Extreme Cold Events and Implications for Disability and Functionality in Women Living in Informal Settlements in Kenya

Background and purpose: Climate change and extreme weather events (EWEs) are expected to have a profound impact on the health and functionality of all humans, but people with disabilities are more vulnerable to these effects. In fact, disabled people are up to four times more likely to die, report bodily harm, and show symptoms of trauma. The effects of EWEs can be worse for women with disabilities residing in informal settlements. Informal settlements, defined as areas lacking secure and durable housing and basic infrastructure, are particularly vulnerable to the effects of climate change because they are often located in ecologically sensitive areas (e.g., floodplains, wetlands, and riverbanks). Extreme cold may be especially harmful to women with disabilities in informal settlements where access to healthcare is limited; buildings and housing are often uninsulated; and steep slopes, narrow pathways, and lack of formal sanitation and solid waste management systems make navigating the environment difficult. Additionally, people with mobility disabilities or with preexisting chronic health conditions (e.g., Arthritis) are already disproportionately impacted by extreme cold. This study aims to explore the impacts of extreme cold on the functionality of women in informal settlements in Kenya, including moderating factors such as age.

Methods: This study is part of a large community-participatory, longitudinal study investigating the impacts of climate change on women’s health and well-being in informal settlements. It used regression analysis to explore the impact of extreme cold events on women’s functionality using a 12-item version of the WHODAS 2.0, which assesses disability status. Baseline survey data were collected from a probability sample of 800 women living in two of the largest informal settlements in Nairobi, Kenya.

Results: Findings indicate that a total of n=391 participants (48.9%) reported having experienced an extreme cold event in the month leading up to the survey. About 21% of participants met the cutoff (24+ on the WHODAS 2.0) for a disability. Participants who reported that an extreme cold event impacted theirs or members of their households' daily lives saw a 2.5-point decrease in their functioning (p < .000). Additionally, age had a significant moderating effect, i.e., for participants who reported that an extreme cold event impacted theirs or members of their households' daily lives, each additional year of age was associated with a 0.12 point decrease in their functioning (p < .000).

Conclusions and implications: Findings suggest that women in informal settlements experience negative effects of extreme cold on their functioning. As a critical disability and climate justice issue, women with disabilities deserve special attention when developing climate adaptation strategies meant to mitigate the negative impacts of climate change on residents of informal settlements. As social workers strive to “create [transformative] social responses to a changing environment” as part of the Social Work Grand challenges, it is critical to not only understand the impacts of EWEs on vulnerable populations, especially women with disabilities living in informal settlements, but to develop new partnerships, deeply engage, support, uplift, and co-create solutions with these women.