Drought, desiccation, dust, and aridity in the American West: A California overview of climate change exposures, regional factors, and social conditions on maternal and child health

• Climate change-heralded dust, drought, wetland desiccation, and wind working in conjunction with social, genetic, and regional factors can impact maternal and child health. • Rural children will likely endure more disproportionate impacts from a dry American West. • These climatic factors can lead to or worsen respiratory and vascular health and may also impact external injury outcomes. • Mitigation efforts should focus on regional recommendations based on local climate, geography and landscape, population demographics, and lifestyle behaviors. When addressing climate change-associated health effects in children, much of the existing literature has focused on heat exposure. The role dust, drought, wetland desiccation (exposed lakebeds), and wind may have on health has been discussed less frequently. Many of these exposures affect children in rural populations who traditionally have fewer resources and healthcare options available to them. Some of the same children also belong to marginalized groups, ethnic minorities, or have pre-existing lung health issues, and often experience health disparities. In this overview, we discuss how these exposures along with social conditions and genetic susceptibility can affect children's health in the American West, considering: dusty conditions and coccidioidomycosis (Valley fever), exposed lakebeds and lung health, environmental factors and Kawasaki disease (KD), and dust events and motor vehicle accidents. With this summary, which utilizes a multifactorial approach, we stress further research could confirm current findings in other regions of the American West in addition to California, identify more vulnerable subgroups, and inform better policy. Considering exposures other than heat in a broader, more holistic perspective can more fully and equitably address climate change and children's health, setting the stage for a better health trajectory throughout the life course, especially in rural and tribal populations. Various climate-related exposures influence maternal and child health through complicated interplay among environmental, biological, and sociological pathways. Addressing lifestyle and behavioral changes may offer the most straight-forward strategies to alter poor health outcome trajectories.