The most at-risk county in the U.S. for climate change damage

Health · Published 19 October 2026

In short: Regarding combined medium-term climate change impacts, Beaufort County, South Carolina, carries the grim distinction of being the most vulnerable area within the contiguous United States. From rising seas to extreme heat, the region faces a unique intersection of environmental and economic vulnerability.

Beaufort County faces a multi-front climate crisis. For the medium term, this location ranks as the most endangered county across the contiguous US regarding total climate change-related harm. This vulnerability is driven by three primary factors: high wet-bulb temperatures, significant economic and farm crop damages, and persistent sea-level rise. The county's geography, where 37.62% of its 923.48 square miles is covered by water, exacerbates these risks.

The region's history adds layers of complexity to its current situation. For decades, the county's economy was shaped by agriculture and the legacy of the plantation system. While the population saw a significant decline between 1900 and 1930 due to the Great Migration—dropping from 35,495 to a low point that wasn't reached again until after 1950—the area has since seen rapid growth. Development has clustered along the U.S. Highway 278 corridor and in the northern portions near military installations.

Public health and equity are central to addressing these risks. Research in South Carolina highlights that Black people and rural individuals consistently experience higher mortality-to-incidence ratios for Alzheimer's Disease and Related Dementias (ADRDs), a disparity that widened during the COVID-19 pandemic. Furthermore, programs like EJ Strong are now applying community-managed disaster risk reduction (CMDRR) to environmental justice communities in the state. These initiatives aim to build resilience by training residents to assess hazards and implement disaster plans tailored to their specific cultural and economic contexts.

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