Environmental Health Literacy as Knowing, Feeling, and Believing: Analyzing Linkages between Race, Ethnicity, and Socioeconomic Status and Willingness to Engage in Protective Behaviors against Health Threats

Abstract

This study investigates the relationships between environmental health literacy, the characteristics of people (race, ethnicity, and socioeconomic status) associated with health disparities, and people’s willingness to engage in protective behaviors against environmental health threats. Environmental health literacy is a framework for capturing the continuum between the knowledge of environmental impacts on public health, and the skills and decisions needed to take health-protective actions. 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 efficacy (believing that protective behaviors work). In June 2020, we collected survey data from North Carolina residents on two topics: the viral infection COVID-19 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 a dependent variable and other characteristics as independent variables, including environmental health literacy. For both topics, our results indicated that no disparities emerged according to socioeconomic factors (level of education, household income, or renting one’s residence). We observed disparities in willingness according to race, comparing Black to White participants, but not when comparing White to American Indian, Alaska Native, Asian, Native Hawaiian, or Pacific Islander participants nor Hispanic to non-Hispanic participants. The disparities in willingness between Black and White participants persisted until we introduced the variables of environmental health literacy, when the difference between these groups was no longer significant in the final regression models. The findings suggest that focusing on environmental health literacy could bridge a gap in willingness to protect oneself based on factors such as race/ethnicity and socioeconomic status, which have been identified in the environmental health literature as resulting in health disparities.

Umweltrisiken und Gesundheitskompetenz: Eine systematische Übersichtsarbeit

“…Eine Studie machte dazu keine Angabe [ 42 ]. Die Hälfte der eingeschlossenen Studien untersuchte die UGK, bei der die Umwelt bereits mit einbezogen ist [ 20 – 30 , 41 ], während sich 11 Studien mit der allgemeinen GK im Kontext eines umweltbezogenen Themas befassen [ 19 , 31 – 38 , 40 , 42 ]. Eine Studie untersuchte beide Aspekte [ 39 ].…”

“…(2021, [ 19 ]; USA) GK (Sonnenlicht) Untersuchung der familiären Kommunikation über Hautkrebs bei Patienten in der Primärversorgung, die ganzjährig der Sonne ausgesetzt sind Querschnittstudie (quantitativ), Fragebogen Allgemeine Bevölkerung ( n = 599) Rekrutierung: Register einer Klinik in New Mexico Antwortrate: 99,8 % Fähigkeit, medizinische Formulare auszufüllen; Häufigkeit von Hilfe beim Lesen von Krankenhausunterlagen; Häufigkeit von Problemen beim Verständnis medizinischer Sachverhalte Geht nicht daraus hervor – GK wird nur in Zusammenhang mit anderen Variablen untersucht Binder et al. (2022, [ 20 ]; USA) UGK (PFAS) Untersuchung der Beziehungen zwischen UGK und soziodemographischen bzw. sozioökonomischen Merkmalen bzgl.…”

“…Die GK bzw. UGK wurde durch Abfrage der dafür notwendigen Fähigkeiten mittels Fragebögen [ 19 , 20 , 22 , 24 , 25 , 27 – 29 , 32 – 35 , 37 – 40 , 42 ] oder Interviews [ 23 , 26 , 30 , 31 , 36 , 41 ] erfasst. Eine Studie wandte beide Methoden an [ 21 ].…”

“…Binder et al. [ 20 ] verwendeten Fragen mit wahren oder falschen Fakten über per- und polyfluorierte Alkylverbindungen (PFAS), Fragen zur Wissensadäquanz (Diskrepanz zwischen angestrebtem und tatsächlichem Wissen) und Fragen zur Handlungskompetenz, d. h., wie wirksam Verhaltensweisen bei der Vermeidung einer Exposition waren. Ein ähnliches Vorgehen ist bei Zhao et al.…”

Environmental contaminants and child development: Developmentally‐informed opportunities and recommendations for integrating and informing child environmental health science

“…Communities who are most impacted by environmental toxicant exposures often have the least power or access to policymakers and limited time for advocacy, so it is important for both CEH and developmental scientists to support communities to engage in collective action and advocacy to protect their children and ensure that community voices are heard (Haynes et al., 2016 ; Lichtveld et al., 2016 ; Miller, Varisco et al., 2022 ; Raphael, 2019 ). Given the history of racist policies and mismanagement of environmental pollution, it is essential to build trust among historically marginalized communities (Binder et al., 2022 ). Citizen science approaches provide a way to partner with community members to gather data and inform study designs that are community‐oriented (Sandhaus et al., 2019 ).…”