Climate change is already being felt on local levels, with historical records from the State of Indiana (USA) revealing warmer winters, and more extreme precipitation events.To refine our understanding of climate change impacts on human health, we conducted a state-level assessment of future climate change impacts on human health using outputs from advanced climate model projections for this century. Future projections show a steep increase in extreme heat events, leading to greater potential vulnerability to heat disasters for Indiana communities. Additionally, a 2-to 4-fold increase in days with "uncomfortable night" conditions by the end of the century will strongly impact the cardiopulmonary health of more vulnerable populations (i.e., elderly, those with pre-existing conditions, children, and those with inadequate access to cooling).Continued trends for warmer winters and more flooding suggest a much greater risk for the expansion and virulence of a number of vector-borne diseases, such as Lyme disease, West Nile Virus, and "tropical" diseases for which the mosquito vectors will thrive.Higher temperatures will also drive more frequent and severe harmful algal blooms in lakes and reservoirs, with implications for human and animal health. Food systems will

In the coming decades, Indiana's changing climate will bring with it higher temperatures, longer heat waves, more extremely hot days and more frequent extreme storm events. Those changes will affect the health of Hoosiers in every part of the state. The pathways that lead to human health impacts are both direct and indirect. Direct effects include health impacts resulting directly from a hazard, such as heat stroke from extreme heat and respiratory illnesses from poor air quality. Indirect effects include increasing risks from "tropical" diseases like West Nile and Zika as populations of the insects that can spread these viruses grow, and increased rates of anxiety and depression as more Hoosiers cope with harm to loved ones or property after severe weather events. This report from the Indiana Climate Change Impacts Assessment (IN CCIA) describes historical and future climate-related health impacts that affect Hoosiers. The findings presented here are primarily based on the IN CCIA Health Working Group technical report (Filippelli et al., in review) and the IN CCIA report Indiana's Past and Future Climate (Widhalm et al., 2018a). Many analyses in this report focus on how climate change will affect death rates. Fortunately, only a small fraction of the people whose health is compromised by climate change will die from it, but the non-lethal health problems (morbidity) experienced by the much larger population of Hoosiers will also burden society. These other illnesses still cause missed work or school, lost income, increased health expenses, and general disruption to people's lives. However, because morbidity research has focused on national and international estimates that are not specific to Indiana, these results are not reported here.