Atlantic basin hurricanes drive serious meteorological hazards for the southeast United States, including rainfall-induced flooding. The well-known Saffir-Simpson Hurricane Wind Scale communicates only wind hazard, creating the potential for low wind, high rainfall storms to be perceived as mild. Researchers have emphasized the need to center rainfall hazard in hurricane warning messaging, and prerequisite to this is verifying the accuracy of hurricane rainfall forecasts. This paper investigates the characterization of forecasted and observed rainfall for three Atlantic hurricanes with varying rainfall impact: Florence (2018), Michael (2018), and Ian (2022). We first quantified, visualized, and compared the distribution of daily and total rainfall for each storm to establish the concept of varied rainfall impact. By a Mann-Whitney U Test, we found that the distributions of total rainfall for Florence/Michael and Florence/Ian were significantly different while differences between Michael/Ian were not significant. We then compared Excessive Rainfall Outlooks (EROs) against a flash flood proxy both visually and through fractional coverage calculations. We used these to calculate fractions brier scores (FBS) and fractions skill scores (FSS) using old and new ERO definitions. New ERO definitions improved FSS scores across all hurricanes. Florence had the highest FSS, followed by Michael, then Ian, though all scores were deemed skillful. To the authors’ knowledge, this is the first instance of FSS scores used for ERO verification. These findings provide a framework for a wider study on forecast verification across hurricane rainfall scenarios, a key step towards improving how we communicate and characterize these hazards.

Using a WRF-based numerical modeling framework, case study analyses were conducted to assess the role of urban land cover on two high-impact flooding events across the metropolitan area of Atlanta, Georgia. An overarching goal of this study is to advance the concept of the urban rainfall effect (URE) from theoretical paradigms to applied hydrometeorological prediction. The URBAN simulated runs generally captured the magnitude and spatial coverage of extreme rainfall over and downwind of Atlanta, as compared to the observations. The NO URBAN runs consistently underestimated extreme rainfall in both cases. Our results support previous studies that the urban environment can serve as an amplification mechanism when an environment is primed for convective processes. A key finding is that extreme rainfall – urbanization – flash flooding connections are partially explained by a “prime and pump” mechanism. Urban destabilization primes the environment with enhanced convective available potential energy (CAPE), while surface-based convergence spatially focuses the extreme rainfall. To further quantify how the URE translates to a flood hazard, we introduced a new model-based metric to represent hydrological “flashiness.” While there was some variability, this may be one of the first attempts to quantify flashiness within a hydrometeorological modeling framework.

Importance:In the current era of climate change, extreme heat exposure poses escalating threats to maternal-fetal health. Despite the expansive scale of extreme heat exposure worldwide, dramatized by the record-breaking global ocean and atmospheric temperatures throughout 2023 and into 2024, the extent of the threat posed by heat is underestimated and underappreciated. Unlike the physical destruction wrought by climate-driven events like hurricanes and wildfires, heat exposure does not cause severe damage to the built environment. Yet, in most years, heat has been the deadliest hazard in the United States. Objectives:This expert review aims to illuminate how climate-related heat affects maternal-fetal health and exacerbates health inequities. It will also discuss current knowledge gaps and underscore the crucial role that obstetric providers play in safeguarding pregnant persons from exposure to hazardous heat and increasing patient awareness of climate-related heat. Evidence Acquisition:Evidence for this review was primarily acquired through a comprehensive search of PubMed-indexed articles using MeSH terms and text words to search for concepts related to "climate change," "heat," "obstetrics," "pregnancy," "heat stress disorders," and their synonyms. Results:Extreme heat exposure threatens the health and well-being of pregnant persons and elevates the likelihood of poor birth outcomes like preterm birth, fetal demise, and stillbirth, among other pregnancy complications. Extreme heat exposure also increases the risk of dehydration, heat exhaustion, heat stroke, and gestational hypertension for pregnant persons. Conclusions and Relevance:Ultimately, obstetric professionals are essential to improving the care of pregnant persons at increased risk from salient climate-related heat exposure.

Extreme weather events cause significant societal impacts, in particular, when they behave unexpectedly. The "brown ocean (BO)" effect, describing the ability of the land surface via soil moisture to support tropical cyclone (TC) maintenance and intensification (TCMI) after landfall, remains poorly understood. Building upon our previous modeling framework utilizing the NASA Unified WRF (NU-WRF) system, this follow-on study explores the contributions of the dynamics of the soil moisture and advected water vapor to the TCMI of Tropical Storm (TS) Bill (2015) over the U.S. southern Great Plains (SGP). Impacts of various soil moisture conditions and surface enthalpy flux conditions on Bill's inland intensification were investigated by comparing their land-atmosphere interaction components of energy fluxes along with a backward trajectory analysis and three-dimensional visualization of low-level atmospheric moisture. Results demonstrate that the high antecedent soil moisture across the central United States (Great Plains and Mississippi Valley) from prior rainfall was crucial for the TCMI of TS Bill over the SGP. Without ample latent heat flux over land, even a moisture- laden low-level jet from the ocean rapidly dried over land, preventing intensification and causing storm dissipation in our simulations. Backward trajectory analysis suggests that high soil moisture content can enhance humidity within the storm's inflow, including the advection from the ocean, far inland, thus supporting the TCMIs. Ultimately, the inflow feeding the inland TC core is influenced by active land-air interactions within the boundary layer, where soil moisture and lower boundary conditions directly impact lower-tropospheric humidity, enabling or hindering the BO effect and subsequent TC intensification.

In late September 2024, Hurricane Helene contributed to catastrophic flooding in the Southeastern United States. The impacts of the hurricane were compounded by a predecessor rain event (PRE) 1-day earlier, inducing unusually high precipitation and soil moisture (SM). In this case study, we examined the predictability of precipitation and SM conditions associated with these events in NOAA's operation Coupled Forecast System model (CFSv2). Specifically, we investigated the predictability of Helene and the PRE as a function forecast lead time (LT). To assess the model's ability to represent both Helene and PRE, as well as the predictability of their resulting precipitation and SM, we applied tracking of both systems with different LTs from 3 to 6 days. Our results show that the predictability drops around 4- to 5-day LTs, in association with biases in the timing and location of Helene and PRE, as well as underestimated precipitation associated with the PRE.

Hurricanes pose a wide range of health and safety threats, from wind and flooding to less recognized hazards such as heat stress. Although heat exposure has been documented after hurricanes, little research has examined how it affects disaster relief workers during recovery operations. This study evaluated the heat stress conditions faced by emergency response personnel deployed to southeastern Texas following Hurricane Beryl in July 2024, a period marked by prolonged power outages and extreme heat. Heat hazard scenarios were assessed for the Houston area using occupational exposure limits-the Recommended Alert Limit (RAL) and Recommended Exposure Limit-in combination with wet bulb globe temperature (WBGT) data and factors like worker acclimatization status, work intensity, work/rest schedules, and use of personal protective equipment (PPE). Depending on the scenario, WBGT values exceeded critical safety thresholds throughout this period. For unacclimatized workers engaged in medium to very heavy labor with minimal rest, conditions exceeded the RAL between 74% and 100% of the time. Even heat acclimatized workers deployed outdoors would have faced considerable heat stress, especially during heavy work levels. The presence of restrictive PPE significantly increased heat stress, with all scenarios surpassing safety thresholds. These findings underscore the heightened vulnerability of disaster response personnel to heat-related health risks in the aftermath of hurricanes. Acclimatization, workload, rest breaks, and PPE use are key factors influencing heat health risks. Tailored heat mitigation strategies are needed to safeguard workers operating in high-pressure, resource-limited environments where standard workplace safety practices may be difficult to implement.

5wPatients with end stage kidney disease (ESKD) who receive in-center hemodialysis are disproportionately vulnerable to extreme weather events, including hurricanes and heat waves, that may disrupt access to healthcare providers, and life-sustaining treatments. This current era of climate-driven compounding disasters is progressively elevating the level of threat to the health and well-being of patients with ESKD. This analysis brings together multi-disciplinary expertise to explore the contours of this increasingly complex risk landscape. Despite the challenges, important advances have been made for safeguarding this medically high-risk patient population. Hemodialysis services providers have devised innovative systems for preparing their patients and sustaining, or rapidly reestablishing, hemodialysis services in the aftermath of a disaster, and maintaining open lines of communication with their caseloads of ESKD patients throughout all phases of the event. A description of lessons learned along the path towards improved patient support in disasters, is provided. The article concludes with a detailed case example, describing dialysis providers' effective response throughout Hurricane Ian's passage across the State of Florida in 2022. Based on lessons learned, this analysis outlines strategies for protecting patients with ESKD that may be adapted for future climate-potentiated disaster scenarios.

Water, weather, and climate affect everyone. However, their impacts on various communities can be very different based on who has access to essential services and environmental knowledge. Structural discrimination, including racism and other forms of privileging and exclusion, affects people's lives and health, with ripples across all sectors of society. In the United States, the need to equitably provide weather, water, and climate services is uplifted by the Justice40 Initiative (Executive Order 14008), which mandates 40% of the benefits of certain federal climate and clean energy investments flow to disadvantaged communities. To effectively provide such services while centering equity, systemic reform is required. Reform is imperative given increasing weather-related disasters, public health impacts of climate change, and disparities in infrastructure, vulnerabilities, and outcomes. It is imperative that those with positional authority and resources manifest responsibility through (1) recognition, inclusion, and prioritization of community expertise; (2) the development of a stronger and more representative and equitable workforce; (3) communication about climate risk in equitable, relevant, timely, and culturally responsive ways; and (4) the development and implementation of new models of relationships between communities and the academic sector.

Urbanization has accelerated dramatically across the world over the past decades. Urban influence on surface temperatures is now being considered as a correction term in climatological datasets. Although prior research has investigated urban influences on precipitation for specific cities or selected thunderstorm cases, a comprehensive examination of urban precipitation anomalies on a global scale remains limited. This research is a global analysis of urban precipitation anomalies for over one thousand cities worldwide. We find that more than 60% of the global cities and their downwind regions are receiving more precipitation than the surrounding rural areas. Moreover, the magnitude of these urban wet islands has nearly doubled in the past 20 y. Urban precipitation anomalies exhibit variations across different continents and climates, with cities in Africa, for example, exhibiting the largest urban annual and extreme precipitation anomalies. Cities are more prone to substantial urban precipitation anomalies under warm and humid climates compared to cold and dry climates. Cities with larger populations, pronounced urban heat island effects, and higher aerosol loads also show noticeable precipitation enhancements. This research maps global urban rainfall hotspots, establishing a foundation for the consideration of urban rainfall corrections in climatology datasets. This advancement holds promise for projecting extreme precipitation and fostering the development of more resilient cities in the future.

Urbanization is advancing rapidly, covering less than 2 yet profoundly influencing global environments and experiencing disproportionate impacts from extreme weather events. Effective urban management and planning require high-resolution, temporally consistent datasets that capture the complexity of urban growth and dynamics. This study presents NDUI+, a novel global urban dataset addressing critical gaps in urban data continuity and quality. NDUI+ integrates data from the Defense Meteorological Satellite Program's Operational Linescan System (DMSP-OLS), VIIRS Nighttime Light, and Landsat 7 NDVI using advanced remote sensing and deep learning techniques. The dataset resolves sensor discontinuity challenges, offering a seamless 30-meter spatial and annual temporal resolution time series from 1999 to the present. NDUI+ demonstrates high precision and granularity, aligning closely with high-resolution satellite data and capturing urban dynamics effectively. The dataset provides valuable insights for urban climate studies, IPCC assessments, and urbanization research, complementing resources like UT-GLOBUS for urban modeling.

Climate-driven disasters have disproportionate and often devastating consequences on individuals with disabilities. Warming ocean and air temperatures are fueling more extreme tropical cyclones, further endangering those living in at-risk regions. Although hurricane preparedness is particularly critical for those with functional impairments and/or special medical needs, studies show such persons are less ready for disasters than the general population. This review calls attention to the time-urgent need to improve hurricane readiness among persons with disabilities. It summarizes evidence that climate change is resulting in cyclonic storms that are increasingly jeopardizing the health and safety of affected persons and reflects on how this trend may compound the particular hardships those with disabilities experience during times of disaster. It identifies unique storm-related challenges faced by patient populations commonly cared for by physiatrists, including those with stroke, traumatic brain injury, multiple sclerosis, spinal cord injury, and limb loss. Available research pertaining to the gaps in emergency preparedness practices among persons with disabilities is reviewed as are potential strategies to mitigate barriers to achieving disaster readiness and resilience. Lastly, the review provides physiatrists with a comprehensive guide for optimally safeguarding their patients before, during, and after catastrophic hurricanes.

Medically high-risk patients (MHRPs)—persons living with health conditions that require readily available, dependable, and sometimes uninterrupted access to health services and supplies—face escalating risks when exposed to disasters.1Espinel Z. Nogueira L.M. Gay H.A. et al.Climate-driven Atlantic hurricanes create complex challenges for cancer care.Lancet Oncol. 2022; 23: 1497-1498https://doi.org/10.1016/S1470-2045(22)00635-0Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar,2Balbus J.M. Malina C. Identifying vulnerable subpopulations for climate change health effects in the United States.J Occup Environ Med. 2009; 51: 33-37https://doi.org/10.1097/JOM.0b013e318193e12eCrossref PubMed Scopus (242) Google Scholar MHRPs include persons with cognitive and functional impairments3Shapiro L.T. Gater Jr., D.R. Espinel Z. Kossin J.P. Galea S. Shultz J.M. Preparing individuals with spinal cord injury for extreme storms in the era of climate change.eClinicalMedicine. 2020; 18100232https://doi.org/10.1016/j.eclinm.2019.12.002Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar; health conditions requiring access to essential services, such as cancer therapies4Nogueira L.M. Yabroff K.R. Bernstein A. Climate change and cancer.CA Cancer J Clin. 2020; 70: 239-244https://doi.org/10.3322/caac.21610Crossref PubMed Scopus (52) Google Scholar or psychiatric treatment; or transient health conditions that temporarily increase vulnerability, such as pregnancy or post-surgical recovery.5Alnajar A. Bud Frazier O.H. Elgalad A. Smith P.A. Shultz J.M. Preparing end-stage heart failure patients and care providers in the era of climate change-driven hurricanes.J Card Surg. 2021; 36: 3491-3493https://doi.org/10.1111/jocs.15784Crossref PubMed Scopus (2) Google Scholar Disasters are events that disrupt societal functioning, causing widespread human, material, or environmental harm while exceeding the coping capacity of the affected communities. With increasing frequency, the overlapping and amplifying impacts of compounding disasters—diverse co-occurring or rapidly-sequential disruptive events, ranging from global (climate change, pandemic diseases) to local—are exacerbating harm and complicating recovery. MHRPs experience disproportionate risks across a broad spectrum of disasters. Throughout 2023, the hottest year on record (Fig. 1), climate change-fuelled extreme weather events (EWEs) featured prominently. Deadly heat domes formed over vast areas of the Americas—in the global North and South—previously assumed to be sheltered from extreme weather. Dense Canadian wildfire smoke reached US population centres unaccustomed to this environmental hazard and ill prepared to respond. Within 19 days, warm Atlantic waters generated nine named tropical storms. Climate-driven drought magnified the severity of wildfires in Chile. Brazil experienced unprecedented precipitation and deadly flooding from an extratropical cyclone. Yet strategies to protect the health of MHRPs from these hazards and harms remain poorly conceived and rarely implemented. MHRPs experience unique vulnerabilities during disasters depending on their medical diagnosis, stage and severity of illness, treatment regimens and side-effects, current health and functional status, and reliance on healthcare and social support systems. In a disaster context, MHRPs frequently experience elevated risks while evacuating and sheltering, increased healthcare needs, aggravation of symptoms, interruption of vital healthcare services, increased susceptibility to injury or disease outbreaks, increased risk of cardiorespiratory events, and elevated stress levels.1Espinel Z. Nogueira L.M. Gay H.A. et al.Climate-driven Atlantic hurricanes create complex challenges for cancer care.Lancet Oncol. 2022; 23: 1497-1498https://doi.org/10.1016/S1470-2045(22)00635-0Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar, 2Balbus J.M. Malina C. Identifying vulnerable subpopulations for climate change health effects in the United States.J Occup Environ Med. 2009; 51: 33-37https://doi.org/10.1097/JOM.0b013e318193e12eCrossref PubMed Scopus (242) Google Scholar, 3Shapiro L.T. Gater Jr., D.R. Espinel Z. Kossin J.P. Galea S. Shultz J.M. Preparing individuals with spinal cord injury for extreme storms in the era of climate change.eClinicalMedicine. 2020; 18100232https://doi.org/10.1016/j.eclinm.2019.12.002Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar, 4Nogueira L.M. Yabroff K.R. Bernstein A. Climate change and cancer.CA Cancer J Clin. 2020; 70: 239-244https://doi.org/10.3322/caac.21610Crossref PubMed Scopus (52) Google Scholar, 5Alnajar A. Bud Frazier O.H. Elgalad A. Smith P.A. Shultz J.M. Preparing end-stage heart failure patients and care providers in the era of climate change-driven hurricanes.J Card Surg. 2021; 36: 3491-3493https://doi.org/10.1111/jocs.15784Crossref PubMed Scopus (2) Google Scholar, 6Adams R.M. Eisenman D.P. Glik D. Community advantage and individual self-efficacy promote disaster preparedness: a multilevel model among persons with disabilities.Int J Environ Res Public Health. 2019; 16: 2779https://doi.org/10.3390/ijerph16152779Crossref PubMed Scopus (38) Google Scholar Higher mortality rates were documented following hurricane-related disruptions of radiotherapy treatments for patients with lung cancer7Nogueira L.M. Sahar L. Efstathiou J.A. Jemal A. Yabroff K.R. Association between declared hurricane disasters and survival of patients with lung cancer undergoing radiation treatment.JAMA. 2019; 322: 269-271https://doi.org/10.1001/jama.2019.7657Crossref PubMed Scopus (40) Google Scholar and haemodialysis treatments for patients with end stage kidney disease (ESKD).8Blum M.F. Feng Y. Anderson G.B. Segev D.L. McAdams-DeMarco M. Grams M.E. Hurricanes and mortality among patients receiving dialysis.J Am Soc Nephrol. 2022; 33: 1757-1766https://doi.org/10.1681/ASN.2021111520Crossref PubMed Scopus (4) Google Scholar Because the physical, psychological, and socioeconomic challenges associated with chronic medical and psychiatric conditions make it harder for MHRPs to cope with added stressors when a disaster strikes,9Espinel Z. Shultz J.M. Aubry V.P. et al.Protecting vulnerable patient populations from climate hazards: the role of the nation's cancer centers.J Natl Cancer Inst. 2023; 115: 1252-1261https://doi.org/10.1093/jnci/djad139Crossref PubMed Scopus (1) Google Scholar medical, sociopolitical, and environmental factors need to be considered while developing strategies to safeguard MHRPs from disasters. For example, in addition to well-established emergency preparedness strategies developed to protect the general population, including guidelines for developing a household plan for sheltering in place or evacuating, MHRPs require additional strategies customized for the specific needs and vulnerabilities of their medical conditions and tailored to different hazard scenarios. Importantly, sociopolitical contexts have profound implications for disaster preparedness strategies because structural factors, such as exposure to systemic racism, patriarchy, and ableism, shape the hazard profile and limit access to emergency resources when disaster strikes.10Nogueira L. White K.E. Bell B. et al.The role of behavioral medicine in addressing climate change-related health inequities.Transl Behav Med. 2022; 12: 526-534https://doi.org/10.1093/tbm/ibac005Crossref PubMed Scopus (8) Google Scholar Throughout the Americas, healthcare settings serving individuals facing the greatest barriers to vital resources differ from the healthcare settings serving those who benefit from privilege. To avoid widening disparities, strategies that prioritise equity such as reducing out-of-pocket expenses when developing MHRP-specific disaster preparedness and response strategies; promoting intersectional approaches that address social determinants of health; improving diversity among health and disaster professionals; co-creating knowledge in settings where disenfranchised communities interact with healthcare; and developing contextually relevant strategies, are crucial for protecting the health and safety of all MHRPs and ensuring availability and continuity of care during disasters. Environmental factors and associated risks must also be considered during impact (e.g., infection risks during flooding events, cardiorespiratory risks during wildfires, thermoregulatory risks during extreme temperatures), and in the aftermath (e.g., food and water insecurity, displacement). Prolonged periods without power are especially concerning for MHRPs who rely on electricity-dependent assistive equipment, refrigeration for essential medications, or heating/cooling systems for ambient temperature control. Creating customized disaster preparedness strategies is complicated by climate change, which alters the frequency, predictability, and behaviour of extreme weather events. We recommend a three-pronged approach to develop disaster preparedness and response strategies that protect the health and safety of MHRPs from rapidly evolving environmental hazard scenarios propelled by climate change. First, facilitate information sharing among medical specialties so that best practices for safeguarding one MHRP population can be adapted for others.9Espinel Z. Shultz J.M. Aubry V.P. et al.Protecting vulnerable patient populations from climate hazards: the role of the nation's cancer centers.J Natl Cancer Inst. 2023; 115: 1252-1261https://doi.org/10.1093/jnci/djad139Crossref PubMed Scopus (1) Google Scholar For example, during Hurricane Ian in 2022, haemodialysis services providers used centralised databases to track their patients with ESKD and direct them to nearby dialysis centres that had reopened after the storm to rapidly resume their treatments. Similar protocols could be devised to minimise disaster-triggered disruptions to life-sustaining treatments for other MHRP populations.1Espinel Z. Nogueira L.M. Gay H.A. et al.Climate-driven Atlantic hurricanes create complex challenges for cancer care.Lancet Oncol. 2022; 23: 1497-1498https://doi.org/10.1016/S1470-2045(22)00635-0Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar,2Balbus J.M. Malina C. Identifying vulnerable subpopulations for climate change health effects in the United States.J Occup Environ Med. 2009; 51: 33-37https://doi.org/10.1097/JOM.0b013e318193e12eCrossref PubMed Scopus (242) Google Scholar Second, stimulate multi-disciplinary research to address distinct hazards, specific vulnerabilities, and unique challenges that MHRPs and their health and psychosocial support systems face during compounding disaster scenarios. For example, interventions that address risks for MHRPs exposed to extreme temperatures could integrate climate monitoring, active patient tracking, individualized disaster preparedness communications delivered during patient encounters or using digital messaging technologies, and contextual strategies centering on community expertise and cultural norms. Research is urgently needed to develop strategies to optimize mental health and well-being for MHRPs grappling with the layered psychosocial stressors of surviving and recovering from a disaster while living with a challenging medical condition. Finally, research will facilitate the development of preparedness strategies adapted to the complexities of the compounding risk landscape that leverage technology and infuse local knowledge to circumvent disaster-related care disruptions. Third, equitably prioritise the roles and expertise of persons from communities targeted for marginalisation and professionals from underrepresented backgrounds in every step of the process.10Nogueira L. White K.E. Bell B. et al.The role of behavioral medicine in addressing climate change-related health inequities.Transl Behav Med. 2022; 12: 526-534https://doi.org/10.1093/tbm/ibac005Crossref PubMed Scopus (8) Google Scholar Failure to integrate the wisdom and lived experience of diverse individuals—including MHRPs themselves and their caregivers, support networks, and providers—limits the knowledge and sensitized perspectives available to tackle growing challenges in this era of climate-driven compounding disasters. The expanding constellation of disruptive events unfolding around the globe in this era of compounding disasters provides powerful impetus for healthcare and emergency management professionals to devise strategies to safeguard MHRPs during disasters, an effort that can be accelerated through collaborative partnerships that incorporate diverse expertise and backgrounds. James M. Shultz conceptualized the paper, selected authors, led the writing, and serves as corresponding author. Sandro Galea contributed instrumentally to the review and editing of the manuscript and the recommendations for safeguarding high-risk patients and he encouraged contributions from MHRP representatives. Zelde Espinel provided key input on mental health, psychosocial support, and compounding disasters. Amruta Nori-Sarma contributed to the focus on environmental hazards, particularly extreme heat, review, and editing. Lauren T. Shapiro brought the perspective of a practicing physiatrist who treats a range of medically high-risk patients, particularly those with mobility impairment. Karen Dimentstein contributed the essential perspective of an individual who is a medically high-risk person and added to the review and editing throughout. J. Marshall Shepherd contributed the atmospheric science viewpoint and added to the focus on compounding disasters. Leticia M. Nogueira contributed instrumentally to conceptualization, integration of climate change and health equity issues, review, and editing, and she serves as senior author. None. The authors declared no conflicts of interest. None.

Caribbean small island developing states are becoming increasingly vulnerable to compounding disasters, prominently featuring climate-related hazards and pandemic diseases, which exacerbate existing barriers to cancer control in the region. We describe the complexities of cancer prevention and control efforts throughout the Caribbean small island developing states, including the unique challenges of people diagnosed with cancer in the region. We highlight potential solutions and strategies that concurrently address disaster adaptation and cancer control. Because Caribbean small island developing states are affected first and worst by the hazards of compounding disasters, the innovative solutions developed in the region are relevant for climate mitigation, disaster adaptation, and cancer control efforts globally. In the age of complex and cascading disaster scenarios, developing strategies to mitigate their effect on the cancer control continuum, and protecting the health and safety of people diagnosed with cancer from extreme events become increasingly urgent. The equitable development of such strategies relies on collaborative efforts among professionals whose diverse expertise from complementary fields infuses the local community perspective while focusing on implementing solutions.

Cloud and rainfall distributions in urban spaces have implications for planning, hydrological response, reservoir management, renewable energy generation, transportation, and agricultural productivity. Studies have confirmed that large urban areas can initiate or modify precipitation, but there are still questions about the role of city size and atmospheric interactions. The majority of case study approaches have focused on large cities or urban clusters and have largely ignored small to moderate sized cities. Herein, an analysis of the Augusta, Georgia metropolitan statistical area is conducted. Using a gridded, daily multi-sensor precipitation dataset and satellite-based cloud cover climatology, the warm seasons (June, July, and August) covering the period from 2002 to 2019 were analyzed using spatial comparisons within an upwind-downwind framework and z-score statistics. Such methodologies have been published for larger urban areas. We confirmed that a moderate-sized city like Augusta, Georgia and neighboring Aiken, South Carolina is associated with spatial patterns consistent with the “urban rainfall effect” (URE) and possibly an “urban cloud effect” (UCE). Contextual analysis of other local mesoscale signatures related to nearby water bodies are also provided as a sanity check on process identification.

Click to increase image sizeClick to decrease image size Disclosure StatementNo potential conflict of interest was reported by the author.Additional informationFundingThis research was funded by NASA Grant 80NSSC20K1268 and an internal grant from the UGA Vice Provost.Notes on contributorsMarshall ShepherdDr. J. Marshall Shepherd is the Georgia Athletic Association Distinguished Professor of Geography and Atmospheric Sciences at the University of Georgia and Director of its Atmospheric Sciences Program. Dr. Shepherd was the 2013 President of American Meteorological Society (AMS). Prior to his work in academia, he spent 12 years as a scientist at NASA Goddard Space Flight Center and was Deputy Project Scientist of the Global Precipitation Measurement Mission. Dr. Shepherd is the host of The Weather Channel’s Weather Geeks Podcast and a senior contributor to Forbes magazine. In 2022, he was selected SEC Professor of the Year. In 2021, Dr. Shepherd was elected to the National Academy of Sciences, National Academy of Engineering, and the American Academy of Arts and Sciences, the only member of the University of Georgia faculty to ever achieve this trifecta. He has received numerous awards, including the 2004 White House PECASE Award, the Captain Planet Foundation Protector of the Earth Award, the 2019 AGU Climate Communication Prize, the 2020 Mani L. Bhaumik Award for Public Engagement with Science, and the 2018 AMS Helmut Landsberg Award. He received his B.S., M.S., and Ph.D. in meteorology from Florida State University. He has two TEDx talks on climate science and communication that collectively exceed two million views. He is routinely asked to brief the media, Congress, and the White House on weather–climate–science related topics. Dr. Shepherd has almost 100 peer-reviewed publications on various topics.

Within the Charlotte, North Carolina, to Atlanta, Georgia, megaregion (Charlanta), the Atlanta metropolitan area has been shown to augment proximal cloud-to-ground (CG) lightning occurrence. Although numerous studies have documented this "urban lightning effect" (ULE) with regard to CG lightning, relatively few have investigated urban effects on distributions of total lightning (TL). Moreover, there has yet to be a study of the ULE using TL observations from the Geostationary Lightning Mapper (GLM). In an effort to fill this gap, we investigated spatial distributions of TL around the cities of Atlanta, GA, Greenville, SC, and Charlotte, NC, using GLM data collected during the warm seasons of 2018-2021. Analyses reveal augmentation of TL intensity and frequency over the major cities of Atlanta and Charlotte, with a diminished urban signal over the smaller city of Greenville. This work also demonstrated the potential efficacy of the emerging satellite-based TL climatology in ULE studies.

Rapidly growing cities along the Interstate‐85 corridor from Atlanta, GA, to Raleigh, NC, rely on small rivers for water supply and waste assimilation. These rivers share commonalities including water supply stress during droughts, seasonally low flows for wastewater dilution, increasing drought and precipitation extremes, downstream eutrophication issues, and high regional aquatic diversity. Further challenges include rapid growth; sprawl that exacerbates water quality and infrastructure issues; water infrastructure that spans numerous counties and municipalities; and large numbers of septic systems. Holistic multi‐jurisdiction cooperative water resource planning along with policy and infrastructure modifications is necessary to adapt to population growth and climate. We propose six actions to improve water infrastructure resilience: increase water‐use efficiency by municipal, industrial, agricultural, and thermoelectric power sectors; adopt indirect potable reuse or closed loop systems; allow for water sharing during droughts but regulate inter‐basin transfers to protect aquatic ecosystems; increase nutrient recovery and reduce discharges of carbon and nutrients in effluents; employ green infrastructure and better stormwater management to reduce nonpoint pollutant loadings and mitigate urban heat island effects; and apply the CRIDA framework to incorporate climate and hydrologic uncertainty into water planning.