Investigating associations and mediating effects between climate and mental health and violence in informal settlements in Kenya

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PROJECT SUMMARY/ABSTRACT Climate change and related weather events and environmental changes are expected to have a profound impact on psychological well-being and mental health. Residents of informal settlements in lower- and middle-income countries (LMICs) are especially vulnerable to the effects of changes in climate because these settlements are often located in ecologically sensitive areas, including valleys, floodplains, wetlands, industrial sites, and waste dumps—sites that are more susceptible to extreme weather events (EWEs) like floods, landslides, droughts, and heatwaves. Residents also face serious barriers to adaptation or reducing the effects of climate change, including poverty, political and social marginalization, and exclusion from formal services and legal land tenure. Though there is limited data, estimates also suggest that depressive disorder, suicide attempts, alcohol use, psychosocial stress, and interpersonal violence are likely higher among residents of informal settlements than in other populations in LMICs. Climate change is expected to exacerbate these mental health and violence challenges in the coming years. There is, however, a lack of empirical research exploring associations and potential mediating effects between climate and mental health- and violence-related outcomes in informal settlements. The objective of this Exploratory/Developmental Research Grant Award (R21), therefore, is to investigate associations and potential mediators between climate and mental health- and violence-related outcomes in these communities. This objective will be achieved through the following aims: 1) Household-level surveys will be collected monthly for 18 months from a probability sample of 800 women in Kibera and Mathare informal settlements in Nairobi. Surveys will include measures of mental health, well-being, substance use, and interpersonal violence. 2) Daily temperature and precipitation data from near Mathare and Kibera will be provided by the Kenya Meteorological Department and used to determine prevalence and frequency of EWEs in these settlements. This data will be compared with residents’ reports of localized EWEs including floods, landslides and heatwaves to help develop working definitions and meteorological thresholds of EWEs in informal settlements that align with residents’ experiences. 3) Meteorological data will be combined with participants’ responses from the monthly surveys in Aim 1 and surveys taken approximately 72 hours after EWEs in informal settlements. The combined dataset will be analyzed using time-series analysis to test associations and potential mediators between climate and mental health, well-being, substance use, and interpersonal violence in informal settlements. The long-term goal of this study is to provide helpful information about important climate thresholds related to mental health and interpersonal violence in informal settlements and to uncover key mediating factors underlying connections between these phenomena. Findings from the study could be used to identify critical points for intervention and climate change adaptation and provide a foundation for models and methods exploring climate and mental health and violence in other informal settlements around the world.