Climate-Burdened States Least Prepared for Health Impacts, NRDC Analysis Finds

States facing the greatest health damage from climate change are the least equipped to protect their residents.

Across the United States, climate change is intensifying extreme weather events, resulting in escalating public health harms and severe economic damage. For example, devastating inland flooding in Texas in 2025 killed 134 people and damaged $1 billion worth of residential property; 2025’s catastrophic wildfires in Southern California destroyed more than 10,000 buildings (at a cost of $63 billion) and triggered more than 8,000 health-care visits; and Hurricane Milton’s 2024 landfall in Florida killed 32 people and damaged $34 billion in property. These climate costs are typically borne by disaster victims, insurers, state agencies, and the federal government. Given the retreat of federal leadership from climate policy, state governments are increasingly looking to improve preparedness and resiliency in order to reduce future costs and health impacts.

However, a new analysis led by NRDC and published in the journal Health Affairs sheds light on key state-level gaps between climate change–linked health damage and levels of preparedness. We find that some of the most climate-burdened states are the least equipped to help their residents recover from climate disasters and prepare for future dangers. The intersection of escalating climate risks and adaptation vulnerabilities demands state policy intervention. Better integrating social protection policies into state climate resiliency plans can help states close these gaps and better safeguard their residents.

READ THE FULL ISSUE BRIEF: Who Can Weather the Storm? (PDF)

By Dr. Vijay Limaye; Director, Applied Research Initiatives, Science Office & International, NRDC