In recent years, the scientific community has identified a number of connections between climate change and cancer. The environmental impacts of climate change can increase exposure to cancer risk factors and hinder access to cancer care. Since cancer remains the second-leading cause of death in the United States, it’s important to better understand its relationship to the evolving climate crisis.

To identify the states facing the greatest cancer risks from climate change, we analyzed the state rankings assigned by Trust for America’s Health, a public health policy organization that worked in concert with Johns Hopkins Bloomberg School of Public Health researchers. They measured each states’ vulnerability to overall public health impacts resulting from climate change. 

We then weighed those scores against each state’s annual rate of new cancer cases and the state’s percentage of adult smokers to provide context to the most at-risk populations for cancer.

Southern States Rank Worst, Western U.S. Faces Better Odds

States facing cancer risks from climate change

Among the states most vulnerable to cancer risks from climate change, Kentucky takes the top spot. California ranks as the least-vulnerable state in the country. 

Geographic location, demographics or a combination of both make some states more vulnerable than others. The southern region’s increased potential for severe storms, combined with high rates of both smokers and overall cancer cases, propelled the area’s states to the top of the rankings.

Kentucky Faces Greatest Cancer Risks from Climate Change

The vulnerability to cancer risk from climate change for Kentucky

Kentucky received a score of 5.9 out of 10 from the Trust for America’s Health report on states’ climate change vulnerability for public health impacts. By contrast, Florida scored the highest in the study with a 6.3 and Alaska was identified as having the lowest vulnerability with a score of 3.4. 

The state of Kentucky reached the No. 1 spot in our rankings by also being home to one of the highest populations of smokers in the country. Cigarette usage is common among 23.6% of the population, compared to the national average of 14%. Kentucky residents also have the country’s highest cancer rate with 503 new cases per 100,000 residents, compared to the national rate of 436.

The state is facing climate change dangers in the form of extreme heat, drought, inland flooding and wildfires. One study estimates that by 2050, Kentucky will have 72 dangerous heat days a year, plus a 95% increase in summer drought and 14 more days at risk of wildfires.

California Is Least Vulnerable to Cancer Risks from Climate Change

The vulnerability to cancer risk from climate change for California

California leads the states identified as the least vulnerable to cancer risks from climate change. Although it received a midrange score of 5.5 out of 10 from the Trust for America’s Health report, the state is among the lowest-ranking states for both smoking population (10%) and new incidences of cancer (388).

Led by a political environment that champions climate reform and clean energy, the state is at the forefront of global efforts to address climate change. California has pledged to reduce methane emissions 40% below 2013 levels by 2030, a commitment that exceeds the pace of most global standards.

Connecting Climate Change to Health Dangers

How climate change affects cancer

Changes to Earth’s climate affect human health — and specifically cancer — through multiple indirect ways. Research has tied increased risks from carcinogens to climate-related sources.

Reduced Air Quality

Air pollution is a known cancer danger, especially for those already dealing with respiratory cancers such as mesothelioma or lung cancer. One side effect of the planet’s rising temperatures is reduced air quality, caused by an increase in air pollutants. 

Wildfires have increased in frequency and intensity as climate change worsens, releasing large amounts of carcinogenic air pollutants into the atmosphere. Massive Northern California wildfires in 2020 created the worst air quality in the world, with particulate matter drifting all the way across the country.  

Extreme weather events such as hurricanes often cause flooding that can also lead to air contamination. Hurricane Harvey hit Texas hard in 2017, resulting in the flooding of chemical plants and oil refineries that released large quantities of carcinogenic substances into the Houston metro area.

Ozone Depletion Means More UV Exposure

The hole in the planet’s ozone layer was discovered in 1985 and has fluctuated in size ever since. The ongoing depletion of this protective layer has created an increase in exposure to the sun’s dangerous ultraviolet rays, which are known to heighten the risk of skin cancer.

Carcinogenic Fungi

Researchers have projected a potential future impact of climate change on the world’s food supply. There are concerns about increased dietary exposure to a potent carcinogen known as aflatoxin, which is produced by specific fungi that can contaminate critical agricultural food crops. It is most often associated with an increased risk of liver cancer.

How climate change impacts cancer services

Climate Change Disrupts Cancer Care

Prevention, diagnosis and treatment are all critical steps in cancer care. Climate change can easily disrupt access to the entire cancer care continuum, leaving patients with cancer particularly vulnerable to the effects of related natural disasters. 

Lack of Access for Patients During Extreme Weather Events

The growing intensity — and unpredictability — of extreme weather events is exacerbating the public’s vulnerabilities in both preparing for and responding to cancer concerns during such circumstances. Because cancer patients often require frequent interactions with the health care system, sudden disruptions in accessing care during extreme winter storms or hurricanes can have dangerous health consequences. 

One study found that lung cancer patients who missed their radiotherapy due to a hurricane experienced significantly worse health outcomes than those who did not have a disruption in care. Another published report noted that breast cancer patients who survived Hurricane Katrina had a drastically lower 10-year survival rate than those who hadn’t experienced the weather disaster.

The cancer risks of extreme weather aren’t limited to those previously diagnosed. They also directly impact those seeking preventative screenings and related care by limiting their access and ability to receive diagnoses and treatment early. 

Risks to Medical Infrastructure

Climate change-related extreme weather events also impact medical facilities that don’t necessarily see patients, such as laboratories and medical manufacturers. Loss of power or transportation disruptions can have a major effect on research into improving cancer care and the production of critical cancer medications and equipment.

For example, one factory in Puerto Rico that was responsible for producing IV bags used in many U.S. hospitals was shut down after Hurricane Maria hit the island in 2017. This resulted in a national shortage of IV fluids, and many cancer facilities struggled to continue administering lifesaving treatments.

Staffing shortages following extreme weather events are another concern. One study found that following a natural disaster such as a tsunami, only 38%-47% of medical staff reported back to work within one month. Related staffing shortages could potentially continue for up to 18 months.

How to reduce cancer risks from climate change

Strategies to Combat Climate Change Cancer Risks

Experts have a variety of recommendations for alleviating the impact of climate change on cancer and other health issues. Adaptation is key to mitigating the severity of these risks.

Reduce Greenhouse Emissions

Strategies to reduce greenhouse gas emissions and other hazardous air pollutants are an important step toward reversing climate change effects. Energy-efficient power plants, more efficient industrial processes and fewer vehicle miles traveled will all help to decrease toxic outputs of traditional fossil fuel-based power generation and commercial transportation.

The United States rejoined the Paris Agreement, an international effort to globally reduce carbon emissions, in January 2021. The participation in this United Nations-backed plan should help reduce cancer risks and mortality rates through improved air quality and promotion of healthier lifestyles.

More Urban Green Spaces

In order to offset air pollution, creating more (and preserving existing) green spaces in urban settings is strongly recommended. These spaces have been shown to reduce harmful exposure to air pollution and combat climate change by storing carbon dioxide.

They also promote more healthy lifestyles, which aid in reducing cancer risks. Improving air quality and investing in green public spaces may result in people spending more time outdoors and help encourage physical activity.

Increase Use of Sun Protection

While it’s not a new solution, encouraging vigilant sun safety is important to reducing the risk of cancer from increased UV radiation. Taking steps to stay covered up while in the sun and increasing the use of environmentally friendly sunscreen will help individuals better protect themselves.

Climate change is a serious issue facing our planet and it has a powerful impact on increased cancer risks. Understanding where the two overlap will help you identify what steps you can take to mitigate the effects.

Our research team analyzed multiple data sources to develop a better understanding of the impact of climate change on cancer risks in all 50 states. We then ranked each state on a weighted scale based on the following standards:

  • State preparedness for climate change and health challenges scores — 50 points
  • Percentage of current adult smokers over 18 — 20 points
  • Average annual count of new cancer cases per capita — 30 points

We began with scoring data from Trust for America’s Health report, “Climate Change & Health: Assessing State Preparedness,” which measured states’ vulnerability to overall health dangers due to climate change. We then looked at the Centers for Disease Control and Prevention’s numbers on current smoking prevalence among adults over 18 and its stats on per capita incidences of new cancer rates.

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