Josephine County, Oregon, has the highest rate of wildfire smoke deaths in the United States, according to a 2025 study published in Nature magazine. The county ties with Trinity County, California, for the highest rate of wildfire smoke deaths linked to climate breakdown between 2006 and 2020, with an estimated 17 premature deaths per 100,000 people.
Residents of this evergreen corner of Oregon, near the California border, describe a beautiful tangle of mountains and forest carved out by the Rogue and Illinois rivers. The climate was once the draw—cool and wet in winters, sunny but not too hot in summers. Now, locals say, the term "summer" has been replaced by "smoke season," lasting from May-ish to October-ish.
Living with the Haze
Everyone here has a story about how bad it can get. Ash falls from the sky and coats cars like snow. "You can taste it!" says Cynthia Hewitt, a retiree and restaurant owner. When the smoke is particularly thick, she wets towels and wedges them around her doorframes to try to prevent the haze from coming into her living room. "It gets on the furniture and everything," she says.
Randi Maldonado, a beautician, tries to calm her toddler's lungs by sitting in the bathroom with the door closed and hot water roaring from the bathtub faucet. "Like a humidifier," she says. Her mother, Kim Williams, tells me that her client's husband died not long after leaving the windows open overnight during a wildfire smoke inundation.
A local nurse, Joann Reed, says the smoke has gotten so bad in recent years that even hospitals can't keep it out. She recalls a summer when a hospital where she was working tasked employees with standing near exits, in part to shut doors as fast as possible. "You could see a smoke cloud, just a haze, as you walked up and down the hallways," she tells me. "There's no filtration system strong enough to get rid of that much constant smoke."
A Community Under Strain
Josephine County is far more conservative than Oregon's familiar "Portlandia" tropes. More than one person suggests that the way to solve the wildfire problem is to log or even clearcut the forest so there's less of it to burn. The area's forests are thick, and its valleys are deep, trapping smoke in place for weeks or sometimes months at a time. "Socked in" is a phrase you hear a lot.
"We stay kind of like a convection oven," says Susan Albright, a family nurse practitioner who works at an urgent care in Grants Pass. "Everything just kind of stews." An aging population and high rates of poverty make the county vulnerable to years of insidious haze.
Joy Shinerock, who owns a woodworking art gallery called It's a Burl along Redwood Highway, reflects on the statistics. "Jeez," she says. "I can see why." She pauses, likely thinking about her late husband, Harvey, who died during the summer of 2013 after the smoke rolled into the valley and his illness worsened.
Grief and Resilience
Joy and Harvey fell in love over art and moved to Oregon from California in 1987 to escape wildfires. There were cruel twists of fate: the gallery burned down in a chimney fire in 1995, and the shop burned down a decade later, then melted in a third fire. The rebuilt gallery has stood for decades, with countless burls carved into wizard faces watching visitors from the walls.
When she's at the gallery, Joy feels like Harvey is still here with her. "It's his soul," she says. "People always tell me it's magical."
It's not the flames that kill; it's the smoke. The Camp Fire in Paradise, California, killed 85 people. The Maui fire killed 102. With far less attention, wildfire smoke contributed to an estimated 164,000 premature deaths in the US between 2006 and 2020, according to the same 2025 study in Nature. That's an average of nearly 11,000 deaths per year. By 2050, if industry keeps warming the planet, that number is estimated to jump to 70,000 Americans killed by wildfire smoke per year.
In Josephine County, fires are coming straight to the people. Between 2016 and 2025, Grants Pass saw 94 days with air that was unhealthy for sensitive groups or worse because of wildfire, according to data from the Oregon department of environmental quality. Compare that with only 16 days in the decade before.
Adapting to Danger
Residents are doing their best. Officials drive through the more remote parts of the area making megaphone announcements about evacuations, says Laura Mancuso, who started a local non-profit, Illinois Valley Wellness Resources, that distributes home air purifiers. Neighbors who don't have solid mobile phone coverage have banded together on a Citizens Band radio network to alert each other to fire danger.
Chris Granville, 73, carries a handwritten note in her purse during wildfire season, warning people about her severe asthma and allergies that can cause her to temporarily stop breathing. "Allergy reaction," the note says in purple ink. "Lose ability to talk. Have my own meds. Don't call EMS. Allergic to their med. 20 minutes after I take meds, [I should] get voice back."
The worst part about having to stay inside during smoke season? Chris is unable to volunteer, she says. She drives other seniors to appointments and to get groceries—and she worries about them needing her. "I just want to show kindness," she says. "I wish [the smoke] would go over the ocean where nobody is."
Joy checks the weather. There's still that wildfire one county over—called the East Evans Creek Fire. Her fire-watch app shows a patchwork of red and orange evacuation zones. A woman on vacation stumbles into the gallery and tells Joy, "I just stumbled across this, and—I mean—every single inch of this entire space is just filled with creativity and magic and love. It's a reminder that there is real magic still in the world." Joy smiles. She agrees.
