Experience-driven perceptions misalign with assessed heat risk in the United States

Extreme heat poses a risk to public health, yet illness and death from heat exposure are largely preventable through behavioral adaptation. However, individuals’ perceptions of local heat risks often diverge from expert assessments, limiting protective behaviors. Here we introduce the Risk Analysis – Perception Framework, which quantifies the alignment between assessed risk, based on a standardized public health metric from the Centers for Disease Control and Prevention Heat and Health Index, and perceived risk, modeled using a multi-year national survey (2018–2022). Applying the framework across US counties, we find substantial misalignments between assessed and perceived risk, particularly in the Pacific Northwest and in Appalachia. These gaps highlight how personal experience, contextual cues, and mental shortcuts shape risk perceptions that often diverge from expert assessments of vulnerability. Through systematic risk alignment mapping, the Risk Analysis – Perception Framework provides an empirical approach to target climate risk communication, adaptation strategies, and policy interventions.