Wildfire smoke, September 2020, East Wind Creek near Crow Agency. Photo courtesy of John Doyle.




Title Page




List of Acronyms




Summary of Key Messages and Recommendations

Literature Cited


01. Introduction

Concerns for the Vulnerable

Report Purpose and Genesis

Literature Cited


02. Climate Change and Human Health in Montana

Montana’s Unique Geography

Climate Differs from Weather

The Science of Projecting Montana’s Future Climate: An Overview



Climate Concerns for Human Health

Extreme heat

Smoke and air quality

Climate “surprises”


Literature Cited


03. Climate-related Health Impacts

Extreme Heat

Human impacts from excessive heat

Assessing heat impacts specific to Montana

Air Quality Issues


Wildfires and wildfire smoke

Water-related Illnesses

Food Security and Nutrition Concerns

Vector-borne Disease

Mental Health Concerns

Literature Cited


04. Whose Health is MostVulnerable to Climate change Impacts?

Montana’s Health Profile

Montana is a rural state

Health-wise, where you live matters

Key health issues in Montana

Populations Vulnerable to Climate Change

People with existing chronic conditions

People threatened by increased heat

People living in proximity to wildfire and smoke

People facing food and water insecurity

People who are very young, very old, or pregnant

People with limited access to healthcare services

People living in poverty

American Indians

People lacking adequate health insurance

People with mental health issues

What Conclusions Can We Draw?

Literature Cited


05. Climate Health Actions

Community Actions: Teaming Up for Success

Steps to create a community climate action plan

Act on climate change not only for public health, but also economic well-being

Communities need climate and health data for planning and action

Strategies and actions for communities

Strategies and Actions for Healthcare Practitioners and Institutions


Healthcare institutions

Strategies and Actions for Individuals

Extreme events and disaster planning


Air quality

Flood and drought

Food security

Vector-borne disease

Mental health: getting involved and finding support

What Professional Organizations are Saying

Literature Cited


06. Moving Forward


Appendix A. Analysis of Vulnerability to HeatBased on Historic and Future Temperature, as well as Socioeconomic Factors

Multi-criteria Decision Analysis

Exposure Calculations

Sensitivity Calculations

Weighting Scheme


Literature Cited


Appendix B. Community Tools and Resources




List of Contributors


Back Cover