Epidemiology: Occupational and Environmental
Climate and Health
North Carolina is experiencing hotter temperatures, sea-level rise, impaired air quality and more frequent and intense hurricanes and precipitation events as a result of climate change. These hazards diminish health by causing or exacerbating heat-related illness, asthma, respiratory illness, cardiovascular illness, impaired mental health, and other conditions. Existing inequities in environmental health exposures are exacerbated by climate change – older adults, children, low-income earners, outdoor workers, Spanish speakers, indigenous communities, and communities of color are disproportionately affected.
The NC Climate and Health Program collaborates with partners to build community resilience against climate change and its impact on public health by implementing adaptation actions, leading climate and health trainings, conducting epidemiological analyses, and providing technical expertise. Previous funding has been used to address health effects from heat and wildfires through heat syndromic surveillance, heat-health alert systems, education campaigns and wildfire health curriculum. The next 5 years will build on this adaptation work while incorporating climate justice and focusing on flooding effects around the state. Activities respond to Executive Order No. 80, the NC Climate Risk Assessment and Resilience Plan, and an extensive literature on the health effects of climate change. Much of the program’s adaptation work is focused in the Sandhills region of southeastern North Carolina due to its combination of complex hazards, health conditions, historical injustice, and historical resilience.
- North Carolina Climate and Health Profile (PDF, 437 KB)
- Cold Weather-Related Illness Report, North Carolina 2014 (PDF, 174 KB)
- North Carolina Climate-Related Health Indicators: Human Development (PDF, 502 KB) - Rates of infant mortality, pre-term births, childhood cancers.
- North Carolina Climate-Related Health Indicators: Cancer (PDF, 287 KB) - Rates of high ultraviolet days, high temperature days, non-melanoma skin cancer, and colorectal cancer for North Carolina 2000-2011.
- North Carolina Heat Reports - Statewide heat-related emergency department visits are reported with temperature data weekly May through September.
- Evaluation Plan (PDF, 435 KB)
In North Carolina, heat-related illness (HRI) is an annual concern. According to the 2020 North Carolina Climate Science Report, most parts of North Carolina are projected to see at least 2-3 additional weeks of very hot days (maximum temperature of 95°F or higher) for 2021-2040. On average, there are approximately 4,000 emergency department visits for HRI during heat season (May 1 – September 30) in North Carolina. The majority of emergency department visits for HRI are among males, particularly those between the ages of 25-34 years of age. Though anyone can be affected by complications from HRI, older North Carolinians ( > 65 years) are more likely to be hospitalized for HRI.
Learn more about heat-related illnesses and injuries in North Carolina and how to prevent them: Summer Heat Emergency Data and Prevention Tips.
- Heat Community Readiness Report (PDF, 3 MB)
- Heat Implementation and Monitoring Strategy Executive Summary (PDF, 341 KB)
- Heat Implementation and Monitoring Strategy (PDF, 695 KB)
Compound climate hazards from increasing pollen, ozone, and PM 2.5 levels outdoors and moisture in homes from flood damage can trigger asthma, allergies, and respiratory symptoms for sensitive individuals. Impaired air quality from wildfire smoke may contribute to increased emergency department (ED) visits for asthma, cardiovascular disease, and diabetes in North Carolina. For example, the 2008 wildfire season saw an increase in cardiovascular and respiratory ED visits by 42-66%. Eastern North Carolina, the area of the state most affected by floods and wildfires as well as extreme heat, has the highest rates of emergency department visits for asthma.
- Smoke Community Readiness Report (PDF, 4 MB)
- Smoke Implementation and Monitoring Strategy Executive Summary (PDF, 417 KB)
Extreme Weather Events
Increasing frequency and intensity of precipitation and extreme weather events, specifically hurricanes, has caused extensive and widespread flooding along the coast and in the southeastern region of NC. These events can have a myriad of short-term and long-term public health impacts, including storm-related injuries, transportation fatalities, carbon monoxide poisonings, exposures to floodwaters containing pathogens, respiratory illness, and mental health impacts.
The North Carolina Climate and Health Program is part of a national public health effort to anticipate and prepare for human health effects related to global and local climate change. The program has been supported by the Centers for Disease Control and Prevention's Climate and Health Program since 2010 and was recently awarded funding to continue and expand climate and health adaptation work through 2026.
Guidry, V.T., Thie, L., & Money, E. B. (2020). Health Benefits of North Carolina's Transition to Clean Energy. North Carolina Medical Journal, 81(5), 334-335.
Thie, L., & Tart, K. T. (2018). On the front lines of climate health effects in North Carolina. North Carolina Medical Journal, 79(5), 318-323.
Sun, X., Waller, A., Yeatts, K. B., & Thie, L. (2016). Pollen concentration and asthma exacerbations in Wake County, North Carolina, 2006–2012. Science of the Total Environment, 544, 185-191.
- Governor's 2018 Executive Order 80: NC Commitment to Clean Energy
- 2019 Statewide Heat Emergency Response Plan
- 2020 NC Climate Risk Assessment and Resilience Plan Health Chapter
- NC DHHS 2021 Resilience Strategy Report
- 2018 Early Childhood Action Plan (ECAP)
- Convergence: A Climate and Health Resource for the Carolinas
- Adaptation Plan for Addressing Health Impacts of Climate Change in North Carolina (PDF, 130 KB)
Last Modified: 01-12-2023