Young women are at at increased risk of school dropout, transactional sex, gender-based violence, and early pregnancy, leading authors of a new paper to declare climate change a public health emergency rather than just an environmental issue.

The authors received anecdotes from 297 participants, including 119 elders and 178 young adolescents across six climate-affected regions in Kenya: Mathare, Kisumu, Isiolo, Naivasha, Kilifi, and Kalobeyei Refugee Settlement. They used focus groups, walk-along interviews, and participatory mapping workshops to find out how climate change-induced resource insecurities are shaping sexual health risks. They recount stories about the shame of not having clean clothes or menstrual supplies, and how it led them to stay home from school or enter exploitative relationships just to meet basic needs, and how drought, floods, and resource shortages are aggravating the problem.

The authors then identified direct and indirect pathways linking extreme weather events to poor sexual health outcomes, such as droughts and floods disrupting food systems, contributing to school dropout, street involvement and homelessness, and sexual exploitation.

Water shortages were linked to educational disruptions and exposed girls to harassment and violence at collection sites. Lack of access to safe sanitation contributed to menstruation-related school absences and coercive sexual encounters in exchange for menstrual supplies.

The authors call for climate-informed interventions for young adolescents in low-resource, high-risk settings and say they work offers a roadmap for policy makers, NGOs, and health systems working at the intersection of environmental justice and adolescent health.

“We must act quickly to develop climate-informed, adolescent-centred, and gender-transformative programs,” says co-author Dr. Julia Kagunda, Director of Elim Trust. “These programs must address the root causes of insecurity to protect young people’s health and futures.”