The summer of 2026 was one of shared experiences. Sports-agnostic Americans joined die-hard Knicks fans in the streets to celebrate their NBA Finals victory. The World Cup allowed Americans to share our culture, from Buc-ee’s to Bass Pro to ranch dressing, with international visitors. And from coast to coast, with hot dogs, parades, and over 800,000 fireworks, the nation toasted to 250 years. However, in the background of these celebrations, Americans were also coming together for a different type of event: deadly heat waves. On the Fourth of July, more than 160 million Americans across 30 states marked the holiday under extreme heat – including a heat dome that contributed to 40 deaths across the East Coast and Illinois and left almost a million people without power. In mid-July, the wildfire smoke that spread from the West to East Coast threatened the World Cup final while nearly one-third of the population faced unhealthy air. 

Overall, this summer was the hottest summer on record: July ranked as the hottest month ever recorded in the contiguous U.S., and August broke the global record for heat and humidity. Because of climate change, though, dangerous temperatures are extending even beyond the traditional “summer months”. This past March was the hottest March ever recorded, with temperature records shattered across the American West. Not only was this out-of-season heat wave bad for health, it also melted the paltry snowpack on the Rockies, leading to droughts later in the year. On September 20, in Nashville, Tennessee, it was so hot that the artificial turf field at the Titans–Eagles game reached 157°F, causing players’ shoes to literally melt. September was the warmest September since record-keeping began in 1895.

But it’s not all doom and gloom. Just as sports fanatics had plenty to celebrate this year, so does the heat policy team at FAS.

Actions at the state and local level

People and policymakers are finally taking extreme heat seriously. Ninety percent of adults report that extreme heat has impacted them in some way, including through rising electricity bills, decreased ability to participate in outdoor activities, and disrupted sleep routines. In response to recent heat events, leaders across the country have taken steps to build heat resilience. 

FAS co-created the State and Local Heat Policy Agenda, in collaboration with hundreds of policymakers, practitioners, organizations, and private companies, to be the shared framework for comprehensive heat action. Our 15 recommendations for state and local leaders map across four pillars – homes, workplaces, schools and childcare, and communities – and highlight ways to both protect people now and build greater resilience to extreme heat in the long term. We’re excited to see state and local governments take at least 30 significant actions aligned with the FAS Heat Policy Agenda pillars. Let’s dive in.

Safe Homes

This summer, two cities made the “right to cooling” a reality. The cities of Spokane, WA, and Houston, TX, now require landlords to provide cooling systems for renters, joining at least seven other cities and one state with similar laws. At the state level, Arizona and Washington pursued different policy levers to protect renters. Arizona’s Attorney General filed a lawsuit against three apartment complexes for allowing residential units to exceed 90°F, violating Pima County’s habitability ordinance. Meanwhile, Washington’s newly enacted law prohibits landlords from preventing renters from installing cooling systems. Thinking beyond rental housing, Hawaii enacted HB 2498, launching a resilience pilot program for aging care facilities to help them implement resilience improvements, including cooling enhancements.  

The presence of a cooling device (like HVAC, heat pump, or an air-conditioner unit) in homes and living units is vital. But such a device is only effective if residents can afford to pay for the electricity that runs it. That’s why Michigan this year set an energy affordability goal of limiting energy burden, or the share of annual household income used to pay annual energy bills, for residents most in need to six percent. This follows in the footsteps of Washington’s energy burden target, which was assessed for feasibility in 2025, and made more achievable this year following the passage of HB 1903. This legislation created a statewide low-income home energy assistance program (LIHEAP), a complement to the federal program.

Plug-in solar is a new tool on the minds of many policymakers. Not only do these systems lower electricity costs, they also strengthen system reliability as higher temperatures increase the demand for air conditioning, raising utility bills and straining the grid. Barriers like interconnection agreements, permitting, and fees have previously prevented widespread adoption, so new state legislation is overcoming these obstacles. Following Utah’s lead, this summer, an additional nine states signed plug-in solar bills into law. Additionally, the state legislatures of Massachusetts and New York passed bills through both chambers that now await governors’ signatures.

When affordability measures fail, households behind on their bills still need protections on the hottest days. Fewer than half of U.S. states have policies preventing utility disconnections during hot weather. In July, the California Public Utilities Commission (CPUC) approved a resolution requiring utilities to use the CalHeatScore, a regionally specific heat ranking system, to mark days that were too hot for people to lose power. Utilities have six months to implement the CalHeatScore system, and in the meantime the CPUC lowered the suspension threshold to 90°F from 100°F.

Finally, data centers are a driving force behind increased electricity costs and grid instability. A slew of bills related to data-center development advanced this summer. Six states – Delaware, Florida, Maryland, New Jersey, Tennessee, and Virginia – took various approaches to require data centers to pay the full costs of their energy needs and prevent these costs from falling onto other ratepayers. Maryland, New Jersey, and New York are also leveraging data center development to fund weatherization for low-income households, household efficiency upgrades, and distributed energy resources to reduce strain on the grid. And Virginia imposed an electricity-consumption tax to raise revenue for the state’s general fund. 

Safe Workplaces

Earlier this year, Virginia became the latest state, and the first Southern state, to pass legislation requiring a heat standard for indoor and outdoor workers. By May 2028, the state’s Department of Labor and Industry (DOLI) must finalize rules for water access, rest breaks, shade and cooling areas, employee training, and acclimatization for workers. In pursuit of that goal, DOLI began soliciting input and in August, released a Notice of Intended Regulatory Action. 

In New York, advocates have pushed for state legislation to protect indoor and outdoor workers through the Temperature Extreme Mitigation Program Act. This bill was first introduced in 2023. However, the legislation stalled following industry opposition and the introduction of the federal heat standard rule, prompting state elected officials to pause their efforts. Not waiting for state-level action, in June, Mayor Mamdani signed New York City’s first executive order for worker heat protection.

Safe Schools and Childcare

Students are just a few weeks into the school year, but already about 200,000 students have faced an academic disruption or cancellation due to high temperatures. Thankfully, ahead of the school year, authorities in California and Texas issued new guidelines around heat.

In California, following Senate Bill 1248, local education departments adopted protocols for physical activity modification during extreme temperatures. In Texas, the University Interscholastic League (UIL), which governs all high school sports in the state, passed new rules to protect student athletes and band members from heat. In both states, these guidelines use a tiered system to evaluate risk, call for access to water, shade, and rest to keep students cool and prevent illness, and identify the risk levels that trigger the suspension of outdoor activities. However, both sets of rules are requirements without funding or compliance-tracking provisions, which may affect compliance.

Outside of athletics, financing for school-wide heat resilience is also a challenge due to outdated facilities, leading to a loss of 3.5 million learning days during the 2024-2025 school year. However, state bonds and state and federal tax credits remain available for schools to upgrade and install heating, ventilation, and air conditioning (HVAC) systems. In Wake County, North Carolina, voters will decide on a $680 million bond, with $49 million dedicated to school HVAC replacements. The 21 schools included in the county commissioners’ plans include three that experienced recent air conditioning outages. The Colorado Energy Office awarded over $12 million in geothermal tax credits earlier this year, including $5 million for the Aspen School District and $4.3 million for Adams State University. Seattle also leveraged federal tax credits for geothermal to expand reliable cooling. Finally, the Philadelphia Gas Works is considering leveraging federal tax credits to simultaneously provide cooling to an elementary school and recreation center, equipping the school with air conditioning for the first time. 

Safe Communities

More cities and states are responding to heat by implementing cooling centers, often by leveraging libraries that already serve as de facto daytime shelters. Arizona is a leading example of how to design effective cooling centers as a part of a coordinated heat response. The city of Phoenix established its first 24/7 center in 2024 and Maricopa County created a network that sees roughly 30,000 to 40,000 visits annually. While federal support for these centers expired this year, the state for the first time appropriated $400,000 to support this initiative. Furthermore, New York and Oregon offer examples of how to address the financial challenges of creating local cooling centers. New York established a new Community Resilience Hub grant program with $10 million appropriated from the legislature, and Oregon expanded the grant support from the Department of Human Services to include resilience hubs through HB 4121. 

Cities and states are also realizing they need a coordinated response to heat outside of cooling centers. In Atlanta, the city council unanimously approved a resolution to develop a heat response plan after advocates underscored the inadequacies in the government’s efforts during the Fourth of July heat wave. Beyond immediate response, California and Massachusetts are taking a whole-of-government approach to heat resilience. In August, California released the newest edition of the state’s Extreme Heat Action Plan, which must be updated every three years. The plan centers around four actions: building public awareness, strengthening community services and response, increasing the resilience of the built environment, and utilizing nature-based solutions. Two days later, Massachusetts announced its first Heat Resilience Officer, the second position of its kind in the nation, and the first along the East Coast. This role will lead government coordination to prepare for rising temperatures and reduce the risk and effects of heat waves. 

Another hot-button issue for state finances is the ongoing battle for heat relief in states’ correctional facilities. Lawsuits in five states – California, Florida, Louisiana, Missouri, and Texas – argue that extreme heat violates the Eighth Amendment. In May, a Louisiana judge ruled that the court did not have the power to force the state to improve working conditions for inmates laboring in heat. However, in Texas, a federal judge ordered the state’s Department of Criminal Justice to fully air-condition its prisons by the end of 2029, at a price tag of at least $1.5 billion (and likely more) – much more than Texas’s current budget will allow. While the federal ruling may soon apply to more states, bills to fund AC in prisons have failed in California, Iowa, and Virginia, proving just how difficult it has been to address this issue. 

Actions at the federal level

Federal action on heat has slowed with the leadership and capacity losses we documented last year. Yet there were some positive highlights of the past year and a number of warning signs. 

First, the positives:

• The National Integrated Heat Health Information System, the platform for federal information on extreme heat, stood up a challenge competition to support communities planning and preparing for extreme heat. Forty communities will soon be awarded $25K each to run in-person heat tabletop exercises.
  
• The Federal Emergency Management Agency supported community preparedness for the FIFA World Cup games through $625 million in grants, training and exercises. This investment didn’t come without tradeoffs. Training unrelated to the World Cup was suspended, putting thousands of emergency managers’ careers in limbo.
  
• We saw signs of bipartisan action on extreme heat again in Congress, including additional proposed appropriations to the U.S. Department of Agriculture to address heat and its impacts on livestock and proposed legislation to make extreme heat eligible for the Environmental Protection Agency’s Midsize and Large Drinking Water Infrastructure Resilience and Sustainability Program.
  
• Congress passed the 21st Century ROAD to Housing Act, the first bill in decades that addresses federal policy to increase housing supply. Several programs in the bill stand out for their heat relevance. First off, there’s a temperature sensor pilot program for public housing authorities to collect temperature-related data to see what units are in compliance with standards. Second, there’s the creation of a “whole-home repair” program to provide loans to small landlords and low-income homeowners to do holistic improvements to their properties, including resilience and weatherization actions. Finally, the PRICE Act and HOME Investment Partnerships will both create financing pathways for the building and retrofitting of affordable housing options.
  
• The Government Accountability Office published a report about the state of school facilities, and the needs are stark. Half of school districts face excessive heat or cold in the classroom, and 1 in 5 school districts have had to close schools due to facility issues. And there’s not enough money available to meet the upgrade needs. Funding available is certainly a barrier, and current federal and state requirements are also reducing the speed by which funding can go out the door. In a challenging financial environment, focusing on streamlining resource delivery is a great opportunity for action.

The things to worry about:

• The U.S. House advanced a bill through committee that would prevent the Occupational Safety and Health Administration (OSHA) from finalizing a standard equivalent to the Biden-Harris Administration’s heat rule. The U.S. Senate now has a parallel bill. While this bill is not likely to pass Congress, it signals Republican opposition that the Trump administration could leverage to weaken the proposed rule. The Administration is currently working on a Supplemental Notice of Proposed Rulemaking for the proposed OSHA heat rule, a fancy way of saying they are going to rewrite it. The Small Business Administration and other business lobbying groups are pushing for a weaker rule. If OSHA succeeds in getting this rule done by fall 2027 (as proposed) it will make it a lot harder for states to protect their own workers with stronger rules.
  
• The Department of Energy has been using its “energy emergency” authority to keep fossil fuel plants online in the name of grid reliability. Yes, we need a lot of energy to meet rising demand, but propping outdated facilities up will only raise bills and worsen air quality in the long run. Thankfully, the U.S. Court of Appeals for the D.C. Circuit ruled that the administration overstepped its authority.
  
• The Congressional Budget Office (CBO) released its long-awaited (by us at least!) review of the effects of changing temperatures on Medicare costs. CBO reports are used by lawmakers to evaluate the budgetary impacts of proposed legislation and understand long-term fiscal trends. The report actually found cost savings, which could stand in the way of action on the issue of extreme heat. But this finding relies on the assumption that people will “adapt” to warming temperatures via air conditioning. This is a fairly weighty assumption in the face of rapidly rising energy bills and long-standing evidence that millions currently ration energy usage to stay financially afloat. Without the adaptation assumption, extreme heat will increase Medicare costs.
  
• While the 21st Century ROAD to Housing Act has a lot of good provisions in it, a number of things need to be watched closely that could impact action on heat resilience. The Innovation Fund will be awarded to places that are looking to “minimize the impact of energy standards on housing costs”. Further, updates to the energy efficiency standards for manufactured homes could lead to less efficient homes than previously proposed standards, locking residents into higher bills during extreme heat.

Looking ahead to 2027 and beyond

This November will be a consequential election with Congressional races in all 50 states, 36 states and three territories with gubernatorial elections, and 46 states with legislative elections. New governors, in particular, will want to make their mark quickly and decisively. 

Thankfully, the hottest topic of our political moment – affordability – provides a real policy window for moving heat resilience policies forward. A package of ideas to address rising energy prices by expanding near-term bill relief and investing in home upgrades that ensure long-term readiness could be compelling to new electeds. And we’ve seen how policymakers are smartly leveraging the data center boom to raise revenue that pays for these actions. 

Yet affordability politics are also being used to argue against resilience measures, aligning with a deregulatory thrust in our politics. In Maryland and Vermont, concerns about the rising costs of new housing construction led to policymakers rolling back advanced energy codes. Even new regulations have to adapt to this era. Spokane’s right-to-cooling ordinance was watered down to keep compliance “affordable.” In Massachusetts, concerns about energy prices led to proposals to slash Mass Save, the state’s energy efficiency program. While it’s good to reconsider how or if we raise funds for home upgrades from the ratepayer base, households need capital to upgrade their homes to adapt to extreme heat. In Virginia, concerns about grid stability and utility costs as data centers expand have led to proposals to use fossil fuels, including diesel backup generators, to meet electricity demand. This would increase emissions, reduce air quality, and worsen ozone formation during high-temperature periods. 

Indeed, meaningful action on extreme heat costs money more often than not. Better response capabilities so that the most vulnerable aren’t caught without support during a heat wave? Costs money. Upgrading cooling systems in homes, schools, and childcare? Costs money. Additional up-front investments are hard to justify amid rising costs and shrinking federal support. Nearly half of states are cutting spending to balance the books, putting programs that have saved lives and prepared communities in jeopardy. There are difficult decisions that will need to be made about which programs to save and which to cut, and we can’t pretend that more spending on heat resilience will come easily. Even when spending happens, it’s often not enough. The 24/7 Phoenix cooling center costs $600,000 annually to operate. The $400,000 that Arizona put towards cooling centers in its statewide budget for FY27 would be wiped out keeping the Phoenix center operational for just part of the summer.

Policymakers will need to find ways to move protections and resilience work forward in this austere environment. Focusing on medium- to long-term savings and benefits – and how creative financing can capture these in ways that lower upfront costs – can help. Research from the Pacific Northwest National Laboratory, for instance, found that a home compliant with the 2024 International Energy Conservation Code delivers net positive annual cash flow to the customer from year one. This looks like a $100 lower monthly energy bill in exchange for about a $50 higher monthly mortgage payment. There is a growing base of evidence that worker protections can save public programs such as workers’ compensation money. We also now know that summer 2025’s heat waves caused nearly 10% of all emergency room visits across 19 states, so preventing those cases with cooling access and energy assistance could decrease Medicaid and Medicare costs. Finally, a new study by our team and Groundswell found that covering the AC gap in just three cities, Boston, Minneapolis, and Houston, could save 200 lives and $150 million in avoidable health care costs over five years. These are powerful arguments indeed, and ones that could help heat-resilience solutions scale.

Moving heat policy and practice forward

We at FAS see the heat community’s ability to make progress on heat resilience in this next year as depending on four mutually reinforcing kinds of work: communications, policy, technology and innovation, and evidence. 

• Communications. We need to motivate people to move beyond individual solutions and take actions towards policy, practice, and systems change. The goal is to convey urgency without leaving people frozen in front of a problem that feels too big and overwhelms them. Also, public safety, health, and economic frames tend to travel across the political spectrum in a way that doomsday framing does not.
  
• Policy. We need to identify solutions for this political moment and different political contexts. Some places, like Arizona and California, are ready to advance solutions at every level of government, including even setting ambitious targets for heat action. Other places may need a different tack, such as incentives, financing, and business-led action instead of mandates and regulations. Once the policy is adopted, what’s needed next is implementation support, because standards and plans only matter if communities can actually meet them. Deliberate attention needs to be paid to rural and Tribal communities and their unique challenges.
  
• Technology and Innovation. We won’t be able to fully adapt to extreme heat with our current set of tools. We’ll need everything from new building materials that can repel heat to heat-adapted agricultural products to advanced sensor technology to evaluate localized heat risk to populations and infrastructure. A heat tech community is emerging, with VCs like Tailwind Futures and Convective Capital showing interest in funding early-stage startups. The government can also be a market-shaper, using its tools to pull new technology into the market. The New York State Energy Research and Development Authority’s design challenge created the first-ever window heat pump that has since scaled to places like Boston and Rhode Island.
  
• Evidence. We need to be constantly learning and evaluating our interventions. The field needs a better ground-level picture to inform response. Like, how many childcare centers, schools, and homes can actually hold a safe temperature? Which interventions deliver the most protection per dollar in a given place? How do we define success in terms of children thriving rather than simply not dying? Periodic syntheses of leading practices can keep all of us working from the same current picture as well as inform where we need more innovation.

We know this is daunting. Thankfully, we’re working with over a thousand brilliant practitioners, advocates, researchers, and policymakers from every state in the nation, and our 170+ signatories of the State and Local Heat Policy Agenda are working to advance solutions that work in their contexts and solve their needs. You can do more than despair about record-breaking heat: you can join our movement to protect people from this threat regardless of where and who they are. Interested in getting involved? Reach out to Grace Wickerson (gwickerson@fas.org) and Emma Espenan (eespenan@fas.org), and/or consider co-signing the Heat Policy Agenda here.

Nearly 150 organizations and government officials have endorsed the call to action and solutions for extreme heat, now public at HeatAgenda.US

Washington, D.C. – July 7, 2026 – As millions of Americans continue to struggle to stay cool following one of the hottest Independence Day holidays on record, the Federation of American Scientists (FAS), one of the oldest nonpartisan, nonprofit science policy organizations in the United States, is today releasing the State and Local Heat Policy Agenda – a clear statement of what’s needed to protect American workers, children, and communities from the rapidly escalating threat of extreme heat. Almost 150 organizations and government officials, representing over 40 states, have signed onto this call to action, now visible at HeatAgenda.US.

“More places than ever are now struggling with extreme heat. As America celebrated its 250th anniversary this past weekend, over 185 million Americans – over half the population – were under an extreme heat alert,” observes Dr. Hannah Safford, Associate Director of Climate and Environment. “The State and Local Heat Policy Agenda helps communities adapt to this new normal, by providing easy access to the solutions that science shows can effectively curb the worst impacts of dangerously hot temperatures.”

The State and Local Heat Policy Agenda was created by FAS in collaboration with hundreds of policymakers, practitioners, researchers, advocacy organizations, community-based organizations, government officials, private companies, and other contributors. The Agenda outlines 15 outcomes that state and local leaders should pursue in order to ensure Safe Homes, Safe Workplaces, Safe Schools and Childcare, and Safe Communities when extreme heat hits. 

Signatories include the American Academy of Pediatrics, the American College of Physicians, the American Federation of State, County and Municipal Employees, the Association of State and Territorial Health Officials, the United Auto Workers (UAW) Center for Manufacturing a Green Economy, Climate Mayors, GreenLatinos, the Healthy Schools Network, ICLEI USA, the National Council for Occupational Safety and Health, the National Housing Trust, the Service Employees International Union (SEIU), the Union of Concerned Scientists, WE ACT for Environmental Justice, and more than 100 other labor, health, advocacy, family and children, environmental, and public-sector organizations. The full list of signatories is available here.

To support Agenda implementation, HeatAgenda.US also includes a searchable database of more than 400 specific evidence-based policy solutions to extreme heat, as well as case studies from all 50 states illustrating the success of these solutions in action.

“Our research found heat-related actions happening in every state in the country. To orient this growing community of policymakers, we created the go-to guide for tackling extreme heat,” says Grace Wickerson, Senior Manager of Climate and Health. “Our policy recommendations aim to keep people safe now from dangerous heat exposure while building communities that don’t just survive the heat season, but thrive despite it.”

The call to action and resources available at HeatAgenda.US complements FAS’s federally oriented 2025 Heat Policy Agenda, recognizing the growing importance of state and local leadership on climate-related extreme weather events such as extreme heat.

Interested parties can sign on to the State and Local Heat Policy Agenda here. FAS will continue publicizing new supporters through the end of the summer, illustrating the broad support for action to build a heat-resilient nation.

To learn more, contact Grace Wickerson (gwickerson@fas.org). For media inquiries, contact Katie McCaskey (kmccaskey@fas.org). 

###

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 transformative impact, and seeks to ensure that scientific and technical expertise have a seat at the policymaking table. Established in 1945, FAS continues to bring scientific rigor and analysis to address national challenges. More information about FAS’s work at fas.org.

[Add Your Support Here]

It’s only early July and already more than 3,000 all-time temperature records have fallen in the United States. And as America celebrated its 250th anniversary, over 185 million Americans – over half the population – were under an extreme heat alert. Forecasters are anticipating a very hot summer that could take 2024’s “hottest year on record” crown. 

We’ve always had heat waves and hot places. But extreme heat is now touching every corner of our country. The implications of this growing threat are profound.

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. Additionally, local governments and their partners are footing the bill for increased demand for social services, public safety, and health care. 

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.

Even when heat doesn’t kill, it severely compromises quality of life. During high heat, people have to make impossible choices: between eating or overheating, working in dangerous conditions or losing a paycheck, telling kids they can’t go outside or risking heat illness. They also face aging infrastructure not built for extreme temperatures that buckles in the heat. 

Policy needs to catch up to the scale of the extreme heat problem, and fast. To do so, policymakers at all levels will need to make their communities “heat safe” by (1) reducing heat risk in the places where people spend the most time and (2) preparing social and physical infrastructure to handle rising heat. Heat-safe communities are places that don’t just survive but thrive, and where people and families can grow and prosper.

Addressing rising heat will take all of us. Already, almost 150 organizations and government offices and over 150 experts have committed to supporting the State & Local Heat Policy Agenda. Together, we can create heat-safe homes, workplaces, schools, childcare facilities, and communities – the backbone of a heat-ready nation.

[See all policy recommendations at HeatAgenda.us]

Safe Homes

Home is where families raise children, work, spend time with and care for loved ones, and relax. Yet 13 million households report being too hot at home and at least 80 million people struggle to pay their electricity bills today. A cool home is the best strategy to keep people from getting sick.

To protect every family from dangerous heat at home, policymakers should:

• Establish the right to cooling. Every household should have guaranteed access to active and passive cooling systems that keep their home at safe, comfortable temperatures.
• Protect energy access during hot weather. Every household should be protected from utility disconnection and during power outages in hot weather. Every household should also be able to afford the energy needed to keep homes cool. 
• Upgrade existing homes for extreme heat. Every household should be able to afford and easily implement upgrades to their homes, from heat pumps to cool roofs.
• Create a heat-resilient housing supply. Every new home should be built to stay cool during extreme temperatures, even when the power goes out. 
• Ensure large loads do not create affordability and reliability risks during extreme heat. Every household should be protected from electricity price spikes and reliability issues due to large-load customer demand, like data centers, on high heat days. Households should also not subsidize energy costs and infrastructure for large-load customers.

Safe Workplaces

Every year, an estimated 28,000 workers are injured on the job during high heat days, and dozens lose their lives. Workplace heat protections are both a moral imperative and a common-sense win-win: they prevent injuries and deaths, reduce workers’ compensation claims, decrease employee turnover, and even increase productivity, boosting bottom lines.

To protect every worker from dangerous heat on the job, policymakers should:

• Secure heat protections in all workplaces. Every worker should be guaranteed paid rest, water and shade access, heat-acclimatization periods, and, if applicable, cooling in their employer-provided housing.
• Create or expand paid leave and income protection for days too hot to work. Every worker should be able to stay safe from heat without financial penalty or risk to job security. 
• Incentivize uptake of best practices for workplace heat safety. Every government should develop strategies that encourage employers to implement protections and maintain good heat safety records, such as through workers compensation or procurement practices.

Safe Schools and Childcare

Heat harms our children’s health, development, activity, mood, sleep, and ability to focus. Yet 1 in 3 schools don’t have adequate cooling and 45% of childcare facilities have been physically or financially strained by extreme weather. Kids deserve safe, cool spaces to learn and play.

To protect every child from dangerous heat at school and childcare, policymakers should:

• Keep kids safe from extreme heat at school and childcare. Every child should be guaranteed a cool environment, including classrooms, school grounds, athletic facilities, and school buses. Every school and childcare facility should have plans, training, and policies for hot weather, including school operations, recess, and for sporting and outdoor activities.
• Make heat resilience possible for all schools and childcare facilities. Every school and childcare provider should be able to afford to upgrade their facilities to keep children cool.

Safe Communities

Dangerous heat is happening earlier in the year and lasting longer, while average temperatures across seasons are on the rise, affecting everything from snowpack to crops. Recognizing our new heat reality and preparing accordingly prevents deaths and avoids infrastructure failures and economic losses, while creating places where people want to build their lives and families.

To help every community get heat-safe, policymakers should:

• Prepare for higher temperatures as an acute emergency as well as a chronic risk. Every government should have plans for annual heat preparedness and long-term risk mitigation as well as strategies to coordinate with surrounding governments on efforts.
• Establish a governance structure and training for extreme heat. Every government should designate a public official (either a new hire or current employee) with authority and budget to lead heat efforts, coordinate interagency and intergovernmental efforts, and form partnerships with nonprofits, health systems, and the private sector. Every government should also upskill all frontline employees in their roles for heat mitigation and response.
• Assess heat’s impacts and costs. Every government should track heat impacts on people, infrastructure, the economy, and their budgets and set goals to reduce heat’s effects.
• Declare and respond to heat as an emergency. Every government should have and deploy the resources to protect their populations, such as shelter and welfare checks. Every government should prepare for infrastructure failures like of energy and water systems.
• Shape and finance heat-resilient infrastructure. Every government should set incentives or requirements to reduce heat’s impacts on people and infrastructure and identify or create public and private funding for building and maintaining heat-resilient infrastructure like trees, shade, back up power for critical facilities, and grid upgrades.

To learn more about how every state is implementing the Agenda’s recommendations, click here. To support this effort as a public signatory, click here. And to learn more about how you, your organization, or your government can help build a heat-resilient nation, contact Grace Wickerson (gwickerson@fas.org).

Through partnership with the Doris Duke Foundation, FAS is building bridges between the environmental community and the health community around extreme heat. Informed by the Metropolitan Area Planning Council’s and Boston University’s symposium on heat-health action and partnerships in Massachusetts, FAS seeks to showcase how local and state governments are working across sectors to address extreme heat. With heat being a rising cause of illness and death, these case studies show how governments are engaging in policy entrepreneurship to protect lives through targeted data collection, research, and policy and program design. Lessons learned from these cases can inform how state and local governments can leverage their existing capabilities to reduce risk and improve health outcomes.

Promising examples of progress are emerging from the Boston metropolitan area that show the power of partnership between researchers, government officials, practitioners, and community-based organizations. These include efforts to (1) assess the risk that heat poses to populations, operations, and ways of life, (2) reduce the potential for harmful exposures, and (3) strengthen the public health response. The following cases draw from examples shared at “Fostering Collaborations: A Symposium to Advance Equitable Heat Health Actions”, hosted by Boston University and the Metropolitan Area Planning Council (MAPC) in June of 2025, and show what historically cold places can do to adapt to extreme heat. These cases serve as a resource for documenting progress made across the region. The recommendations in this report are informed by the cases and build from the Metro Mayors Climate Taskforce’s “Keeping Metro Boston Cool: A Regional Heat Preparedness and Adaptation Plan” and upon leading practices identified in MAPC’s Climate Resilience Playbook (a guide of resilience actions for Massachusetts municipalities).

Case studies in this brief include:

• Targeting Assistance to the Most Heat-Impacted Homes and Buildings
• Data-Informed Land Use and Urban Planning Solutions to Cool Blocks and Communities
• Leveraging an Ecosystem of Health System Partnerships to Advance Extreme Heat Emergency Management 

Many people traditionally associate extreme heat with “hot” places, like the Southwest, Texas, and the Southeast, and their record-breaking heat and humidity. While stark, these places are more likely to have the infrastructure (such as widespread adoption of cooling systems) and policies and practices (such as Chief Heat Officers, heat response plans, and protections like utility shutoff prevention and indoor cooling standards) needed to safeguard populations from excess heat exposure. While there is still a lot to do, many communities in the southern United States have already begun to adapt daily life and routines to extreme heat conditions. 

The northern United States is at a frontier of grappling with extreme heat. Places with typically colder climates, like Massachusetts – state motto, “By the sword we seek peace, but peace only under liberty”–  are experiencing extreme heat. The populations here are neither acclimatized to extreme heat nor equipped with the necessary adaptations. This is putting significant pressure on people’s health and livelihoods, the built environment, and the local economy. For example, this summer, the City of Boston declared three heat emergencies, including a June heat wave that smashed previous early season records as temperatures soared to 102°F. In total, the Boston metropolitan area experienced 19 days over 90°F in 2025. By 2030, less than five years away, the area could experience nearly 40 days over 90°F.

Health Dangers of Extreme Heat

Extreme heat exposure causes heat-related illnesses such as heat stress and heat stroke and puts significant pressure on the cardiovascular system and the kidneys, and strains the health of populations with pre-existing conditions or on medications that impact sweat production. While extreme heat can impact everyone, certain populations face higher risks, including children, elderly adults, pregnant mothers, those without access to air conditioning, and outdoor workers. Heat related health impacts are on the rise in Boston.

Protecting human health from extreme heat requires a combination of approaches, including preventing exposure, minimizing risk, increasing adaptive capacity, and bolstering health system preparedness:

• To prevent exposure, decision makers need to consider the “settings” where populations spend the most time from day to day, like homes, schools, child and elder care facilities, workplaces, public transportation, and outdoor recreation spaces, and the institutions and policies that can determine the physical design and operations of these spaces. 
• To minimize risk, populations that are more vulnerable need to be made aware of and protected by strategies that minimize heat gain, such as wearing optimal clothing and reducing behaviors that increase metabolic rate and generate heat.
• To increase adaptive capacity, populations will need to engage in strategies that help their bodies acclimatize to the hotter temperatures as well as recognizing symptoms of over-exposure and taking steps to seek protection or care. 
• To bolster health system preparedness, public safety and health care institutions need to be readied and supported to act quickly and effectively to save lives.

Massachusetts’ Heat Policy Heats Up

Strong policies that support public health response to heat can reduce the risk of systemic failures and protect more lives. To succeed, these policy efforts require public-private partnerships, empowered public health responses, and strong community engagement. 

There is a growing ‘community of practice’ on heat in Massachusetts, consisting of local and state government leaders, academic partners, non-profits, health care institutions, and private sector actors seeking to advance solutions to safeguard lives during heat emergencies and build towards a heat resilient future. Effective partnerships help understand the extreme heat problem, realize new heat-health interventions, develop the evidence around effectiveness, and foster shared accountability. At this critical juncture of changes to federal policy and governance on heat, effective state and local preparedness for extreme heat is critical to safeguard human health, prevent critical infrastructure damages, and secure economic livelihoods. These following cases show what’s possible.

Massachusetts’ Heat-Health Actions and Innovations

Innovation 1. Targeting Assistance to the Most Heat-Impacted Homes and Buildings

In Massachusetts, most residential buildings and many public buildings were designed for a climate with cold winters and temperate summers and were not built with air conditioning (AC) and other cooling systems. The cost and difficulty of retrofitting these buildings for increasingly hot summers is a significant barrier to being better prepared for heat. Many homeowners, renters, and public building operators rely on window AC units, which are both less effective and less efficient than central AC. This in turn increases the cost of operation and monthly energy bills.

For housing, the role of public policy is threefold: (1) establishing minimum habitability standards that affirm a right to cooling, such as indoor temperature maximums for rental housing, (2) maintaining access to energy during extreme heat events through utility shut off moratoriums and expanded energy bill assistance, and (3) streamlining available funds to systematically improve the housing stock to make it more adapted to rising temperatures. The Massachusetts state government can play their part in this ecosystem of protections by regulating utility companies to ensure consumer protections during extreme heat events, improving the floor of minimum habitability through the state sanitation code, bringing together state, federal, and private funding resources that can be used to retrofit the housing stock and develop new housing stock more resilient to extreme heat. Municipal governments’ can play their part by setting beyond code measures to ensure safe indoor temperatures, bringing together resources to serve households in need of housing upgrades, coordinating and empowering local partners to serve the most energy insecure populations and upgrading the public housing stock under their management. Given limited public resources, the most important first step is to prioritize where support should be directed.

Data gathering about risk and vulnerability can help communities get started. With investment from the state of Massachusetts’ Municipal Vulnerability Preparedness program, cities and towns in the Boston metropolitan area, like Everett, have been able to identify their community “hot spots”, where residents experience higher ambient temperatures as a result of urban design choices. This is a part of a broader trend in the Boston metro region to map heat vulnerability, such as the Wicked Hot Mystic Campaign and the Framingham-Natick-Ashland-Holliston Heat Watch Campaign. These higher ambient temperatures can also lead to overheating indoors, requiring more mechanical cooling to maintain habitable temperatures and also limiting the use of passive ventilation cooling at night as cities take longer to cool down. 

With the hot spots identified, key anchor institutions like Cambridge Health Alliance and community organizations like Everett Community Growers are working together to meet the needs of the most vulnerable residents, which includes improving housing’s resilience to extreme heat. One-stop shops for residential weatherization, such as Philadelphia’s Built to Last program, can bring all sources of funding for home improvements under one roof with technical support, making it easier for low-income residents to access available resources. Further, as places like Everett seek to expand their housing supply, it is critical that new stock is built to withstand rising temperatures, mitigate urban heat island effects, and is affordable to current residents.

Boston University’s C-Heat Study is another example of a community-engaged temperature sampling study to understand the lived experiences of residents during extreme heat events. This study places sensors inside of people’s homes in Chelsea and East Boston to see how hot it gets indoors. Many of the homes sampled exceeded temperatures widely recognized as “comfortable” by international standards bodies like the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) in spite of 100% of households having some form of air conditioning. Factors that impacted household’s ability to cool include whether they could use their AC (e.g. due to cost), AC-type, location of the unit, and roof type. Through this critical participatory research, the research team and the community partners developed a set of policy recommendations to mitigate heat’s impacts indoors. These include updates to the state sanitary code or municipal ordinances that set indoor temperature maximums and require AC, weatherization, and other strategies in rental units to maintain safe indoor temperatures, as well as creating programs that encourage landlords to retrofit rental housing. Looking ahead, it will be essential to ensure that the energy needed to run these AC systems is affordable, especially as energy prices rise. The proposed legislation “Energy Affordability, Independence, and Innovation Bill” seeks to lower the cost of energy while also protecting people from utility shutoffs while “An Act Promoting Resilience Against the Heat-Related Impacts of Climate Change” seeks to create energy assistance programs for cooling-related costs.

Publicly-owned buildings and other infrastructure also need to be retrofitted to be more resilient to temperature extremes through cooling system upgrades and passive cooling designs. These strategies benefit populations that spend a significant amount of time in public buildings, such as school-aged children and their instructors. Understanding the scope and scale of the problem is also essential for these buildings. For example, researchers at Boston University (BU) are partnering with Boston Public Schools (BPS) to understand the conditions inside of classrooms. Dr. Patricia Fabian of BU and BPS have installed temperature sensors in over 3,600 rooms within school buildings and created a one-of-a-kind dataset of the state of heat inside of schools. Their results show that within a single school building, the difference between the coolest and hottest classrooms could be more than 26°F. Understanding which classrooms cannot stay cool on extreme heat days is critical for facilities managers and school leadership to be aware of and capable of responding to. It also helps to identify places to target cooling interventions, and justify infrastructure upgrades. The proposed Mass Ready Act would create sources of funding that could be used to finance these identified improvements.

Opportunity Areas for Further Action:

• Expand community-led and cross-sector partnerships to study indoor temperatures and its impacts on population health, wellbeing, and livelihoods.

• Secure near-term access and affordability to cooling by creating programs that provide financial assistance to households that struggle to pay their energy bills.

• Institutionalize cooling in building and housing policy by crafting and implementing building codes and public health regulations that formally integrate thermal safety.

• Retrofit infrastructure for climate resilience, targeting the most vulnerable buildings and homes first. One stop shops for housing upgrades are especially beneficial to reduce the application burden on the most vulnerable homeowners.

• Ensure new construction is built to keep occupants comfortable in the face of anticipated future extreme temperatures.

Innovation 2. Data-Informed Land Use and Urban Planning Solutions to Cool Blocks and Communities

Community-wide cooling solutions can lower ambient outdoor temperatures, reducing the load on indoor cooling systems and mitigating the health risks of being outside. Public policy is a critical enabling function. For example, zoning policy can be leveraged to require or encourage strategies that cool communities, such as urban forestry, shade infrastructure, cool pavements, walls, and roofs, and green roofs. Outdoor spaces under public ownership can be also outfitted with these heat-mitigation strategies, benefiting populations that use transit or primarily walk or bike as well as populations that spend significant amounts of time outdoors. 

Municipal governments in Massachusetts have oversight over land use and zoning as well as own, manage and maintain some public outdoor spaces and right-of-ways. Thus, municipal governments can introduce zoning regulations to drive innovation in heat-resilient design through new construction or upgrades to existing construction. For example, the Massachusetts state government operate the public transportation system, either through the Massachusetts Bay Transportation Authority or 15 Regional Transportation Authorities, manages land and property, and reviews local zoning ordinances for consistency with state law. Thus, the state is responsible for ensuring transportation users have adequate protection from extreme heat exposure and can also be a partner to local governments implementing heat-resilient zoning. The state also is a source of funds, bringing in revenue and also distributing federal dollars. Data on the current impacts of heat can inform the work of land use and urban planners to design high-impact solutions that minimize future heat exposures while also educating the public on heat’s risks.

Governments in the Boston metropolitan area are developing innovative solutions to understanding urban heat. For example, the Boston Region Metropolitan Planning Organization (MPO), the transportation planning agency for the region, was awarded a $1 million dollar grant from the State of Massachusetts to assess heat’s risk to pedestrians and bikers. The “Neutralizing Onerous Heat Effects on Active Transportation” (NO-HEAT) study produced a new set of microclimate data focused on human-scale perception of heat and leveraged that alongside mobility data to identify high-volume routes in vulnerable communities with high risk of heat exposure. Following identification of priority corridors in partnership with Dr. Rounaq Basu of the Georgia Institute of Technology, the project leads from the MPO are now working with municipal staff and advocacy organizations to understand the impacts of this heat risk on people who are walking/biking and identifying solutions that minimize exposure. The project will also make its analysis of heat risk along walk/bike routes public on the Boston Region’s MPO’s website. In addition, an app will be piloted that can guide community members on how to choose transportation routes with more shade and greenery.  Going forward, this work could be expanded to the impacts of heat on public transportation users and how to mitigate that risk, such as through shaded bus shelters and cooling inside T-stations. 

Municipalities are also utilizing their existing resources and policy levers to drive urban transformation. In the City of Cambridge, planners are turning well-known heat islands in the city into gathering spaces with public art installations that reduce heat exposure. The Shade is Social Justice Program partners the City with local and regional artists, such as Massachusetts-based Art for Public Good, on installations around Cambridge that create shaded “third spaces” for public gathering and programming during hotter days. Through art and design, the City of Cambridge is facilitating both public education about extreme heat and its risks, reducing exposure, and creating forums to build community relationships that are key for community resilience. Beyond this work, the City of Cambridge is a leader in resilient land-use policy, creating one of the first performance-based standards for extreme heat mitigation. The “cool score” seeks to drive uptake of infrastructure solutions that mitigate urban heat island effects, and is required for all developments subject to the Green Factor Standard (e.g. new buildings, building enlargements of 50% or more, and surface parking area creation). These efforts underscore the importance of local government programs and policy in both providing and enabling shade and other cooling solutions that lower temperatures community-wide, ultimately benefiting businesses and residents who can stay cooler for less money.

Opportunity Areas for Further Action:

• Identify which stakeholders need to be at the table to create standardized heat vulnerability tools and how they guide decision-making. These tools can be used by city planners, public health departments, and community groups to prioritize high-risk areas and align investments. 

• Understand all the actors inside of each government and at different levels of government who are creating plans to reduce the risk of extreme heat in the built environment (e.g. MPOs and city planning offices) and de-silo these efforts.

• Craft best practices for heat land use and urban planning policy, such as effective heat action and resilience plans, standardized zoning and land use codes, and design guidance for reducing the risk of heat to transportation system users.

• Continue working with the state and fellow Regional Planning Agencies to implement and align the priorities of ResilientMass with ongoing regional planning work

• Invest in both temporary (e.g. pop up shade structures) and long-term solutions (e.g. expanded tree canopy) that mitigate heat at the local level.

Innovation 3. Leveraging an Ecosystem of Health System Partnerships to Advance Extreme Heat Emergency Management 

Across the nation, extreme heat is a public health emergency, causing increased rates of heat-related illness, emergency room visits, hospitalizations, and deaths. These impacts put strain on public safety systems and health care systems. Yet there is no widely agreed upon “playbook” for how to respond to public health emergencies caused by extreme weather events and no agreement on what resources should be made available. Federal law is unclear in its expectations of the roles of state and local governments in heat preparedness and response as well as the federal role in providing assistance. For example, it is unclear if a heat event would qualify for a Major Disaster Declaration under the Stafford Act and/or the Public Health Emergency Declaration under the Public Health Service Act. The costs to human health and wellbeing are not well-captured by the federal disaster declaration processes, which focus on acute and time-bound structural damage. 

The state of Massachusetts has the authority to declare a state of emergency, enabling flexibility to leverage state agency capacity to respond to emerging hazards. There has never been an extreme heat event declared as a state of emergency in Massachusetts. The City of Boston is one of the only municipalities in Massachusetts to have created a local heat emergency pathway and declare heat emergencies. The threshold for declaring a local emergency in Boston is clear, two or more days with a heat index of 95 degrees, which is below the threshold used by the National Weather Service. During these events, the City of Boston opens cooling centers, splash pads, and public pools, as well as creates pathways for shelter for the unhoused. Response is led by the Office of Emergency Management, which relies on federal funding for its operations and staff, and could be impacted by proposed policy changes at the federal level to put the onus of emergency preparedness on state and local governments. Boston’s model is one to learn from, where understanding the successes and challenges can help determine how to replicate across Massachusetts’s municipalities. Effective emergency management relies on public-private partnerships and the health sector is one of the most critical partners in responding to extreme heat.

Safeguarding health during acute extreme heat events is a matter of preparedness.  To be sufficiently prepared, residents should have access to basic information and support on how to effectively protect themselves from extreme heat, reducing their exposures, securing access to cool spaces, and ensuring adequate hydration. This needs to be done in languages that impacted populations speak, which has been done in cities like Los Angeles. More vulnerable residents should be supported in securing these protections by members of their community and by health care teams. For example, health care providers should screen patients for pre-existing conditions that make them more vulnerable to extreme heat, and be able to identify social services programs that can help them mitigate potential exposures, such as energy assistance. For example, the Boston Medical Center has created an innovative “Clean Power Prescription” program to provide energy assistance to the most vulnerable patients in their complex care management program. The Harvard T.H. Chan School of Public Health and Americares have also created a resource guide for physicians and clinics to prepare for extreme heat events, including a ‘Heat Action Plan’ that can be walked through with patients.

When a heat wave is predicted, it is critical to have early warning systems that allow people to activate their preparedness plans and brace themselves for the heat. The Bureau of Climate and Environmental Health at the Massachusetts Department of Public Health has created an unhealthy heat forecast which uses statewide hospitalization data to determine health-based “heat thresholds” for alerting the public and practitioners about upcoming heat events. The Bureau also sends tailored alerts to local public health officials, health care providers, and community-based organizations (this group must opt-in) to help them identify how to spot heat-related illness during the more extreme heat events, three or more days of 85°F. This communication is critical as these personnel are trusted messengers in their communities. Boston-area health systems are also taking action. Mass General Brigham is piloting artificial intelligence-powered tools that utilize patient records to identify those most at risk (e.g. because of age, health conditions, medications and where they live) and then provide patient-specific alerts based on that risk. Cambridge Health Alliance sends email alerts to patients during heat waves.

Finally, during a heat event, the emergency response workforce and the health care workforce needs to be prepared and able to triage and treat surges in heat-related and heat-exacerbated illnesses. Many health care providers are not trained on how to identify and effectively treat heat-related illness, which can hamper their effectiveness. That is why physician training programs like Harvard Medical School are integrating climate change into the curriculum for medical students and offering new fellowships to train climate-ready care providers. Yet these programs are only reaching a small portion of the health professions workforce each year. Scaling these types of programs is needed to ensure a wider swath of the health care workforce knows how to treat heat-illness and its broader impacts on human health, which will in turn improve data accuracy for heat-related health impacts. Additionally, health care systems are also not required to plan for heat and its impacts on care delivery and operations. There is also no regional coordination between systems to manage surges in care needs. Local governments and regional planning organizations like MAPC should be engaged with health care partners about their readiness for extreme heat.

Opportunity Areas for Further Action:

• Test and compare communication strategies (e.g. messages, channels, and messengers) to understand which strategies (e.g. heat alerts in clinical practice) are best at informing and encouraging action-oriented responses from the public.

• Develop screening questions for clinical settings to assess availability of air conditioning, social isolation, and other housing-related conditions as part of health screening.

• Determine what data is needed by municipalities to guide their response actions (e.g. the health impacts of extreme heat) and plan the acquisition of these data sets, like electronic health record data.

• Train local public safety, emergency medical services, health professionals, and other key partners in response to better capture the health impacts of extreme heat.

• Work regionally to develop a heat relief network, such as Maricopa County’s Heat Relief Network, to build connections and collaboration as well as resourcing and personnel sharing to ensure that the entire Boston Metropolitan area is ready for extreme heat.

Conclusion

Extreme heat governance is rapidly maturing to meet the needs of communities unaccustomed to extreme heat, particularly at the local and state levels. As described above, this work cannot be done alone: partnerships and collaborations are necessary to make even modest progress and most effective use of limited resources. Further, the above examples showcase how collaborative research in partnership with key stakeholders can be a powerful tool in guiding local and state government decision-making and informing the policymaking process. Through collective effort, real progress can be made to safeguard health in the face of extreme heat.

The opportunity areas identified by participants at Fostering Collaborations: A Symposium to Advance Equitable Heat Health Actions provide a roadmap for what can come next in local and state heat action in Massachusetts. Interested in getting involved? Please contact Kat Kobylt at KKobylt@mapc.org and head to our website here to learn more.

→ New Report: STAT Network highlights increasing threats, shows how states are rewriting playbooks in real time to protect American health, safety and economic vitality 

→ First-ever survey reveals urgent need for coordinated action: only 5 percent of state health officials feel “very prepared”, 61 percent relied on federal funds now in flux. 

PROVIDENCE, R.I. — November 3, 2025 — A new report from the STAT Network reveals that extreme weather events are jeopardizing the health, safety and economic prospects of Americans. Published today in partnership with the Federation of American Scientists and supported by The Rockefeller Foundation and the Robert Wood Johnson Foundation, the report reveals first-of-its-kind data from state public health officials in 45 states and territories on the urgent need for state-led coordination. The report also spotlights innovations that are being adopted and scaled through the STAT Network despite drastic cuts in federal funding to public health.

“States are navigating a new normal of extreme weather crises—heat waves following floods, wildfires overlapping with hurricanes—while the federal support and data tools they’ve relied on are eroding. No state should be left to shoulder this alone. Through our Extreme Weather & Health group and this report, we elevate what’s working on the ground as states are leading the response and offer a practical roadmap for acting at the speed and complexity of today’s hazards” said Stefanie Friedhoff, Professor of the Practice and STAT Network Lead, Brown University School of Public Health.

The STAT Network, which supports state public health officials across a range of pressing public health issues, started a dedicated extreme weather and health group in August 2024, serving as an essential connection point for collective problem solving in a shifting landscape. Of 136 state respondents who participated in the STAT Extreme Weather & Health survey shared with states in summer 2025: 

→ only 5% feel “very prepared” to handle the escalating public health impacts of extreme weather
→ 61% prepared for extreme weather using federal funds that are now in flux
→ 39% cited federal partnerships as historically one of the most effective mechanisms to address impacts
→ 94% are concerned that socioeconomic disparities moderately (27%) or significantly (67%) contribute to unequal outcomes during extreme weather events in their state.

The new report, Protecting the Health of Americans in the Face of Extreme Weather: A Roadmap for Coordinated Action was developed to support these leaders at this moment of evolving challenges, needs and opportunities. The report details how states are pivoting their preparedness playbooks, showcases replicable new models, and identifies pressing gaps that funders, policymakers and thought leaders must still fill. 

Download the full report

“Extreme weather events are no longer just natural disasters—they’re public health emergencies. From heat waves that overwhelm hospitals to floods that cut off access to care, Americans are feeling the strain in their communities. That’s why The Rockefeller Foundation launched the STAT Network at the height of the COVID-19 pandemic—to strengthen public health infrastructure through interstate collaboration and cross-sector partnerships. That same level of coordination is just as critical today as we face growing threats to health, safety, and economic opportunity” said Derek Kilmer, Senior Vice President for U.S. Program and Policy, The Rockefeller Foundation.

“One in three Americans report being personally affected by extreme weather in just the past two years – illustrating that extreme weather has become extremely common. The good news is that the negative health impacts of extreme weather are largely preventable. FAS is excited to partner with the STAT Network to help states step up as the federal government steps back, putting in place the innovative, evidence-based strategies we need to protect people and communities across the country,” said Dr. Hannah Safford Associate Director of Climate and Environment, Federation of American Scientists.

A changed landscape

Protecting the Health of Americans describes how extreme weather events have become more frequent, severe and widespread. From wildfires that quickly spiraled out of control in Maui and Los Angeles, to illness from extreme heat overloading emergency rooms across the Southwest, to sudden flash flooding from Hurricane Helene catching entire regions off-guard across Appalachia, it is clear that existing playbooks are no longer sufficient to respond to rapidly evolving threats. At the same time, cuts in 2025 at the Centers for Disease Control, the Environmental Protection Agency, the National Weather Service and other federal agencies have removed the backbone of funding, data and technical assistance many states relied on. 

States lead the way

Summarizing ongoing preparedness and response efforts across states, Protecting the Health of Americans offers three pillars for action and shares concrete, replicable examples that emerge from the STAT Extreme Weather & Health Network:

Collaboration. States like Minnesota and California are embedding public health voices in climate and infrastructure decisions, while North Carolina and Texas have demonstrated that shared frameworks like FEMA’s Community Lifelines can unite health, energy and emergency systems under one coordinated response. Partnerships break down silos and accelerate action.

Data. In North Carolina, advanced modeling now informs heat alerts based on real-time health and climate data; Illinois is developing predictive tools that warn hospitals before storms hit; and Alaska’s Local Environment Observer Network turns community observations into early-warning intelligence. States are making data more interoperable, localized and actionable. 

Communication. Massachusetts amplified risk messaging on Triple E and West Nile via medical providers, community groups and local media. California is co-developing an interactive curriculum with community health workers on responding to poor air quality events. Kansas convenes a cross-sector Extreme Weather Events Work Group with community-based organizations to co-create practical toolkits. States are modernizing their communications capacity, building trusted messenger networks and moving past an over-focus on social media outreach.

The new report also includes case examples from states such as Oregon, Arizona and Texas that illustrate how housing insecurity, energy burden, medical dependence on electricity, and lack of access to timely, trusted information add additional burden for low-income, elderly and rural populations—and how systems-level interventions focused on energy resilience, targeted mitigation and partnerships with community-based organizations can save lives.

Insights from this report can serve as a pathway to building community resilience and protecting health from the impacts of extreme weather. Looking ahead, the STAT Network, the Federation of American Scientists and other collaborators look forward to working with state leaders and their partners to translate this roadmap into sustained progress.

The announcement comes ahead of the STAT Network’s participation in The Rockefeller Foundation and Heartland Forward’s “Big Bets for America” convening in Oklahoma City, where leaders across the public, private, and non-profit sectors will discuss opportunities to help communities flourish.

To learn more, download the full report.  

Media Contact:
STAT Network:
Caroline Hoffman
Assistant Director of Content and Strategy
STAT Network at Brown University
caroline_hoffman2@brown.edu 

FAS:
Katie McCaskey
Communications Manager, Media and PR
Federation of American Scientists
(202) 933-8857
kmccaskey@fas.org

About the STAT Network
At a time of unprecedented disruption in the U.S. public health system, the STAT Network serves as a strategic, nonpartisan, practice-focused partner to the state public health workforce in all 50 states as well as three territories. Originally created as the State and Territory Alliance for Testing by the Rockefeller Foundation in 2020 to meet the urgent need for more state-to-state collaboration during the COVID-19 pandemic, the network convenes state health leaders across the country on a weekly basis to problem-solve ongoing threats, share best practices, and support one another. Learn more about STAT at https://sites.brown.edu/stat/ 

About the STAT Extreme Weather & Health sub-network and this report
The STAT Extreme Weather and Health Group was created in August 2024 and meets monthly. Over 480 state officials from public health, preparedness and related departments in 45 states and some countries have attended these sessions over the past year. Between May and July 2025, the Network also fielded a comprehensive Extreme Weather and Health survey, which yielded 136 responses (78% from state officials, 10% from local health officials, and 12% from federal, academic and other partners to state teams). Responses came from 34 states, with near equal participation across the political spectrum. The STAT team also met individually with state- and county-level teams in more than 25 states for in-depth conversations about ongoing response needs and innovations. Protecting the Health of Americans summarizes findings across overall network presentations and discussions, the dedicated state-level survey, and state-level interviews.    

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 transformative impact, 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 bring scientific rigor and analysis to address urgent challenges. More information about our work at the intersection of climate change and health can be found at fas.org/initiative/climate-health.

Earlier this year, FAS sounded the alarm that federal reductions in force, funding pauses and freezes, program elimination, and other actions were stalling or setting back national preparedness for extreme heat – just as summer was kicking into gear. The areas we focused on included:

• Leadership and governance infrastructure
• Key personnel and their expertise
• Data, forecasts, and information availability
• Funding sources and programs for preparedness, risk mitigation and resilience
• Progress towards heat policy goals

With summer 2025 in the rearview mirror, we’re taking a look back to see how federal actions impacted heat preparedness and response on the ground, what’s still changing, and what the road ahead looks like for heat resilience. Consider this your 2025 State of the Heat.

2025 State of the Heat

The State of Summer: How Hot Was It and How Did Communities Cope?

Summer didn’t feel as sweltering this year as it has the past couple of years. That’s objectively true – but only because the summers of 2023 and 2024 were true scorchers.

Summer 2025 was cooler than the past two summers, but still the third-hottest on record. Credit: Amanda Montañez in Scientific American; Source: Copernicus Climate Change Service (data)

Summer 2025 was still the third-hottest on record. High temperature records were shattered across the country. Eight states broke their all-time heat records for June, and in July almost the entire country – including Alaska – saw above-average temperatures. Temperature extremes continued into September. Places like the San Francisco Bay Area experienced their hottest temperatures of the year even as the season turned to autumn. In addition, humidity was a particularly potent threat. One hundred twenty million people experienced near-record humidity this summer alongside temperature extremes. Humidity and heat are a deadly combination because sweating is less effective when humidity is high, raising the risk of overheating and experiencing heat-related illness. This heat led to spikes in heat-related illnesses and hospitalizations, longer droughts, road buckling and damage, and even a federal energy emergency in June 2025.

Since January 2025, and continuing over the course of the summer, FAS’s Climate and Health team has been in regular touch with local and state government officials involved in heat preparedness, response, and resilience. These officials generally shared that heat management activities continued successfully in most places throughout the summer despite disruptions to federal funding and programs. Officials emphasized three specific developments that helped enable that continuity:

1. Tools like the National Weather Service’s HeatRisk tool remained functional. HeatRisk is a critical tool for subnational governments to understand risks, inform and coordinate partners, and design thresholds for emergency response alerts and actions. Further, the Centers for Disease Control and Prevention (CDC)’s Heat and Health Tracker, which monitors heat-related visits in emergency departments across the country, was brought back online following reversals in CDC reductions in force.
2. Some key sources of federal funds, like American Rescue Plan Act (ARPA) funding, remained available. Many local governments – particularly in places without large emergency management programs and Hazard Mitigation Assistance Program (HMGP) funds – have used ARPA funding to support heat response.
3. Low-Income Home Energy Assistance Program (LIHEAP) funding was released after considerable advocacy from the external community and members of Congress. This funding is critical to support home energy assistance for cooling bills.

Yet this continuity is fragile:

• The future of the National Integrated Heat Health Information System (NIHHIS) and the CDC’s Climate and Health program remains uncertain and the National Oceanic and Atmospheric Administration (NOAA) and CDC have faced notable staffing cuts and could face more cuts, jeopardizing the maintenance and existence of tools like HeatRisk and the Heat and Health Tracker. 
• Officials are also concerned about their ability to keep robust heat response programs going in a more austere funding landscape. For example, ARPA funding must be spent by December 31, 2026, and many officials are expecting a steep funding cliff that could lead to cuts to heat-related programs. We are already seeing evidence of this in Miami-Dade County, which eliminated its Chief Heat Officer position as a part of an effort to close a $400 million funding gap that emerged in part as ARPA funds were exhausted. Additional cuts to, and restrictions on, federal health preparedness programs and emergency management programs will also impact the staffing capacity of state and local governments. For example, one of the state officials FAS was working with on heat lost their job because of state budget shortfalls, and others have worried about their future job security.
• Finally, while the LIHEAP program is currently intact, and has bipartisan support in Congress, it could be undermined by Executive Branch pocket rescissions and reductions in force.

The State of Federal Heat Governance: What Changed?

The federal heat landscape continues to be highly dynamic. While extreme heat is no longer a stated priority of the federal government, both this Administration and Congress have acknowledged heat’s risks. Against this backdrop, federal agencies are advancing a mixed bag of heat-related policies. For example:

• The Occupational Safety and Health Administration (OSHA) continues to pursue a heat rule. This rule, which was initiated under the Biden Administration and is a top priority for worker advocates, was included on the Trump Administration’s Unified Agenda as a regulation in development. However, given comments made at summer hearings on this rule, recent reporting has hypothesized that OSHA may model the rule after Nevada’s newer and weaker “performance-based” standards. This rule includes no “trigger temperatures” above which certain protections are required. An evaluation of the Nevada rule’s effectiveness will be limited by cuts to the staff at the National Institute of Occupational Safety and Health (NIOSH), and less funding for NIOSH’s research.
• The National Institutes of Health (NIH) recommits to research on extreme heat and health. The NIH’s Climate Change and Health (CCH) Initiative was reintroduced as the Program on Health and Extreme Weather (HEW). The HEW Program’s strategic framework eliminates language directly referencing climate change and greenhouse gases and aligns with the Department of Health and Human Services’ broader MAHA strategy. As both houses of Congress rejected cuts to the National Institute of Environmental Health Sciences (NIEHS), there could be funding available through NIEHS for studies on the outcomes of heat exposure, long-term health risks, and preventative measures.
• The Government Accountability Office (GAO) says the Federal Emergency Management Agency (FEMA) needs to evaluate its role in addressing extreme heat. A recent GAO report recommended that FEMA improve its benefit-cost analysis for heat, identify heat mitigation projects it might fund, and evaluate its role in heat response – all recommendations from FAS’s 2025 Heat Policy Agenda. FEMA agreed to act partially on the recommendations, citing changes made to HMGP to make extreme heat projects ineligible for standalone funding as a barrier to full action.
• The Department of Energy acknowledges heatwaves as a particular risk. In July, the Department of Energy published a report entitled A Critical Review of the Science of Climate Change. This report has been widely discredited for cherry-picking and misrepresenting scientific studies. However, it is notable that even as the report minimizes the risks of greenhouse gas emissions, it emphasizes the importance of taking action on extreme heat, stating that “heatwaves have important effects on society that must be addressed” and that “inability to afford energy leaves low-income households exposed to weather extremes”. While there are partisan disagreements on how to secure that affordable energy, the report demonstrates that heat risk is an area of consensus between the parties that merits further pursuit.
• The ongoing government shutdown could be used by the Trump Administration to continue their mass firing of federal workers. With the status of Appropriations negotiations stalled, the Office of Management and Budget has asked agencies to prepare contingency plans, and has threatened mass layoffs of furloughed employees. Given that most heat-related activities are not statutorily authorized, this could lead to further cuts to the federal heat workforce. On Friday October 10th, hundreds of workers were laid off across Health and Human Services, including at the CDC’s National Center for Health Statistics and the Administration for Strategic Preparedness and Response.

Congressional actions are also shaping what’s possible for nationwide heat preparedness. To start, the One Big Beautiful Bill Act (OBBBA) cut funding necessary to mitigate extreme heat’s impacts as well as respond to the negative health consequences of heat. Impacts include:

Beyond OBBBA, Congressional appropriations proposals for Fiscal Year (FY) 2026 represent a mixed bag for federal heat policy. The House and the Senate proposals diverge in key ways, and will need to be rectified. Some of the things we are tracking include:

State of the Future: What Comes Next for Heat Policy

Looking ahead, it is essential that the federal government maintains its role as a data collector, steward, and analyst, supports heat-related research and development, supports social services for the most vulnerable American households facing extreme heat. and continues to make investments in state, local, territorial, and tribal (SLTT) governments and their heat mitigation infrastructure and preparedness capacity. At the same time, SLTT governments are rapidly innovating in heat policy, and will be sites of innovation to watch this next year. Our team is tracking promising signs in three key areas:

• More places are standing up heat governance infrastructure. A growing number of state, regional, and local plans acknowledge extreme heat as a risk; at the same time, more and more communities are developing standalone heat preparedness, response, or action plans (see heatplans.org to learn more, and read our “Framework for a Heat Ready Nation” to learn about progress in the Sunbelt region). New heat plans that launched in 2025 include Lincoln-Lancaster Heat Response Plan, the Low Country Heat Action Plan Toolkit, Orange County, NC’s Heat Action Plan, and King County’s Extreme Heat Mitigation Strategy. Many more plans are in the development pipeline. Further, more networks of local governments, including the Ten Across Network and Climate Mayors, are making heat technical assistance a priority.
• More places are expanding their extreme heat protections. Policies that protect people from extreme heat exposure inside of their homes, inside of schools, and at the workplace are also starting to see uptake. LA County set an indoor temperature maximum of 82°F for rental units, creating a legal right to cooling for tenants. Meanwhile, the state of California recently enacted a law that all homes should be able to attain and maintain safe indoor temperatures, without specifying that limit. New Jersey now restricts utilities from shutting off the power due to non-payment from June 15 through August 31; New Jersey is also providing direct utility relief to New Jersey ratepayers. New York State became the first state in the country to regulate extreme heat in schools, setting a maximum temperature threshold of 88F for safe school operations. Finally, in Boston and in New Orleans, ordinances passed that require basic protections from heat, like rest breaks, for all city workers and city contractors. Scaling up these policies that minimize heat overexposure will be critical to be ready for hotter heat seasons to come.
• Regional networks are forming to advance evidence-based public health measures. In light of rollbacks to public health infrastructure at the federal level, two regional networks have formed to coordinate across state public health departments, the West Coast Health Alliance and the Northeast Public Health Collaborative. While the initial focus is on developing evidence-based recommendations on vaccines and combining forces on vaccine procurement for their populations, we will be tracking how these networks address other public health efforts under threat, such as the health risks of extreme heat.

Protecting Americans from extreme heat will require a multiplicity of leadership across the levels of government in the United States and the capacity to connect hundreds of diverse organizations and experts around a shared solution set. To meet this moment, FAS will develop the 2026 State & Local Heat Policy Agenda, a blueprint for polycentric action towards a Heat Ready Nation. The 2026 Heat Policy Agenda will align the growing heat community around a shared set of objectives and equip state and local decision makers with the strategies they can deploy for heat season 2026 and beyond. We are focused on strategies that (1) build government capacity to address the threat of extreme heat and (2) ensure every American can be safe from heat in their homes, in their workplaces, and in their communities. 

Over the next couple of months, the FAS team will be documenting the policy levers available at the state and local levels to address extreme heat and crafting model guidance, model executive orders, model legislation, and financing models. Want to be a part of this effort? Reach out to Grace Wickerson at gwickerson@fas.org if you want to contribute by:

• Identifying promising extreme heat policies as well as evidence for their effectiveness.
• Offering your expertise on potential heat-related policy interventions.
• Sharing about heat-related advocacy efforts and potential technical assistance needs. 
• Raising your hand as an extreme heat champion inside of state or local government.

Extreme heat poses serious and growing risks to children’s health, safety, and education. Yet, schools and childcare facilities are unprepared to handle rising temperatures. To protect the health and well-being of American children, Congress should (1) set policies that guide childcare facilities and schools in preparing for and responding to extreme heat, (2) collect the data required to inform extreme heat readiness and adaptation, and (3) strategically invest in necessary infrastructure upgrades to build heat resilience.

Children are Uniquely Vulnerable to Extreme Heat Exposure and Acute and Chronic Health Impacts

At least five factors drive children’s vulnerability to negative health outcomes from extreme heat, like heat-related illnesses and chronic complications. First, children’s bodies take a longer time to increase sweat production and acclimatize to higher temperatures. Second, young children are more prone to dehydration than adults because a larger percentage of their body weight is water. Third, infants and young children have challenges regulating their body temperatures and often do not recognize when they should act to cool down. Fourth, compared with adults, children spend more time active outdoors, which results in increased exposure to high ambient heat. Fifth, children usually depend on others to provide them with water and protect them from unsafe outdoor environments, but children’s caretakers often underestimate the seriousness of the symptoms of heat stress. Research shows that extreme heat days are linked to increased emergency room (ER) visits for children, especially the 16% of children living at or below the federal poverty line. Extreme heat also exacerbates children’s chronic diseases, like asthma and eczema, increasing health care costs and decreasing children’s overall quality of life.

The Consequences of Chronic Extreme Heat Exposure on Children’s Learning and Well-Being 

Studies show that excess temperatures reduce cognitive functioning. Hot weather also impacts children’s behavior, making them more prone to restlessness, irritability, aggression, and mental distress. Finally, nighttime extreme heat exposure can disrupt sleep patterns, making it harder to fall asleep and stay asleep. These factors can all reduce children’s ability to focus, learn and succeed in school. For each 1°F rise in average annual temperature in school districts without air conditioning or proper heat protections, there is a 1% drop in learning. The Environmental Protection Agency found that these learning losses could translate into nearly $7 billion dollars in annual future income losses if warming trends continue.

Extreme Heat’s Threat to Schools and Childcare Facilities

Rising temperatures force school districts and childcare facilities into a dilemma: choosing between staying open in unsafe heat or closing and disrupting learning and care. 

Staying open can expose students and young children to extreme indoor and outdoor temperatures. The Government Accountability Office found that 41% of U.S. schools need to upgrade their heating, ventilation, and air conditioning (HVAC) systems: upgrades that will cost billions of dollars that schools in low-income areas do not have. Similar infrastructure challenges extend to childcare facilities. Extreme heat also makes outdoor recess more dangerous, as unshaded playgrounds and asphalt surfaces can heat up far above ambient temperatures and pose burn risks. 

Yet when schools close for heat, children still suffer. Even five days of closures for inclement weather in a school year can cause measurable learning loss. Additionally, students may lose access to school meals; while food service continuation plans exist, overheated facilities can complicate implementation. Many children, especially in low-income families, also don’t have access to reliable cooling at home, meaning that when schools close for heat, these children receive little respite. Finally, parents are directly impacted as well: school closures also mean parents lose access to childcare, forcing many to miss work or pay for alternative arrangements, straining vulnerable households. 

Advancing Solutions that Safeguard American Children from the Impacts of Extreme Heat

To support the capacity of child-serving facilities to adapt to extreme heat, Congress should direct the Department of Education to develop extreme heat guidance, technical assistance programs, and temperature standards, following existing state-level policies as a model for action. Congress should also direct the Administration for Children and Families to develop analogous policies for early childhood facilities and daycare centers receiving federal funding. Finally, Congress should direct the U.S. Department of Agriculture to develop a waiver process for continuing school food service when extreme heat disrupts schedules during the school year. 

To support improved federal data collection efforts on extreme heat’s impacts, Congress should direct the Department of Education and Administration for Children and Families to collect data on how schools and childcare facilities are experiencing and responding to extreme heat. There should be a particular focus on the infrastructure upgrades that these facilities need to make to be more prepared for extreme temperatures — especially in low-income and rural communities.Lastly, to foster much-needed infrastructure improvements in schools and childcare facilities, Congress should consider amending Title I of the Elementary & Secondary Education Act or directing the Department of Education to clarify that funds for Title I schools may be used for school infrastructure upgrades needed to avoid learning losses. These upgrades can include the replacement of HVAC systems or installation of cool roofs, walls, and pavement, solar and other shade canopies, and green roofs, trees, and other green infrastructure, which can keep school buildings at safe temperatures during heat waves. Congress should also direct the Administration for Children and Families to identify funding resources that can be used to upgrade federally-supported childcare facilities.

Public health insurance programs, especially Medicaid, Medicare, and the Children’s Health Insurance Program (CHIP), are more likely to cover populations at increased risk from extreme heat, including low-income individuals, people with chronic illnesses, older adults, disabled adults, and children. When temperatures rise to extremes, these populations are more likely to need care for their heat-related or heat-exacerbated illnesses. Congress must prioritize addressing the heat-related financial impacts onthese programs. To boost the resilience of these programs to extreme heat, Congress should incentivize prevention by enabling states to facilitate health-related social needs (HRSN) pilots that can reduce heat-related illnesses, continue to support screenings for the social drivers of health, and implement preparedness and resilience requirements into the Conditions of Participation (CoPs) and Conditions for Coverage (CfCs) of relevant programs. 

Extreme Heat Increases Fiscal Impacts on Public Insurance Programs

Healthcare costs are a function of utilization, which has been rapidly rising since 2010. Extreme heat is driving up utilization as more Americans seek medical care for heat-related illnesses. Extreme heat events are estimated to be annually responsible for nearly 235,000 emergency department visits and more than 56,000 hospital admissions, adding approximately $1 billion to national healthcare costs. 

Heat-driven increases in healthcare utilization are especially notable for public insurance programs. One recent study found that there is a 10% increase in heat-related emergency department visits and a 7% increase in hospitalizations during heat wave days for low-income populations eligible for both Medicaid and Medicare. For every 10 additional days of extreme heat above 90°F, annual Medicaid transfer payments increase by nearly 1%, equivalent to an $11.78 increase per capita. 

Additionally, Medicaid funds services for over 60% of nursing home residents. Yet Medicaid reimbursement rates often fail to cover the actual cost of care, leaving many facilities operating at a financial loss. This can make it difficult for both short-term and long-term care facilities to invest in and maintain the cooling infrastructure necessary to comply with existing requirements to maintain safe indoor temperatures. Further, many short-term and long-term care facilities do not have the emergency power back-ups that can keep the air conditioning on during extreme weather events and power outages, nor do they have emergency plans for occupant evacuation in case of dangerous indoor temperatures. This can and does subject residents to deadly indoor temperatures that can worsen their overall health outcomes.

The Impacts of the One Big Beautiful Bill Act

The One Big Beautiful Bill Act (H.R. 1) will have consequential impacts on federally-supported health insurance programs. The Congressional Budget Office projects that an estimated 10 million people could lose their healthcare coverage by 2034. Researchers have estimated that a loss of coverage could result in 50,000 preventable deaths. Further, health care facilities and hospitals will likely see funding losses as a result of Medicaid funding reductions. This will be especially burdensome to low-resourced hospitals, such as those serving rural areas, and result in reductions in available offerings for patients and even closure of facilities. States will need support navigating this new funding landscape while also identifying cost-effective measures and strategies to address the health-related impacts of extreme heat.

Advancing Solutions that Safeguard America’s Health from Extreme Heat

To address these impacts in this additionally challenged context, there are common-sense strategies to help people avoid extreme heat exposure. For example, access to safely cool indoor environments is one of the best preventative strategies for heat-related illness. In particular, Congress should create a demonstration pilot that provides eligible Medicare beneficiaries with cooling assistance and direct CMS to encourage Section 1115 demonstration waivers for HRSN related to extreme heat. Section 1115 waivers have enabled states to finance pilots for life-saving cooling devices and air filter distributions. These HRSN financing pilots have helped several states to work around the challenges of U.S. underinvestment in health and social services by providing a flexible vehicle to test methods of delivering and paying for healthcare services in Medicaid and CHIP. As Congress members explore these policies, they should consider the impact of H.R. 1’s new requirements for 1115 waiver’s proof of cost-neutrality.

To further support these efforts for heat interventions, Congress should direct CMS to continue Social Drivers of Health (SDOH) screenings as a part of Quality Reporting Programs and integrate questions about extreme heat exposure risks into the screening process. These screenings are critical for identifying the most vulnerable patients and directing them to the preventative services they need. This information will also be critical for identifying facilities that are treating high proportions of heat-vulnerable patients, which could then be sites for testing interventions like energy and housing assistance.

Congress should also direct the CMS to integrate heat preparedness and resilience requirements and metrics into the Conditions of Participation (CoPs) and Conditions for Coverage (CfCs), such as through the Emergency Preparedness Rule. This could include assessing the cooling capacity of a health care facility under extreme heat conditions, back-up power that is sufficient to maintain safe indoor temperatures, and policies for resident evacuation in the event of high indoor temperatures. For safety net facilities, such as rural hospitals and federally qualified health centers, Congress should consider allocating resources for technical assistance to assess these risks and the infrastructure upgrades.

Agriculture, food, and related industries produce nearly 90% of the food consumed in the United States and contribute approximately $1.54 trillion to the national GDP. Given the agricultural sector’s importance to the national economy, food security, and public health, Congress must pay attention to the impacts of extreme heat. To boost the resilience of this sector, Congress should design strategic insurance solutions, enhance research and data, and protect farmworkers through on-farm adaptation measures.  

Extreme Heat Reduces Farm Productivity and Profitability

Extreme heat threatens agricultural productivity by increasing crop damage, causing livestock illness and mortality, and worsening water scarcity. Hotter conditions can damage crops through crop sunburn and heat stress, reducing annual yields for farms by as much as 40%. Animals raised for meat, milk, and eggs also experience increased risks of heat stress and heat-related mortality. For dairy production in particular, an estimated 1% of total annual yield is lost to heat stress alone. Further straining agricultural productivity, extreme heat accelerates water scarcity by increasing water evaporation rates. These higher evaporation rates force farmers to use even more water, drawing often from already stressed water sources. The compounding pressures posed by extreme heat can translate into significant economic losses: a study of Kansas commodity farms found that for every 1°C (1.8°F) increase in temperature, net farm incomes drop by 66%. Together, this means reduced revenue for farms and less food available for people.

Insurance solutions can help mitigate these financial impacts from extreme heat if employed responsibly. Multiple permanently authorized federal programs provide insurance or direct payments to help producers recover losses from extreme heat, including the Federal Crop Insurance Program, the Noninsured Crop Disaster Assistance Program, the Livestock Indemnity Program, and the Emergency Assistance for Livestock, Honey Bees, and Farm-Raised Fish Program. These programs need to ensure that producers are adequately covered against heat-related impacts and incentivize practices that reduce the risk of extreme heat related damages. This in turn will reduce the fiscal exposure of federal farm risk management programs. Congress should call on the United States Department of Agriculture (USDA) to research the feasibility of incentivizing heat resilience through federal crop insurance rates. Congress should also consider insurance premium subsidies for producers who adopt practices that enhance heat resilience for crops and livestock. 

Given the increasing stress of extreme heat on the water systems necessary to sustain agricultural production, National Oceanic and Atmospheric Administration (NOAA) should build on its Weather, Water, and Climate Strategy and collaborate with USDA on a national water security strategy that accounts for current and future hotter temperatures. To enhance system-wide drought resilience, Congress can also appropriate funds to leverage existing USDA programs to support on-farm adoption of shade systems, effective water management, cover crops, and soil regeneration practices. 

Finally, there are still notable knowledge gaps around extreme heat and its impacts on agriculture. These gaps include the long-term effects of higher temperatures on yields, farm input costs, and federal program spending. To address these information gaps and guide future research, Congress can direct the USDA Secretary to submit a report to Congress on the impacts of extreme heat on agriculture, farm input costs and losses, consumer prices, and the federal government’s spending (e.g.,  federal insurance and direct payment programs for losses of agricultural products and the provision of Supplemental Nutrition Assistance Program (SNAP) benefits).

Extreme Heat Lowers Agricultural Workers’ Productivity and Exposes Them to Health Risks

Higher temperatures and resulting heat stress are endangering farmer and farmworker safety and reducing their overall productivity, impacting bottom lines. Farmworkers are essential to the American food system, yet they are among the most vulnerable to extreme heat, facing a 35 times greater risk of dying from heat-related illnesses than workers in other sectors. This risk is intensifying as the sector increasingly relies on H‑2A farmworkers, who are hired to fill persistent domestic farm labor shortages. In many regions, over 25% of certified H‑2A farmworkers are required to work when local average temperatures exceed 90°F, and counties with the highest concentrations of H‑2A workers often coincide with the hottest parts of the country. After the work day, many of these workers return to substandard employer-provided housing that lacks essential cooling or ventilation, preventing effective recovery from daily heat exposure and exacerbating heat-related health risks. On top of the health risks, these conditions make people less effective on the job, which translates to economy-wide impacts: heat-related labor productivity losses across the U.S. economy currently exceeds $100 billion annually.

To address these risks, Congress should pass legislation requiring the Occupational Safety and Health Administration to finalize a federal heat standard that provides sufficient coverage for farming operations. In tandem with Occupational Safety and Health Administration (OSHA) finalizing the standard, USDA should be funded to provide technical assistance to agricultural employers for tailoring heat illness prevention plans and implementing cost-effective interventions that improve working conditions while maintaining productivity. This should include support for agricultural employers to integrate heat awareness into workforce training, resources for safety equipment and education, and support for the addition of shade structures. Doing so would ensure that agricultural workers across both large and small-scale farming operations have access to essential protections, like shade, clean water, and breaks, as well as sufficient capacity to comply. Current funding streams that could have an extreme heat infrastructure “plus-up” include the Environmental Quality Incentives Program and the Farm Service Agency’s microloans program.Lastly, Congress should also direct OSHA to continue implementing its National Emphasis Program on Heat, which enforces employers’ obligation to protect workers against heat illness or injury. OSHA should additionally review employers’ practices to ensure that H2A and other agricultural workers are protected from job or wage loss when extreme heat renders working conditions unsafe.

This memo addresses HUD’s learning agenda question, “How do the impacts, costs, and resulting needs of slow-onset disasters compare with those of declared disasters, and what are implications for slow-onset disaster declarations, recovery aid programs, and HUD allocation formulas?” We examine this using heat events as our slow-onset disaster, and hurricanes as declared disaster.

Heat disasters, a classic “slow-onset disaster”, result in significant damages, which can exceed damage caused by more commonly declared disasters like hurricanes due to high loss of life from heat. The Federal Housing and Urban Development agency (HUD) can play an important role in heat disasters because most heat-related deaths occur in the home or among those without homes; therefore, the housing sector is a primary lever for public health and safety during extreme heat events. To enhance HUD’s ability to protect the public from extreme heat, we suggest enhancing interagency data collection/sharing to facilitate the federal disaster declarations needed for HUD engagement, working heat mitigation into HUD’s programs, and modifying allocation formulas, especially if a heat disaster is declared.

Challenge and Opportunity

Slow-Onset Disasters Never Declared As Disasters

Slow-onset disasters are defined as events that gradually develop over extended periods of time. Examples of slow-onset events like drought and extreme heat can evolve over weeks, months, or even years. By contrast, sudden-onset disasters like hurricanes, occur within a short and defined timeframe. This classification is used by international bodies such as the United Nations Office for Disaster Risk Reduction (UNDRR) and the International Federation of Red Cross and Red Crescent Societies (IFRC).

HUD’s main disaster programs typically require a federal disaster declaration , making HUD action reliant on action by the Federal Emergency Management Agency (FEMA) under the Stafford Act. However, to our knowledge, no slow-onset disaster has ever received a federal disaster declaration, and this category is not specifically addressed through federal policy.

We focus on heat disasters, a classic slow-onset disaster that has received a lot of attention recently. No heat event has been declared a federal disaster, despite several requests. Notable examples include the 1980 Missouri heat and drought events, the 1995 Chicago heat wave, which caused an estimated 700 direct fatalities, as well as the 2022 California heat dome and concurrent wildfires. For each request, FEMA determined that the events lacked sufficient “severity and magnitude” to qualify for federal assistance. FEMA holds a precedent that declared disasters need to have a discrete and time-bound nature, rather than a prolonged or seasonal atmospheric condition.

“How do the impacts, costs, and resulting needs of slow-onset disasters compare with those of declared disasters?” 

Heat causes impacts in the same categories as traditional disasters, including mortality, agriculture, and infrastructure, but the impacts can be harder to measure due to the slow-onset nature. For example, heat-related illness and mortality as recorded in medical records are widely known to be significant underestimates of the true health impacts. The same is likely true across categories.

Sample Impacts

We analyze impacts within categories commonly considered by federal agencies–human mortality, agricultural impacts, infrastructure impacts, and costs for heat, and compare them to counterparts for hurricanes, a classic sudden-onset disaster. Other multi-sectoral reports of heat impacts have been compiled by other entities, including SwissRe and The Atlantic Council Climate Resilience Center.

We identified 3,478 deaths with a cause of “cataclysmic storms” (e.g., hurricanes; International Classification of Disease Code X.37) and 14,461 deaths with a cause of heat (X.30) between 1999-2020 using data from the Centers for Disease Control and Prevention’s (CDC). It is important to note that the CDC database only includes death certificates that list heat as a cause of death, while it is widely recognized that this can be a significant underaccount. However, despite these limitations, CDC remains the most comprehensive national dataset for monitoring mortality trends.

HUD can play an important role in reducing heat mortality. In the 2021 Pacific Northwest Heat Dome, most of the deaths occurred indoors (reportedly 98% in British Columbia) and many in homes without adequate cooling. In hotter Maricopa County, Arizona, in 2024, 49% of all heat deaths were among people experiencing homelessness and 23% occurred in the home.  Therefore, across the U.S., HUD programs could be a critical lever in protecting public health and safety by providing housing and ensuring heat-safe housing.

Agricultural Labor

Farmworkers are particularly vulnerable to extreme heat, and housing can be part of a solution to protect them. According to the Environmental Protection Agency (EPA), between 1992 to 2022, 986 workers across industry sectors died from exposure to heat, with agricultural workers being disproportionately affected. According to the Environmental Defense Fund, farmworkers in California are about 20 times more likely to die from heat-related stress, compared to the general population, and they estimate that the average U.S agricultural worker is exposed to 21 working days in the summer growing season that are unsafe due to heat. A study found that the number of unsafe working days due to extreme heat will double by midcentury, increasing occupational health risks and reducing labor productivity in critical sectors. Adequate cooling in the home could help protect outdoor workers by facilitating cooling periods during nonwork hours, another way in which HUD could have a positive impact on heat.

Infrastructure and Vulnerability

Rising temperatures significantly increase energy demand, particularly due to the widespread reliance on air conditioning. This surge in demand increases the risk of power outages during heat events, exacerbating public health risks due to potential grid failure. In urban areas, the built environment can add heat, while in rural areas residents are at greater risk due to the lack of infrastructure. This effect contributes to increased cooling costs and worsens air quality, compounding health vulnerabilities in low-income and urban populations. All of these impacts are areas where HUD could improve the situation through facilitating and encouraging energy-efficient homes and cooling infrastructure.

Costs

In all categories we examined, estimates of U.S.-wide costs due to extreme heat rivaled or exceeded costs of hurricanes. For mortality, the estimated economic impact of mortality (scaled by value of statistical life, VSL = $11.6 million) caused by extreme heat reached $168 billion, significantly exceeding the $40.3 billion in VSL losses from hurricanes during the same period. Infrastructure costs further reflect this imbalance. Extreme heat resulted in an estimated $100 billion in productivity loss in 2024 alone, with over 60% of U.S. counties currently experiencing reduced economic output due to heat-related labor stress. Meanwhile, Hurricanes Helene and Milton together generated $113 billion in damage during the 2024 Atlantic hurricane season.

Crop damage reveals the disproportionate toll of heat and drought, with 2024 seeing $11 billion in heat/drought impacts compared to $6.8 billion from hurricanes. The dairy industry experiences a substantial recurring burden from extreme heat, with annual losses of $1.5 billion attributed to heat-induced declines in production, reproduction, and livestock fatalities. Broader economic impacts from heat-related droughts are severe, including $14.5 billion in combined damages from the 2023 Southern and Midwestern drought and heatwave, and $22.1 billion from the 2022 Central and Eastern heat events. Comparatively, Hurricane Helene and Hurricane Milton produced $78.7 billion and $34.3 billion in damages, respectively. Extreme heat and drought exert long-term, widespread, and escalating economic pressures across public health, agriculture, energy, and infrastructure sectors. A reassessment of federal disaster frameworks is necessary to appropriately prioritize and allocate funds for heat-related resilience and response efforts.

Resulting Needs

Public Health and Medical Care: Immediate care and resources for heat stroke and exhaustion, dehydration, and respiratory issues are key to prevent deaths from heat exposure. Vulnerable populations including children, elderly, and unhoused are particularly at risk. There is an increased need for emergency medical services and access to cooling centers to prevent the exacerbation of heat stress and to prevent fatalities.

Cooling and Shelter: Communities require access to public cooling centers and for air conditioning. Clean water supply is also essential to maintain health.

Infrastructure and Repair: The use of air conditioning increases energy consumption, leading to power outages. Updated infrastructure is essential to handle demand and prevent blackouts. Building materials need to include heat-resistant materials to reduce Urban Heat Island effects.

Emergency Response Capacity: Emergency management systems need to be strengthened in order to issue early warnings, produce evacuation plans, and mobilize cooling centers and medical services. Reliable communication systems that provide real-time updates with heat index and health impacts will be key to improve community preparedness.

Financial Support and Insurance Coverage: Agricultural, construction, and service workers are populations which are vulnerable to heat events. Loss of income may occur as temperatures rise, and compensation must be given.

Social Support and Community Services: There is an increasing need for targeted services for the elderly, unhoused, and low-income communities. Outreach programs, delivery of cooling resources, and shelter options must be communicated and functional in order to reduce mortality. Resilience across these sectors will be improved as data definitions and methods are standardized, and when allocations of funding specifically for heat increase. 

“What are implications for slow-onset disaster declarations, recovery aid programs, and HUD allocation formulas?”

Slow-onset disaster declarations

No heat event–or to our knowledge or other slow-onset disaster–has been declared a disaster under the Stafford Act, the primary legal authority for the federal government to provide disaster assistance. The statute defines a “major disaster” as “any natural catastrophe… which in the determination of the President causes damage of sufficient severity and magnitude to warrant major disaster assistance to supplement the efforts and available resources of States, local governments, and disaster relief organizations in alleviating the damage, loss, hardship, or suffering caused thereby.” Though advocacy organizations have claimed that the reason for the lack of disaster declaration is because the Stafford Act omits heat, FEMA’s position is that amendment is unnecessary and that a heat disaster could be declared if state and local needs exceed their capacity during a heat event. This claim is credible, as the COVID-19 pandemic was declared a disaster without explicit mention in the Stafford Act.

Though FEMA’s official position has been openness to supporting an extreme-heat disaster declaration, the fact remains that none has been declared. There is opportunity to improve processes to enable future heat declarations, especially as heat waves affect more people more severely for more time. The Congressional Research Service suggests that much of the difficulty might stem from FEMA regulations focusing on assessment of uninsured losses makes it less likely that FEMA will recommend that the President declare a disaster. Heat events can be hard to pin down with defined time periods and locations, and the damage is often to health and other impacts that are slow to be quantified^. Therefore, real-time monitoring systems that quantify multi-sectoral damage could be deployed to provide the information needed. Such systems have been designed for extreme heat, and similar systems are being tested for wildfire smoke–these systems could rapidly be put into use.

The U.S. Department of Housing and Urban Development (HUD) plays a critical role in long-term disaster recovery, primarily by providing housing assistance and funding for community development initiatives (see table above). However, HUD’s ability to deploy emergency support is contingent upon disaster declaration under the Stafford Act and/or FEMA activation. This restriction limits HUD’s capacity to implement timely interventions, such as retrofitting public housing with cooling systems or providing emergency housing relief during extreme heat events. 

Without formal recognition of a heat event as a disaster, HUD remains constrained in its ability to deliver rapid and targeted support to vulnerable populations facing escalating risks from extreme temperatures. Without declared heat disasters, the options for HUD engagement hinge on either modifying program requirements or supporting the policy and practice needed to enable heat disaster declarations.

HUD Allocation Formulas

Congress provides funding through supplemental appropriations to HUD following major disasters, and HUD determines how best to distribute funding based on disaster impact data. The calculations are typically based on Individual and Public Assistance data from FEMA, verified loss data from the Small Business Administration (SBA), claims from insurance programs such as the National Flood Insurance Program (NFIP), and housing and demographic data from the U.S Census Bureau and American Community Survey. CDBG-DR and CDBG-MIT typically require that at least 70% and 50% of funds benefit low and moderate income (LMI) communities respectively. Funding is limited to areas where there has been a presidentially declared disaster.

For example, the Disaster Relief Supplemental Appropriations Act, 2025 (approved on 12/21/2024) appropriated $12.039 billion for CDBG-Disaster Recovery funds (CDBG-DR) for disasters “that occurred in 2023 or 2024.” HUD focused its funding on areas with the most serious and concentrated unmet housing needs from within areas that experienced a declared disaster within the time frame. Data used to determine the severity of unmet housing needs included FEMA and SBA inspections of damaged homes; these data were used in a HUD formula. 

Opportunities exist to adjust allocation formulas to be more responsive to extreme heat, especially if CDBG is activated for a heat disaster. For example, HUD is directed to use the funds “in the most impacted and distressed areas,” which it could interpret to include housing stock that is unlikely to protect occupants from heat.

Gaps

Extreme heat presents multifaceted challenges across public health, infrastructure, and agriculture, necessitating a coordinated and comprehensive federal response. The underlying gap is the lack of any precedent for declaring an extreme-heat disaster; without such a declaration, numerous disaster-related programs in HUD, FEMA, and other federal agencies cannot be activated. Furthermore, likely because of this underlying gap, disaster-related programs have not focused on protecting public health and safety from extreme heat despite its large and growing impact.

Plan of Action 

Recommendation 1. Improve data collection and sharing to enable disaster declarations.

Because lack of real-time, quantitative data of the type most commonly used by disaster declarations (i.e., uninsured losses; mortality) is likely a key hindrance to heat-disaster declarations, processes should be put in place to rapidly collect and share this data.

Health impacts could be tracked most easily by the CDC using the existing National Syndromic Surveillance System and by expanding the existing influenza-burden methodology, and by the National Highway Traffic Safety Association’s Emergency Medical Services Activation Surveillance Dashboard. To get real-time estimates of mortality, simple tools can be built that estimate mortality based on prior heatwaves; such tools are already being tested for wildfire smoke mortality. Tools like this use weather data as inputs and mortality as outputs, so many agencies could implement–NOAA, CDC, FEMA, and EPA are all potential hosts. Additional systems need to be developed to track other impacts in real time, including agricultural losses, productivity losses, and infrastructure damage.

To facilitate data sharing that might be necessary to develop some of the above tools, we envision a standardized national heat disaster framework modeled after the NIH Data Management and Sharing (DMS) policy. By establishing consistent definitions and data collection methods across health, infrastructure, and socioeconomic sectors, this approach would create a foundation for reliable, cross-sectoral coordination and evidence-based interventions. Open and timely access to data would empower decision-makers at all levels of government, while ethical protections—such as informed consent, data anonymization, and compliance with HIPAA and GDPR—would safeguard individual privacy. Prioritizing community engagement ensures that data collection reflects lived experiences and disparities, ultimately driving equitable, climate-resilient policies to reduce the disproportionate burden of heat disasters.

While HUD or any other agency could lead the collaboration, much of the National Integrated Heat Health Information System (NIHHIS) partnership (HUD is a participant) is already set up to support data-sharing and new tools. NIHHIS is a partner network between many federal agencies and therefore has already started the difficult work of cross-agency collaboration. Existing partnerships and tools can be leveraged to rapidly provide needed information and collaboration, especially to develop real-time quantification of heat-event impacts that would facilitate declaration of heat disasters. Shifting agency priorities have reduced NIHHIS partnerships recently; these should be strengthened, potentially through Congressional action.

Recommendation 2. Incorporate heat mitigation throughout HUD programs

Because housing can play such an important role in heat health (e.g., almost all mortality from the 2021 Heat Dome in British Columbia occurred in the home; most of Maricopa County’s heat mortality is either among the unhoused or in the home), HUD’s extensive programs are in a strong position to protect health and life safety during extreme heat. Spurring resident protection could include gentle behavioral nudges to grant recipients, such as publishing guidance on regionally tailored heat protections for both new construction and retrofits. Because using CDBG funds for extreme heat is uncommon, HUD should publish guidance on how to align heat-related projects with CDBG requirements or how to incorporate heat-related mitigation into projects that have a different focus. In particular, it would be important to provide guidance on how extreme heat related activities meet National Objectives, as required by authorizing legislation.

HUD could also take a more active role, such as incentivizing or requiring heat-ready housing across their other programs, or even setting aside specific amounts of funds for this hazard. The active provision of funding would be facilitated by heat disaster declarations, so until that occurs it is likely that the facilitation guides suggested above are likely the best course of action.

HUD also has a role outside of disaster-related programs. For example, current HUD policy requires residents in Public Housing Agency (PHA) managed buildings to request funding relief to avoid surcharges from heavy use of air conditioning during heat waves; policy could be changed to proactively initiate that relief from HUD. In 2024, Principal Deputy Assistant Secretary Richard Monocchio sent a note encouraging broad thinking to support residents through extreme heat, and such encouragement can be supported with agency action. While this surcharge might seem minor, ability to run air conditioning is key for protecting health, as many indoor heat deaths across Arizona to British Columbia occurred in homes that had air conditioning but it was off.

Recommendation 3. HUD Allocation Formula: Inclusion of Vulnerability Variables

When HUD is able to launch programs focused on extreme heat, likely only following an officially declared heat disaster, HUD allocation formulas should take into account heat-specific variables. This could include areas where heat mortality was highest, or, to enhance mitigation impact, areas with higher concentrations of at-risk individuals (older adults, children, individuals with chronic illness, pregnant people, low-income households, communities of color, individuals experiencing houselessness, and outdoor workers) at-risk infrastructure (older buildings, mobile homes, heat islands). By integrating heat-related vulnerability indicators in allocations formulas, HUD would make the biggest impact on the heat hazard.

Conclusion

Extreme heat is one of the most damaging and economically disruptive threats in the United States, yet it remains insufficiently recognized in federal disaster frameworks. HUD is an agency positioned to make the biggest impact on heat because housing is a key factor for mortality. However, strong intervention across HUD and other agencies is held back by lack of federal disaster declarations for heat. HUD can work together with its partner agencies to address this and other gaps, and thereby protect public health and safety.

Record-breaking heat is increasing the need for home cooling solutions to maintain safe and liveable indoor temperatures. Over the last two decades, U.S. consumers and the private sector have leaned heavily into purchasing and marketing conventional air conditioning (AC) systems, such as central air conditioning, window units and portable ACs, to cool down overheating homes. But in the absence of intentional planning, the rapid scaling of AC can intensify dangerous vulnerabilities, including rising energy bills and increased utility debt; surging electricity demand that increases reliance on high-polluting power infrastructure; and increasing pressure on an aging power grid, making it prone to life-threatening blackouts.

To be prepared for more extreme temperatures, Americans need resilient cooling: a holistic strategy that works across three interdependent systems: buildings, communities, and the electric grid. Buildings are the front line of defense, and must be designed to maintain comfortable indoor temperatures both with and without power. Communities comprise the physical environment around and between buildings, where shared infrastructure can cool ambient temperatures, while making indoor environments cooler and safer. And electric grids are the backbone of mechanical cooling, and ensure that buildings and neighborhoods have the power needed to stay safe under extreme conditions. A resilient cooling strategy that works across these systems ensures that everyone can affordably maintain safe indoor temperatures during extreme heat events while reducing power outage risks.

FAS’s new Resilient Cooling Strategy and Policy Toolkit is designed to help state and local policymakers implement resilient cooling in ways that cut costs, protect public health, and reduce grid strain. This toolkit is organized around the Policy Principles for Resilient Cooling, a set of objectives for a robust resilient cooling strategy, and also includes actionable policy options and levers that state and local governments can deploy to expand access to resilient cooling technologies and strategies across technology systems. This work is a part of ongoing translation of FAS’ 2025 Heat Policy Agenda, a national strategy focused on improving extreme heat preparedness, management, and response.

The Policy Principles for Resilient Cooling are:

• Expand Cooling Access and Affordability. Affordable and accessible cooling reduces the population-wide risk of heat-related illness and death. Targeted financial supports, such as subsidies, rebates, and incentives, can reduce both upfront and ongoing costs of cooling technologies, thereby lowering barriers and enabling broader adoption.
• Incorporate Public Health Outcomes as a Driver of Resilience. Indoor heat exposure and heat-driven factors that reduce indoor air quality are health risks. Policymakers can embed heat-related health risks into building codes, energy standards, and guidelines for energy system planning, including by establishing minimum indoor temperature and air quality requirements, integrating health considerations into energy system planning standards, and investing in multi-solving community interventions like green infrastructure.
• Advance Sustainability Across the Cooling Lifecycle. Rising AC demand is intensifying the problem it aims to solve: ambient extreme heat. This happens as AC increases electricity consumption, prolongs reliance on high-polluting power plants, and leaks refrigerants that release powerful greenhouse gases. Policymakers can adopt codes and standards that reduce reliance on high-emission energy sources and promote low-global warming potential (GWP) refrigerants and passive cooling strategies.
• Promote Solutions for Grid Resilience. The U.S. electric grid is struggling to keep up with rising demand for electricity, creating potential risks to communities’ cooling systems. Policymakers can proactively identify potential vulnerabilities in energy systems’ ability to sustain safe indoor temperatures. Demand-side management strategies, distributed energy resources, and grid-enhancing technologies can  ensure its reliability during extreme heat events.
• Build a Skilled Workforce for Resilient Cooling. Resilient cooling provides an opportunity to create pathways to good-paying jobs, reduce critical workforce gaps, and bolster the broader economy. Investing in a workforce that can design, install, and maintain resilient cooling systems can strengthen local economies, ensure preparedness for all kinds of risks to the system, and bolster American innovation.

By adopting a resilient cooling strategy, state and local policymakers can address today’s overlapping energy, health, and affordability crises, advance American-made innovation, and ensure their communities are prepared for the hotter decades ahead. 

For more information and insights on solutions to foster resilience to extreme heat, contact us:

• Autumn Burton, Senior Associate, Climate, Health, and Environment, aburton@fas.org 
• Grace Wickerson, Senior Manager, Climate and Health, gwickerson@fas.org 
• Megan Husted, Climate and Energy Associate, mhusted@fas.org

Every region in the U.S. is experiencing year after year of record-breaking heat. More households now require home cooling solutions to maintain safe and liveable indoor temperatures. Over the last two decades, U.S. consumers and the private sector have leaned heavily into purchasing and marketing conventional air conditioning (AC) systems, such as central air conditioning, window units and portable ACs, to cool down overheating homes. 

While AC can offer immediate relief, the rapid scaling of AC has created dangerous vulnerabilities: rising energy bills are straining people’s wallets and increasing utility debt, while surging electricity demand increases reliance on high-polluting power infrastructure and mounts pressure on an aging power grid increasingly prone to blackouts. There is also an increasing risk of elevated demand for electricity during a heat wave, overloading the grid and triggering prolonged blackouts, causing whole regions to lose their sole cooling strategy. This disruption could escalate into a public health emergency as homes and people overheat, leading to hundreds of deaths. 

What Americans need to be prepared for more extreme temperatures is a resilient cooling strategy. Resilient cooling is an approach that works across three interdependent systems — buildings, communities, and the electric grid — to affordably maintain safe indoor temperatures during extreme heat events and reduce power outage risks. 

This toolkit introduces a set of Policy Principles for Resilient Cooling and outlines a set of actionable policy options and levers for state and local governments to foster broader access to resilient cooling technologies and strategies. For example, states are the primary regulators of public utility commissions, architects of energy and building codes, and distributors of federal and state taxpayer dollars. Local governments are responsible for implementing building standards and zoning codes, enforcing housing and health codes, and operating public housing and retrofit programs that directly shape access to cooling. 

The Policy Principles for Resilient Cooling for a robust resilient cooling strategy are:

• Expand Cooling Access and Affordability. Ensuring that everyone can affordably access cooling will reduce the population-wide risk of heat-related illness and death in communities and the resulting strain on healthcare systems. Targeted financial support tools — such as subsidies, rebates, and incentives — can reduce both upfront and ongoing costs of cooling technologies, thereby lowering barriers and enabling broader adoption. 
• Incorporate Public Health Outcomes as a Driver of Resilience. Indoor heat exposure and heat-driven factors that reduce indoor air quality — such as pollutant accumulation and mold-promoting humidity  — are health risks. Policymakers should embed heat-related health risks into building codes, energy standards, and guidelines for energy system planning, including establishing minimum indoor temperature and air quality requirements, integrating health considerations into energy system planning standards, and investing in multi-solving community system interventions like green infrastructure.
• Advance Sustainability Across the Cooling Lifecycle. Rising demand for air conditioning is intensifying the problem it aims to solve by increasing electricity consumption, prolonging reliance on high-polluting power plants, and leaking refrigerants that release powerful greenhouse gases. Policymakers can adopt codes and standards that reduce reliance on high-emission energy sources and promote low-global warming potential (GWP) refrigerants and passive cooling strategies.
• Promote Solutions for Grid Resilience. The U.S. electric grid is struggling to keep up with rising demand for electricity, creating potential risks to communities’ cooling systems. Policymakers can proactively identify potential vulnerabilities in energy systems’ ability to sustain safe indoor temperatures. Demand-side management strategies, distributed energy resources, and grid-enhancing technologies can prepare the electric grid for increased energy demand and ensure its reliability during extreme heat events.
• Build a Skilled Workforce for Resilient Cooling. Resilient cooling provides an opportunity to create pathways to good-paying jobs, reduce critical workforce gaps, and bolster the broader economy. Investing in a workforce that can design, install, and maintain resilient cooling systems can strengthen local economies, ensure preparedness for all kinds of risks to the system, and bolster American innovation.

By adopting a resilient cooling strategy, state and local policymakers can address today’s overlapping energy, health, and affordability crises, advance American-made innovation, and ensure their communities are prepared for the hotter decades ahead.