Climate change is a global crisis that disproportionately affects vulnerable agrarian communities, exacerbating food insecurity and health risks. This qualitative study explored the relationship between climate change and health in the following two rural sub-counties of Kilifi County, Kenya: Ganze and Magarini. In fall 2023, we conducted 16 focus group discussions with adolescent girls (14–17), young adults (18–30), and older adults (31+). Thematic analysis revealed that climate change adversely affects health through key social determinants, including economic instability, environmental degradation, limited healthcare access, food insecurity, and disrupted education. Participants reported increased food scarcity, disease outbreaks, and reduced access to medical care due to droughts and floods. Economic hardship contributed to harmful survival strategies, including transactional sex and school dropout among adolescent girls. Mental health concerns, such as stress, substance use, and suicidal ideation, were prevalent. These findings highlight the wide-ranging health impacts of climate change in agrarian settings and the urgent need for comprehensive, community-informed interventions. Priorities should include improving nutrition, reproductive and mental health services, infectious disease prevention, and healthcare access.