Situated in the heart of the Ohio River valley, Cincinnati will find itself constantly worried about inundations from one source or another. Even high ridges will find themselves moving from islands at time to being underwater for short periods of time. The rising sea level from melting poles will eventually make the city unlivable altogether. During the shift itself, the greatest danger comes from local torrential rains colliding with a backwash coming up from the Mississippi. Survivors will find themselves moving into the Appalachian mountains over time, pushed there by a widening Ohio River that will cut off access in all directions within months of the shift.