As global environmental change, including climate change, is expected to increase pressure on disease transmission processes, integrated tools such as the WADI will become more critical. The WADI methodology can be extended with the use of scenarios or projected data (e.g. climate change, land use change, or population density projections) to better understand the dynamic nature of vulnerability to water-associated disease. For instance, some areas in Malaysia such as the highlands could suffer expansion of vulnerable areas if temperatures increase enough to support dengue vector populations, a future application of the tool. The approach also has potential to be incorporated with other types of vulnerability assessment, such as for floods or droughts, and forms part of an emerging suite of tools available for vulnerability assessment at the water-health nexus.