Climate events like drought adversely affect the health and livelihoods of mobile or migrant communities. Individuals take various actions to reduce these risks – but how does climate adaptation in one domain, like livelihood, potentially increase risk in another, like health? How might actions to reduce health risks now, like by improving food security, increase health risks later, like to mental health?

We present findings from individual surveys (n = 90) and in-depth interviews (n = 16) with Rendille people in northern Kenya that were conducted to understand the health impacts of and responses to hydroclimate extremes. Like many other mobile peoples, Rendille are on the climate frontlines.

During a recent unprecedented drought (2020–2023), Rendille employed a range of strategies to reduce livelihood impacts and improve food security, including selling and slaughtering animals, sharing food, and going into debt to buy food. Importantly, herders changed their movement patterns, trekking an average of 7 days farther than usual with their animals in search of pasture. Some herders who moved their animals reported that being so far away increased loneliness and stress; however, we found no clear differences in self-reported health effects between herders who stayed close to home vs herders who left.

Examining potential co-harms or tradeoffs between different adaptations – like reducing risks to livelihood at a cost to health – will help policymakers and stakeholders better evaluate actions to reduce climate-related risks, especially for mobile populations.