The impact of heat stress on the mental health of rural workers in Rajasthan

The Hindu

09-07-2025

A multi-city study in India found that around 1,116 people die from extreme heat each year. Climate change causes extreme weather events that disproportionately impact those already marginalised by caste, socio-economic class, gender, sexuality, (dis)ability, religion, and geography. It is becoming clear that heat experiences are not just physical; they are also influenced by social status and privilege. In Delhi, for instance, 192 persons, mostly homeless or working-class, died during last year's heatwave.
While discussions largely focus on how climate change affects productivity, income and physical health impacts, mental health implications remain under explored. This gap led the Mariwala Health Initiative to study three rural areas in Rajasthan, one of India's hottest States, to assess the impact of heat stress on rural workers, especially those facing multiple marginalisations. The study included 97 participants—43 men and 53 women—and four focus group discussions with women. The group came from OBC, ST, SC, Muslim, Christian, and general castes communities, as well as families impacted by silicosis.
Why rural India?
Research often highlights the heat faced by urban working-class communities due to working and living conditions.
The prioritisation of urban settings and neglect of mental health consequences limits climate justice discussions and subsequent policy interventions. The Heat Action Plan of Rajasthan overlooks actionable points for rural communities with scant attention paid to their psychosocial needs. Critically, three-quarters of Rajasthan's population lives in rural areas, primarily as manual labourers under MGNREGA, or in mining, stone-breaking, construction, and agriculture. This economic and social marginalisation is emblematic of systemic distress that heat and climate change only intensify.
Additionally, their livelihoods are significantly linked to climate-dependent resources. This dependency puts them at higher risk of heat stress, water scarcity, and food insecurity as the climate crisis worsens. Limited access to healthcare, inadequate infrastructure, and lower literacy rates compound their vulnerability to heat stress and affect their ability to cope with climate shocks and adopt measures to mitigate impacts.
Psychosocial manifestations of heat stress
The study, conducted over the span of a year, found that prolonged exposure to heat influences people's perceptions of themselves, their families, and their community members, leading to a range of psychosocial responses.
Many reported extreme irritation, tension and heightened fatigue at having to work in extreme heat conditions. Respondents frequently described experiencing intense mood changes—such as feeling deeply sad, constantly anxious, or easily angered—as a regular part of their daily lives. They also reported that facing heat stress sometimes affected cognitive function, leading to difficulties with concentration and decision-making. They also felt that there were more instances of them being short-tempered, making decisions in a bad mood, and subsequently using violent behaviour and language.
Some labourers said they have worked honestly and for long hours, but if insulted or bothered without reason, they have reacted quickly, and fights have occurred. The absence of basic facilities like shaded areas or a steady water supply at worksites exacerbates their suffering.
Persons from Dalit or Adivasi communities face discrimination, and mentioned that they have to bring their own water to NREGA sites as access to shared water resources is denied.
For both working women and men, the fear of wage cuts if productivity falls below employer expectations, forces them into overwork, even in extreme heat. Resting, they said, was not an option, as it could cost them their wages. Financial insecurity fuels anxiety, helplessness, and depression.
The compulsion to continue to work outdoors or to maintain daily activities without protection against heat also results in emotional exhaustion and feelings of helplessness and despair. Some coping mechanisms used by men were increased alcohol and substance consumption. Male workers reported that they would have to get 'mentally ready' (taiyaar hona) to work in heatwaves, and so drinking alcohol was necessary. It was observed that this led to deregulation of impulse control, such as drunk and fast driving, a lack of concern for survival, and depressive episodes.
Both men and women expressed heightened anxiety, especially about losing control over agricultural harvests. They also felt unable to plan for their future or for those of the next generation.
For women, who may have to do both household and outdoor work during heatwaves - not only do they experience increased gender-based violence from family members, but in case work sites are shut down, this contributes to social isolation and loneliness. A 70-year-old widow, with a daughter who has a mental illness and a son-in-law battling cancer, walks 14 km daily to sell the milk from her cattle at the market. She suffers from severe arthritis, her legs and arms are bent because of the disease. 'Even if I am affected by the heat, there is nothing that I can do about it. I have to work to survive,' she said. She has been doing this as well as domestic and caregiving work in the heat.
Those with mental or physical health conditions found that heat stress worsened their symptoms.
Physical illnesses and related mental health symptoms
Extreme heat increases the risk of heat-related illnesses, with reports of constant headaches (suggesting heatstroke), blood pressure fluctuations, exhaustion, and dehydration being common. Heatstrokes alone can cause confusion, agitation and other mental health symptoms. Many people stated they lack time to visit a hospital when unwell, relying instead on local quacks, untrained practitioners, or direct visits to pharmacists, as primary healthcare centres are often closed. Since there is a direct correlation between physical health and mental health, it is no surprise that workers spoke of stress in a way that encapsulated both.
Individuals with chronic illnesses, such as silicosis—a preventable yet debilitating and incurable disease caused by working without protective gear in stone mines—continue to work and send their children to do the same, despite knowing the fatal consequences. The extreme heat exacerbates the physical symptoms of their illness, leading to panic attacks, depressive symptoms, and shortness of breath. In addition, persons with disabilities are left with no choice but to work in the heat.
Rethinking policy
India's disaster management framework determines which calamities qualify for financial assistance through the National and State Disaster Response Funds. However, extreme heat—despite its devastating impact on lives and livelihoods—is not recognised as a disaster eligible for relief measures, except in a few States. This exclusion leaves millions, particularly rural workers, without institutional support during increasingly frequent and intense heat waves.
Rajasthan has introduced a Rural Heat Action Plan. However, the plan falls short in several key areas. It does not account for how different marginalised communities are disproportionately affected by extreme heat. There is a glaring absence of climate adaptation measures tailored to their specific vulnerabilities, such as lack of access to drinking water on communal work sites, shaded workspaces, addressing 'rest' in a domestic work space, or financial compensation for heat-related productivity loss, etc. Furthermore, the plan completely overlooks the mental health consequences of heat stress.
During field visits to labour sites, we found no evidence of the interventions promised in the policy. The lack of awareness and implementation raises serious concerns about the effectiveness of the plan and the State's commitment to protecting its most marginalised citizens from the escalating heat waves.
These findings highlight the need for public health interventions addressing not only physical dangers but also the psychosocial effects of rising heat. Policy and related strategies must engage with the deep structural inequalities tied to heat-related psychosocial stressors.
(Raj Mariwala is director, Mariwala Health Initiative, Mumbai. [e-mail]; Ishwar Singh is an independent researcher and activist based in central Rajasthan. [e-mail]; Saba Kohli Dave is an editorial associate and development practitioner based in Delhi. [e-mail])