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Environmental health literacy (EHL) is coalescing into a new sub-discipline that combines key principles and procedural elements from the fields of risk communication, health literacy, environmental health sciences (EHS), communications research and safety culture. These disciplines have contributed unique expertise and perspectives to the developm...
Context in source publication
Context 1
... are a number of different sources of the emergence of environmental health literacy ( Figure 1). Risk communication, one of EHL's roots, has deep historical origins and can be traced to the display of symbols in ancient cultures to connote tribal and state affiliations on the battlefield. ...
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Context
The community research fellows training (CRFT) program is a community-based participatory research (CBPR) initiative for the St. Louis area. This 15-week program, based on a Master in Public Health curriculum, was implemented by the Division of Public Health Sciences at Washington University School of Medicine and the Siteman Cancer Center....
Citations
... Additionally, improving the environmental health literacy (EHL) of individuals is imperative for them to understand how to reduce these exposures. Environmental health literacy (EHL) is the knowledge of harmful environmental exposures and how they affect health [66,77,78]. Although environmental exposure (exposome) contributes 70% to chronic disease risk, [79] EHL is low in the general population [77] and among healthcare providers [80][81][82]. ...
... Environmental health literacy (EHL) is the knowledge of harmful environmental exposures and how they affect health [66,77,78]. Although environmental exposure (exposome) contributes 70% to chronic disease risk, [79] EHL is low in the general population [77] and among healthcare providers [80][81][82]. To address this, the National Institutes of Health (NIH) has called for increased EHL research, including methods to increase EHL, [77] and for applications (RFAs) of EHL research [83]. ...
... Although environmental exposure (exposome) contributes 70% to chronic disease risk, [79] EHL is low in the general population [77] and among healthcare providers [80][81][82]. To address this, the National Institutes of Health (NIH) has called for increased EHL research, including methods to increase EHL, [77] and for applications (RFAs) of EHL research [83]. Thus, the Million Marker (MM) EDC testing kit and service is a major step in allowing the public to "learn what's inside" of them and take action to reduce their personal exposures. ...
Background
Exposures to endocrine disrupting chemicals (EDCs) have been linked to chronic diseases including breast cancer, metabolic syndrome, diabetes, and infertility. Exposure during pregnancy may have a lifelong impact on the fetus. Services are needed to allow individuals to learn about their personal EDC exposures and how to reduce them. Million Marker (MM) aims to crowdsource and scale the biomonitoring of environmental chemicals and provide actionable results to empower individuals to proactively assess, track, and reduce their EDC exposures. In previous research, we developed and tested the first mobile EDC intervention service (mail-in urine testing and exposure report-back) for its efficacy in increasing EH literacy (EHL), willingness to reduce exposures (i.e., readiness to change, RtC), and system usability. After intervention, we found increased EHL, increased RtC in women (but not men), and decreased EDC exposure. However, some participants did not increase their RtC and had difficulty carrying out the intervention on their own. The reasons for these less optimal results were the difficulty in the EHL subject matter—participants still felt ill-prepared to apply their knowledge to making healthier lifestyle changes. Therefore, in this study, we will address these perceived limitations.
Methods
We will test a self-directed online interactive curriculum with live counseling sessions and individualized support modeled after the highly effective Diabetes Prevention Program (DPP). Recruiting from the Healthy Nevada Project (HNP), one of the largest population health cohorts in the world, we test the effectiveness of our EDC-specific online intervention curriculum via EHL and RtC surveys and determine changes in EDC exposure before and after intervention in a randomized controlled trial. We will also test for common clinical biomarkers via a commercially available at-home test (Siphox). We will recruit and randomize 300 women and 300 men of reproductive age (total n=600) from HNP. Our target population is men and women of reproductive age (18–44 years old).
Discussion
At the conclusion of this project, we will be well-positioned to scale our services to clinics and the general public, with the eventual aims of FDA approval, insurance coverage, and incorporation into routine clinical care.
... Obwohl die Konzepte Ähnlichkeiten aufweisen, sind sie doch stark von unterschiedlichen Forschungsperspektiven und -disziplinen geprägt. Bekannte Beispiele sind "climate and health literacy" [12], "environmental health literacy" [7] oder "planetary health literacy" [11]. ...
Zusammenfassung
Hintergrund
Der Klimawandel und seine Auswirkungen auf die Gesundheit rücken zunehmend in den gesundheitspolitischen Blickpunkt. Herausforderungen ergeben sich u. a. durch häufigere Hitzewellen, erhöhte Pollenbelastung, vermehrtes Auftreten von Vektoren. Auch sind Personen in vulnerablen Kontexten überproportional betroffen. Dem Gesundheitssystem kommt durch Gesundheitsförderung, Prävention und Krankenversorgung in diesem Zusammenhang eine wesentliche Rolle zu. In einem klimaresilienten Gesundheitssystem haben klimakompetente Angehörige der Gesundheitsberufe eine zentrale Rolle. Der Artikel beleuchtet die Arbeiten auf nationaler Ebene, die darauf abzielen, ein gemeinsames Verständnis aufzubauen und einen adäquaten inhaltlichen Rahmen der gesundheitsbezogenen Klimakompetenz auszuarbeiten.
Materialien und Methoden
Zur Erarbeitung der Fragestellung wurde eine explorative Herangehensweise mit einer Kombination verschiedener Methoden ausgewählt. Basierend auf einer Literaturrecherche wurde der inhaltliche Rahmen entlang internationaler Beispiele guter Praxis für die österreichischen gesetzlich Gesundheitsberufe abgeleitet. Zur Qualitätssicherung und -verbesserung erfolgte eine Begutachtung durch Expert:innen aus den Bereichen Klima, Gesundheit und Bildung.
Ergebnisse
Zur langfristigen Verankerung der Klimakompetenz in den Gesundheitsberufen braucht es drei Implementierungsprozesse, um die Zielgruppen, d. h. jene, die eine Ausbildung absolvieren, die bereits in Gesundheitsberufen Tätigen und Lehrende für Gesundheitsberufe, zu adressieren. Den inhaltlichen Rahmen dafür bildet das berufsgruppenübergreifende Handbuch zur Stärkung der Klimakompetenz in den Gesundheitsberufen.
Schlussfolgerung
Ein systematischer Aufbau und die Stärkung der Klimakompetenz im Gesundheitssystems, insbesondere bei den Angehörigen der Gesundheitsberufe, ist zielführend, um die vielfältigen und erheblichen Auswirkungen des Klimawandels auf die Gesundheit und das Wohlbefinden der Menschen abzufedern.
... Finn and O'Fallon [35] 1 (1.8) At its most basic, environmental HL has been described as an ability to make connections between environmental exposures and human health. ...
Background
The concept of health literacy (HL) is constantly evolving, and social determinants of health (SDoH) have been receiving considerable attention in public health scholarship. Since a 1-size-fits-all approach for HL fails to account for multiple contextual factors and as a result poses challenges in improving literacy levels, there is a need to develop a deeper understanding of the current state of HL and digital health literacy (DHL) research.
Objective
This study examined scholars’ conceptualization and scope of work focused on HL and DHL.
Methods
Using a search string, investigators (N=2042) focusing on HL, DHL, or both were identified from the grantee websites of the National Institutes of Health RePORTER (RePORT Expenditures and Results) and the Canadian Institutes of Health Research. The investigators were emailed a survey via Qualtrics. Survey questions examined the focus of work; whether the investigators studied HL/DHL in combination with other SDoH; the frameworks, definitions, and approaches used; and research settings. We analyzed survey data using SPSS Statistics version 28 and descriptive analysis, including frequencies and percentages, was conducted. Chi-square tests were performed to explore the association between the focus of work, settings, and age groups included in the investigators’ research.
Results
A total of 193 (9.5%) of 2042 investigators responded to the online survey. Most investigators (76/153, 49.7%) were from public health, 83/193 (43%) reported their research focused on HL alone, 46/193 (23.8%) mentioned DHL, and 64/193 (33.2%) mentioned both. The majority (133/153, 86.9%) studied HL/DHL in combination with other SDoH, 106/135 (78.5%) conducted HL/DHL work in a community setting, and 100/156 (64.1%) reported not using any specific definition to guide their work. Digital tools (89/135, 65.9%), plain-language materials (82/135, 60.7%), and visual guides (56/135, 41.5%) were the top 3 approaches used. Most worked with adults (131/139, 94.2%) and all races and ethnicities (47/121, 38.8%).
Conclusions
HL and DHL research largely considered SDoH. Multiple HL tools and approaches were used that support the examination and improvement of literacy and communication surrounding health care issues.
... Efforts to build environmental health literacy among the general population may provide an essential foundation for the uptake of environmental health education efforts in the context of prenatal care. Environmental literacy must include a basic ability to "recognize" the potential for an environmental exposure to be risky, and to take steps to reduce/avoid exposure or mitigate the risk [68,69]. Strategies to inform the public about the nature of developmental/childhood environmental risks must strive to convey the current state of the science, scientific uncertainties, and risk mitigation strategies, supported by the precautionary principle [70,71]. ...
... Strategies to inform the public about the nature of developmental/childhood environmental risks must strive to convey the current state of the science, scientific uncertainties, and risk mitigation strategies, supported by the precautionary principle [70,71]. Embedded within models of environmental health literacy are concepts of environmental justice that recognize the disproportionate environmental risks faced by communities marginalized by racialization, poverty, and other social risk factors [68]. Promoting environmental health literacy supports the mobilization of citizen science, academic-community partnerships, and public demand for policies and investments to address environmental health disparities [68]. ...
... Embedded within models of environmental health literacy are concepts of environmental justice that recognize the disproportionate environmental risks faced by communities marginalized by racialization, poverty, and other social risk factors [68]. Promoting environmental health literacy supports the mobilization of citizen science, academic-community partnerships, and public demand for policies and investments to address environmental health disparities [68]. ...
Prenatal exposures to environmental toxicants can adversely affect fetal and child development and lead to increased risk of chronic disease. While regulatory action is essential to reduce sources of environmental toxicants, prenatal care presents an opportunity to educate, mobilize, and support prospective parents to reduce exposures to such hazards. As the first phase of an interdisciplinary research collaboration to inform the development of prenatal environmental health education strategy in Canada, we surveyed reproductive-aged female individuals. The online survey (July–September 2021) yielded a nationally representative sample of 1914 reproductive-aged females living in Canada. The questionnaire topics addressed the respondents’ knowledge and perceptions of environmental health risks, preventive actions and related facilitators and barriers, information sources and preferences, reproductive history, and demographics. The analysis included bivariate and multivariate techniques. Our results suggest broad awareness among reproductive-aged females that exposure to toxicants can be harmful, and that reducing prenatal exposures can benefit child health. However, fewer than half of respondents felt that they had enough knowledge to take protective measures. Despite high levels of preference for prenatal care as an ideal context for learning about environmental health risks and protective measures, fewer than one in four respondents had ever discussed environmental health concerns with a healthcare provider. Our findings reveal a knowledge–action gap and a corresponding opportunity to improve environmental health education and advocacy in prenatal care in the Canadian context.
... Data on environmental (health) literacy is not available in Germany, but it could be deduced from the data on health literacy (27) that people from precarious milieus also have a lower level of environmental (health) literacy, and perhaps, the necessary skills to understand environmental (health) risks (28) were not sufficient. This assumption can be supported by the study by Zhao et al. (26) which also showed that education and income influence environmental health literacy. ...
Introduction
Precarious milieus more frequently suffer from environmental risks and show lower environmental awareness and behavior than other milieus in the German population. This study investigates the factors that influence environmental awareness in precarious milieus and the roles of environmental knowledge and the perception of environment-related health burdens.
Methods
A quantitative secondary data analysis of the German Environmental Awareness Study 2018 (N = 2017) was used to analyze the perception of environmental health burdens, environmental knowledge, and environmental awareness between precarious milieus (n = 190) and seven other milieus. One-way analysis of variance (ANOVA) and Bonferroni post hoc tests were used for this purpose. More in-depth analyses of the precarious milieus were carried out using multiple regression analyses.
Results
There were significant differences in the perceptions of environmental health burdens affected by rail-traffic noise and neighborhood noise. Furthermore, environmental knowledge in precarious milieus was significantly lower than in five out of the seven other milieus (all p < 0.001) and was significantly associated with environmental cognition and gender. Precarious milieus had higher environmental affect than established milieus but less than that of critical-creative milieus and young idealists (all p < 0.001). Environmental cognition and environmental behavior were significantly associated with environmental affect. Environmental cognition was significantly higher in precarious milieus than in established milieus and among young pragmatists but was lower than in critical-creative milieus and among young idealists (all p < 0.001). Environmental affect, environmental knowledge, and gender were significantly associated with environmental cognition. In precarious milieus, environmental behavior was significantly lower than in traditional milieus and critical-creative milieus and among young idealists (all p < 0.001) and was significantly associated with environmental affect.
Conclusion
The differences in the perception of environmental health burdens, environmental knowledge, and environmental awareness among precarious milieus indicate that there is a need for specific education and support structures for these population groups. Further research is needed to determine what other factors within the precarious milieus influence environmental knowledge and awareness, as well as the skills needed to understand environmental information, which are included in the framework of environmental (health) literacy.
... This field represents a recent subset of health literacy (HL) that integrates principles from both HL and environmental literacy, encompassing functional, critical, and interactive dimensions [12,13]. Consequently, EHL incorporates fundamental principles and procedural components from the domains of HL, risk communication, environmental health sciences, communications research, and safety culture [14]. The Society for Public Health Education (SOPHE) clarifies that the aim of EHL is to "develop the wide range of skills and competencies that people need in order to seek out, comprehend, evaluate, and use environmental health information to make informed choices, reduce health risks, improve quality of life and protect the environment" [15]. ...
... The Society for Public Health Education (SOPHE) clarifies that the aim of EHL is to "develop the wide range of skills and competencies that people need in order to seek out, comprehend, evaluate, and use environmental health information to make informed choices, reduce health risks, improve quality of life and protect the environment" [15]. In this perspective, EHL could be a key element to promote structural changes through community participation and to guarantee environmental justice [14,16,17]. ...
... In recent years, young people have become increasingly sensitive to environmental issues, as demonstrated by movements such as Friday for Future or School Strikes for Climate [27]. In this context, EHL measurement becomes a very useful tool for assessing the level achieved by a population on this subject and, consequently, an opportunity for implementing Development and validation of the EHLI 5 of 7 educational interventions [14,28,29], including information curricula and community-based participatory research [30]. These approaches have already been applied to environmental health [31,32]. ...
Environmental health literacy (EHL) is a rather recent concept that applies health literacy skills to environmental issues. Research in this field is still at the beginning, and there is currently no existing tool in the literature designed to comprehensively assess individual general EHL among university students. The aim of our study is to fill this gap through the validation of the Environmental Health Literacy Index (EHLI) in such a target group. We adapted a previously administered survey, originally completed by 4778 university students from various Italian universities. Starting from the original questionnaire, our methodology involved a three-round item selection process, followed by a comprehensive evaluation of the instrument’s psychometric properties. The EHLI consists of 13 Likert-type items, covering three primary domains of health literacy: functional (six items), interactive (three items), and critical (four items). The Cronbach’s alpha coefficient is 0.808 for the global scale, while it stands at 0.888 for the functional, 0.795 for the critical, and 0.471 for the interactive components. The area under the receiver operating characteristic curve reached a value of 0.643. Spearman correlation analysis revealed a significant yet slight correlation between EHLI and both functional health literacy score and the extent of pro-environmental behaviors adoption. Our study serves as an important initial step in developing a tool able to evaluate the EHL of university-aged individuals. Further research efforts may improve the questionnaire’s validity and completeness, as well as to explore its applicability to different age groups.
... This is the nexus of environmental health literacy (EHL). 8 Research has shown that not only do participants want their results, but that report back leads to participants learning about environmental health and consideration of possible exposure reduction strategies. These findings have been observed even in the face of uncertainty around the exposures. ...
... The potential outcomes of EHL include: improving public health, increased research transparency, a mental model shift of where exposure sources are located (far away vs in home), reduction of exposures, and improvement of health outcomes for individuals and communities. 4,8,11 Finn and O'Fallon proposed an EHL hierarchy: recognize, understand, apply, analyze, evaluate, and create. This is similar to Bloom's taxonomy, which tracks increased comprehension of educational topics. ...
... (Q #15)" was chosen as a measure of EHL because it demonstrates that participants were understanding and applying their results, each of which are a level in the EHL hierarchy by Finn and O'Fallon. 8 These findings suggest that the survey questions we asked may not be accurately, or comprehensively, assessing EHL. This work supports the body of literature that RBRR should be standard practice in exposure assessment research. ...
Report-back of research results (RBRR) is becoming standard practice for environmental health research studies. RBRR is thought to increase environmental health literacy (EHL), although standardized measurements are limited. For this study, we developed a report back document on exposure to air pollutants, Polycyclic Aromatic Hydrocarbons, during pregnancy through community engaged research and evaluated whether the report increased EHL. We used focus groups and surveys to gather feedback on the report document from an initial group of study participants (Group 1, n = 22) and then sent the revised report to a larger number of participants (Group 2, n = 168). We conducted focus groups among participants in Group 1 and discussed their suggested changes to the report and how those changes could be implemented. Participants in focus groups demonstrated multiple levels of EHL. While participant engagement critically informed report development, a survey comparing feedback from Group 1 (initial report) and Group 2 (revised report) did not show a significant difference in the ease of reading the report or knowledge gained about air pollutants. We acknowledge that our approach was limited by a lack of EHL tools that assess knowledge and behavior change, and a reliance on quantitative methodologies. Future approaches that merge qualitative and quantitative methodologies to evaluate RBRR and methodologies for assessing RBRR materials and subsequent changes in knowledge, attitudes, and behavior, may be necessary.
... Although the theory of environmental health literacy continues to evolve, it has been suggested that environmental health literacy of an individual is likely to be topic and context-specific. Levels of environmental health literacy will vary based on personal experiences and background relevant to a particular environmental exposure in various contexts [26]. Building tools to assess individual environmental health literacy related to specific Values in the table represent the estimate and 95% confidence interval associated with a one-unit increase in the subscales (e.g., scientific uncertainty). ...
Background
Perinatal exposure to phthalates is associated with adverse health impacts for parents and children. The field of environmental health literacy seeks to measure how environmental health information is conceptualized and used to inform behaviors. We assessed whether scores on the validated Phthalate Environmental Reproductive Health Literacy (PERHL) scale were associated with biomarkers of phthalate exposure.
Methods
42 members of the Environmental Reproductive and Glucose Outcomes (ERGO) cohort completed the PERHL scale and provided spot urine samples. Phthalate summary measures for model outcomes were created by calculating molar sums of specific gravity-corrected metabolite concentrations representing exposure to parent phthalate, Di(2-ethylhexyl)phthalate (DEHP), personal care product (PCP)-associated phthalates, and parent butyl-phthalates. Linear regression models were used to estimate the associations of the PERHL scale scores with phthalate summary measures, controlling for educational attainment (college degree or higher vs. no college degree), age (years), and race and ethnicity (non-Hispanic White vs. non-White).
Results
Higher scores on the PERHL Scale and subscales were generally associated with lower ΣDEHP, Σbutyl, and ΣPCP metabolite concentrations. A one-point increase in the ‘Protective Behavior/Risk Control’ subscale score was significantly associated with a −30.3% (95% CI: −50.1, −2.6) decrease in ΣDEHP, and a −30.6% (95% CI: −51.5, −0.63) decrease in Σbutyl metabolite concentrations.
... Environmental health literacy (EHL) is the understanding and knowledge surrounding how certain environmental exposures can impact health. Increasing EHL in the general public is a crucial step in reducing EDC exposures and their adverse effects [27]. The actual level of EHL in the general public in the US is not known, as efforts to quantify it have only just been initiated within the last few decades [27]. ...
... Increasing EHL in the general public is a crucial step in reducing EDC exposures and their adverse effects [27]. The actual level of EHL in the general public in the US is not known, as efforts to quantify it have only just been initiated within the last few decades [27]. However, most experts agree that efforts are needed to increase EHL in the general public [27][28][29], especially in low-income communities, marginalized communities, and communities of color, all of which are at greater risk of toxic exposures due to societal inequities [28,[30][31][32]. ...
... The actual level of EHL in the general public in the US is not known, as efforts to quantify it have only just been initiated within the last few decades [27]. However, most experts agree that efforts are needed to increase EHL in the general public [27][28][29], especially in low-income communities, marginalized communities, and communities of color, all of which are at greater risk of toxic exposures due to societal inequities [28,[30][31][32]. ...
Background: Interventions are needed to help people reduce exposure to harmful chemicals from everyday products and lifestyle habits. Report-back of individual exposures is a potential pathway to increasing environmental health literacy (EHL) and readiness to reduce exposures. Objectives: Our objective was to determine if report-back of endocrine-disrupting chemicals (EDCs) can reduce EDC exposure, increase EHL, and increase readiness to change (i.e., to implement EDC exposure-reduction behaviors). Methods: Participants in the Healthy Nevada Project completed EHL and readiness-to-change surveys before (n = 424) and after (n = 174) a report-back intervention. Participants used mail-in kits to measure urinary biomarkers of EDCs. The report-back of results included urinary levels, information about health effects, sources of exposure, and personalized recommendations to reduce exposure. Results: EHL was generally very high at baseline, especially for questions related to the general pollution. For questions related to chemical exposures, responses varied across several demographics. Statistically reliable improvements in EHL responses were seen after report-back. For readiness to change, 72% were already or planning to change their behaviors. Post-intervention, women increased their readiness (p = 0.053), while men decreased (p = 0.007). When asked what challenges they faced in reducing exposure, 79% cited not knowing what to do. This dropped to 35% after report-back. Participants with higher propylparaben were younger (p = 0.03) and women and participants who rated themselves in better health had higher levels of some phthalates (p = 0.02–0.003 and p = 0.001–0.003, respectively). After report-back, monobutyl phthalate decreased among the 48 participants who had valid urine tests before and after the intervention (p < 0.001). Conclusions: The report-back intervention was successful as evidenced by increased EHL behaviors, increased readiness to change among women, and a decrease in monobutyl phthalate. An EHL questionnaire more sensitive to chemical exposures would help differentiate high and low literacy. Future research will focus on understanding why men decreased their readiness to change and how the intervention can be improved for all participants.
... A growing number of countries are including environmental health literacy as part of the core curriculum for secondary school students 93,94 . Education targeted at adolescents in schools would have broad reach and prevent exposures over a longer period than programs initiated during pregnancy, thereby reducing the duration and cumulative exposure burdens. ...
Endocrine disrupting chemicals (EDCs) can cause harm to a woman’s reproductive health. Avoiding exposure is an effective way to prevent that. This report provides recommendations using the latest scientific understandings to protect female reproductive health from hazardous chemicals.
