Climate Awareness, Not Eco-Anxiety, Drives Green Attitudes in Health Workers

Climate change is no longer a distant environmental problem confined to melting glaciers and shifting weather patterns; it has become a public health emergency that lands squarely on the desks of doctors, nurses, and allied health workers. Heat waves overwhelm emergency departments, vector-borne diseases creep into new territories, and air pollution fills respiratory wards. Yet surprisingly little is known about how the people who staff hospitals and clinics actually perceive the climate crisis, how anxious they feel about it, and whether those feelings translate into genuine environmental concern. A new cross-sectional study from Türkiye, published in BMC Health Services Research, offers one of the most detailed portraits to date of the psychological landscape of climate change among healthcare professionals, and its findings challenge a common assumption: it is knowledge and cognitive engagement, not emotional distress, that appears to drive environmentally responsible attitudes in this workforce.

The research team, led by Tuğba Özdemir of Istanbul Gedik University together with Tuğba Çetinol Taştemel of Çanakkale Onsekiz Mart University and Gülendam Karadağ of Dokuz Eylul University, surveyed 460 healthcare professionals aged 18 years or older who were working in clinical settings. The study employed a cross-sectional, correlational design, meaning that data were collected at a single point in time and relationships between variables were examined statistically rather than manipulated experimentally. Participants completed a socio-demographic form along with three validated instruments: the Environmental Sensitivity Scale, which measures the degree to which individuals care about and feel responsibility toward environmental issues; the Global Climate Change Awareness Scale, which assesses knowledge and awareness of climate-related facts and consequences; and the Eco-Anxiety Scale, which captures the emotional dimension of climate distress, including worry, rumination, and feelings of helplessness about environmental degradation.

The analytical toolkit was deliberately rigorous. All statistical analyses were performed using SPSS 24.0, and the researchers applied a combination of descriptive statistics, Spearman correlation analysis, and multiple linear regression. Descriptive statistics established where the sample stood on each scale; Spearman correlation, a non-parametric technique suited to ordinal or non-normally distributed data, quantified the strength and direction of associations between variables; and multiple linear regression allowed the team to determine which factors independently predicted environmental sensitivity when all other variables were held constant. This layered approach matters because simple correlations can be misleading. A variable may appear related to an outcome simply because it travels with a third factor, and regression modeling is the standard method for teasing apart such entangled relationships.

The headline results were nuanced. Healthcare professionals in the sample demonstrated moderate levels of climate change awareness, moderate levels of environmental sensitivity, and moderate levels of eco-anxiety. In other words, this was neither a workforce gripped by paralyzing climate dread nor one indifferent to the crisis; it occupied a middle ground across all three psychological dimensions. But the regression analysis revealed a striking asymmetry in what actually predicted environmental sensitivity. Awareness of global climate change emerged as a significant predictor, as did being a nurse, being aged 45 years or older, and membership in an environmental organization. By contrast, the rumination sub-dimension of eco-anxiety showed only a marginal, non-significant association with environmental sensitivity, with a p-value of 0.064, just shy of the conventional 0.05 threshold for statistical significance.

This pattern carries real theoretical weight. Eco-anxiety, the chronic fear of environmental doom, has attracted enormous media attention in recent years, with some commentators suggesting that distress about the planet might be a motivating force for environmental action. The Turkish data suggest a more complicated picture among healthcare workers: emotional rumination about climate change, on its own, does not reliably translate into environmental sensitivity. What does translate is cognitive engagement, the factual awareness of what climate change is and what it does. In psychological terms, the study hints that the pathway from climate concern to pro-environmental attitudes may run through knowledge and understanding rather than through anxiety, at least in this professional population. Awareness, in this framing, functions as the cognitive scaffolding upon which environmental sensitivity is built.

The demographic predictors are equally instructive. Nurses showed significantly higher environmental sensitivity than other professional groups in the sample, a finding that resonates with the nature of nursing itself. Nurses spend more continuous time at the bedside than most other clinicians, they manage the material flows of healthcare, from single-use plastics to pharmaceutical waste, and public health nursing in particular has long framed environmental conditions as determinants of health. Age also mattered: professionals aged 45 years or older reported greater environmental sensitivity, suggesting either a cohort effect shaped by decades of accumulating environmental awareness or a developmental effect in which life experience deepens concern for the world that will be inherited by younger generations. Membership in an environmental organization was another significant predictor, which is intuitive but not trivial; affiliation with environmental groups likely reinforces sensitivity through repeated exposure to environmental information, norms, and collective action.

The methodological strengths of the study deserve attention alongside its findings. The sample of 460 clinical professionals is substantial for a single-country survey of this kind, and the use of three validated scales rather than ad hoc questions strengthens the reliability of the measurements. The researchers obtained ethical approval from the Çanakkale Onsekiz Mart University Health Sciences Ethics Committee, with institutional permission from the Provincial Directorate of Health, and all participants provided written informed consent, including consent for the anonymous use and publication of their data. The study was conducted in accordance with the Declaration of Helsinki, the ethical framework governing human-subjects research, and permission to use the scales was secured from their developers. These procedural details matter because survey research on sensitive psychological states, including anxiety, depends on trust and transparency to produce credible data.

At the same time, the cross-sectional design imposes limits that the authors and readers must keep in view. Because everything was measured at one moment, the study can establish associations but not causation. It is possible that environmental sensitivity drives people to learn more about climate change, rather than awareness driving sensitivity, or that both are shaped by an unmeasured third factor such as education, personality, or political orientation. The marginal, non-significant p-value for rumination also leaves open the possibility that eco-anxiety plays a modest role that a larger sample might detect. And the sample, drawn from clinical settings in Türkiye, may not generalize to healthcare workers in countries with different climate exposures, health system structures, or cultural attitudes toward environmental issues. Replication in longitudinal designs and across regions would be the natural next step.

Why does all this matter beyond the psychology of a single profession? Because healthcare systems are themselves major contributors to climate change, and healthcare professionals are uniquely credible messengers on climate and health. If awareness, rather than anxiety, is the lever that moves environmental sensitivity in this workforce, then the policy implications point toward education and institutional support rather than alarm. The study’s authors conclude that enhancing educational efforts, institutional support, and environmental policies may strengthen healthcare professionals’ capacity to address climate-related health risks and promote environmentally responsible practices in healthcare settings. In practical terms, that could mean integrating climate and health content into medical and nursing curricula, giving hospital staff the tools to reduce the environmental footprint of care delivery, and supporting professional participation in environmental organizations. The message from this research is ultimately an optimistic one: the route to a greener healthcare workforce may run not through fear, but through understanding.

Subject of Research: Climate change awareness, eco-anxiety, and environmental sensitivity among healthcare professionals

Article Title: Healthcare professionals’ awareness of climate change and its association with eco-anxiety and environmental sensitivity: a cross-sectional study

Article References: Özdemir, T., Çetinol Taştemel, T., & Karadağ, G. (2026). Healthcare professionals’ awareness of climate change and its association with eco-anxiety and environmental sensitivity: a cross-sectional study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15770-x

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15770-x

Keywords: climate change, eco-anxiety, environmental sensitivity, healthcare professionals, nurses, cross-sectional study, climate awareness, environmental psychology, public health, health services research, Türkiye, regression analysis