Rural poverty and climate mental health

by Zhihong Cai
December 3, 2025

Share this entry:

Defining rural poverty

Poverty is a key driver of climate-related mental health impacts, and rural populations are especially vulnerable. Globally, nearly 80% of people in extreme poverty live in rural areas, often relying on climate-sensitive livelihoods such as agriculture, forestry, fishing, hunting, mining, or tourism. In the United States, about 46 million people (15% of the population) live in rural areas, where uninsured rates are higher, health facilities are fewer, and chronic disease is more common than in urban settings. For this entry, rural low-income communities refer to populations outside cities—villages, small towns, or isolated homesteads—that face persistent poverty and limited services. While poverty also exists in cities, communities in rural poverty generally have fewer resources and are more directly dependent on natural resources, leaving them highly exposed to environmental change. This pattern applies globally: in the Global South, poverty is widespread and often national in scale, while in wealthier countries, rural low-income populations exist alongside more affluent areas, but face parallel vulnerabilities.

As the United Nations reports, climate change “disproportionately affects the poorest and most vulnerable“. With limited political power and resources, rural low-income communities are often located in hazard-prone areas and struggle to adapt or recover from climate-driven disasters. Those who contribute least to global emissions therefore bear the heaviest burdens. These climate-driven disparities compound existing health inequalities. Addressing rural poverty is critical for advancing climate and health justice.

Rural poverty in the climate crisis: vulnerabilities multiplied

Many of the factors that make communities in rural poverty vulnerable to climate change also directly and indirectly harm mental health:

Structural inequalities: Rural populations often live in climate-vulnerable areas, including floodplains, drought-prone zones, wildfire-prone areas, areas of sea-level intrusion and/or heavily polluted areas.
Fragile infrastructure: Roads, bridges, internet and communication systems, and water and waste management are often unreliable and vulnerable to disrepair.
Housing: Homes without proper insulation or cooling leave residents at higher risk during heatwaves or cold spells. Decades of disinvestment have also limited housing options and allowed housing stock to deteriorate, leaving families chronically exposed to environmental hazards.
Economic instability and food insecurity: Living paycheck to paycheck or subsistence farming offers little protection against climate shocks like crop failure or storm damage.
Lacking adequate transportation: Makes it difficult to evacuate before disasters, increasing exposure to traumatic events and post-disaster mental health problems. Rural communities have fewer roads, making it hard to evacuate.
Pollution: While urban residents are more commonly exposed to vehicle exhaust, rural populations face pollution from biomass combustion and burning. Agricultural burning, seasonal wildfires, and the use of wood, coal, or other fuels for household heating release large amounts of fine particulate matter and toxic chemicals into the air, which harm physical and mental health. In addition, communities located near farms, mining, or small-scale manufacturing may encounter hazardous pollutants such as pesticides or heavy metals.

How does climate change impact the mental health of low-income rural communities?

Climate change harms mental health through multiple pathways, including post-traumatic stress after disasters, anxiety over environmental change, and mood problems linked to heat and pollution. These impacts are especially severe in low-income rural communities, where poverty, family hardship, and environmental vulnerability are combined with limited access to mental health care due to stigma, cost, and scarce services. For example, research as part of the Rural Families Speak project found many rural low-income mothers with clinical depression symptoms, stigma is a barrier to care, and mothers in the study reported strong distrust in health-care professionals and their prescribed treatments, which further reduces help-seeking. In another example, studies show that food insecurity is associated with increased depressive symptoms, feelings of shame, and social isolation, particularly among older adults in low- and middle-income countries. Climate change worsens challenges by increasing trauma from disasters and the psychological strain from heatwaves and poor air quality. Rural areas also face higher suicide risks as prolonged droughts, rising temperatures, and farm losses drive distress, particularly among disadvantaged groups with few resources. Limited health care access, often further disrupted by disasters, leaves many without treatment.

Despite evidence that the highest rates of mental illness occur in the lowest-income communities in the United States, mental health has long been overlooked in global climate justice policy—only entering the United Nations climate conference agenda in 2023. Some rural communities can have a sense of community interconnectedness, connection to land, and solidarity, which may provide emotional support. However, others can be socially isolated. The unique needs and strengths of each rural low-income community must be placed first in addressing trauma, anxiety, basic needs, and related challenges as climate impacts intensify.

Unequal Socioeconomic Impacts

Climate change often amplifies pre-existing inequalities. Here are a few factors among rural low-income communities that are exacerbated by climate impacts:

Gender: Rural women-headed households face greater economic losses from climate extremes due to gender inequalities. Combined with caregiving pressures, these losses raise women’s risk of stress and depression. For example, in Kenya, drought-related income loss has been linked to rising gender-based violence and substance abuse, with women often the victims. Such layered challenges worsen women’s mental health in low-income communities.
Children and the elderly: Stressful events in early life—like disasters, displacement, or food insecurity—are linked to poorer mental health outcomes later, including anxiety and depression. For children in low-income families, these risks are worsened by limited access to clean water, nutrition, education, and recreation and outdoor play which can magnify trauma and hinder recovery. The elderly face compounded grief—not only from losing homes, but also places with deep personal meaning—while often being isolated and lacking social support.
Race/Ethnicity: Communities of color and Indigenous populations are far more likely to live in poverty. They face a “double injustice” of historic marginalization. Historical forced relocation to reservations placed Indigenous tribes on undesirable lands that are now among the most climate-vulnerable. As climate change worsens conditions in these fragile areas, it disrupts traditional governance, cultural and spiritual practices, and deep connections to the land.
Geography: Geographic location is a factor both within the United States and internationally. Disparities in climate mental health impacts are often most severe in the Global South, as compared to the Global North. In the Global South, rural communities face intensified fragilities due to limited infrastructure, healthcare access, and social protections. The majority of the rural poor live in Subsaharan Africa and South Asia.

Case studies on rural poverty and climate mental health

United States
In the U.S., climate-related disasters and extreme heat disproportionately harm the mental health of low-income communities. After the 2018 Camp Fire in California, which destroyed many mobile home parks, survivors were diagnosed with PTSD at rates comparable to war veterans. Research also shows that prolonged heat increases aggression and suicide risk. These findings show how climate change acts as a “threat multiplier” for America’s poor, worsening financial stress, housing insecurity, and lack of care.

Kenya
Kenya is experiencing a mental health crisis partly triggered by climate extremes. Communities have endured cycles of severe droughts and destructive floods that disrupt lives and livelihoods, leading to widespread anxiety, depression, and trauma. In 2020, the Taskforce on Mental Health in Kenya released a report urging the government to declare mental health a National Emergency, and acknowledging that climate change is a key driver of worsening well-being. However, a majority of Kenyans continue to lack access to mental healthcare. Mental health issues are particularly prevalent among smallholder crop farmers. Local initiatives are beginning to address these gaps by offering therapy sessions for women smallholder farmers, using telecom services to deliver pre-recorded counseling calls, and training community health champions as frontline responders. Though still limited in reach, these community-based efforts demonstrate practical ways to expand mental health support in rural Kenya.

Philippines
The Philippines, one of the world’s most climate-vulnerable countries, sees frequent natural disasters with profound mental health repercussions. For example, one study found that four months after Super Typhoon Haiyan, 80.5% of people who helped with relief response were at risk for mental disorders. Recent evidence shows that children in the Philippines are among the most climate-anxious globally, reporting extreme psychological distress related to repeated typhoons, displacement, and livelihood loss. These young people often live in poor, rural communities with limited mental health care, where schools and local health systems are under-resourced. Studies recommend incorporating climate-related mental health support into school curricula and community health systems to address this growing crisis.

What can we do to address climate mental health in rural low-income communities?

1. Expand Access to Mental Health Care
Make mental health services more available in rural and low-income areas by investing in local clinics, mobile counseling units, and telemedicine, and reduce stigma through community education. After disasters, provide temporary counseling centers and safe spaces to support recovery.

2. Strengthen Social Safety Nets
Reduce climate-related distress by improving financial protection, such as crop and livestock insurance, emergency cash support, and public work programs during climate shock events. Community savings groups and microfinance can also help families cope and recover more quickly, reducing long-term stress.

3. Increase Global Support and Climate Finance
Low-income countries need greater international funding to build climate-resilient health systems and include mental health in adaptation plans. Initiatives like the UN Loss and Damage Fund, established at COP27, represent important progress, but remain underfunded, with wealthy nations yet to deliver sufficient contributions. Climate finance should prioritize mental health, recognizing that climate disruptions can break down already fragile health delivery systems, especially in rural areas, where disasters cut off supply chains and medical services.

4. Strengthen Healthcare Infrastructure and Workforce
This includes upgrading rural clinics and hospitals to withstand extreme weather, ensuring reliable supply chains for medicines and equipment, and training healthcare professionals to address climate-related mental health needs. By reinforcing both infrastructure and human resources, health systems can better support vulnerable populations during and after climate shocks.

5. Provide Professional Training and Community Support
Strengthening mental health support in low-income communities requires training both professionals and community members. Healthcare providers—including doctors, nurses, and community health workers—should be equipped to recognize and address climate-related mental health issues. Training can integrate psychological first aid, stress management, and trauma care, guided by the WHO’s Mental Health Gap Action Programme (mhGAP). In addition, workshops for residents, school-based mental health education, and local crisis hotlines (such as ruralminds.org) can provide practical coping strategies and ensure accessible support during emergencies. Together, these approaches build a stronger safety net by combining professional expertise with community resilience.

6. Address Social Determinants of Health
Improving mental health in low-income communities requires tackling the root social, economic, and environmental conditions in which people live that drive vulnerability, known as social determinants of health. This includes expanding access to education, clean water, nutritious food, and safe housing; strengthening healthcare infrastructure; and reducing exposure to pollution. Without addressing these underlying determinants, mental health interventions alone will not be sufficient to build long-term resilience.

What else we need to know

Research on climate-related mental health impacts is still limited, especially for low-income rural populations. Most existing studies focus on the U.S. and other high-income countries; there is little research on the Global South — one review found no studies in many African countries.

There’s a need for:

Longitudinal studies tracking mental health outcomes over time in rural, resource-poor areas after climate disasters, where recovery is often slower due to limited infrastructure and health services.
Research on which interventions work best in resource-poor rural settings.
Investigation into vulnerabilities of marginalized rural groups (e.g., farmers with serious mental illness) to climate stressors, especially when livelihoods are climate-sensitive and relocation options are limited.

Closing these knowledge gaps is key to developing effective, equitable policies that ensure mental health support reaches rural communities most at risk.

Author and version info

Published: December 3, 2025

Author: Zhihong Cai, MPH Candidate in Environmental Health Sciences at Yale School of Public Health.
LinkedIn: www.linkedin.com/in/zhihong-cai-44541a342

Editor: Colleen Rollins, PhD

Rural poverty and climate mental health

Defining rural poverty

Rural poverty in the climate crisis: vulnerabilities multiplied

How does climate change impact the mental health of low-income rural communities?

Unequal Socioeconomic Impacts

Case studies on rural poverty and climate mental health

What can we do to address climate mental health in rural low-income communities?

What else we need to know

Further reading

Articles and Online Sources

Reports

Selected Research/Scientific Papers

Author and version info

Table of Contents

Rural poverty and climate mental health

Defining rural poverty

Rural poverty in the climate crisis: vulnerabilities multiplied

How does climate change impact the mental health of low-income rural communities?

Unequal Socioeconomic Impacts

Case studies on rural poverty and climate mental health

What can we do to address climate mental health in rural low-income communities?

What else we need to know

Further reading

Articles and Online Sources

Reports

Selected Research/Scientific Papers

Author and version info

#ezw_tco--1 .ez-toc-title{ font-size: 120%; ; ; } #ezw_tco--1 .ez-toc-widget-container ul.ez-toc-list li a{ ; ; ; } #ezw_tco--1 .ez-toc-widget-container ul.ez-toc-list li.active{ background-color: #ffffff; } Table of Contents

Table of Contents