Intersecting vulnerabilities: Climatic and demographic contributions to future population exposure to Aedes-borne viruses in the United States

Understanding how climate change and demographic factors may shape future population exposure to viruses such as Zika, dengue, or chikungunya, transmitted by Aedes mosquitoes is essential to improving public health preparedness. In this study, we combine projections of cumulative monthly Aedes-borne virus transmission risk with spatially explicit population projections for vulnerable demographic groups (age and economic factors) to explore future county-level population exposure across the conterminous United States. We employ a scenario matrix – combinations of climate and socioeconomic scenarios (Representative Concentration Pathways and Shared Socioeconomic Pathways) – to assess the full range of uncertainty in emissions, socioeconomic development, and demographic change. Human exposure is projected to increase under most scenarios, up to +177% at the national scale in 2080 relative to 2010. Projected exposure changes are predominantly driven by population changes in vulnerable demographic groups, although climate change is also important, particularly in the western region where future exposure may decrease by >30% under the strongest climate change mitigation scenario. The results emphasize the crucial role that socioeconomic and demographic change play in shaping future population vulnerability and exposure to Aedes-borne virus transmission risk in the United States, and underscore the importance of including socioeconomic scenarios in projections of climate-related vector-borne disease impacts.