Weather and health shocks in rural Uganda: heterogeneous consumption effects and coping strategies

Abstract Background Compound and cascading shocks are common in rural areas and pose significant threats to food security and household welfare. While the importance of these combined shocks for rural communities is gaining attention, there is still very limited empirical research on the topic. This paper aims to assess the joint effects of weather and health shocks on the food, non-food, and total consumption of rural households in Uganda while also exploring heterogeneity in these effects across households and discussing the underlying mechanisms and coping strategies Our analysis uses customized high-frequency panel household survey data collected across six waves, employing fixed effects quantile regression method and a control function approach to address the potential endogeneity of health shocks. Results The findings indicate that a short-term increase in temperature above the long-term average is associated with a reduction in total and non-food consumption by approximately 15–26%. Among poorer households, the association between temperature and non-food consumption is particularly strong, exceeding 30%. Moreover, lagged temperature shocks are associated with significant declines in non-food consumption across all quantiles. This pattern suggests that the relationship between heat stress and household welfare may extend beyond the immediate exposure period. Higher lagged temperatures amplify the hospitalization–food consumption relationship. Positive rainfall deviations increases average food consumption overall but has heterogeneous effects across the distribution, reducing food consumption at the 20th–40th percentiles and increasing it at the 60th–80th percentiles, and compounds the adverse effect of prolonged illness. Additionally, the findings reveal considerable mobility in consumption among rural households over 12 months. Even households in the richest quartile may find themselves in the lowest consumption categories at certain times of the year. To manage these fluctuations in consumption, the poorest quartiles tend to rely on group networks and loans, while wealthier quartiles more frequently utilize remittances. Conclusion and policy implications Recognizing Uganda’s vulnerability to extreme weather events and epidemics, this paper suggests key policy measures. Enhancing social protection through access to credit, social networks, safety nets, and health insurance can help households cope with climate challenges. These strategies will strengthen food system resilience and promote sustainable development.