Driving into Josephine County, Oregon, you can't miss the sign - letters so big they form an arch over 6th Street in Grants Pass. Locals say it's a flex, or was before the irony set in. This evergreen corner near the California border, carved out by the Rogue and Illinois rivers, once boasted a climate that was the draw: cool, wet winters; sunny but not too hot summers; forests shielding you from unbearable heat. Now, 'summer' is a dirty word.
Across the US and Europe this summer, people choked beneath red skies and endured extraordinarily unhealthy air - scenes grimly familiar to anyone in the American West. But Josephine County takes the cake: it's the deadliest place for wildfire smoke in the US, according to a 2025 study in Nature. Tied with Trinity County, California, it has the highest rate of wildfire smoke deaths linked to climate breakdown between 2006 and 2020 - an estimated 17 premature deaths per 100,000 people.
Everyone here has a story. Ash falls from the sky and coats cars like snow. 'You can taste it!' says Cynthia Hewitt, retiree and restaurant owner, who wets towels and wedges them around her doorframes when smoke gets thick. 'It gets on the furniture and everything.' Everything includes wine - certain bottles from bad smoke years carry a campfire tang that clings to the grapes.
Randi Maldonado, a beautician met in a hair salon with two workers and three air purifiers, tries to calm her toddler's lungs by sitting in the bathroom with the door closed and hot water roaring from the tub faucet - 'like a humidifier.' Her mother, Kim Williams, tells of a client's husband who died not long after leaving windows open overnight during a smoke inundation.
Joann Reed, a local nurse, says smoke has gotten so bad that even hospitals can't keep it out. She recalls a summer years ago when hospital employees were tasked with standing near exits to shut doors as fast as possible. 'You could see a smoke cloud, just a haze, as you walked up and down the hallways. There's no filtration system strong enough to get rid of that much constant smoke.'
Some wear masks; others wish they were brave enough but tire of stares from those who see masks as code for 'woke America.' (Josephine County is far more conservative than 'Portlandia' tropes; more than one person suggests logging or even clearcutting the forest to reduce fuel.)
It's true the area's forests are thick and valleys deep, trapping smoke for weeks or months. 'Socked in' is a phrase you hear a lot. 'We stay kind of like a convection oven,' says Susan Albright, family nurse practitioner at an urgent care in Grants Pass. 'Everything just kind of stews.' Add an aging population and high poverty rates, and you have a county ravaged not by one bad fire but by years of insidious haze.
Joy Shinerock, owner of the woodworking art gallery It's a Burl along Redwood Highway, pauses when told about the statistics - the worst death rate in the nation. She might be thinking about her late husband, Harvey. Despite the hazy red skies and smoky, 1970s-casino air, Josephine County is extremely lovable - and loved fiercely by people like Joy.
A burl, it turns out, is a knotty growth on a tree, sometimes caused by stress or disease - a tumorous blob that can grow to the size of a car. Joy had just given birth to their youngest, Sara ('It's a girl!'), when Harvey named the gallery. Sara, now a mother of two and the gallery's manager, sits nearby. Joy, at 78, is more gen Z-coded than most, wearing purple headphones, watching Korean soap operas, doing Sudoku, and talking to me. Behind her hangs a watercolor portrait of Harvey in overalls, peering over glasses.
Harvey was a woodworker who started the gallery with Joy. He died in the summer of 2013 after smoke rolled into the valley and his illness worsened. 'I couldn't believe him. I just couldn't believe him,' Joy says. They'd moved from California to Oregon in 1987 to escape wildfires, but cruel twists followed: the gallery burned in a chimney fire in 1995, the shop burned a decade later, and then the replacement melted in a third fire. The rebuilt gallery has stood for decades, with burls carved into wizard faces watching visitors.
'The flames don't kill - it's the smoke,' the article reminds us. The Camp Fire in Paradise, California, killed 85; 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 - nearly 11,000 per year. By 2050, if industry keeps warming the planet, that number could jump to 70,000 per year.
Lately, more attention is paid to how smoke sickens wildland firefighters. The Trump administration last year reversed a longstanding ban on US Forest Service members wearing masks on wildfire assignments; masks are now passed out.
In Josephine County, fires come straight to the people. Between 2016 and 2025, Grants Pass saw 94 days with air unhealthy for sensitive groups or worse due to wildfire, compared to only 16 days in the prior decade, per Oregon DEQ data. Smoke burrows into lungs, causing inflammation and sometimes choking off breath - making those with COPD, asthma, allergies, and congestive heart failure especially vulnerable. Locals say it can feel like someone standing on your chest.
Residents do their best. Officials drive through remote areas near Cave Junction, making megaphone announcements about evacuations, says Laura Mancuso, who started non-profit Illinois Valley Wellness Resources to distribute home air purifiers. Neighbors without solid cell coverage banded together on a Citizens Band radio network to alert each other.
Chris Granville, 73, carries a handwritten note during wildfire season warning about severe asthma and allergies that can cause her to temporarily stop breathing. 'Allergy reaction,' it reads 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 of smoke season? She can't volunteer - she drives other seniors to appointments and groceries and worries about them needing her. 'I just want to show kindness. I wish [the smoke] would go over the ocean where nobody is.'
Back to 2013: Joy would look out odd-shaped windows and see Harvey asleep in a hammock while soup-thick smoke clung to the valley. A nighttime cough and intense fatigue had started in late spring, deepened, and rattled. Harvey went in and out of the hospital, frustrated, leaving before answers. By late summer, he entered for the final time. Diagnosis: pneumonia. Joy and Sara believe smoke contributed and accelerated the illness. Doctors listed cause of death as sepsis - seemingly unrelated, but smoke weakens the immune system and increases sepsis risk. It's hard to link any individual death to smoke, but studies show long-term exposure is analogous to smoking cigarettes. Sara and Joy believe Harvey died too soon.
How do we still love our home when it's dangerous? When there are cancerous knots in the wood? Joy has congenital heart failure and a heart arrhythmia; she knows smoke is extra-risky for her, just as it was for Harvey. She checks the weather - there's still a wildfire one county over, the East Evans Creek Fire. Her fire-watch app shows red and orange evacuation zones. The next afternoon, smoke rises unseen; the evacuation zone grows. The sky stays blue above the gallery, classic rock on the radio. A vacationing woman stumbles in, marveling, '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.'
John D Sutter is an assistant professor of environmental media at the University of Oregon, independent climate journalist and film-maker, living in Eugene, Oregon.