Coping and Adaptation Strategies for Climate Change Among Women with Chronic Health Conditions and Disabilities: A Mixed-Methods Study

Background

Women with disabilities and chronic conditions living in the Global South are a climate-vulnerable population and are at higher risk of negative health outcomes due to climate change and weather-related events. Women with chronic conditions and disabilities living in informal settlements are subject to further vulnerabilities impacting their health. Informal settlements, defined as areas lacking secure and durable housing and basic infrastructure, are often located in ecologically sensitive areas (e.g., floodplains, wetlands, and riverbanks) making them especially vulnerable to the effects of climate change. Additionally, buildings and houses in these communities are often uninsulated. Steep slopes, narrow pathways, and lack of formal sanitation and solid waste management systems can also make navigating terrain difficult. Finally, access to healthcare is limited, and dense populations can promote the spread of infectious diseases. However, women with disabilities and chronic conditions living in informal settlements have been utilizing strategies to adapt.

Methods

In-depth interviews were conducted with 120 women as part of a study exploring women’s resilience in the face of climate change and weather-related events in two large informal settlements (Mathare and Kibera) in Nairobi, Kenya in 2023. Interviews were audio recorded with the consent of participants and transcribed. Thematic analysis was used to explore women’s disabilities and chronic health conditions and their strategies to cope and adapt in these settlements.

Results

Participants described a number of chronic health conditions and disabilities women are faced with in informal settlements, including diabetes, HIV/AIDS, pulmonary and heart conditions, and physical disabilities. However, they also discussed several strategies for coping and adaptation: Health 1. Disease prevention (weather-related strategies; cleaning; hygiene practices), 2. Health resources and healthcare (health services; health providers); 3. Health institutions or programs; Spirituality 1. Relying on God and prayer, 2. Spiritual support from others; Community 1. General support or collaboration (general problem solving; general collaborating with neighbors), 2. Resource support or collaboration (resource sharing; resource favors), 3. Infrastructure or environmental collaboration (infrastructure communal cleaning), 4. Emotional support or collaboration (empathy for others; guiding others), 5. Financial support or collaboration (pooling money; group-based finances), Emotional Resilience 1. Perseverance, 2. Self-motivation, 3. Stating busy or active, 4. Emotional support for others; and Youth 1. Youth cleaning drainages.

Conclusion

Despite the disadvantage women with chronic illnesses and disabilities in the Global South face, particularly in informal settlements, findings from this study suggest that they have developed a number of coping and adaptation strategies. Findings indicate that women in these communities, despite coping with a variety of disabilities and chronic conditions, have learned to tap into social, familial, and health supports to help them navigate their communities even in the face of climate change. These findings can inform how social workers understand current coping and resilience strategies for this population–allowing for better co-creation of community-based interventions to enhance equitable health promotion and wellness in the face of climate change for some of the world’s most climate-vulnerable people.