2026 budget. The NIHHIS and CDC will develop an enhanced method for improving the accuracy of tracking heat deaths. 

Recommendation 5. Connect with people and communities.

The Moonshot should emphasize social infrastructure projects and facilitate access to funding by establishing a centralized portal for comprehensive local heat action planning and programs. The Moonshot will help build cool, safe, healthy communities by integrating heat into federal climate equity programs and supporting local heat plans and projects that reflect community input and priorities. Local heat plans should be comprehensive and integrate a suite of actions that emphasize social infrastructure and include built infrastructure and natural infrastructure. 

Recommendation 6. Initiate all-of-government action.

The Moonshot will catalyze the implementation of the plan across the government, including all the agencies and departments identified in Recommendation 1. It will establish the grant portal to enhance access to federal resources for heat-related projects for state, local, tribal, and territorial governments, and community groups. It will launch a communications plan targeting press, social media, public employees at all levels of government, stakeholders, and more. 

Recommendation 7. Support legislation to secure long-term success 

In coordination with the White House Office of Legislative Affairs and Office of Management and Budget (OMB), the Moonshot should work with Congress to draft and support federal legislation and appropriations addressing extreme heat. Congressional authority is needed to firmly establish this human-centric approach to extreme heat. The Moonshot may recommend Congressional hearings on legislation or a Congressional commission to review the Administration’s work on heat. For example, the passage of S. 2645 would enshrine the position of NIHHIS in law. The Moonshot will help Congress fulfill its role in the all-of-government response and help empower local action. 

Costs

Using information gathered in Recommendation 2, the Moonshot will focus on capturing and directing existing federal funding, including from the IRA, BIL, agency budgets, and grant programs to uplift actions addressing extreme heat and implementing the Moonshot action plan. Initial costs should be minimal: $1 million to hire the Executive Director and two staff and to report on existing programs, funding, and agency budgets. The Moonshot will produce a budget cross-cut initially and annually thereafter and assemble a budget proposal for the WHIWG on Extreme Heat for the FY 2025 and FY 2026 budget.

The Moonshot recommendation is aligned with the OMB Budget Memo of August 17, 2023, which transmits Guidance for Research and Development Priorities for the FY 2025 Budget. The OMB priorities call for addressing climate change by protecting communities’ health and mitigating its health effects, especially for communities that experience these burdens disproportionately.

Conclusion

Extreme heat is a serious public health problem disproportionately impacting many vulnerable populations, and the threat is increasing tremendously. So far in winter 2023, more than 130 monthly high-temperature records were set across the U.S. 

The federal government has several programs addressing the threat of extreme heat in the U.S., and the WHIWG reflects the all-of-government approach needed to meet the threat. The next step is to capture the full potential of existing programs and funding by launching a focused and intensive National Moonshot to Combat Extreme Heat with quantitative goals to track and reduce heat deaths and build healthy communities. This  effort will enable state and local governments and communities, especially those disproportionately impacted by extreme heat, to more readily access federal funding to develop and implement comprehensive heat action plans. The Moonshot will reduce heat deaths, improve the quality of life in cities, and reduce economic productivity loss while increasing the visibility of federal leadership on this issue. 

With heat season 2024 beginning on April 29th, it’s essential to establish an all-of-government response to address extreme heat at all levels.

This idea of merit originated from our Extreme Heat Ideas Challenge. Scientific and technical experts across disciplines worked with FAS to develop potential solutions in various realms: infrastructure and the built environment, workforce safety and development, public health, food security and resilience, emergency planning and response, and data indices. Review ideas to combat extreme heat here.

Frequently Asked Questions
What entities are partners in NIHHIS?

Federal agencies involved in NIHHIS include: National Oceanic and Atmospheric Administration, Centers for Disease Control and Prevention, Administration for Community Living, Administration for Children and Families, Administration for Strategic Preparedness and Response, Environmental Protection Agency, Department of Housing and Urban Development, Federal Emergency Management Agency, Department of Defense, Department of Energy, Department of Transportation, National Institute for Occupational Safety and Health, Department of Veterans Affairs, US Census Bureau, Forest Service, National Park Service, Department of Health and Human Services, National Institute of Environmental Health Sciences, Occupational Safety and Health Administration, Substance Abuse and Mental Health Services Administration, and United States Agency for International Development.

Non-federal partners include, but are not limited to: CAPA Strategies, ESRI, Global Cool Cities Alliance, National League of Cities, and Global Heat Health Information Network.

For America to Become Climate Resilient, We Need Innovative Policy Solutions to Address The Extreme Heat Crisis

As 2023 was the hottest year on record, America must start to prepare for even hotter years in the future. To meet this moment, the Federation of American Scientists (FAS) has launched the Extreme Heat Policy Sprint, an initiative to accelerate experts’ high-impact policy recommendations to comprehensively address the extreme heat crisis.

The urgency of this initiative is underscored by global average temperatures soaring to a record 2.63°F (1.46°C) increase from pre-industrial levels and heat-related mortalities forecasted to surge 370% within the next three decades. In Maricopa County, Arizona alone, at least 579 people lost their lives to heat last year, with senior citizens accounting for one in three deaths. This staggering number is widely considered an undercount, as heat-related mortalities are difficult to document.

With heat being the top weather-related killer of Americans and the nation having faced the hottest summer on record, the federal government made the largest resourcing of extreme heat mitigation in history last year. The United States Department of Agriculture (USDA) distributed $1 billion in grants to projects expanding urban tree canopies to reduce average temperatures during extreme heat events, amongst other co-benefits like flood reduction and improved public health outcomes. In addition, the National Oceanic and Atmospheric Administration (NOAA) provided $5 million in funding for two centers of excellence to deliver actionable, place-based climate information for community heat resilience. These efforts were complemented by the Federal Emergency Management Agency’s (FEMA) distribution of $1.8 billion through two grant programs designed to help communities increase their resilience to the impacts of climate change, including extreme heat. 

Despite these federal programs, the resourcing needs for future extreme heat conditions are growing exponentially, with anticipated exposure to dangerous heat (>125 °F) expected to impact 107.6 million Americans by 2053. Several key U.S. cities are expected to experience risky wet bulb temperatures of +87°F, which would trigger deadly heat stress and stroke in vulnerable populations within just a few years. These conditions would completely suspend safe outdoor operations of the city during the summer months. Further, the exponential growth of cooling technology adoption across the country catalyzes increased demand for energy, thereby increasing fossil fuel emissions and straining electric grids to the point of risky blackouts. 

With such immense risks coming alarmingly soon, there is a need for transformative strategies to protect Americans from the heat where they live, where they work, and in their communities. Resilience to heat must be included in nationwide planning and management. The built environment must be adapted to chronic, sustained heat. Novel resilient cooling technologies need to be brought rapidly to market. Communities need climate services that include heat risk and offer regionally-specific solutions. The full health and economic costs of heat must be accounted for and responded to. All of this requires integrating heat resilience into every part of the federal government and developing new governance models for climate and health, focusing on adaptation-forward, people-centered disaster response approaches.  

Introducing the Participants of the Extreme Heat Policy Sprint

This critical situation sets the stage for the pivotal contributions of the experts in the Extreme Heat Policy Sprint. Each of these professionals offer innovative and impactful policy recommendations, drawing from diverse areas of expertise, including but not limited to climate resilience, health care, public policy, law, and urban planning. This collaboration is essential in shaping effective federal strategies to mitigate the far-reaching impacts of extreme heat on communities nationwide.

Infrastructure and the Built Environment

Workforce Safety and Development

Public Health and Preparedness

Food Security

Planning and Response

Data and Indices

Leveraging Positive Tipping Points to Accelerate Decarbonization

Summary

The Biden Administration has committed the United States to net-zero emissions by 2050. Meeting this commitment requires drastic decarbonization transitions across all sectors of society at a pace never seen before. This can be made possible by positive tipping points, which demarcate thresholds in decarbonization transitions that, once crossed, ensure rapid progress towards completion. A new generation of economic models enables the analysis of these tipping points and the evaluation of effective policy interventions. 

The Biden Administration should undertake a three-pronged strategy for leveraging the power of positive tipping points to create a larger-than-anticipated return on investment in the transition to a clean energy future. First, the President’s Council of Advisors on Science and Technology (PCAST) and the Council of Economic Advisors (CEA) should evaluate new economic models and make recommendations for how agencies can incorporate such models into their decision-making process. Second, federal agencies should integrate positive tipping points into the research agendas of existing research centers and programs to uncover additional decarbonization opportunities. Finally, federal agencies should develop decarbonization strategies and policies based on insights from this research.

Challenge and Opportunity

Climate change brings us closer each year to triggering negative tipping points, such as the collapse of the West Antarctic ice sheet or the Atlantic Meridional Overturning Circulation. These negative tipping points, driven by self-reinforcing environmental feedback loops, significantly accelerate the pace of climate change. 

Meeting the Biden Administration’s commitment to net-zero emissions by 2050 will reduce the risk of these negative tipping points but requires the United States to significantly accelerate the current pace of decarbonization. Traditional economic models used by the federal government and organizations such as the International Energy Agency consistently underestimate the progress of zero-emission technologies and the return on investment of policies that enable a faster transition, resulting in the agency’s “largest ever upwards revision” last year. A new school of thought presents “evidence-based hope” for rapidly accelerating the pace of decarbonization transitions. Researchers point out that our society consists of complex and interconnected social, economic, and technological systems that do not change linearly under a transition, as traditional models assume; rather, when a positive tipping point is crossed, changes made to the system can lead to disproportionately large effects. A new generation of economic models has emerged to support policymakers in understanding these complex systems in transition and identifying the best policies for driving cost-effective decarbonization.

At COP26 in 2021, leaders of countries responsible for 73% of world emissions, including the United States, committed to work together to reach positive tipping points under the Breakthrough Agenda. The United Kingdom and other European countries have led the movement thus far, but there is an opportunity for the United States to join as a leader in implementing policies that intentionally leverage positive tipping points and benefit from the shared learnings of other nations. 

Domestically, the Inflation Reduction Act (IRA) and the Infrastructure Investment and Jobs Act (IIJA) include some of the strongest climate policies that the country has ever seen. The implementation of these policies presents a natural experiment for studying the impact of different policy interventions on progress towards positive tipping points.

How do positive tipping points work?

Figure 1. Diagram of a system and its positive tipping point. The levers for change on the left push the system away from the current high-emission state and towards a new net-zero state. As the system moves away from the current state, the self-reinforcing feedback loops in the system become stronger and accelerate the transition. At the positive tipping point, the feedback loops become strong enough to drive the system towards the new state without further support from the levers for change. Thus, policy interventions for decarbonization transitions are most crucial in the lead up to a positive tipping point. (Adapted from the Green Futures Network.)

Just as negative tipping points in the environment accelerate the pace of climate change, positive tipping points in our social, economic, and technological systems hold the potential to rapidly accelerate the pace of decarbonization (Figure 1). These positive tipping points are driven by feedback loops that generate increasing returns to adoption and make new consumers more likely to adopt (Figure 2):

The right set of policies can harness this phenomenon to realize significantly greater returns on investment and trigger positive tipping points that give zero-emission technologies a serious boost over incumbent fossil-based technologies.

Figure 2. Examples of positive feedback loops: (a) learning by doing, (b) social contagion, and (c) complementary technology reinforcement.

One way of visualizing progress towards a positive tipping point is the S-curve, where the adoption of a new zero-emission technology grows exponentially and then saturates at full adoption. This S-curve behavior is characteristic of many historic energy and infrastructure technologies (Figure 3). From these historic examples, researchers have identified that the positive tipping point occurs between 10% and 40% adoption. Crossing this adoption threshold is difficult to reverse and typically guarantees that a technology will complete the S-curve.

Figure 3. The historic adoption of a sample of infrastructure and energy systems (top) and manufactured goods (bottom). Note that the sharpness of the S-curve can vary significantly. (Source: Systemiq)

For example, over the past two decades, the Norwegian government helped build electric vehicle (EV) charging infrastructure (complementary technology) and used taxes and subsidies to lower the price of EVs below that of gas vehicles. As a result, consumers began purchasing the cheaper EVs, and over time manufacturers introduced new models of EVs that were cheaper and more appealing than previous models (learning by doing and economies of scale). This led to EVs skyrocketing to 88% of new car sales in 2022. Norway has since announced that it would start easing its subsidies for EVs by introducing two new EV taxes for 2023, yet EV sales have continued to grow, taking up 90% of total sales so far in 2023, demonstrating the difficult-to-reverse nature of positive tipping points. Norway is now on track to reach a second tipping point that will occur when EVs reach price parity with gas vehicles without assistance from taxes or subsidies.

Due to the interconnected nature of social and technological systems, triggering one positive tipping point can potentially increase the odds of another tipping point at a greater scale, resulting in “upward-scaling tipping cascades.” Upward-scaling tipping cascades can occur in two ways: (1) from a smaller system to a larger system (e.g., as more states reach their tipping point for EV adoption, the nation as a whole gets closer to its tipping point) and (2) from one sector to another. For the latter, researchers have identified three super-leverage points that policymakers can use to trigger tipping cascades across multiple sectors:

  1. Light-duty EVs → heavy-duty EVs and renewable energy storage: The development of cheaper batteries for light-duty EVs will enable cheaper heavy-duty EVs and renewable energy storage thanks to shared underlying battery technology. The build-out of charging infrastructure for light-duty EVs will also facilitate the deployment of heavy-duty EVs.
  2. Green ammonia → heavy industries, shipping, and aviation: The production of green ammonia requires green hydrogen as an input, so the growth of the former will spur the growth of the latter. Greater production of green hydrogen and green ammonia will catalyze the decarbonization of the heavy industries, shipping, and aviation sectors, which use these chemicals as fuel inputs.
  3. Traditional and alternative plant proteins → land use: Widespread consumption of traditional and alternative plant proteins over animal protein will reduce pressure on land-use change for agriculture and potentially restore significant amounts of land for conservation and carbon sequestration.

The potential for this multiplier effect makes positive tipping points all the more promising and critical to understand.

Further research to identify positive tipping points and tipping cascades and to improve models for evaluating policy impacts holds great potential for uncovering additional decarbonization opportunities. Policymakers should take full advantage of this growing field of research by integrating its models and insights into the climate policy decision-making process and translating insights from researchers into evidence-based policies. 

Plan of Action

In order for the government to leverage positive tipping points, policymakers must be able to (1) identify positive tipping points and tipping cascades before they occur, (2) understand which policies or sequences of policies may be most cost-effective and impactful in enabling positive tipping points, and (3) integrate that insight into policy decision-making. The following recommendations would create the foundations of this process.

Recommendation 1. Evaluate and adopt new economic models

The President’s Council of Advisors on Science and Technology (PCAST) and the Council of Economic Advisors (CEA) should conduct a joint evaluation of new economic models and case studies to identify where new models have been proven to be more accurate for modeling decarbonization transitions and where there are remaining gaps. They should then issue a report with recommendations on opportunities for funding further research on positive tipping points and new economic models and advise sub agenciessubagencies responsible for modeling and projections, such as the Energy Information Administration within the Department of Energy (DOE), on how to adopt these new economic models.

Recommendation 2. Integrate positive tipping points into the research agenda of federally funded research centers and programs.

There is a growing body of research coming primarily from Europe, led by the Global Systems Institute and the Economics of Energy Innovation and Systems Transition at the University of Exeter and Systemiq, that is investigating global progress towards positive tipping points and different potential policy interventions. The federal government should foster the growth of this research area within the United States in order to study positive tipping points and develop models and forecasts for the U.S. context.

There are several existing government-funded research programs and centers that align well with positive tipping points and would benefit synergistically from adding this to their research agenda:

Recommendation 3. Use insights from positive tipping points research to develop and implement policies to accelerate progress towards positive tipping points

Researchers have already identified three super-leverage points around which the federal government should consider developing and implementing policies. As future research is published, the PCAST should make further recommendations on actions that the federal government can take in leveraging positive tipping points.

Super-Leverage Point #1: Mandating Zero-Emission Vehicles (ZEVs) 

ZEV mandates require car manufacturers to sell a rising proportion of ZEVs within their light duty vehicles sales. Ensuring a growing supply of ZEVs results in falling costs and rising demand. Evidence of the effect of such policies in U.S. states, Canadian provinces, and China and future projections suggest that ZEV mandates are a crucial policy lever for ensuring a full EV transition. Such policies rely on the reallocation of private capital rather than government spending, making it particularly cost-effective. Combined with the investments in EV manufacturing and public charging infrastructure in the IRA and IIJA, a national ZEV mandate could radically boost the EV transition. 

A national ZEV mandate is unlikely to pass Congress anytime soon. However, the recently proposed Environmental Protection Agency (EPA) greenhouse gas emissions standards for passenger cars and trucks would effectively require 67% of car sales to be ZEVs by 2032 in order for car manufacturers to comply with the regulations. The proposed standards would provide regulatory strength behind the Biden Administration’s goal of 50% of new cars sold by 2030 to be ZEVs. The EPA should finalize these standards as soon as possible at or above the currently proposed stringency. 

The proposed EPA standards are projected to result in a 50% reduction in the price of EV batteries by 2035. This will have knock-on effects on the cost of batteries for renewable energy storage and battery electric trucks and other heavy-duty vehicles, which would likely bring forward the cost parity tipping point for these technologies by a number of years.

Super-Leverage Point #2: Mandating Green Ammonia Use in Fertilizer Production 

Ammonia is the primary ingredient for producing nitrogen-based fertilizer and requires hydrogen as an input. Traditionally, this hydrogen is produced from natural gas, and the production of hydrogen for ammonia accounts for 1% of global CO2 emissions. Green hydrogen produced from water and powered by renewable energy would enable the production of green ammonia for nitrogen-based fertilizers.

Based on a DOE tipping point analysis, green ammonia production is one of the most promising areas for initial large-scale deployment of green hydrogen, thanks to its ability to use established ammonia supply chains and economies of scale. Green ammonia production also has one of the lowest green premia in the hydrogen economy. Green ammonia production will enable infrastructure development and cost reductions for green hydrogen to decarbonize other sectors, including shipping, aviation, and heavy industries like steel. 

The Biden Administration should set a target for green ammonia production for domestic fertilizer in the Federal Sustainability Plan similar to India’s draft hydrogen strategy requiring 20% green ammonia production by 2027–2028. The EPA should then propose Clean Air Act carbon emission limits and guidelines for nitrogen-based fertilizer production plants, similar to the recently proposed standards for coal and natural gas power plants, to provide regulatory strength behind that target. These limits would effectively require fertilizer plants to blend a growing percentage of green ammonia into their production line in order to meet emission limits. According to the DOE, the clean hydrogen production tax credit in the IRA has enabled cost parity between green ammonia and fossil-based ammonia, so the EPA should be able to set such limits without increasing food production costs.

Super-Leverage Point #3: Public Procurement to Promote Plant and Alternative Proteins

Shifting protein consumption from meat to plant and alternative proteins can reduce emissions from livestock farming and reduce land use change for meat production. Plant proteins refer to protein-rich plants, such as nuts and legumes, and traditional products made from those plants, such as tofu and tempeh. Alternative proteins currently on the market include plant- and fermentation-based protein products intended to mimic the taste and texture of meat. Studies show that if plant and alternative proteins are able to reach a tipping point of 20% market share, this would ease up 7–15% of land currently used for agriculture to conservation and the restoration of its ability to serve as a carbon sink. 

Public procurement of alternative proteins for federal food programs leverages government spending power to support this nascent market and introduce new consumers to alternative proteins, thus increasing its accessibility and social traction. Last year, the National Defense Authorization Act established a three-year pilot program for the U.S. Navy to offer alternative protein options. The California state legislature also invested $700 million to support schools in procuring more plant-based foods and training staff on how to prepare plant-based meals.

The United States Department of Agriculture (USDA) is a major procurer of food through collaboration between the Agricultural Marketing Service (AMS) and the Food and Nutrition Service (FNS) and distributes the majority of procured food through the Child Nutrition Programs (CNPs), especially the National School Lunch Program (NSLP). Currently, AMS does not procure any traditional or alternative protein products made from plant protein, but USDA guidelines do allow traditional and alternative protein products to fulfill meat/meat alternate requirements for CNPs. The AMS should develop product specifications and requirements for procuring these types of products and assist traditional and alternative protein companies to become USDA food vendors. The FNS should then launch a pilot program spending, for example, 1% of their procurement budget on traditional and alternative protein products. This should be supported by education and training of food service workers at schools that participate in the NSLP on how to prepare meals using traditional and alternative proteins.

Conclusion

The sooner that positive tipping points that accelerate desired transitions are triggered, the sooner that decarbonization transitions will be realized and net-zero goals will be met. Early intervention is crucial for supporting the growth and adoption of new zero-emission technologies. The recommendations above present the foundations of a strategy for leveraging positive tipping points and accelerating climate action.

Acknowledgements

I’d like to acknowledge Erica Goldman for her generous feedback and advice on this piece and for her thought leadership on this topic at FAS.

FAQs about Leveraging Positive Tipping Points to Accelerate Decarbonization
What are the necessary conditions for a positive tipping point?

The key conditions for triggering a positive tipping point are affordability, attractiveness, and accessibility of new zero-emission technologies compared to incumbents. Affordability is often the most crucial condition: achieving price parity with incumbent technologies (with and then without the support of taxes and subsidies) can unlock rapid growth and adoption. Attractiveness refers to consumer preferences about a new technology’s performance, complementary features, or ability to signal social values. Accessibility refers to whether supporting infrastructure or knowledge, such as charging stations for EVs or recipes for cooking alternative proteins, is commonly available to support adoption. Due to the relative nature of these conditions, policymakers can influence them either by making the new technology more affordable, attractive, and accessible or by making the incumbent technology less affordable, attractive, and accessible. Often, a combination of both approaches is required to achieve the optimal effect.

Are federal policymakers the only actors that can trigger positive tipping points? What about state policymakers?

States can cooperate to identify and coordinate policies that activate upward-scaling tipping cascades into other states and eventually the federal government. A promising example of this is the growing adoption of California’s Advanced Clean Cars II EV sales mandate by Vermont, New York, Washington, Oregon, Rhode Island, New Jersey, Maryland, and soon Colorado, Massachusetts, and Delaware.

What about individuals and social movements?

Social contagion, mentioned above, is a powerful type of feedback loop that can drive the spread of not just technology adoption but also new behaviors, opinions, knowledge, and social norms. Through social contagion, social movement can be formed, capable of wielding greater influence than the sum of individuals. That influence can then translate into demands for government and industry action to decarbonize. A prime example is Greta Thunberg and the Fridays for Future student movement. Another example is the Social Tipping Point Coalition that in 2021 rallied a coalition of over 100 scientists, universities, nongovernmental and grassroots organizations, and other individuals to petition the new Dutch parliament to implement new climate policies.

What about industry stakeholders?

Industry has a direct hand in creating the conditions for a positive tipping point through their business models, technological development, and production. Industries are more likely to invest in adopting and improving low- and zero-carbon technologies and practices if the government clearly signals that it will back the transition, resulting in positive, reinforcing “ambition loops” between government climate policy and industry climate action. Industry coordination is also key to ensuring that new technologies are complementary and that infrastructure supporting a technology is developed alongside the technology itself. For example, coordination between EV companies is necessary to develop compatible charging mechanisms across manufacturers. Coordination between charging companies and EV companies can help charging companies identify which geographies have greatest demand for chargers.

What about international coordination?

International coordination strengthens positive feedback loops and accelerates cost reductions for green technologies. For example, a recent study suggests that if the three largest car markets—the United States, Europe, and China—implement zero-emission vehicle (ZEV) sales mandates (i.e., requirements that an increasing percentage of each car manufacturer’s sales must be EVs), EVs will be able to reach cost parity with gas vehicles five years sooner than in the scenario without those ZEV mandates.

What has the federal government done to identify or accelerate positive tipping points so far?

The U.S. Global Change Research Program’s 2022–2031 Strategic Plan includes tipping points and nonlinear changes in complex systems as two of its research priorities. Specifically, the Strategic Plan highlights the need to investigate “the potential for beneficial tipping points” and incorporate research on nonlinearity in economics-based models to evaluate societal decisions in future National Climate Assessments. However, it will take another four to five years to produce the next National Climate Assessment under this strategic plan. (The fifth National Climate Assessment, which is expected to be published this fall, was drafted before the new strategic plan was published.) Thus, additional executive and agency action is necessary to operationalize positive tipping points in the federal government before the next National Climate Assessment is released.

How can we track progress towards positive tipping points?

The federal government currently collects some data on the sales and adoption rates of the relatively more mature clean energy technologies, such as electric vehicles. A 2022 Bloomberg report attempted to identify “early-stage tipping points” at around 5% adoption for 10 clean energy technologies that reflect when their adoption becomes measurably exponential and compare their adoption curves across countries globally. Beyond adoption rates, a number of additional factors indicate progress towards positive tipping points, such as the number of companies investing in a zero-emission technology or the number of states adopting regulations or incentives that support zero-emission technologies in a sector. Tracking these indicators can help policymakers sense when a system is approaching a positive tipping point. The nonprofit Systems Change Lab currently tracks the adoption of decarbonization technologies and factors that affect decarbonization transitions on a global scale. Philanthropic funding or a public-private partnership with the Systems Change Lab could leverage their existing infrastructure to track tipping point indicators on a national scale for the United States.

What are the risks or potential unintended consequences to consider when crossing a positive tipping point?

Approaching a positive tipping point first requires a system to become destabilized in order to make change possible. Once a positive tipping point is crossed, the system then accelerates towards a new state and begins to restabilize. However, the destabilization during the transition can have unintended consequences due to the rapid shift in how social, economic, and technological systems are organized and how resources are distributed within those systems. Potential risks include economic precarity for people employed in rapidly declining industries and resulting social instability and backlash. This can potentially exacerbate inequality and undesirable social division. As such, policies ensuring a just transition must be implemented alongside policies to accelerate positive tipping points. Research on the interaction between these policies is currently ongoing. It is essential that decisions to develop policies that accelerate movement towards positive tipping points always consider and evaluate the potential for unintended consequences.

Six hot opportunity areas to beat the heat through federal policy

Extreme heat is the number one weather-related killer of Americans, yet receives minimal targeted federal support and dedicated funding for planning, mitigation, and recovery.

This summer, 130 million Americans were placed under some type of heat alert. National records for heat continue to be shattered each month, with July estimated to be the hottest month recorded on Earth. This relentless heat will continue to affect millions of Americans in August and for every summer to come. 

Extreme heat is the number one weather-related killer of Americans, yet receives minimal targeted federal support and dedicated funding for planning, mitigation, and recovery. Unlike other weather-related disasters, the consequences of extreme heat are hard to respond to and challenging to account for under current federal law. For starters, the Stafford Act does not consider extreme heat to be a Major Disaster (Sec. 102), barring sufficient coordinated federal action. Further, extreme heat is not only risky to infrastructure, like our power grids, roads, and homes, but also has devastating direct impacts on public health.

Prolonged exposure to extreme heat increases the risk of developing potentially fatal heat-related illnesses, such as heat stroke where the human body reaches dangerously high internal temperatures. If a person cannot cool down, especially when the nights bring no relief from the heat, this high core temperature can result in organ failure, cognitive damage, and death. These human health impacts are harder to account for in benefit-cost analyses that drive disaster preparedness funding allocations. Extreme heat is a crisis that impacts everyone. However, certain populations are more vulnerable to the increased health risks from heat, including older adults, outdoor workers, those with preexisting health conditions, low income communities, and people experiencing homelessness. 

Extreme heat also creates conditions that increase the likelihood and severity of other natural hazards, such as droughts and wildfires, further threatening public health. These compounding disasters put a major strain on national and global agricultural systems and threaten food security. This is particularly true for low-income communities as “heatflation” makes staple foods more unaffordable. 

We can better prevent, manage, and recover from extreme heat. With increased federal attention towards the effects of extreme heat and climate adaptation and resilience, there is an opportunity to take action. Federal policy can be a powerful lever of systems change, ensuring better coordination across federal agencies, state and local governments, and public and private sectors to beat the heat.

Starting now, the Federation of American Scientists is launching an Open Call for Extreme Heat Policy Ideas to source policy solutions to improve how the federal government coordinates a comprehensive response to heat. FAS is collecting ideas throughout Fall 2023 to prepare effectively for the next heat season. More information can be found by following this link.

FAS has completed a preliminary diagnosis of six opportunity areas for innovative extreme heat policy ideas that can make the most substantial impact on American heat resiliency: Infrastructure, Workforce, Public Health, Food Security, Planning and Management, and Data and Indices.

Infrastructure

Many Americans offset heat through increasing their use of air conditioning. Yet, this creates many issues, including the risk of overloading our electrical grids, equity concerns surrounding who has continuous access to air conditioning, and variance in the effectiveness of different air conditioning units. 1 in 4 Americans experience energy insecurity which puts them at risk of energy shut-offs, and Americans at large hold $19.3 billion in energy debt as of March 2023.

Further, AC units fail to address fundamental issues in infrastructure, such as the poor design of buildings or lack of building codes that specify maximum temperature inside buildings. A study done by CAPA Strategies and the Portland Bureau of Emergency Management on heat in public housing found that even units with AC saw observed temperatures consistently greater than 80℉, putting the health of residents at risk. Even more alarming, research has projected that in the event of a multi-day blackout during a heatwave, the heat-related mortality rate in Phoenix, Atlanta, and Detroit would increase dramatically. In Phoenix, more than 50% of the urban population would require medical attention. This calls into question an AC-only heat mitigation strategy. Rather, how we design and build our infrastructure can make our communities more heat resilient. 

Extreme heat presents multiple challenges to our current infrastructure, including concerns over grid and transportation resilience, lack of building codes for heat, lack of well-researched passive cooling technologies (i.e. non-air conditioning) to combat heat, and urban planning and design to beat the heat. Infrastructure investments, such as increasing grid resilience and creating more urban green space and nature-based solutions, can serve as preventive measures to keep communities cool as temperatures continue to rise. 

With the Bipartisan Infrastructure Law and the Inflation Reduction Act, several federal agencies have created programs that could address infrastructure concerns surrounding extreme heat. 

While these programs provide necessary support and funding to address infrastructure concerns, multiple gaps still persist. First, federal agencies may have capital but are not coordinated in their approach to addressing extreme heat and proactively building community resilience to heat. The Equitable Long-Term Recovery and Resilience Interagency Working Group has found difficulties in interagency coordination of notices of funding opportunities, place-based engagement for deployment of funds, direct technical assistance to communities, and maintenance of continuous sources of funding along a project’s timeline (i.e. ensure once infrastructure is built that there are people to upkeep passive infrastructure such as green spaces or people to staff active infrastructure like cooling centers). Without strategy and clarity for how communities should proceed and what they should invest in, there will be no sustainable change in infrastructure across the nation. 

Second, nuances in specific programs and the way grants are chosen through benefit-cost analysis (i.e. greater value to property damage over harder to quantify measures like impacts on human lives) may limit funding that goes to projects specifically focused on extreme heat. For example, while communities have been told that FEMA’s BRIC can fund extreme heat resilience, BRIC grant applications have been repeatedly rejected for extreme heat-related projects, a consequence of the “cost-effective” statute for BRIC. Even if a cooling center is approved, BRIC money cannot staff the center in the event of a disaster. 

Third, many jurisdictions around the country lack building codes that specify a maximum indoor temperature inside buildings as well as required strategies to mitigate extreme heat – contributing to heightened risk for individuals developing heat-related illnesses.  

Workforce

Rising temperatures place many members of the workforce, such as farmworkers and construction workers, at increased risk for heat-related illnesses. Extreme heat also leads to immense losses in workplace productivity, with research estimating a total annual loss of $100 billion to the U.S. economy. Without any measures to address the impacts of extreme heat in the future, this figure could double to $200 billion by 2030 and $500 billion by 2050. The Occupational Safety and Health Administration (OSHA) within the Department of Labor recently released a heat hazard alert which provides information to employers about how they should be protecting employees in extreme heat conditions as well as information on employees’ rights. With recent direction from the White House, OSHA will also increase its inspections and enforcement of violations in industries at higher risk for extreme heat, such as agriculture. Yet, OSHA is historically under-resourced in its ability to effectively carry out inspections and enforcement, with each inspector now responsible for securing the rights of 200,000 workers. 

This under-resourcing extends to OSHA’s ability to create a national standard for protection against extreme heat which is still years off from implementation. This leaves employee protection to state-level standards. Some states, including California and Oregon, have issued heat standards to protect workers. Yet, other states, such as Texas, have eliminated the requirement for employers to provide basic safety measures like water breaks. In this current system, employees are being put at significant risk. Providing employees consistent breaks for water and shade while working in extreme heat conditions is a simple way to mitigate these risks while lowering costs of workers’ compensation for employers in the event of a work-exposure related heat illness. 

Public Health

Each summer, extreme heat can cost the healthcare industry upwards of $1 billion dollars. Exposure to extreme heat, and often accompanying high humidity, can cause multiple heat-related illnesses, including heat cramps, heat exhaustion and heat stroke. The risks of developing severe symptoms are heightened by social and environmental factors, such as lack of access to air conditioning, shade, or transportation to medical centers. Individual factors, including types of medication being taken, can also increase sensitivity towards heat. Further, rising temperatures exacerbate negative mental health outcomes, such as fatigue and aggression. 

When patients with a heat-illness are admitted to the hospital, there are numerous limitations with coordination and response. Diagnostic codes, used for insurance claims, exist for heat-related illness. However, physicians may not recognize the symptoms of heat-related illnesses and instead diagnose and assign other related codes, such as dehydration. Therefore, patients may not be properly diagnosed and treated. This also leads to significant underreporting of the effects of extreme heat on health. 

Quick coordination and response by health care professionals is critical in preventing long-term damage. A nationwide survey by Americares found that less than 20% of staff in clinics feel that their clinics are “very resilient” to extreme weather. During the Northwest Heat Dome in 2021, a lack of coordinated public health preparation led to 229 deaths, more than any other disaster that year. In order to increase preparedness and timely response, it is essential for the public health workforce to be educated on best practices in responding to heat-illnesses. For example, after the Northwest Heat Dome, Seattle has begun to implement new plans for hospitals to meet to review best practices if extreme heat is forecasted, including checking whether centers have ice and body bags available. 

Extreme heat can also have unexpected consequences on public health. For instance, extreme heat creates favorable conditions for infectious disease carriers, such as ticks and fungal spores, to exist in areas of the country where they were historically unable to survive. Transmission of disease is also more likely as people congregate in community hubs, such as cooling centers or beaches. 

As heat waves become more frequent and intense across the nation, it’s critical to create standardized coordination efforts. The Office of Climate Change and Health Equity serves as a resource hub, producing a seasonal Climate and Health Outlook and the new Heat-Related Emergency Medical Services Activation Surveillance Dashboard. Yet, they are not federally funded and are therefore limited in their capacity to coordinate heat and health resilience. In terms of public health preparedness resources, the Center for Disease Control’s (CDC) Climate Ready States and Cities Initiative can only support nine states, one city, and one county, despite 40 jurisdictions having applied. The Trust for America’s Health (TFAH) found increasing funding from $10 million to $110 million is required to support all states, and improve climate surveillance. 

The threat of extreme heat speaks to a critical need for a funded agency or office to take a leadership role in the following three efforts: 1) strengthening holistic natural disaster resiliency and response efforts within the healthcare and public health sectors through interagency collaboration 2) orchestrating and supporting efforts to close information gaps, synthesize data, and identify practical applications of information on natural disasters and climate threats and 3) coordinate efforts to develop communication and education on climate-related health threats. 

Food Security

Extreme heat and its exacerbation of other natural hazards, including droughts, can have a significant impact on our agricultural productivity and food security. The COVID-19 pandemic has illustrated the impact of large-scale emergencies on our national and global food supply chains and distribution systems. 

Increases in temperature may directly cause a reduction in crop growth and agricultural yields by affecting plants’ growth cycle. Rising temperatures affect livestock, potentially leading to increased mortality and reduced production of certain products, such as milk and eggs. It also impacts the way food can be stored and transported. Changes in food supply can ultimately increase the costs of certain foods and thus may not be affordable for everyone, particularly low-income populations. 

Extreme heat also contributes to the creation of favorable conditions for droughts, increasing the risk for crop failure. For instance, in Texas and the Midwest, extended droughts are causing farmers to be concerned about their agricultural yields and placing too heavy of a reliance on irrigation systems. Over a thousand communities are currently under disaster designation by the USDA this summer because of extended drought exacerbated by extreme heat.

It is critical for resources to be devoted to the research and development of strategies to improve the heat resilience of crops and livestock given the economic unsustainability of evergreen emergency disaster assistance. A report by the Perry World House Center recommended specific strategies including restorative agriculture practices, diversifying crop production, and learning from indigenous agricultural practices. The US Department of Agriculture’s Climate Hubs provide information on climate resilience to inform decision-making by natural resource and agricultural managers – and would benefit from additional appropriations. Additionally, the USDA’s Partnerships for Climate Smart Commodities is investing $1 billion into financing pilot projects that use climate-smart practices, yet no projects focus explicitly on extreme heat resiliency. 

Planning and Management

Despite its immense impacts, extreme heat is not considered a hazard that can trigger a federal emergency declaration under the Stafford Act. Many agencies, such as the Department of Interior and Housing and Urban Development, are not able to unlock funds without an emergency declaration and supplemental appropriations from Congress, illustrating the need to create more active resilience measures for these agencies to strategically act on extreme heat. 

The lack of specific staff within agencies and overarching federal leadership for heat resilience, response, and recovery limits an effective and coordinated response. Communities need agencies to have the tools, guidance, and technical assistance needed for implementation of extreme heat resilience. Lastly, having no federal office with national responsibility for extreme heat presents a major risk as certain parts of the country reach the upper limits of human habitability despite all resilience efforts triggering potentially destabilizing internal climate migrations.

Within local and state governments, there is often no specific agency or officer responsible for heat. Currently, only a handful of local jurisdictions are beginning to experiment with different organizational structures to address heat, such as the appointment of a designated Chief Heat Officer in Miami-Dade, Florida. On the state and local level, there is a lack of research into which organizational structure is most effective and efficient at extreme heat mitigation and response. In addition, there’s no incentive from the federal government for local jurisdictions to create effective heat response personnel. 

Finally, many states and local jurisdictions fail to plan for heat as a part of their Hazard Mitigation Plans, often required by FEMA to unlock disaster preparedness and recovery investments. Yet, there are currently no best practices on how to plan and respond, beyond high-level, non-specific guidance documents from the CDC and Environmental Protection Agency, leaving each city to create their own plans of action.

Data and Indices

While heat blankets entire regions, its impacts are not felt equitably across the population. Urban heat island effects can make parts of cities far hotter – thus worsening the disaster for people residing in these zones. Further, there is a lack of consensus over how to name, categorize, and communicate the severity of extreme heat events. Heat is very context dependent. Temperature is not the only consideration in determining the severity of heat. Levels of humidity are an integral factor in determining the extent to which the human body can control internal temperature. 

Inadequate data collection can result in underestimating the severity of heat, particularly in urban neighborhoods. Localized factors, including neighborhood design and the infrastructure of individual buildings can exacerbate the severity and consequences of heat. Within one city or local jurisdiction, data for heat can vary by multiple degrees. When these temperatures are not accurately accounted for, it can contribute to lack of efficient planning and emergency management. The National Oceanic and Atmospheric Administration and the Center for Disease Control created the National Integrated Heat Health Information System (NIHHIS) to provide tools and information on extreme heat. While NIHHIS produces useful information, such as the vulnerability mapping tool and urban heat island mapping campaign with the EPA, there is still a gap in applying this information and connecting localities with useful data and information on which strategies are most effective at combating extreme heat. Since this issue is dependent on context and locality, it’s crucial to have a system that collects nuanced data that tracks all of the impacts of extreme heat. 

Issues in communicating extreme heat’s severity arise because different heat indices use different standards and ultimately communicate output at varying levels of severity. This contributes to confusion surrounding what temperatures should constitute extreme heat. For instance, heat index calculations are a common measurement that take humidity into account. However, the formula assumes that people are resting in the shade. On the other hand, Wet Bulb Globe temperature calculations use direct sunshine measurements and assume people are active. Both of these measurements assume people are healthy. Not only does this create confusion about which index to rely on, it also excludes and may underestimate the severity of heat in certain populations. Naming heat waves is one solution that’s been explored in Spain to make it easier to explain the severity of extreme heat to the public.

Extreme heat presents multiple challenges to our planning, response, and management systems. While the consequences of extreme heat can be deadly, they can be avoided with a coordinated and comprehensive federal response. If you’re feeling inspired to act, submit an idea to our Open Call for Extreme Heat Policy Ideas here.