What do climate impacts, health, and migration reveal about vulnerability and adaptation in the Marshall Islands?

Climate change is impacting public health in the Republic of the Marshall Islands (RMI). Meanwhile, migration within the RMI and abroad is driven, in part, by access to better healthcare, and migration is also expected to be accelerated by climate change. Based on a survey of 199 RMI households, this study used logistic regression and hierarchical clustering to analyze the relationships between climate stressors, climate-related health impacts, and migration outcomes and identify vulnerable segments of the population. Climate stressors were experienced by all respondents but no significant correlations were found between stressors, health impacts, and expectation to migrate. When grouped according to the climate stressors they faced, however, one group was characterized by low stressors, high wealth, and a low expectation to migrate, whereas another experienced very high climate stressors, low wealth, and a high expectation to migrate. Only the first exhibited a statistically significant relationship between climate-related health impacts and migration; however, for the second, climate stressors were significantly related to proximate determinants of health, and there was no association with migration. To create equitable adaptation outcomes across diverse society, policies should expand economic and education prospects and reduce vulnerability to the direct and indirect health impacts of climate change.