Extreme Weather Events and Mental Health in Climate-Vulnerable Communities: Results from a Large-Scale Survey of Women Living in Informal Settlements in Nairobi, Kenya

Background and Purpose: Climate change has profound direct and indirect impacts on mental health. Despite variations in climate risks across different geographic locations and terrain, the local social, economic, and political conditions that shape vulnerabilities result in the most underserved communities bearing a disproportionate burden of climate impacts and compounding impacts on mental health. Residents of informal settlements–defined as areas lacking durable housing, basic infrastructure, and secure tenancy–are among the most vulnerable to the impacts of climate change. These settlements are often located in ecologically sensitive areas more susceptible to extreme weather events (EWEs). Rates of common mental health disorders, including depression and anxiety, are already higher in informal settlements, and climate change is expected to exacerbate these challenges. Adding to experiences of marginalization, women residents of these settlements are more likely to experience worse health-related impacts from EWEs than men but are less likely to have access to health-related services. Despite this, there is little research on the impacts of EWEs on the mental health of residents living in informal settlements, especially women. This study aims to help fill this gap by exploring the relationship between experiences of EWEs and mental health among women living in informal settlements.

Methods: Baseline survey data was collected from a probability sample of 800 women living in two of the largest informal settlements in Nairobi, Kenya–Kibera and Mathare. Mental health measures included the Personal Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), previously validated in this context. Participants were asked whether they or their families had experienced an extreme weather event in the past month, including colder than usual temperatures, hotter than usual temperatures, droughts, heavy downpours, or “other.” Separate linear regressions were used to explore associations between experiences of EWEs and depression and anxiety.

Results: Approximately 37% of participants had symptoms of mild depression, 22% moderate, and 4% severe. Just under 36% of participants had symptoms of mild anxiety, 12% moderate, and 6% severe. Results from regression analyses showed significant associations between mental health outcomes and the following extreme weather events: hotter than usual temperatures (depression β=2.03, p=.005; anxiety β=1.89, p =.003); colder than usual temperatures (depression β =1.42, p =.001; anxiety β = 1.33, p = .001) and droughts (depression β = 3.93, p = .002; anxiety β = 4.26, p <.0001).

Conclusion and implications: Given already high rates of depression and anxiety in this population and limited access to mental health resources, our findings reveal a critical point for intervention. Expanded mental health support, including participatory and locally-led action, may be a critical prevention and adaptation strategy to reduce the impacts of climate change on mental health in these communities. By leveraging interdisciplinary and empowerment approaches to address climate impacts, social workers can not only help strengthen their capacity to address the urgent mental health challenges posed by climate change, but also empower communities to champion their resilience-building through adaptation efforts.