We can use our superpower to help end fossil fuel pollution and rise to the challenge of climate change.

In this commentary, we argue that health professionals can play a pivotal role in accelerating the adoption of public policies that will help communities, nations, and the world end fossil fuel pollution and rise to the challenges of climate change. We briefly describe our previously published research showing that communicating about fossil fuel pollution and the health relevance of climate change has many benefits in building public support for climate action. Most importantly, we make the case that because health professionals, especially medical doctors and other clinicians, are highly trusted, we collectively have a unique opportunity to bring people together across the political continuum to have constructive dialogues about the intertwined problems of fossil fuel pollution and climate change and what to do about them - even in the current hyper-partisan environment.

Climate change belief systems across political groups in the United States.

Beliefs and attitudes form the core of public opinion about climate change. Network analysis can reveal the structural configuration of these beliefs and attitudes. In this research, we utilize a belief system framework to identify key psychological elements, track change in the density of these belief systems over time and across political groups, and analyze the structural heterogeneity of belief systems within and between political groups in the United States. Drawing on fifteen waves of nationally representative survey data from 2010 to 2021 (N = 16,742), our findings indicate that worry about climate change is the most central psychological element. Interestingly, we find that among politically unaffiliated individuals, the connections between psychological elements have strengthened over time, implying an increase in the consistency of belief systems within this group. Despite the political polarization in beliefs about climate change between Republicans and Democrats, our findings reveal that the ways these two groups organize and structure climate change beliefs systems are not markedly different compared to those of other groups. These findings provide theoretical and practical insights for climate change experts and communicators.

Calling attention to opponents of climate action in climate and health messaging.

Previous research suggests that providing information about the health effects of climate change and the health benefits of climate action can increase public engagement with the issue. We sought to extend those findings with an experiment to test the motivational value of calling attention to opponents of climate action. In February, 2022, we conducted a survey experiment with adults from the USA, quota-sampled to represent the USA population (n=2201). Participants were randomly assigned to a no-message control condition, or one of four message conditions identified as authored by concerned health professionals. These messages warned recipients about the negative effects of climate change on health, and either made no mention of an opponent to climate action, or were messages augmented by identifying one of three opponents: (1) fossil fuel chief executive officers and their lobbyists, (2) politicians, or (3) a combination of the two. Portrayal of opponents to climate action increased attitudinal engagement, support for mitigation policies, and intentions to advocate for climate solutions, compared with message conditions not identifying an opponent-with the combined opponent portrayal tending to result in the largest effects; these effects were evident with audiences across political lines, especially political conservatives. Climate and health messages-with or without portrayal of an opponent-also increased trust in the messengers relative to the no-message control. These findings suggest that identifying opponents to climate action can be advantageous to building support for such action, reducing political issue polarisation, and fostering greater trust in health professionals as climate messengers.

What motivates people to defend science: Evidence from the 2017 March for science.

The 2017 March for Science was an international march organized in response to concerns over the Trump administration's misuse of science that drew unprecedented numbers of supporters as well as attention from the media, celebrities, and political figures. The March's turnout and publicity begs the question: what motivates people to defend science? Using data from a survey of March for Science listserv members in the US, we used a structural equation model to test posited relationships between self- and collective response efficacy, perceived threat, anger, fear, and the intention to engage in advocacy to defend science. We found that each of these constructs were associated with the intention to engage in advocacy, illuminating the motivators that lead to this intention and how individuals may be activated to engage on behalf of science in the future. These insights have both theoretical and practical significance, as advocacy is integral for both supporting and advancing fact-based policy- and decision-making.

Public health benefits of zero-emission electric power generation in Virginia.

Curbing the worst impacts of global climate change will require rapidly transitioning away from fossil fuel across all sectors of the economy. This transition will also yield substantial co-benefits, as fossil fuel combustion releases harmful pollutants into the air. In this article, we present an analysis of the co-benefits to health and health-care costs related from decarbonization of the power sector, using the Virginia Clean Economy Act (VCEA) as a case study. Using a model that combines a source-response matrix approach to pollutant concentration modelling tied to health impact functions, our analysis shows that, by 2045, the VCEA will save up to 32 lives per year across the state, and avoid up to $355 million per year in health-related costs. Fossil-fuel free generation will also help the most disadvantaged communities, as counties in the highest poverty rate quintile also avoid the most pollutant-related deaths.

Learning to treat the climate emergency together: social tipping interventions by the health community.

Accelerating the decarbonisation of local and national economies is a profound public health imperative. As trusted voices within communities around the world, health professionals and health organisations have enormous potential to influence the social and policy landscape in support of decarbonisation. We assembled a multidisciplinary, gender-balanced group of experts from six continents to develop a framework for maximising the social and policy influence of the health community on decarbonisation at the micro levels, meso levels, and macro levels of society. We identify practical, learning-by-doing approaches and networks to implement this strategic framework. Collectively, the actions of health-care workers can shift practice, finance, and power in ways that can transform the public narrative and influence investment, activate socioeconomic tipping points, and catalyse the rapid decarbonisation needed to protect health and health systems.

Advocacy to support climate and health policies: recommended actions for the Society of Behavioral Medicine.

Climate change poses serious threats to public health and is exacerbating health inequities. Policy changes are essential to mitigate climate change impacts on human and planetary health. The purpose was to describe recommendations by the Policy and Advocacy Subgroup of the Society of Behavioral Medicine (SBM) Climate Change, Behavior Change and Health Presidential Working Group (PWG). The Policy and Advocacy subgroup was comprised of experts in public health, climate policy, and health behavior change, who worked together to identify priorities and develop recommendations. We worked under the premise that building political will for climate policy action is the most urgent goal, and we recommended promotion of citizen advocacy for this purpose. Because citizen advocacy is a set of behaviors, SBM members can use behavioral science to identify and scale up interventions, working collaboratively with communities targeted for marginalization. Recommendations for SBM included establishing an organizational home for climate and health work, providing training and resources, engaging in climate advocacy as an organization, and networking with other organizations. Recommendations for a proposed SBM Climate and Health Committee, Council, or Special Interest Group included developing trainings and resources, seeking opportunities for networking and collaborations, and identifying a research agenda. Individual behavior changes are insufficient to address climate change; policy actions are needed. SBM and similar organizations can support their members to work in developing, evaluating, and scaling up advocacy interventions for action on climate policy to magnify the power of the health and medical sectors to protect planetary and human health.

Increasing advocacy for climate protection policies is a top priority. Recommendations are made for research and advocacy engagement by the Society of Behavioral Medicine and its members.

Communication research to improve engagement with climate change and human health: A review.

Because of the world's dependence on fossil fuels, climate change and air pollution are profoundly harming both human and planetary health. Fortunately, climate solutions are also health solutions, and they present both local and global opportunities to foster cleaner, healthier, and safer communities. In this review, we briefly discuss the human health harms of climate change, climate and health solutions, and provide a thorough synthesis of social science research on climate and health communication. Through our review, we found that social science research provides an evidence-based foundation for messaging strategies that can build public and political will for climate and health solutions. Specifically, messages that convey the health harms of climate change and highlight the health benefits of climate solutions may be especially effective in building this public and political will. We also found that health professionals are trusted sources of information about climate change, and many have shown interest in engaging with the public and policymakers about the health relevance of climate change and clean energy. Together, the alignment between message strategies and the interest of highly trusted messengers strongly suggests the potential of health students and health professionals to create the conditions necessary to address climate change as a public health imperative. Therefore, our review serves as a resource for those interested in communicating about climate change and health and suggests that social scientists can continue to support practitioners with research and advice on the most effective communication strategies.

Health professional's willingness to advocate for strengthening global commitments to the Paris climate agreement: Findings from a multi-nation survey.

Health professionals have the potential to address the health threats posed by climate change in many ways. This study sought to understand the factors that influence health professionals' willingness to engage in climate advocacy. We hypothesized and tested a model with six antecedent factors predicting willingness to engage in advocacy for strengthening global commitments to the Paris Agreement. Using survey data from members of health professional associations in 12 nations (n = 3,977), we tested the hypothesized relationships with structural equation modeling. All of the hypothesized relationships were confirmed. Specifically, higher rates of perceived expert consensus about human-caused climate change predicted greater climate change belief certainty and belief in human causation. In turn, all three of these factors, including higher levels of perceived health harms from climate change, positively predicted affective involvement with the issue. Affective involvement positively predicted the feeling that health professionals have a responsibility to deal with climate change. Lastly, this sense that climate advocacy is a responsibility of health professionals strongly predicted willingness to advocate. As a unique study of predictors of health professionals' willingness to advocate for climate change, our findings provide unique insight into how an influential set of trusted voices might be activated to address what is arguably the world's most pressing public health threat. Limitations of the study and suggestions for future research are presented, and implications for message development are discussed.

Views of health professionals on climate change and health: a multinational survey study.

Climate change arguably represents one of the greatest global health threats of our time. Health professionals can advocate for global efforts to reduce emissions and protect people from climate change; however, evidence of their willingness to do so remains scarce. In this Viewpoint, we report findings from a large, multinational survey of health professionals (n=4654) that examined their views of climate change as a human health issue. Consistent with previous research, participants in this survey largely understood that climate change is happening and is caused by humans, viewed climate change as an important and growing cause of health harm in their country, and felt a responsibility to educate the public and policymakers about the problem. Despite their high levels of commitment to engaging in education and advocacy on the issue, many survey participants indicated that a range of personal, professional, and societal barriers impede them from doing so, with time constraints being the most widely reported barrier. However, participants say various resources-continuing professional education, communication training, patient education materials, policy statements, action alerts, and guidance on how to make health-care workplaces sustainable-can help to address those barriers. We offer recommendations on how to strengthen and support health professional education and advocacy activities to address the human health challenges of climate change.

The Effectiveness of Narrative Versus Didactic Information Formats on Pregnant Women's Knowledge, Risk Perception, Self-Efficacy, and Information Seeking Related to Climate Change Health Risks.

Climate change is a global threat that poses significant risks to pregnant women and to their developing fetus and newborn. Educating pregnant women about the risks to their pregnancy may improve maternal and child health outcomes. Prior research suggests that presenting health information in narrative format can be more effective than a didactic format. Hence, the purpose of this study was to test the effectiveness of two brief educational interventions in a diverse group of pregnant women (n = 151). Specifically, using a post-test only randomized experiment, we compared the effectiveness of brief information presented in a narrative format versus a didactic format; both information formats were also compared to a no information control group. Outcome measures included pregnant women's actual and perceived knowledge, risk perception, affective assessment, self-efficacy, intention to take protective behaviors, and subsequent information seeking behavior. As hypothesized, for all outcome measures, the narrative format was more effective than the didactic format. These results suggest the benefits of a narrative approach (versus a didactic approach) to educating pregnant women about the maternal and child health threats posed by climate change. This study adds to a growing literature on the effectiveness of narrative-based approaches to health communication.

Does 'When' really feel more certain than 'If'? Two failures to replicate Ballard and Lewandowsky (2015).

We report on two independent failures to conceptually replicate findings by Ballard & Lewandowsky (Ballard and Lewandowsky 2015 Phil. Trans. R. Soc. A 373, 20140464 (doi:10.1098/rsta.2014.0464)), who showed that certainty in, and concern about, projected public health issues (e.g. impacts of climate change) depend on how uncertain information is presented. Specifically, compared to a projected range of outcomes (e.g. a global rise in temperature between 1.6°C and 2.4°C) by a certain point in time (the year 2065), Ballard & Lewandowsky (Ballard and Lewandowsky 2015 Phil. Trans. R. Soc. A 373, 20140464 (doi:10.1098/rsta.2014.0464)) showed that focusing people on a certain outcome (a global rise in temperature of at least 2°C) by an uncertain time-frame (the years 2054-2083) increases certainty in the outcome, and concern about its implications. Based on two new studies that showed a null effect between the two presentation formats, however, we recommend treating the projection statements featured in these studies as equivalent, and we encourage investigators to find alternative ways to improve on existing formats to communicate uncertain information about future events.

Fossil fuels are harming our brains: identifying key messages about the health effects of air pollution from fossil fuels.

BACKGROUND: Previous research suggests that providing generalized information about the health implications of air pollution from fossil fuels may be effective at promoting public support for a transition to cleaner sources of energy. We sought to extend that work by identifying the specific messages about the health implications of air pollution from fossil fuels that are most and least concerning to people, and whether rankings of concern vary among different audiences. We also hypothesized that reading the statements would influence people's attitudes and behavioral intentions in a manner supportive of a transition to cleaner sources of energy. METHODS: We conducted a survey with a diverse sample of U.S. adults (n = 1644) from a non-probability internet panel. Using maximum difference scaling, participants ranked a set of ten statements that revealed which statements were the most and least concerning to them. We also measured attitudes about air pollution and energy use before and after the ranking exercise to assess changes in opinion caused by cumulative exposure to the messages. RESULTS: Across all sub-groups examined, participants were most concerned by a message about the neurological impacts of air pollution on babies and children. After the ranking exercise, participants expressed increases in perceived health harm of air pollution and fossil fuels, a desire for more clean energy, and intention to engage in consumer advocacy to support clean energy. CONCLUSIONS: To our knowledge, this study is the first to assess how people respond to information about the neurological health harms of air pollution from fossil fuels. While efforts to communicate the cardio-pulmonary health harms of air pollution are well established, our study suggests that efforts should now be organized to communicate the neurological effects of air pollution from fossil fuels, especially the neuro-developmental effects on babies and children.

Discussing global warming leads to greater acceptance of climate science.

Climate change is an urgent global issue, with demands for personal, collective, and governmental action. Although a large body of research has investigated the influence of communication on public engagement with climate change, few studies have investigated the role of interpersonal discussion. Here we use panel data with 2 time points to investigate the role of climate conversations in shaping beliefs and feelings about global warming. We find evidence of reciprocal causality. That is, discussing global warming with friends and family leads people to learn influential facts, such as the scientific consensus that human-caused global warming is happening. In turn, stronger perceptions of scientific agreement increase beliefs that climate change is happening and human-caused, as well as worry about climate change. When assessing the reverse causal direction, we find that knowing the scientific consensus further leads to increases in global warming discussion. These findings suggest that climate conversations with friends and family enter people into a proclimate social feedback loop.

Limiting global warming to 1.5 to 2.0°C-A unique and necessary role for health professionals.

In an Editorial, Edward Maibach and colleagues discuss the important role of health professionals in future responses to threats of climate change.