It was an incredibly warm winter in the nation’s capital—March was the warmest on record, capping five straight months of above-average temperatures. And I’m looking at a forecast now calling for a high of ninety-five degrees on Saturday, even before June hits.

Yet policymakers here are reluctant (let’s phrase it generously) to take serious action to combat the underlying problem of climate change. There have been some positive steps—like the EPA’s proposal to limit carbon pollution from new power plants and the delay and possible termination of the Keystone XL pipline—but many frustrating failures as well. It’s been years since any serious effort was made at climate change legislation. I can’t remember the last time Obama spoke about it, and his campaign is not promising much of anything in that regard. In fact, this morning’s New York Times describes in detail how Obama is eager to expand oil drilling off the coast of Alaska.

Perhaps if policymakers were more keenly attuned to the negative externalities of climate change—the bad effects beyond just breaking out your shorts a little earlier than usual—more serious action might be possible. Bill McKibben, in an excellent article for The Nation earlier this year, noted that rising temperatures will have devastating effects on plants, soil and the agricultural industry; dried-out forests mean more massive wildfires; mild winters lead to more disease-spreading ticks.

But there’s a human cost as well: more than many realize, the human body is extremely sensitive to heat, and higher temperatures mean many more deaths across the country. A new report from the National Resources Defense  Council estimates that by the end of the century, 150,000 additional Americans will die from excessive heat caused by climate change if the problem isn’t arrested.

Assuming that by the year 2100 carbon pollution doubles, which it’s projected to do absent any policy changes, the report looks at how many Extreme Heat Events there would be in American cities. EHEs are when a location’s temperature, dew point, cloud cover, wind speed and surface atmospheric pressure combine to create unhealthy conditions for human beings, particularly the young, elderly and infirm. The report is based on two peer-reviewed studies in meteorological journals.

Louisville, Kentucky, is projected to be the worst hit, with 19,000 excess deaths projected by the end of the century. Detroit and Cleveland are the next on the list, with 17,900 and 16,600 excess deaths respectively.

The toll in other cities:

• Baltimore: 2,900 deaths

• Boston: 5,700 deaths

• Buffalo: 3,190

• Chicago: 6,400 deaths

• Columbus: 6,000 deaths

• Denver: 3,500 deaths

• Los Angeles: 1,200 deaths

• Minneapolis: 7,500 deaths

• New York: 1,127 deaths

• Philadelphia: 700 deaths

• Pittsburgh: 1,200 deaths

• Providence, RI: 2,000 deaths

• St. Louis: 5,600 deaths

• Washington, D.C.: 3,000 deaths

A complete list is here. It’s a sobering wake-up call to the suffering that awaits if carbon pollution isn’t slowed down.