Resilience in Public Health

Although we haven't yet seen a significant increase in extreme heat events in Minnesota, climate change is expected to increase the frequency and severity of heat events in the future.  Some areas of Minnesota could see over 50 days with temperatures above 90°F by 2060, depending on the emissions scenario.⁴ Exposure to temperatures that approach or exceed our core temperature (98.6°F) requires our bodies to enact processes to cool down, such as sweating. The greater the difference between ambient air and body core temperatures, the harder our bodies have to work. Factors like age, pregnancy, pre-existing conditions, medication usage, occupation, and humidity can increase the risk of heat illnesses and impacts.^5–7 In addition, urban areas can have hot spots measuring up to 20°F warmer than neighboring areas.⁸ For example, a recent heat mapping campaign showed up to an 11°F difference between locations in Hennepin and Ramsey counties.⁹ Heat events can also indirectly affect our health care infrastructure by increasing emergency medical services (e.g., ambulance, first responders) calls and emergency department visits, for example, or causing power outages.

As the climate changes, warmer temperatures and humidity can increase the concentration of ground-level pollution.¹⁰ Particulate matter (PM), ozone, and other pollutants from sources such as industrial pollution, fossil-fuel combustion, and wildfire smoke are well-known to cause impacts to human health, including neurological disorders, respiratory diseases, cardiovascular disease exacerbation, skin and eye irritation, and cancer.¹¹ The smaller (or finer) the molecule, the deeper it can travel into our lungs, leading to more severe health outcomes.¹¹ While the current and future effects of climate change on wildfires in Minnesota are not yet clear, the area burned by wildfire is increasing in the western U.S. and Canada as a result of climate change and wind can carry wildfire smoke from regions across the continent, exposing Minnesotans to hazardous pollutants.^10,12,13 Further, with shifting precipitation patterns increasing wildfire risks, air quality alerts may surpass the usual five-to-seven per year. In 2023, for example, a record of 21 alerts were issued over 52 days.¹⁴ Recommendations for staying safe during poor air quality days often include reducing outdoor activities and remaining indoors with doors and windows closed. However, there are growing concerns about indoor air quality, especially for older homes, wood-burning or gas appliances, and outdated HVAC systems.¹⁵ 

Events like floods and drought can alter water quality, leading to increased frequency of diseases. For example, following flooding events, water management systems can overflow and contaminate drinking water and well systems, leading to an increase in gastrointestinal diseases.¹⁶ Increased rainfall intensity, and associated runoff at some times of year, could cause more rainfall-driven floods, with complex changes to how the landscape cycles water (e.g., less snowpack, more fall rains, higher evaporation, etc.) expected to cause more frequent transitions from flood conditions and drought¹⁷, challenging our food and water system^18,19, and could lead to increasing foodborne illnesses like Salmonella and norovirus.²⁰ The stress of these events can impact the physical, mental, and emotional health of Minnesotans. 

Minnesota is all too familiar with mosquitoes and ticks; however, with a changing climate, the prevalence of mosquitos and ticks and associated illnesses will likely increase throughout the state.² For example, the blacklegged (deer) tick habitat range has expanded north and westward in recent decades.^21,22 Deer ticks are of special concern as they can transmit several diseases, including Lyme Disease, Anaplasmosis, and Babesiosis. Climate change may also expand the range of suitable habitat for other vectors and introduce new species to Minnesota, including the Lone Star Tick (Alpha gal syndrome)^23,24 and A. aegypti mosquito (dengue, Yellow Fever, Zika, and chikungunya).²⁵ Similarly, habitats are changing globally, so diligence in travel preparedness and precaution is essential.

1. US EPA, O. Social Vulnerability Report. https://www.epa.gov/cira/social-vulnerability-report (2021). 

2. Schramm, P. J. et al. Human Health. Fifth National Climate Assessment https://nca2023.globalchange.gov/chapter/15/ (2023). 

3. Heat-related Illness Emergency Department Visits: MNPH Data Access - MN Dept. of Health. MN Data https://data.web.health.state.mn.us/heat_ed. 

4. Liess, S. et al. MN CliMAT. Fine-scale Climate Projections over Minnesota for the 21st Century. https://app.climate.umn.edu/?output_type=numDif&scenario=ssp370_2060-2079&model=ensemble&variable=tmax-degF&time_frame=yearly&aoi=p%7EMN_outline%7E0#intro_pane (2025). 

5. Narayanan, A., Rezaali, M., Bunting, E. L. & Keellings, D. It’s getting hot in here: Spatial impact of humidity on heat wave severity in the U.S. Sci. Total Environ. 963, 178397 (2025). 

6. Sobolewski, A., Młynarczyk, M., Konarska, M. & Bugajska, J. The influence of air humidity on human heat stress in a hot environment. Int. J. Occup. Saf. Ergon. 27, 226–236 (2021). 

7. Sorensen, C. & Hess, J. Treatment and Prevention of Heat-Related Illness. N. Engl. J. Med. 387, 1404–1413 (2022). 

8. Urban Heat Islands - Heat.gov. https://heat.gov/urban-heat-islands/. 

9. New urban heat island data pinpoints hottest spots in metro area | Ramsey County, Minnesota. https://www.ramseycountymn.gov/news/new-urban-heat-island-data-pinpoints-hottest-spots-metro-area. 

10. Impact of anthropogenic climate change on wildfire across western US forests | PNAS. https://www.pnas.org/doi/full/10.1073/pnas.1607171113. 

11. Nolte, C. G. et al. Air Quality. Fifth National Climate Assessment https://nca2023.globalchange.gov/chapter/14/ (2023). 

12. US EPA, O. Climate Change Indicators: Wildfires. https://www.epa.gov/climate-indicators/climate-change-indicators-wildfires (2025). 

13. O’Dell, K. et al. Estimated Mortality and Morbidity Attributable to Smoke Plumes in the United States: Not Just a Western US Problem. GeoHealth 5, e2021GH000457 (2021). 

14. MPCA meteorologists forecast another summer of increased air quality alerts for Minnesota | Minnesota Pollution Control Agency. https://www.pca.state.mn.us/news-and-stories/mpca-meteorologists-forecast-another-summer-of-increased-air-quality-alerts-for-minnesota (2025). 

15. Indoor Air Quality - Joseph M. Seguel, Richard Merrill, Dana Seguel, Anthony C. Campagna, 2017. https://journals.sagepub.com/doi/10.1177/1559827616653343. 

16. Cann, K. F., Thomas, D. R., Salmon, R. L., Wyn-Jones, A. P. & Kay, D. Extreme water-related weather events and waterborne disease. Epidemiol. Infect. 141, 671–686 (2013). 

17. Akinsanola, A. A., Kooperman, G. J., Reed, K. A., Pendergrass, A. G. & Hannah, W. M. Projected changes in seasonal precipitation extremes over the United States in CMIP6 simulations. Environ. Res. Lett. 15, 104078 (2020). 

18. Special Report on Climate Change and Land — IPCC site. https://www.ipcc.ch/srccl/. 

19. Effects of climate change on midwestern ecosystems: Eastern North American temperate freshwater marsh, wet meadow and shrubland | U.S. Geological Survey. https://www.usgs.gov/publications/effects-climate-change-midwestern-ecosystems-eastern-north-american-temperate. 

20. Awad, D. A., Masoud, H. A. & Hamad, A. Climate changes and food-borne pathogens: the impact on human health and mitigation strategy. Clim. Change 177, 92 (2024). 

21. Eisen, R. J., Eisen, L. & Beard, C. B. County-Scale Distribution of Ixodes scapularis and Ixodes pacificus (Acari: Ixodidae) in the Continental United States. J. Med. Entomol. 53, 349–386 (2016). 

22. Changing Geographic Range of Vectorborne Disease - MN Dept. of Health. https://www.health.state.mn.us/diseases/vectorborne/vectorborne.html. 

23. Current and Future Distribution of the Lone Star Tick, Amblyomma americanum (L.) (Acari: Ixodidae) in North America | PLOS One. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0209082. 

24. Thompson, J. M. Geographic Distribution of Suspected Alpha-gal Syndrome Cases — United States, January 2017–December 2022. MMWR Morb. Mortal. Wkly. Rep. 72, (2023). 

25. Khan, S. U. et al. Current and Projected Distributions of Aedes aegypti and Ae. albopictus in Canada and the U.S. Environ. Health Perspect. 128, 057007 (2020).