Climate change anxiety among young women living in the urban slums of Kampala, Uganda: findings from the baseline assessment of the TOPOWA cohort study.

Introduction: Climate change is an emerging global health crisis, particularly in low-resource settings like Uganda's urban slums. These areas face significant challenges in mitigating climate risks, exacerbating the vulnerability of residents. This study aims to assess the prevalence of climate change anxiety and its association with generalised anxiety among young women living in urban slums. Understanding this relationship is crucial for developing community-based mental health strategies and resilience-building initiatives to address the psychological impact of climate change. Methods: This study utilises baseline data from 'The Onward Project On Wellbeing and Adversity' (TOPOWA), a prospective cohort study focused on mental illness and social determinants of health among young women aged 18-24 years living in Kampala's urban slums. A total of 300 women were recruited from three sites: Banda, Bwaise and Makindye. At baseline, interviewer-administered surveys measured climate change anxiety using the 13-item Climate Anxiety Scale and generalised anxiety using a 7-item scale. Bivariate and multivariate analyses were conducted to determine the associations between climate anxiety, generalised anxiety and demographic factors. Results: Of the 249 women included in the analysis, 21% reported moderate to severe levels of climate change anxiety, while the remaining 79% experienced mild to minimal levels. Multivariate analysis revealed a strong association between higher levels of generalised anxiety and increased climate change anxiety. Additionally, older age was linked to higher climate anxiety, whereas higher education levels and living in multigenerational households were associated with lower levels of climate anxiety. Conclusion: One in five young women in Kampala's urban slums experiences moderate to severe climate change anxiety, closely linked to generalised anxiety. These findings highlight the urgent need for targeted mental health interventions and community-based resilience programmes. Leveraging family support in multigenerational households may also play a role in reducing climate-related anxiety and fostering adaptive coping mechanisms.