The AUstralian-CLimate and Health Attitudes, RIsk and Trust in the sYstem (AU-CLARITY) Study: A National, Representative Survey.

Abstract

Climate change, associated with heat spikes, floods, wildfires and changing patterns of vector-borne diseases, is a major determinant of health, and health system functioning. Understanding public perceptions of climate-related health risks and system preparedness can support equitable policy responses and effective health messaging. Cross-sectional. Online survey from 20 June to 27 August 2025. 6030 adults, aged ≥ 18 years, broadly representative of the Australian population. The AUstralian-CLimate and Health Attitudes, RIsk and Trust in the sYstem (AU-CLARITY) survey collected data on demographics, health status, experiences of climate-related events, and views on climate change and health system preparedness. Respondents (65%, 3910/6030) were concerned about climate change, yet only 45% (2735/6030) perceived it as a serious risk to their own health. Personal risk perception declined with age (odds ratio [OR] = 0.98; 95% confidence interval [CI], 0.98-0.98) and was higher among females (OR = 1.28; 95% CI, 1.15-1.43), First Nations people (OR = 1.44; 95% CI, 1.22-1.71), multilingual individuals (OR = 1.44; 95% CI, 1.22-1.71) and those with higher education (OR = 1.28; 95% CI, 1.12-1.46). Personal experience of a climate-related event increased perceived risk (OR = 1.97; 95% CI, 1.73-2.24). Regional and remote residents were less likely to perceive health risk (OR = 0.76; 95% CI, 0.65-0.89). A third (37%; 2209/6030) of respondents believed that the healthcare system was prepared for climate change. Being female (OR = 2.35; 95% CI, 2.10-2.65), having a chronic condition (OR = 1.47; 95% CI, 1.28-1.68) and older age (OR = 1.01; 95% CI, 1.01-1.01) increased perceptions that the system was unprepared. Those with higher education, who had been personally impacted, or identified as First Nations had more confidence in the system's preparedness. Many Australians recognise climate change as a health challenge; personal risk perception and confidence in system preparedness vary. Targeted health policies are needed to effectively communicate health risks and support healthcare's climate change resilience.