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The Cape Hatteras Lighthouse in North Carolina was moved inland in 1999 to prevent it from being lost to the sea due to coastal erosion and sea level rise. The structure, weighing over 4,800 tons, had seen its distance from the ocean shrink from 1,500 feet at construction to 120 feet by the end of the twentieth century. This relocation serves as an example of the 'hard choices' required to protect historic sites as sea levels in the Outer Banks rise two to three times faster than the global average and Category 4 and 5 hurricanes in the North Atlantic have roughly doubled since 1970.

The report analyzes 52 tide gauges from Maine to Texas, projecting that by 2045, many U.S. East and Gulf Coast communities will face a ten-fold increase in tidal flooding. It argues that such flooding will disrupt daily life, damage infrastructure, and necessitate a coordinated national response combining local adaptation—such as elevating roads and restoring wetlands—with global carbon emission reductions.