Environmental health literacy as knowing, feeling and believing: an analysis of the links between race, ethnicity and socioeconomic status and the willingness to adopt protective behaviors against health threats

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Int J Environ Res Public Health. 2022 Feb 25;19(5):2701. doi: 10.3390/ijerph19052701.

ABSTRACT

This study examines the relationships between environmental health literacy, people’s characteristics (race, ethnicity, and socioeconomic status) associated with health disparities, and people’s willingness to engage in protective behaviors against environmental threats to health. Environmental health literacy is a framework for capturing the continuum between knowledge of environmental impacts on public health and the skills and decisions needed to take action to protect health. We pay particular attention to three dimensions of environmental health literacy: factual knowledge (knowing the facts), knowledge sufficiency (feeling ready to decide what to do), and response effectiveness (believing that the behaviors of protection are working). In June 2020, we collected survey data from North Carolina residents on two topics: COVID-19 viral infection and industrial contaminants called per- and polyfluoroalkyl substances (PFAS). We used their responses to test stepwise regression models with willingness to engage in protective behaviors as the dependent variable and other characteristics as the independent variables, including environmental health literacy. For both themes, our results indicate that no disparity appears according to socioeconomic factors (level of education, household income or location of residence). We observed disparities in willingness by race, comparing black participants to white participants, but not comparing white participants to Native American, Alaska Native, Asian, Hawaiian, or Pacific Islander participants, nor Hispanic participants. to non-Hispanic participants. Willingness disparities between black and white participants persisted until we introduced the environmental health literacy variables, when the difference between these groups was no longer significant in the final regression models. The results suggest that focusing on environmental health literacy may close a gap in the willingness to protect oneself based on factors such as race/ethnicity and socioeconomic status, which have been identified in the literature on environmental health as driving health disparities.

PMID:35270393 | DO I:10.3390/ijerph19052701

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