Protecting the health of Americans in the face of extreme weather

This report was created to support state and local officials in health, emergency preparedness and related agencies at this moment of evolving challenges, needs and opportunities. It covers the intersection of health and natural disasters, such as wildfires and hurricanes; weather extremes, such as extreme temperatures, air quality and flooding; and weather-related harms, such as vector-borne and fungal diseases that are impacted by weather conditions. It provides framing and specific details on how states are pivoting their preparedness playbooks, showcases replicable new models, and identifies pressing gaps that funders, policymakers and thought leaders must still fill.

This report summarizes findings from three forms of engagement with state health officials and their partners:

1. Presentations and discussions at monthly convenings of the STAT Extreme Weather and Health Network. Over 480 state officials from public health, preparedness and related departments in 45 states as well as some counties have attended these sessions since August 2024 (average session participation: 93).
2. The STAT Extreme Weather & Health Network Survey, an online, anonymous, voluntary survey delivered between May and July 2025 to STAT Network members. Of 136 responses, 78% came 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.
3. Key informant interviews: 44 interviews with teams in 26 states and the District of Columbia, as well as 4 interviews with some of their partners, conducted between December 2024 and September 2025.