The present study aimed at investigating public perceptions of the relevance of climate change, the connection between climate change and health, and options for action against climate change. The main results were that the majority of a public population: (1) acknowledged the existence of climate change and its implications for human health, and were concerned about the associated risks of climate change; (2) perceived that other population groups would be more strongly impacted by climate change than the German population and themselves (only one in five participants had personally experienced health effects due to climate change); and (3) claimed to contribute to climate protection, while noting potential improvement in the climate change mitigating activities of cities and councils.
In the scientific community, there is a consensus that climate change is human-induced and associated with wide-ranging environmental changes that may negatively impact human health; accordingly, climate change is considered the greatest existential challenge faced by humanity [1, 2, 7, 17]. Despite this, research from 2018 [15] found that the public perception of climate change was characterised by psychological distance, with most participants downplaying its associated health risks. The authors called for targeted communication measures with comprehensive information and action plans for broad parts of the population, in order to influence risk perception and willingness to act. However, the results of the present study do not show a fundamental alteration in public perception. Concern about climate change and its implications remained high, particularly in relation to extreme weather events. Also, the health impacts of climate change were perceived as stronger for other population groups than for the participants themselves. Possible explanations for this have relevance for both climate change and its implications for health. Climate change and greenhouse gas emissions are not visible, and they are rarely immediately connected with their health risks [18, 19]. The high complexity of climate change, in terms of its processes, consequences and public controversies (fuelled by politicians and public figures), leads to public questioning of the substantially confirmed scientific findings on climate change and its implications [20–22]. Furthermore, cognitive dissonance theory might explain participants’ belief that other groups will be more strongly impacted by climate change than themselves. Specifically, dissonance between knowledge, conflicting values and actual behaviour may contribute to a distortion of understanding, information processing and decision making [23]. Cognitive dissonance theory has been recognised as influential in clinical medical practice and medical education [24], as well as the psychology of eating animals [25], and it might also apply to perceptions of climate change and its influence on human health. Different models of dissonance reduction strategies have been described, targeting attitudes, distraction and forgetting, denial of responsibility, and behaviour [26]. In particular, behavioural change strategies require significant effort, and they are not often experienced as comfortable or easy [23, 26]. This might explain why extensive action for climate protection is often lacking, on both individual and collective levels.
Nevertheless, in contrast to previous survey findings [15], a large proportion of participants in the present study saw and acknowledged health risks from climate change, in general. This difference may indicate the beginning of a shift in public perception regarding the association between climate change and human health. In recent years, media coverage of climate change and its consequences has increased in Germany, partly driven by the German alliance for climate change and health (KLUG e.V.) [27], and internationally, through the reports of the Intergovernmental Panel on Climate Change (IPCC) [3]. The health benefits connected to climate protection, especially regarding mobility and nutrition, are topics of public interest. Thus, coverage of these benefits may contribute to increasing the public’s awareness of the association between climate change and health. In line with this, healthcare professionals are becoming increasingly visible and outspoken on this association, and this might inspire the public to improve their contributions to climate change mitigation [12, 28–30]. Moreover, the idea that clinicians should play a more active role in responding to the climate crisis is being increasingly disseminated [31, 32]. To date, it remains unclear whether – and if so how – clinicians in Germany are addressing climate change and health issues, and if they may effectively compensate for patients’ and the public’s lack of knowledge in this respect. More research is needed regarding this significant opportunity for public education and sensitisation.
Strengths And Limitations
The results of the present study should be interpreted with caution, as the sample was not representative of the general population in Germany. Specifically, a large proportion of the sample was comprised of women with more advanced educational qualifications, reflecting a bias. Also, the fact that the survey was hosted by the BKK24 health insurance fund may have influenced the sample by reaching proportionately more individuals who were insured by that specific fund.