Application of the intergovernmental panel on climate change risk framework to estimate risk of weather-related diarrheal disease in Western Kenya

Identifying the underlying climate sensitive health risk factors is critical to establish actionable strategies to mitigate the health impacts of climate change. This is particularly true within low- and middle-income countries (LMICs) with limited resources, heterogenous climates, and varying degrees of social vulnerability. In Kenya, diarrheal disease is one of the leading causes of death and identifying climate sensitive risk factors is critical. This research aims to characterize factors associated with a high risk of diarrheal disease in western Kenya by developing a risk index based on the Intergovernmental Panel on Climate Change (IPCC) risk framework. We developed a conceptual model of risk factors based on prior research with risk factors grouped into the four components of the IPCC risk framework: hazard, exposure, and vulnerability (which is comprised of sensitivity and adaptive capacity). We obtained 30 data elements corresponding to the four components for 99 sub-counties in 14 western Kenya counties. We conducted principal component analysis (PCA) to develop a risk index for diarrheal disease. Our risk index aligns with epidemiological literature, including precipitation, temperature, water sanitation and hygiene (WASH), sensitive populations, education, poverty, and health facilities. Within counties, we found that the modeled risk varied substantially, and a geographic cluster of high-risk sub-counties was identified. Further research is needed to determine whether modeled risk proves to be consistent with observed risk of diarrheal disease in relation to weather variables. Further work is needed to determine whether this approach is useful to policymakers.