From heatwaves to power shifts: the hidden links between climate shocks, health access, and attitude toward coups in Africa

BACKGROUND: Climate shocks increasingly threaten Africa’s economic and institutional stability, yet their indirect effects through social sectors such as health remain insufficiently understood. Guided by political economy and welfare theory, this study examines how climate-induced disruptions affect access to healthcare, public or institutional trust, and the broader risk of social unrest and attitude towards coups d’état support across African countries. METHODS: The analysis uses cross-sectional data from 53,176 households across Africa and applies an ordered probit model with country fixed effects to account for country size and population structure. RESULTS: Climate shocks notably drought and flood events, significantly reduce access to healthcare services and erode public trust in health governance systems. Diminished health access and declining institutional confidence further increase the likelihood of social unrest and coup events, serving as key mediating channels through which environmental stress contributes to political instability. CONCLUSION: Strengthening climate-resilient health infrastructure, decentralizing public health financing, and investing in highly exposed regions are essential policy responses. Enhancing social protection and institutional credibility can help break the destabilizing feedback loop between environmental shocks, welfare declines, and political unrest.