Vulnerability of Agriculture To Climate

PLOS ONE
RESEARCH ARTICLE
Vulnerability of agriculture to climate change

increases the risk of child malnutrition:
Evidence from a large-scale observational
study in India
Bidhubhusan Mahapatra ID1*, Monika Walia ID2, Chitiprolu Anantha Rama Rao3☯‡,
Bellapukonda Murali Krishna Raju3☯, Niranjan Saggurti1☯‡
1 Population Council, Zone 5A, India Habitat Centre, New Delhi, India, 2 International Food Policy Research
a1111111111
Institute, New Delhi & Ex-Population Council, New Delhi, India, 3 ICAR-Central Research Institute for Dryland
a1111111111 Agriculture, Santoshnagar, Saidabad, Hyderabad, India
a1111111111
a1111111111 ☯ These authors contributed equally to this work.
a1111111111 ‡ CARR and NS are joint senior authors on this work.
* [email protected], [email protected]
Abstract
OPEN ACCESS
Citation: Mahapatra B, Walia M, Rao CAR, Raju

BMK, Saggurti N (2021) Vulnerability of agriculture Introduction
to climate change increases the risk of child
The impact of climate change on agriculture and food security has been examined quite
malnutrition: Evidence from a large-scale
observational study in India. PLoS ONE 16(6): thoroughly by researchers globally as well as in India. While existing studies provide evi-
e0253637. https://doi.org/10.1371/journal. dence on how climate variability affects the food security and nutrition, research examining
pone.0253637 the extent of effect vulnerability of agriculture to climate change can have on nutrition in
Editor: Srinivas Goli, University of Western India are scarce. This study examined a) the association between the degree of vulnerability
Australia, AUSTRALIA in agriculture to climate change and child nutrition at the micro-level b) spatial effect of cli-
Received: January 3, 2021 mate vulnerability on child nutrition, and c) the geographical hotspots of both vulnerability in
Accepted: June 9, 2021 agriculture to climate change and child malnutrition.
Published: June 28, 2021

Methods
Peer Review History: PLOS recognizes the
benefits of transparency in the peer review The study used an index on vulnerability of agriculture to climate change and linked it to
process; therefore, we enable the publication of child malnutrition indicators (stunting, wasting, underweight and anaemia) from the National
all of the content of peer review and author Family Health Survey 4 (2015–16). Mixed-effect and spatial autoregressive models were fit-
responses alongside final, published articles. The
ted to assess the direction and strength of the relationship between vulnerability and child
editorial history of this article is available here:
https://doi.org/10.1371/journal.pone.0253637 malnutrition at macro and micro level. Spatial analyses examined the within-district and
across-district spill-over effects of climate change vulnerability on child malnutrition.
Copyright: © 2021 Mahapatra et al. This is an open
access article distributed under the terms of the
Creative Commons Attribution License, which Results
permits unrestricted use, distribution, and
Both mixed-effect and spatial autoregressive models found that the degree of vulnerability
reproduction in any medium, provided the original
author and source are credited. was positively associated with malnutrition among children. Children residing in districts with
a very high degree of vulnerability were more like to have malnutrition than those residing in
Data Availability Statement: The NFHS-4 data is
available at the DHS website and can be districts with very low vulnerability. The analyses found that the odds of a child suffering
downloaded from https://dhsprogram.com/data/ from stunting increased by 32%, wasting by 42%, underweight by 45%, and anaemia by
PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 1 / 15

PLOS ONE Climate change vulnerability and child nutrition in India
available-datasets.cfm. The climate data can be 63% if the child belonged to a district categorised as very highly vulnerable when compared
accessed by giving request at: http://dsp.imdpune. to those categorised as very low. The spatial analysis also suggested a high level of cluster-
gov.in/. The authors had no special access
privileges to the data others would not have.
ing in the spatial distribution of vulnerability and malnutrition. Hotspots of child malnutrition
and degree of vulnerability were mostly found to be clustered around western-central part of
Funding: The author(s) received no specific
funding for this work.
India.
Competing interests: The authors have declared

Conclusion
that no competing interests exist.
Study highlights the consequences that vulnerability of agriculture to climate change can
have on child nutrition. Strategies should be developed to mitigate the effect of climate
change on areas where there is a clustering of vulnerability and child malnutrition.
Introduction
Climate change is probably the most complex and challenging environmental problem faced
by the world today and is increasingly being recognized as a potent threat to agriculture in
general, and specifically to food security [1, 2]. Climate scientists have predicted that climate
change is going to have a significant impact on agriculture which will ultimately affect the
quality and quantity of food production [1, 3]. It is estimated that agricultural output in devel-
oping countries will decline by 10–20% by 2080 [4]. This will have adverse consequences in
achieving universal food security and meeting the nutritional requirement of communities [2,
5, 6]. Estimates suggest that with the changing climate, in 2050, there will be 62% more severe
stunting cases than what could be without any change in the current climatic scenario [7]. Cur-
rently, about one billion people are deprived of enough food [8], over 150 million children are
stunted, and another 50 million are wasted [9]. Though recent evidence suggests that there
have been some improvements in nutritional indicators, climate change can undermine ongo-
ing efforts to reduce hunger and enhance food security [7, 10]. The situation in India is much
like the global scenario where with changing climate and ever-growing population, the
demand for food is bound to increase further. An increase in 1–2˚C in temperature is going to
have a negative impact on the yield of major cereal crops in low altitude countries like India
[11] which in turn will impact the nutritional status of the population [12].
The literature review for this study focused on reviewing documents on issues of climate
change, agriculture, food security, and nutrition. The literature search suggests that there have
been several studies globally and in the Indian context that have examined the impact of cli-
mate change on agriculture and food security. The available body of evidence estimating
impact of climate change on agriculture, food security and nutrition have documented the
impact of rainfall and temperature variability (including level and pattern) as well as of
extreme weather events on undernutrition among children [3, 13–17]. A study conducted in
Mali, Africa found that by 2025, due to climate and livelihood changes an additional million
children will be exposed to increased risk of malnutrition [13]. Similarly, a longitudinal study
conducted in Ethiopia between 1996–2004 estimated that while one standard deviation (SD)
increase in rainfall may lead to 0.24 SD increase in moderate stunting, one SD increase in tem-
perature may lead to 0.22 SD decrease in moderate stunting [13, 14]. In Indian context, studies
examining the impact of climate change on malnutrition found that children in flood affected
households were twice more likely to be stunted and underweight compared to their counter-
parts living in non-flooded areas. Research specific to India suggests that with the current level
of crop yields remaining constant till 2050, there will be a severe shortage of micronutrient

supply to the households [18]. Prior research has also examined the impact of rainfall and tem-
perature variability (including level and pattern) on undernutrition among children. While
existing studies provide evidence on how climate variability affects the food security and nutri-
tion, there has been dearth of research examining the extent of effect vulnerability of agricul-
ture to climate change can have on nutrition in India. The current study contributes to
existing body of evidence on climate change and nutrition by assessing whether vulnerability
of agriculture to climate change is linked to the nutritional status of communities. The study
aims to answer three research questions: (i) Is there an association between the degree of vul-
nerability in agriculture to climate change and child nutrition at the micro-level? (ii) Is there
any spatial effect of climate vulnerability on child nutrition? and (iii) Which are the geographi-
cal hotspots of both vulnerability in agriculture to climate change and child malnutrition?
Methods
Data
The study used two data sources: (i) climate vulnerability index developed under National Ini-
tiative on Climate Resilient Agriculture (NICRA) project of the Indian Council of Agricultural
Research (ICAR) [12, 19] and (ii) children’s nutritional status derived from National Family
Health Survey 4 (NFHS-4).
Climate vulnerability index. Intending to make Indian agriculture resilient to climate
change, ICAR launched the NICRA in the year 2011. Per Intergovernmental Panel on Climate
Change (IPCC), the NICRA study considered the integrated approach to define vulnerability
as “a function of the extent and degree to which an entity is exposed, the sensitivity of the
entity to climate change and adaptive capacity to adapt to and cope with the changing climate”
[20]. The study used 38 indicators from various sources to construct the index on vulnerability
of agriculture to climate change for 572 Indian districts (as per the Census of India 2001).
These indicators were chosen and assigned to the three components of vulnerability–sensitiv-
ity, exposure, and adaptive capacity based on literature review, their relevance, and discussions
with subject experts (Table 1). Selection of these 38 indicators was based on the extent and
intensity of the effect of climate change and/or variability as reflecting its sensitivity. For exam-
ple, indicators such as net sown area and rural population density (Table 1) determine the
extent of the problem whereas the indicators such as water holding capacity of soil, frequency
and intensity of occurrence of climate shocks determine the intensity or degree of effect of
such shock. Likewise, indicators that are relatively more responsive to policy measures were
considered for the adaptive capacity component of vulnerability. Indicators under each com-
ponent of vulnerability were first normalized using the following min-max formula. When the
indicator was positively related to the index, the formula used was:
Xi Xmin
Zi ¼
Xmax Xmin
When the indicator was negatively related to the index, the formula used was:
Xmax Xi
Zi ¼
Xmax Xmin
where Zi = normalized value of ith district with respect to the indicator X

Xi = value of indicator in original units for ith district
Xmin = minimum value of the indicator in original units across the districts
Xmax = maximum value of the indicator in original units across the districts

Table 1. Indicators of sensitivity, exposure and adaptive capacity used for computing vulnerability index.
Sensitivity Exposure Adaptive capacity
Net sown area in relation to geographical area (%) Change (%) in annual rainfall during mid-century Rural poor defined as the % of rural population that
(2021–50) relative to the baseline (1961–90) is below poverty line
Extent of degraded and waste lands in relation to Change (%) in June rainfall during mid-century (2021– SC/ST population (%)
geographical area (%) 50) relative to the baseline (1961–90)
Average annual rainfall (mm) Change (%) in July rainfall during mid-century (2021– Workforce in agriculture defined as % of workers
50) relative to the baseline (1961–90) engaged in agriculture in relation to total workers
Cyclone proneness constructed by combining the Change (%) in number of rainy days during mid- Literacy (%)
number of cyclones crossing the district, number of century (2021–50) relative to the baseline (1961–90)
severe cyclones crossing the district, probable
maximum precipitation for a day, probable maximum
winds in knot, probable maximum storm surge
Area prone to flood incidence as % geographical area Change in maximum temperature (˚C) during mid- Gender gap defined as the difference between total
century (2021–50) relative to the baseline (1961–90) literacy and female literacy
Drought proneness computed by combining the Change in minimum temperature (˚C) during mid- Access to markets defined as number of agricultural
probability of occurrence of severe and moderate century (2021–50) relative to the baseline (1961–90) markets per 1 lakh holdings
droughts
Available water holding capacity of the soil defined as Change in incidence of extremely hot days during Road connectivity defined as % of villages that have
the amount of water that the soil can hold (mm) March to May when temperature exceeds the normal by paved roads in relation to total number of villages
4˚C at least during mid-century (2021–50) relative to
the baseline (1961–90)
Stage of groundwater development (Ratio of draft to Change in incidence of extremely cold days during Rural electrification defined as number of villages
availability) December to February when temperature falls below the with electricity supply in relation to total number of
normal by 4˚C at least during mid-century (2021–50) villages (%)
relative to the baseline (1961–90)
Rural population density defined as number of rural Change in frequency of occurrence of frost days (during Net irrigated area defined as % of net sown area
people per square km of geographical area Dec-Feb) during mid-century (2021–50) relative to the with access to irrigation
baseline (1961–90)
Area owned by small and marginal farmers in relation Change in drought proneness during mid-century Density of livestock defined as number of livestock
to total sown area (%) (2021–50) relative to the baseline (1961–90) (small and large ruminants) expressed in terms of
adult cattle units per sq. km of geographical area
Change in incidences of dry spells of � 14 days during Fertilizer consumption (N + P + K) per ha of gross
June to October during mid-century (2021–50) relative sown area
to the baseline (1961–90)
Extreme rainfall events represented through four Groundwater availability (ha m/sq. km)
different indicators: change (%) in 99 percentile rainfall,
change (%) in number of events with > 100 mm rainfall
in 3 days, change in mean maximum rainfall in single
day as % to annual normal, and change in mean
maximum rainfall in 3 consecutive days as % to annual
normal during mid-century (2021–50) relative to the
baseline (1961–90)
Share of agriculture in district domestic product
defined as % of district domestic product
contributed by agriculture
Source: Rao et al. [12]
https://doi.org/10.1371/journal.pone.0253637.t001
This was followed by computing the weighted mean of assigned indicators to construct
indices for sensitivity, exposure, and adaptive capacity. Lastly, the vulnerability index was com-
puted by taking weighted average of the three indices—with weights of 25, 40 and 35 to expo-
sure, sensitivity and adaptive capacity respectively [12, 19]. All census districts were
categorized into five equal quintiles where the districts with top 20% vulnerability score were
considered very highly vulnerable and those in the bottom 20% were considered as very low
vulnerable. More information on the various definitions, formulas, and weights used to com-
pute component-wise and vulnerability index can be found in detail in the study report [19].

National Family Health Survey-4 (NFHS-4). The Indian equivalent of the Demographic
and Health Survey (DHS)—NFHS is conducted at regular intervals to generate information on
various fertility, mortality, child health, and nutrition indicators at the district, state, and
national levels. The fourth round of NFHS was conducted in 2015–16 and 699,686 women aged
15–49 years old were interviewed from 601,509 households across all states and union territories
(UTs) of India. Data on stunting, wasting and underweight for 243,213 children and anaemia
for 216,049 children born to ever-married women in the last five years preceding the survey was
available. The women were recruited through a stratified two-stage sampling process. In the
first stage, primary sampling units (PSUs) were selected systematically using a probability pro-
portional to size approach, and a fixed number of households and eligible women were selected
within the PSUs. In rural areas, a village was considered as the PSU, whereas in urban areas it
was a census enumeration block. More information on the sampling procedure along with the
distribution of socio-demographic, household-level and individual-level characteristics at the
state as well as district level can be found in the NFHS-4 Reports [21].
Matching vulnerability index data with NFHS-4. While the vulnerability index was com-
puted for 572 districts as per Census 2001, NFHS-4 provided information on the nutritional
status of children under five years of age for all 640 districts as listed in Census 2011. Therefore,
to conduct the analysis, a district-level mapping exercise was carried out. A list of 572 districts,
for which vulnerability index data was computed, was first matched with NFHS districts based
on the district/town names. Districts that were common across both data were assigned the
corresponding overall vulnerability, sensitivity, exposure, and adaptive capacity indices. For
newly formed districts that were available in NFHS-4 data but not in the vulnerability data,
indices corresponding to their origin district were assigned. For example, Anjaw district of
Arunachal Pradesh was assigned the indices corresponding to its origin district Lohit as avail-
able in the vulnerability data. In four instances where new districts were carved out from more
than one Census 2001 district, all four indices for newly formed districts were computed by
calculating the median of origin district indices. All 16 metropolitan cities/ UTs for which vul-
nerability index was not available were excluded from the analysis. Following the assumption
that these 16 districts were not considered as they are mostly urban and may not have relevant
indicators required for constructing the index, 10 more districts were dropped from the
remaining UTs. This resulted in observations from 614 districts of all states sans UTs. After
these matching, the district level vulnerability map was recreated for the 614 districts (S1 Fig)
and compared with the map based on 572 districts created originally by Rao et al. [19] and
found no difference in district categorization.
Ethics statement
The authors did not collect any primary data for this study. Further, the climate change vulner-
ability index did not include any data collected from human participants. The nodal agency
for collecting NFHS-4 data was International Institute for Population Sciences (IIPS), Mum-
bai. The protocol for NFHS-4 data collection was approved by institutional review boards of
IIPS and ORC Macro.
Measures
Nutritional status outcomes. Among all living children under the age of 5 years, nutri-
tional status outcomes considered for this study were stunting, severe stunting, wasting, severe
wasting, underweight, severe underweight, anaemia, multiple malnutrition, and all forms of
malnutrition. DHS definitions per the World Health Organization’s (WHO) child growth stan-
dard were used to compute measures on children’s nutritional status. Any child whose height-

for-age z score was below minus 2 (-2.0) SD of the mean value was defined as stunted, whereas
a child with height-for-age z score below -3.0 SD of the mean was defined as severely stunted. A
child was defined as wasted if his/her weight-for-height z score was below -2.0 SD of the mean
value. Severely wasted children had a weight-for-height z score below -3.0 SD of the mean. Any
child whose weight-for-age z score was below -2.0 SD of the mean value was defined as under-
weight, whereas a child with a weight-for-age z score below -3.0 SD of the mean was defined as
severely underweight. Children aged 6–59 months who stayed in the household the night before
the interview with haemoglobin count lower than 11.0 grams per decilitre (g/dl) were defined as
anaemic. All living children under the age of 5 years were defined to have multiple malnutrition
if out of the four considered nutritional outcomes—stunting, wasting, underweight, and anae-
mia—they had at least two. If a child was stunted, wasted, underweight as well as anaemic s/he
was defined to have all forms of malnutrition. The socio-economic and demographic character-
istics that were used as covariates in multivariable analyses are religion, caste, wealth index,
place of residence of the household, number of household members, age of the child, sex of the
child, mother’s education, and birth order. These variables were recoded from the original ques-
tions to make them suitable for the present analysis.
Statistical analyses
Bivariate and multivariable analyses were conducted to examine the association of degree of
vulnerability with the nutritional status of children. Spatial analysis was also conducted to
understand the macro-level association and spill-over effect a district’s climate vulnerability
can have on child malnutrition. The analysis was started by conducting bivariate analysis
between the degree of vulnerability and nutritional status of children. To answer the first
research question, mixed-effect multilevel models were fitted to examine the strength of associ-
ation between vulnerability and child nutrition. In the mixed-effect model, births were nested
within primary sampling units (as defined in NFHS-4 data), which were nested within a dis-
trict and controlled for socio-demographic, household, and maternal characteristics.
Spatial analysis was conducted at the district-level where child malnutrition indicators were
transformed into proportions. First, spatial autocorrelation was computed using Moran’s I
and Geary’s C to understand the extent of spatial clustering in child malnutrition and climate
vulnerability. Both these indices provide an idea on the extent to which a spatial regression is
suitable. The Moran’s I value ranges from -1 to +1 where a positive value indicates positive
spatial autocorrelation, and a negative value indicates the negative autocorrelation. Higher the
absolute Moran’s I value, stronger is the spatial autocorrelation and vice-versa [22]. The
Geary’s C ranges from 0 to 2; where 1 is no spatial autocorrelation, values near 0 are positively
spatially correlated and those closer to 2 are highly negatively autocorrelated. Additionally,
hotspots and coldspots were identified using bivariate Local Indicators of Spatial Association
(LISA) (Research question # 3). The bivariate LISA generates a choropleth map highlighting
the districts with a significant local Moran statistic and classifies them into high-high and low-
low spatial clusters, and high-low and low-high spatial outliers. The high-high pairing suggests
clustering of values, whereas high-low and low-high locations indicate spatial outliers.
Subsequently, mixed spatial autoregressive error models were fitted for each of the nutrition
outcome indicators independently that considered both spatial lag and spatial error. In these
spatial regression models, the degree of vulnerability was considered as the key predictor and
shares of poor population (head count ratio [23]), proportion of population who belong to
rural areas, general caste and Hindu religion were included as covariates. Given that coeffi-
cients from a spatial autoregression should not be directly interpreted [24, 25], calculations
were within the district (direct) and spill-over (indirect) based on the model coefficients to

answer the second research question. Stata module spregress followed by estat impact was used
to derive these estimates. In addition to the spatial and multivariable analyses, districts bur-
dened with vulnerability and malnutrition were also identified by filtering out districts catego-
rized as having high/very high vulnerability and listing out those districts with child
malnutrition levels higher than country average (Research question # 3). Except for the Bivari-
ate LISA, the rest of the analyses were performed using STATA 16.1 (StataCorp., TX, USA).
The maps from Bivariate LISA were generated using GeoDa.
Results
In the study sample, about one-fifth (21%) of children were found to be wasted, two-fifths
were stunted (39%) and underweight (36%), and three-fifths had anaemia (59%) (Fig 1).
Nearly half of the children (48%) had multiple malnutrition and one in twenty (5%) had all the
form of malnutrition.
Q1. Is there an association between the degree of vulnerability in

agriculture to climate change and child nutrition at micro-level?
The degree of vulnerability was positively associated with malnutrition among children
(Table 2). For example, children residing in districts with very high degree of vulnerability
were more like to have stunting (41% vs 31%, Adjusted Odds Ratio [AOR]: 1.32, 95% CI: 1.21–
1.44), wasting (24% vs 19%, AOR: 1.42, 95% CI: 1.27–1.60), underweight (39% vs 30%, AOR:
1.45, 95% CI: 1.30–1.61) and anaemia (63% vs 52%, AOR: 1.75, 95% CI: 1.47–2.08) than those
living in districts considered to have very low degree of vulnerability. The magnitude of differ-
ence between very high and very low degree of vulnerability was observed to be higher for chil-
dren severely stunted, severely wasted and severely underweight.
Q2. Is there any spatial effect of climate vulnerability on child nutrition?

The spatial autocorrelation assessed using Moran’s I and Geary’s C suggests that there is clear
evidence of geographic clustering in both nutrition indicators and degree of vulnerability
(Table 3). The evidence of clustering was found to be strongest for children being underweight,
Fig 1. Prevalence of various nutritional status indicators among children aged five or below.
https://doi.org/10.1371/journal.pone.0253637.g001

Table 2. Unadjusted percentage and adjusted odds ratio predicting the nutritional status of children by the degree of climate vulnerability, India.
Degree of climate vulnerability Intra-class correlation
coefficient
Very low Low Moderate High Very high District District>PSU
Stunting
% (N = 211,748) 31.4 36.5 38.9 43.1 40.9
AOR (95% CI) Referent 1.15 (1.05–1.26) 1.25 (1.15–1.37) 1.34 (1.23–1.46) 1.32 (1.21–1.44) 0.02 0.10
Severe stunting
% (N = 211,748) 11.4 14.3 16.2 19.8 18.5
AOR (95% CI) Referent 1.16 (1.04–1.30) 1.32 (1.18–1.47) 1.51 (1.36–1.69) 1.54 (1.38–1.71) 0.03 0.14
Wasting
% (N = 211,748) 19.2 20.3 20.1 21.5 23.6
AOR (95% CI) Referent 1.02 (0.90–1.15) 1.12 (0.99–1.26) 1.25 (1.11–1.41) 1.42 (1.27–1.60) 0.04 0.15
Severe wasting
% (N = 211,748) 6.2 7.0 7.1 7.6 8.8
AOR (95% CI) Referent 1.06 (0.90–1.26) 1.22 (1.04–1.43) 1.35 (1.15–1.58) 1.61 (1.38–1.88) 0.05 0.26
Underweight
% (N = 211,748) 30.0 33.7 35.5 40.0 38.6
AOR (95% CI) Referent 1.08 (0.97–1.21) 1.27 (1.14–1.41) 1.44 (1.30–1.60) 1.45 (1.30–1.61) 0.03 0.11
Severe underweight
% (N = 211,748) 8.1 9.9 10.6 13.0 12.9
AOR (95% CI) Referent 1.13 (1.00–1.29) 1.26 (1.11–1.43) 1.49 (1.32–1.69) 1.61 (1.43–1.82) 0.03 0.16
Anaemia
% (N = 197,186) 52.3 54.4 58.8 61.0 62.6
AOR (95% CI) Referent 1.02 (0.85–1.22) 1.43 (1.20–1.71) 1.59 (1.33–1.89) 1.75 (1.47–2.08) 0.10 0.21
Multiple malnutrition
% (N = 188,930) 38.9 44.1 47.2 52.2 51.6
AOR (95% CI) Referent 1.12 (0.99–1.26) 1.38 (1.23–1.55) 1.58 (1.41–1.77) 1.65 (1.47–1.85) 0.04 0.13
Note: Mixed effect multilevel model adjusted for religion, caste, wealth index, place of residence, number of household members, age of the child, sex of the child,
mother’s education, birth order
followed by stunting and anaemia. The spatial autoregressive model suggests that malnutrition
among children is likely to be more in districts that are very highly vulnerable to climate com-
pared to those that have a very low degree of vulnerability (Table 4). For example, stunting is
likely to be 3% more in very highly vulnerable districts than those with very low vulnerability.
Similarly, compared to districts categorised as very low in terms of vulnerability, children from
the very high category are 4% more likely to have wasting and underweight, and 6% more
likely to have anaemia. Similar within district effects were noted for those districts with high
vulnerability. The study also examined if the district’s vulnerability has a spill-over across dis-
tricts. Districts categorized as very high vulnerability were also found to be more likely to have
a spill-over effect across the neighbouring districts. For example, districts with very high vul-
nerability are likely to have a spillover effect of stunting by 0.24 percentage point compared to
very low vulnerability district.
Q3. Which are the geographical hotspots of the degree of vulnerability in

agriculture to climate change and child malnutrition?
The Bivariate LISA maps (Fig 2) show the hotspots and coldspots in the spatial relationship
between the degree of vulnerability and child malnutrition indicators. The number of high-

Table 3. Moran’s I and Geary’s C values assessing degree of autocorrelation in degree of vulnerability and nutri-
tion status of children.
Moran’s I
Indicators I Z-Value P-Value
Very high degree of vulnerability 0.459 18.8 <0.001
Stunting 0.643 26.3 <0.001
Severe stunting 0.571 23.3 <0.001
Wasting 0.500 20.5 <0.001
Severe wasting 0.273 11.2 <0.001
Underweight 0.730 29.8 <0.001
Severe underweight 0.627 25.6 <0.001
Anaemia 0.617 25.2 <0.001
Geary’s C
C Z-Value P-Value
Very high degree of vulnerability 0.591 -13.2 <0.001
Stunting 0.315 -24.1 <0.001
Severe stunting 0.397 -19.9 <0.001
Wasting 0.495 -16.6 <0.001
Severe wasting 0.708 -7.9 <0.001
Underweight 0.240 -27.0 <0.001
Severe underweight 0.358 -21.2 <0.001
Anaemia 0.367 -21.0 <0.001
high clusters varied across child nutrition indicators: 92 for underweight, 79 for stunting, 75
for wasting and 65 for anaemia. Similarly, the number of low-low clusters were highest for
underweight (113) and least for wasting (82). The LISA maps suggest that hotspots of child
malnutrition and degree of vulnerability are mostly clustered around western-central part of
India though there were some hotspots for stunting in the eastern part of the country as well.
Further drill-down of the district-level data found a total of 69 districts that had high levels of
stunting, wasting, underweight and anaemia together with high/very high level of vulnerability
(S1 Table). These districts belonged to the states of Bihar, Chhattisgarh, Gujarat, Haryana,
Jharkhand, Karnataka, Madhya Pradesh, Maharashtra, Rajasthan, and Uttar Pradesh (Table 5).
Discussion
Climate scientists have predicted that climate change is going to have a significant impact on
agriculture which will ultimately affect the quality and quantity of food production [1, 3]. This
study examined how the vulnerability of a district to climate can affect child nutrition. The
study found that districts highly vulnerable to climate change can have more child malnutrition
than districts which are relatively less vulnerable. The mixed-effect analysis found that the odds
of a child suffering from stunting increased by 32%, wasting by 42%, underweight by 45% and
anaemia by 63% if the child belonged to a district categorised as very highly vulnerable when
compared to those categorised as very low. The magnitude of effects was stronger when exam-
ined for severe- stunting, wasting and underweight. The macro-level spatial analysis demon-
strated that rates of child malnutrition were higher by 3–5% for very highly vulnerable districts
than very low vulnerable ones. The study also investigated if the effect of high/very high vulner-
ability on child nutrition transferred to neighbouring districts and found significant evidence of
spill-over for stunting but not for wasting, underweight and anaemia. Lastly, the study used
bivariate spatial maps and macro-level data to identify the clusters where child malnutrition

Table 4. Expected percentage gain/reduction in nutritional status of children within and across districts by degree of vulnerability estimated using spatial autore-
gressive model.
Degree of climate vulnerability
Very low Low Moderate High Very high
Stunting
Within-district direct effect Referent 1.32 (-0.26–2.91) 2.25 (0.54–3.96) 3.08 (1.23–4.92) 3.50 (1.49–5.50)
Across district spill-over effect Referent 0.09 (-0.04–0.22) 0.16 (-0.01–0.32) 0.21 (0.01–0.41) 0.24 (0.03–0.46)
Auto-correlation 0.73, P<0.001
Severe stunting
Wasting
Within-district direct effect Referent 0.40 (-1.12–1.91) 0.53 (-1.09–2.15) 2.37 (0.64–4.10) 3.62 (1.76–5.48)
Across district spill-over effect Referent 0.04 (-0.13–0.21) 0.06 (-0.12–0.24) 0.26 (-0.02–0.53) 0.39 (0.03–0.75)
Severe wasting
Within-district direct effect Referent 0.03 (-0.93–0.99) 0.67 (-0.34–1.67) 1.24 (0.17–2.31) 2.42 (1.30–3.54)
Across district spill-over effect Referent 0.001 (-0.13–0.13) 0.09 (-0.07–0.25) 0.17 (-0.05–0.39) 0.33 (-0.04–0.69)
Underweight
Across district spill-over effect Referent 0.07 (-0.11–0.26) 0.23 (0.002–0.46) 0.44 (0.13–0.76) 0.42 (0.11–0.72)
Severe underweight
Anaemia
Within-district direct effect Referent -0.1 (-2.78–2.57) 2.57 (-0.37–5.5) 3.61 (0.41–6.82) 4.91 (1.35–8.47)
Across district spill-over effect Referent -0.01 (-0.15–0.14) 0.14 (-0.09–0.36) 0.19 (-0.09–0.48) 0.26 (-0.09–0.62)
Note: Spatial autoregressive models were adjusted for proportion poor, living in rural areas, and belonging to general caste and Hindu religion.
and vulnerability were high. Further, the study identified 69 districts that were battling the dou-
ble burden of high/very high climate vulnerability as well as child malnutrition.
India being the second largest populous country with a heavy dependency on agriculture,
high vulnerability of certain regions to climate change can be cause of concern to agricultural-
ists and policymakers [26]. Though the country has seen significant economic development in
the last couple of decades, similar progress has not been made in addressing child malnutrition
[27]. Child malnutrition is prevalent across states whether they are at the forefront of eco-
nomic development (e.g. Gujarat) or lagging (e.g. Bihar, and Uttar Pradesh) [28]. While the
study provides indisputable evidence on effect agriculture’s vulnerability to climate change,
this effect may be further explained by inadequate health infrastructure and poverty. A closer
look at the 69 districts facing the double burden of climate vulnerability and child malnutrition
suggests that most of these districts and states are characterized by poor health infrastructure
in rural areas, low literacy, rudimentary sanitation, and poverty. A study by Khan and
Mohanty has highlighted how poverty has a significant impact on child malnutrition in India

Fig 2. Bivariate LISA-based maps highlighting hotspots and coldspots in spatial correlation between the degree of vulnerability and child malnutrition.
https://doi.org/10.1371/journal.pone.0253637.g002
[28]. Consistent with earlier studies, the hotspots of child malnutrition and degree of vulnera-
bility are concentrated in the areas where hotspots of poverty and child malnutrition have
been identified. This suggests a close relationship between the degree of vulnerability and pov-
erty level which should be explored further in future research. The clustering of vulnerability
levels and child malnutrition indicates the extent to which climate change can affect the food
production system and ultimately the nutrition of children in the short run and adults in the
long run. However, the early evidence from this study provided an opportunity to govern-
ments and programmers to develop sustainable solutions towards mitigating the effects that
climate change will have on agriculture and human health.
Of the notable findings in this study is the estimation of within-district and spill-over effect
of climate vulnerability on child malnutrition. Among all the malnutrition indicators, the effect
of vulnerability was most on anaemia (5% [within-district + spill-over]), followed by under-
weight, stunting and wasting (4%). Notably, the malnutrition indicators had higher spatial auto-
correlation suggesting geographical clustering. Within-district effects of climate vulnerability,
particularly for high and very highly vulnerable districts were substantially significant. This
indicated that there will be a significant effect of climate vulnerability on child malnutrition

Table 5. Number of districts by state which have child malnutrition levels higher than India average in districts categorized as “high” or “very high” in degree of
vulnerability.
Stunting Wasting Underweight Anaemia
Andhra Pradesh (2) Bihar (7) Andhra Pradesh (2) Andhra Pradesh (1)
Assam (1) Chhattisgarh (5) Bihar (19) Bihar (18)
Bihar (19) Gujarat (19) Chhattisgarh (5) Chhattisgarh (1)
Chhattisgarh (4) Haryana (5) Gujarat (14) Gujarat (13)
Gujarat (12) Jharkhand (12) Haryana (2) Haryana (9)
Haryana (1) Karnataka (16) Jharkhand (12) Himachal Pradesh (2)
Jharkhand (12) Madhya Pradesh (30) Karnataka (13) Jammu & Kashmir (1)
Karnataka (9) Maharashtra (14) Madhya Pradesh (32) Jharkhand (11)
Madhya Pradesh (23) Odisha (1) Maharashtra (12) Karnataka (15)
Maharashtra (9) Punjab (2) Odisha (1) Madhya Pradesh (33)
Rajasthan (15) Rajasthan (20) Rajasthan (19) Maharashtra (4)
Uttar Pradesh (27) Tamil Nadu (6) Uttar Pradesh (22) Odisha (1)
Uttar Pradesh (11) Uttarakhand (1) Punjab (2)
Uttarakhand (2) West Bengal (1) Rajasthan (16)
West Bengal (1) Uttar Pradesh (22)
Uttarakhand (1)
among districts categorized as very high/high, irrespective of the neighbouring districts’ vulner-
ability level. The spill-over effect of vulnerability was significant for all malnutrition indicators
except for anaemia. This again highlighted that the effect of vulnerability is not limited by the
geographical boundaries rather the effect can extend to neighbouring districts as well. Interest-
ingly, the spill-over was not present when severe malnutrition was examined.
The findings of the study should be interpreted in the light of following limitations. First,
union territories and completely urban districts were excluded from the analysis as the vulnera-
bility index values were not available for those areas. Second, the original index was based on 572
districts which re-mapped into 614 districts, as a result some of the district’s vulnerability ranking
may have been wrongly assigned. However, it is assumed that such misplacing would be very
minimal and not likely to change the results presented in the study. To ensure that mapping of
degree of vulnerability is robust, the vulnerability maps provided by Rao et al. [19] for 572 dis-
tricts were matched with the one generated for 614 districts. Third, the study did not examine
the dietary intake pattern (both quantity and quality) of children and their families which is likely
to have an influence on their nutritional status. Future research should collect dietary intake data
and examine if vulnerability to climate change has an influence on dietary intake and whether
the pattern of consumption play a role in determining the relationship between vulnerability and
nutritional status. Lastly, obtaining data on all the variables/indicators for a uniform reference
period at the district-level is extremely difficult. While vulnerability index computation used the
most recent data available for each unit of analysis, for missing data statistical methods such as
using nearest neighbourhood value, average value of respective state, simulation and extrapola-
tion methods were used to derive the indicators at the district level for computing vulnerability
index. While not a limitation to this study, it is also to be noted that the vulnerability index cre-
ated were assigned unequal weights to the three dimensions of adaptive capacity, exposure, and
sensitivity. Though unequal weight assignment is well justified by the authors [12, 19], it would
have been worth exploring how the vulnerability index would look if equal weights were assumed
and how that, in turn, would affect the evidence generated by the study.
The study has important implications for both research and policy to address climate vul-
nerability and child malnutrition. Existing and future programs in India, specifically those

focussing on nutrition and agriculture, should consider the vulnerability of agriculture to cli-
mate change in developing their strategies. For areas where agriculture is vulnerable to climate
change, there should be increasing efforts to grow staple crops that can sustain in given cli-
matic conditions as well as meet the nutritional requirements of the population. Given that the
current research identifies such geographic cluster, it would be important to develop cluster-
specific agricultural plans based on the nutritional requirements of the area. While this study
identified clusters of geographies where vulnerability and malnutrition exist, it would be
important to further drill down and identify the sub-clusters (sub-district or panchayat) within
those areas where the problem lies. This will help more specific targeted programming for agri-
culture and providing nutrition supplements to children. While this study identified the effect
of vulnerability to climate change on child malnutrition, future research should explore
whether the climate vulnerability has an impact on adults’ nutritional status and other co-mor-
bidities emerging from malnutrition. In conclusion, this is the first study to examine the rela-
tionship between the degree of vulnerability in agriculture to climate change and child
malnutrition. The study found strong evidence at both micro and macro levels on how the vul-
nerability of agriculture to climate change can result in child malnutrition. The clustering of
vulnerability and child malnutrition at few select states and districts that are historically
known for multiple deprivations further highlights the need to have a holistic approach to
bring change in the lives of people living in those geographical areas. Finally, this effect of cli-
mate vulnerability is not limited to that district, but it spills to the adjoining areas as well.
Supporting information
S1 Fig. Degree of vulnerability of agriculture to climate change at district level.
(TIF)
S1 Table. Districts categorized as “high” or “very high” in degree of vulnerability and hav-
ing child malnutrition levels higher than India average.
(DOCX)
Author Contributions
Conceptualization: Bidhubhusan Mahapatra, Chitiprolu Anantha Rama Rao.
Data curation: Monika Walia, Bellapukonda Murali Krishna Raju.
Formal analysis: Bidhubhusan Mahapatra, Monika Walia, Bellapukonda Murali Krishna
Raju.
Investigation: Chitiprolu Anantha Rama Rao.
Methodology: Bidhubhusan Mahapatra, Niranjan Saggurti.
Software: Bidhubhusan Mahapatra.
Supervision: Niranjan Saggurti.
Validation: Chitiprolu Anantha Rama Rao.
Visualization: Bidhubhusan Mahapatra, Chitiprolu Anantha Rama Rao.
Writing – original draft: Bidhubhusan Mahapatra.
Writing – review & editing: Monika Walia, Chitiprolu Anantha Rama Rao, Niranjan
Saggurti.

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Vulnerability of agriculture to climate change

Citation: Mahapatra B, Walia M, Rao CAR, Raju

Published: June 28, 2021

PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 1 / 15

Competing interests: The authors have declared

PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 2 / 15

where Zi = normalized value of ith district with respect to the indicator X

PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 3 / 15

Source: Rao et al. [12]

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PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 5 / 15

PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 6 / 15

Q1. Is there an association between the degree of vulnerability in

Q2. Is there any spatial effect of climate vulnerability on child nutrition?

PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 7 / 15

Q3. Which are the geographical hotspots of the degree of vulnerability in

PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 8 / 15

PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 9 / 15

PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 10 / 15

PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 11 / 15

PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 12 / 15

PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 13 / 15

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PLOS ONE | https://doi.org/10.1371/journal.pone.0253637 June 28, 2021 15 / 15

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