Where Heat Risk and Public Concern Diverge Across U.S. Counties
Extreme heat is one of the most serious and growing threats to public health in the United States—but many of its harms are preventable. Preparing for heat waves depends not only on where risks are highest, but also on whether people recognize those risks and take protective action. Research shows that public concern about extreme heat often does not match expert assessments of heat-related health risk. These gaps matter: when heat risks are underestimated, communities may be less prepared, while overestimation can distort priorities. Understanding where heat risk and public concern align—or diverge—is essential for effective communication, planning, and climate adaptation.
The map below shows how assessed extreme heat health risk compares with public worry about heat across U.S. counties. By combining a health-based heat risk index with survey-based estimates of residents’ concern, counties are grouped into four categories reflecting whether risk and worry are high or low. The resulting patterns highlight places where heat risk may be underestimated, overestimated, or well aligned with public concern—offering guidance for targeted communication, preparedness, and policy responses
Full article.
This map is based on a peer-reviewed study published in Nature Communications that examines how public concern about extreme heat aligns, or fails to align, with assessed heat-related health risk across the United States. The researchers combined a national public health heat risk index from the U.S. Centers for Disease Control and Prevention with survey-based estimates of how worried residents are about extreme heat, modeled at the county level using data from more than 11,000 survey responses collected between 2018 and 2022. By comparing these two measures, the study identifies places where heat risks may be underestimated or overestimated by the public, with implications for risk communication, preparedness, and climate adaptation policy.
This map combines two independent data sources to assess how public concern about extreme heat aligns with expert assessments of heat-related health risk. Assessed heat risk is measured using the CDC’s Heat and Health Index, which integrates historical heat exposure, health sensitivity, sociodemographic vulnerability, and environmental factors. Public worry about extreme heat is estimated using nationally representative survey data collected between 2018 and 2022. The percentage of residents worried about extreme heat in each county is modeled using multilevel regression with poststratification (MRP), a standard method for producing small-area estimates from survey data. Both measures are rescaled to a common 0–100 range, and the difference between assessed risk and perceived risk is calculated to identify alignment gaps at the county level.
Counties were grouped into quadrants based on heat risk and heat worry. High versus low heat risk was defined relative to the median risk value, with counties above the median categorized as high risk and those below as low risk. High versus low heat worry was defined using a majority threshold, with values above 50 classified as high worry and values at or below 50 classified as low worry. These thresholds produced four quadrants representing all combinations of risk and worry.
The exact survey question wording used in the study is:
“How worried are you that extreme heat might harm your local area?”
Respondents could answer using the following response options:
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Very worried
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Moderately worried
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A little worried
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Not at all worried
(Responses of Very worried or Moderately worried were coded as indicating concern in the analysis.)
How to read this map
Each county is classified into one of four categories based on whether assessed heat health risk and public worry about extreme heat are relatively high or low. Counties with high risk and low worry represent potential “blind spots,” where heat threats may be underestimated and additional communication or preparedness efforts could be needed. Counties with high risk and high worry show alignment between risk and concern, but may still face structural barriers to protection. Counties with low risk and high worry suggest possible overestimation of risk or emerging concerns, while low risk and low worry counties generally reflect lower current exposure but may still require monitoring as climate conditions change. Hovering over a county provides detailed values and a suggested action tailored to each category.