Multnomah, Clackamas and Washington counties have released five new health dashboards that track the impacts of extreme weather and poor air quality. The dashboards document five key areas: heat, cold, air quality, infectious disease and mental health. These new dashboards expand on three previous Regional Climate and Health Data Reports.
Building on reports from 2019 (data from 2010-17), 2021 (data from 2010-20) and 2023 (data from 2012-22), these new dashboards include data from 2014 through 2024, creating a comprehensive 14-year dataset across all reports for most indicators. This extensive data helps document and track the health impacts of climate change, monitor regional climate shifts and identify adaptation and mitigation strategies.
The dashboards feature new data not previously included, such as:
- Mental health survey data from across the tri-county region.
- Expanded disease monitoring, now including Valley Fever (Coccidioidomycosis).
- Enhanced extreme weather tracking with a new focus on ice fall injuries and carbon monoxide poisoning during cold weather.
- Ambulance arrivals for heat-related illness.
- Manual review of heat-related illness cases to identify risk factors like occupation, intoxication and homelessness.
The dashboards also incorporate 11 current indicators, including:
- Emergency Department (ED) visits and hospitalizations related to extreme weather.
- ED visits for respiratory illness and allergies related to poor air quality.
- The number of insect-related illnesses such as West Nile and Lyme disease.
- Rates of communicable diseases more likely to spread during warmer conditions.
Climate change and health equity
“The dashboards show that climate change unequally impacts the most vulnerable communities, and that these groups differ somewhat by county,” said Brendon Haggerty, Multnomah County Healthy Homes & Communities Manager.
- In Multnomah County, the most impacted communities are people with lower incomes, communities of color and unhoused populations.
- In Washington County, these groups are also impacted, along with farmworkers, older adults living alone and people with chronic conditions.
- In Clackamas County, the affected communities include more farmworkers, non-English speakers and rural communities.
“The changing climate will affect everyone’s health,” said Dr. Sarah Present, Clackamas County health officer. “Having this information about how and where we are seeing the effects will improve our whole community’s ability to prepare. In public health, we will be able to focus resources helping those who are most at risk, but everyone can use this data to understand their own personal risks.”
“Dashboards like this can help us better understand who experiences the impacts and hazards of climate change, allowing us as regional partners to coordinate and focus our resources on communities that need more support in building their resilience,” said Kathleen Johnson, Washington County’s senior environmental health coordinator.
Key findings
Extreme heat
Since the 2021 heat dome, tri-county ED visits, hospitalizations and deaths from heat-related illness have remained consistently higher than pre-2021 levels. Heat risk days are occurring more often and in longer stretches. Occupational exposure has emerged as the most common risk factor identified in heat-related ED visits.
Extreme cold
While cold-related deaths have declined since peaking in 2021, hospitalizations have steadily increased — especially in Washington and Multnomah counties — driven by an increase in injuries from falls on ice and a sharp rise in carbon monoxide poisonings during winter storms and power outages.
Air quality
The region is experiencing more days of unhealthy to hazardous air quality. In 2024, the region saw the highest number of ED visits for non-infectious respiratory illness in six years. Asthma and allergy-related hospitalizations and deaths have also increased steadily since 2020, correlating with worsening wildfire smoke and pollen seasons.
Infectious disease
After a COVID-related dip in 2020, the rates of communicable disease influenced by climate change surged through 2023. While Salmonellosis and Campylobacterosis declined from 2023 to 2024, Tuberculosis cases rose sharply again in 2024, reversing a prior one-year decline. Though still rare, cases of the fungal infection Valley Fever (Coccidioidomycosis) have risen dramatically since 2020, signaling potential geographic spread due to changing environmental conditions.
Mental health
A first-ever collaboration between regional public and behavioral health confirmed the link between local climate disasters (e.g., the 2021 heat dome and 2020 wildfires) and increased anxiety, trauma and eco-distress. A multilingual online survey (Jan. 20–May 28, 2025; 297 responses) found that three of four respondents reported extreme sadness, anxiety, fear and helplessness due to extreme weather.
This emotional strain was most severe among youth, frontline communities and those with existing mental health challenges. Despite only 25% expressing optimism, many respondents shared ways to build resilience and reduce stress through physical activity, spending time in nature and community engagement.
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