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 assessed heat risk used here draws on the CDC’s Heat & Health Index (HHI), which captures far more than temperature alone. The HHI combines 25 indicators across four dimensions: historical heat exposure and heat-related illness at the local level; pre-existing health conditions—such as cardiovascular disease, diabetes, and respiratory illness—that make individuals more vulnerable when heat strikes; sociodemographic factors like income, age, and health insurance coverage that shape people’s ability to cope; and features of the natural and built environment that can amplify or buffer heat exposure. Because the index reflects this full spectrum of vulnerability, the geographic pattern of assessed risk may look different from what temperature maps alone would suggest—areas with moderate temperatures but high rates of chronic disease or limited access to healthcare, for example, can still rank as high risk.

Public worry about heat, by contrast, is rooted in people’s lived experience: how hot it has felt, whether they or their neighbors have been affected, and how salient heat feels as a personal threat. Because these perceptions don’t necessarily track the broader set of health and social factors that drive assessed risk, gaps between risk and worry are common—and worth mapping. When a county faces elevated health vulnerability but residents report relatively low concern, that mismatch can signal a need for more targeted outreach and preparedness support.

The interactive tool below offers two map views. The main view displays the gap between assessed heat risk and public worry, with counties 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. To explore the components behind those gaps, use the pulldown menu at the top of the tool to switch to a dual-map view. In this second view, the left map shows CDC-assessed heat risk and the right map shows public worry about heat, displayed side by side so you can see exactly how each factor contributes to the patterns in the main gap map.

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A Simplified View of the Gap

The map below distills the county-level relationship between assessed heat risk and public worry into a single overview. Each county is colored according to which of the four gap categories it falls into. Counties in red mark what might be called danger zones—places where CDC-assessed health risk is high but residents report relatively low concern about heat, suggesting a potential preparedness gap that merits attention. Yellow counties also face elevated risk, but public worry there is comparatively high, meaning concern and vulnerability are more closely aligned. Blue counties are the inverse: heat risk is lower, yet worry runs high—possibly reflecting recent heat experiences or broader climate anxiety. Pale yellow counties show lower levels of both risk and worry. Taken together, this map offers a quick way to see where the mismatches concentrate geographically—particularly the red areas, where the gap between what experts assess and what residents feel may leave communities less prepared when dangerous heat arrives.

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:

  • Very worried

  • Moderately worried

  • A little worried

  • Not at all worried

(Responses of Very worried or Moderately worried were coded as indicating concern in the analysis.)

The YPCCC is pleased to offer our downscaled heat risk perception estimates to the public. These data are distributed under the following terms of use. This is a legal agreement between you, the end-user (“User”) and Yale University on behalf of the Yale Program on Climate Change Communication (the “YPCCC”).  By downloading the survey data made available on this web site (“Data”) you are agreeing to be bound by the terms and conditions of this agreement.  If you do not agree to be bound by these terms, do not download or use the Data. The YPCCC hereby grants to the User a non-exclusive, revocable, limited, non-transferable license to use the Data solely for (1) research, scholarly or academic purposes, (2) the internal use of your business, or (3) your own personal non-commercial use.  You may not reproduce, sell, rent, lease, loan, distribute or sublicense or otherwise transfer any Data, in whole or in part, to any other party, or use the Data to create any derived product for resale, lease or license.  Notwithstanding the foregoing, you may incorporate limited portions of the Data in scholarly, research or academic publications or for the purposes of news reporting, provided you acknowledge the source of the Data (with express references to the YPCCC, as well as the complete title of the report) and include the following legend: The YPCCC bears no responsibility for the analyses or interpretations of the data presented here.

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Frequently Asked Questions

What does this tool show? This tool maps the gap between how serious extreme heat risk actually is in U.S. counties—based on a comprehensive public health index—and how worried residents of those counties say they are about heat. When assessed risk and public worry don’t match, it can signal communities that may need more targeted outreach and preparedness support.

Where does the heat risk data come from? Assessed heat risk is based on the CDC’s Heat & Health Index (HHI), which integrates 25 indicators across four dimensions: historical heat exposure and heat-related illness; pre-existing health conditions such as heart disease, diabetes, and respiratory illness; sociodemographic factors including poverty, age, lack of health insurance, and social isolation; and features of the natural and built environment like tree canopy, impervious surfaces, and air quality. The index was developed at the ZIP code level and aggregated to counties and states.

Where does the public worry data come from? Estimates of public worry come from a multi-year national survey (2018–2022) of over 11,000 U.S. adults conducted through the IPSOS KnowledgePanel. Respondents were asked how worried they are that extreme heat might harm their local area. Those who answered “very worried” or “moderately worried” were classified as worried. Researchers at Yale University and George Mason University then used advanced statistical modeling—multilevel regression with poststratification, enhanced with machine learning—to produce reliable estimates for every county in the contiguous United States, even those with few or no direct survey respondents.

What do the four categories on the map mean?

The maps sort every county into one of four groups based on whether its assessed heat risk and public worry each fall above or below a threshold:

Higher Risk, Lower Worry (Danger Zone): These counties face elevated health vulnerability from extreme heat, but a relatively small share of residents report being worried. This is the most common pattern nationwide—nearly half of all counties fall into this category—and it is especially prevalent across the Pacific Northwest, Appalachia, Michigan, Georgia, and Maine. The mismatch may leave these communities less prepared when dangerous heat arrives.

Higher Risk, Higher Worry: In these counties, public concern roughly matches the level of assessed risk. They are concentrated along the southwestern border and in parts of Texas and California—places with long histories of intense heat where experiential knowledge aligns more closely with expert assessments. Even here, though, familiarity with heat can breed complacency.

Lower Risk, Higher Worry: These counties have lower assessed health risk but higher-than-expected public concern. Only a handful of counties fall into this category nationwide, which suggests that Americans rarely overestimate heat risk relative to expert assessments.

Lower Risk, Lower Worry: These counties currently face lower assessed risk, and residents report relatively low concern. They are concentrated in the upper Midwest, New England, and parts of the southern Appalachians. However, many of these areas are warming rapidly, have limited cooling infrastructure, and may be unprepared for future heat events.

Why doesn’t the risk map just show the hottest places? Because heat risk to human health depends on much more than temperature. A county with moderate summer temperatures but high rates of chronic disease, widespread poverty, limited healthcare access, older housing stock, or an aging population can face serious health consequences during a heat wave. The CDC’s Heat & Health Index captures this full spectrum of vulnerability, which is why the geographic pattern may look quite different from a simple temperature map.

How is public worry measured and modeled? Survey respondents were asked a single question: “How worried are you that extreme heat might harm your local area?” The research team used a technique called multilevel regression with poststratification (MRP), enhanced with machine learning algorithms (XGBoost, Random Forest, and Elastic Net), to generate county-level estimates from individual survey responses. The models incorporated local climate data, sociodemographic characteristics, and other contextual factors. The final ensemble model achieved a mean absolute error of about 1.6 percentage points when validated against the most heavily surveyed counties.

How is the “gap” between risk and worry calculated? The CDC’s Heat & Health Index was rescaled to a 0–100 range to match the percentage scale of the worry estimates. The gap for each county is simply the rescaled HHI score minus the estimated percentage of residents who are worried about extreme heat. Positive values mean assessed risk exceeds public worry; negative values mean worry exceeds assessed risk.

What are the thresholds for “higher” vs. “lower” risk and worry? Counties are classified as higher or lower assessed risk based on the national median of the Heat & Health Index. For worry, the threshold is 50 percent—whether a majority of residents report being at least moderately worried. Because only about 35 percent of Americans overall say they are worried about extreme heat, very few counties cross the majority-worry threshold, which is why the “higher worry” categories contain far fewer counties.

How many counties fall into each category? The largest group by far is Higher Risk, Lower Worry, with roughly 1,440 counties. Lower Risk, Lower Worry accounts for about 1,550 counties. Higher Risk, Higher Worry contains around 113 counties. Lower Risk, Higher Worry includes just two counties nationwide—Bossier Parish, Louisiana and Tom Green County, Texas—underscoring that underestimation of heat risk is a far more common pattern than overestimation.

Why might people underestimate heat risk? The study finds that risk perceptions are shaped heavily by personal experience—how hot it has felt recently, whether heat has caused visible harm nearby. In regions without a long cultural memory of dangerous heat, or where heat’s health impacts are less visible than those of hurricanes or floods, residents may not recognize their vulnerability. Counties with higher poverty rates and larger shares of residents over 65 tend to show bigger gaps between assessed risk and public concern. Limited historical exposure, older housing without adequate cooling, barriers to healthcare access, and cultural norms of self-reliance can all contribute.

What factors predict the gap between risk and worry? Statistical analysis identified several demographic and socioeconomic factors associated with the size and direction of the gap. Higher poverty rates and larger proportions of residents over 65 are associated with underestimating heat risk relative to expert assessments. Higher educational attainment and larger Black populations are associated with higher perceived risk relative to assessments. Hispanic population share is associated with underestimation, but this pattern reverses in high-poverty Hispanic communities. These relationships likely reflect a complex mix of lived experience, cultural knowledge, access to information, and structural vulnerability.

Does the map show future heat risk? No. The assessed risk reflects current and historical conditions as captured by the CDC’s Heat & Health Index, and the worry estimates are based on surveys from 2018 through 2022. The maps do not project future climate conditions. However, many counties currently classified as lower risk—particularly in the northern United States—are warming rapidly and may face significantly higher heat-health risks in the coming decades, often without the cooling infrastructure or public awareness needed to respond.

Can I look up a specific county? Yes. Use the interactive tool above to search for or click on any county in the contiguous United States. The tool will display that county’s assessed heat risk, estimated public worry, and which of the four gap categories it falls into.

Where can I learn more about the research behind these maps? These maps are based on the study “Experience-driven perceptions misalign with assessed heat risk in the United States” by J.R. Marlon, N. Begotka, and colleagues at Yale University, ClimateCheck, Tulane University, Georgia State University and Georgia Tech, and George Mason University. The study introduces the Risk Analysis–Perception (RAP) framework for systematically quantifying gaps between expert risk assessments and public perceptions. More information about the CDC’s Heat & Health Index is available at the CDC’s Environmental Public Health Tracking Network.