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BACKGROUND: In 2016, 23% of children (155 million) aged <5 were stunted. Global-level modeling has consistently found climate change impacts on food production are likely to impair progress on reducing undernutrition.

OBJECTIVES: We adopt a new perspective, assessing how climate change may affect child stunting via its impacts on two interacting socioeconomic drivers: incomes of the poorest 20% of populations (due to climate impacts on crop production, health, labor productivity, and disasters) and food prices.

METHODS: We developed a statistical model to project moderate and severe stunting in children aged <5 at the national level in 2030 under low and high climate change scenarios combined with poverty and prosperity scenarios in 44 countries.

RESULTS: We estimated that in the absence of climate change, 110 million children aged <5 would he stunted in 2030 under the poverty scenario in comparison with 83 million under the prosperity scenario. Estimates of climate change attributable stunting ranged from 570,000 under the prosperity/low climate change scenario to >1 million under the poverty/high climate change scenario. The projected impact of climate change on stunting was greater in rural vs. urban areas under both socioeconomic scenarios. In countries with lower incomes and relatively high food prices, we projected that rising prices would tend to increase stunting, whereas in countries with higher incomes and relatively low food prices, rising prices would tend to decrease stunting. These findings suggest that food prices that provide decent incomes to farmers alongside high employment with living wages will reduce undernutrition and vulnerability to climate change.

CONCLUSIONS: Shifting the focus from food production to interactions between incomes and food price provides new insights. Futures that protect health should consider not just availability, accessibility, and quality of food, but also the incomes generated by those producing the food.