Introduction by Croakey: With new research showing that many Australians are poorly informed about the risks of climate change for their health and for health systems, experts have called for effective climate and health communications.
“People need to know what the risk means for them, what they can do about it, and what support is available to help them act,” write Professor Jeffrey Braitwaite and Dr K-lynn Smith.
“Sustained adaptation will require governments, health organisations, professional bodies and community groups to communicate much more clearly and consistently about what climate change means for health.”
(As an aside, Croakey could not find any explicit mentions of climate health matters in the recently released National Health Literacy Framework, although it does say: “Public health emergencies, including the COVID-19 pandemic and natural disasters, have demonstrated the critical importance of timely, clear and trusted communication.”)
Jeffrey Braithwaite and K-lynn Smith write:
With a strong El Niño already in force in 2026, Australians once again face the prospect of heatwaves, drought, bushfires and smoke-filled air. Whatever this season brings, there is a bigger question we need to confront: do Australians understand what climate change is doing to our health, and how well prepared our health system is to cope?
New research suggests the answer is: not nearly well enough. The Australian Climate and Health Attitudes, Risk and Trust in the System study is the first national survey to examine Australians’ perceptions of health-system preparedness for climate change.
Published in The Medical Journal of Australia this month, the study surveyed 6,030 adults across every state and territory. We asked people what they thought about the causes of climate change, its consequences for human health and the resilience of Australia’s health system.
The good news is that most Australians understand the broad picture. Most regard climate change as a global emergency, believe human activity is responsible and recognise that Australia is already experiencing its effects.
But when climate change gets closer to home – to our own bodies, families, hospitals and health services – the picture becomes much less reassuring.
More than half of respondents regarded climate change as a threat to Australians’ health. Yet only 45 percent saw it as a serious threat to their own health or that of their family.
That gap is really telling. Climate change is sometimes still imagined principally as an environmental problem: hotter days, burning forests, damaged ecosystems and rising seas. All of these are important, but climate change is also increasingly a health problem.
It affects respiratory and cardiovascular disease, heat-related illness, infectious disease, mental health, food and water security, and the ability of health services to function during emergencies.
Some of the people most vulnerable to these effects were also among those less likely to perceive climate change as a health threat. Older Australians and people living in regional and rural areas, for example, expressed lower levels of concern.
That creates a potentially dangerous mismatch between actual vulnerability and perceived risk. People who do not see themselves as vulnerable are less likely to prepare. That’s a tragedy in waiting.
Personal experience matters
Sometimes it takes a disaster to make the risk real. One of the clearest findings from our research was the effect of personal experience.
People who had lived through a bushfire, flood, heatwave or another climate-related event were much more likely to recognise the health threat posed by climate change.
Nearly one-quarter of those who had experienced such an event said they had needed medical or psychological support as a consequence.
Direct experience, in other words, can be a powerful teacher. But it is a lesson we should not have to keep learning through disaster.
Australia already saw what disaster brings on a massive scale during the 2019–20 “Black Summer” bushfires.
Smoke exposure was associated with increased emergency department visits and hospital admissions for respiratory and cardiovascular conditions, as well as excess deaths.
The estimated health costs associated with bushfire smoke reached almost $2 billion. That is an extraordinary cost – in dollars, illness and lives – incurred after the damage was done.
Imagine what even a fraction of that investment could achieve if directed towards preparedness, prevention and stronger health-system resilience before the next disaster.
Do Australians think the health system is ready? Here the study findings are particularly striking.
Around 40 percent of respondents said the health system was not being affected by climate change. Another 27 percent were unsure.
Asked whether the health system was prepared to respond to climate-related emergencies, around 40 percent believed it was prepared, while almost three in ten were uncertain.
Perhaps most surprisingly, only around one in five thought the health system needed greater capacity to respond to climate-related events.
That suggests a substantial gap – a huge gulf, in fact – between the growing pressures being documented by health researchers and what the community believes is happening.
Hospitals and health services are themselves exposed to extreme weather.
Heat, bushfire, flood and storm events can disrupt electricity, transport, supply chains and staffing. At the same time, those events can increase the number and complexity of patients requiring care.
Climate change therefore creates a double burden: it increases demand on the health system while also threatening the infrastructure and workforce needed to meet that demand – at the very time it’s needed.
If the public does not appreciate this connection, building sustained support for adaptation becomes harder.
Effective communications
Simply telling people that climate change is dangerous is unlikely to be enough.
Australians are saturated with messages competing for their attention, from advertising to social media to public information campaigns. Generic warnings such as “prepare for summer” or “take care in the heat” can easily disappear into the noise.
Climate and health communication needs to be more specific. People need to know what the risk means for them, what they can do about it, and what support is available to help them act.
Heatwaves provide a good example. Extreme heat is Australia’s deadliest climate-related hazard, but the risk is not distributed evenly.
Older people, young children and people living with chronic health conditions can be particularly vulnerable. Some medications, including certain antidepressants and antihistamines, can increase susceptibility to heat.
Other medicines, including insulin, need appropriate temperature control – something that becomes considerably more difficult during prolonged power outages.
Forewarning someone simply that a heatwave is coming is therefore only the beginning.
Effective public health communication might combine a local heat warning with practical information about cooling down in the local RSL club, how to get transport assistance, how to manage your meds and what symptoms you should look out for and that might trigger medical attention.
For people at greatest risk, targeted communication like this will be more useful than another generic campaign.
And communication needs to be designed with communities rather than simply delivered to them.
People who have experienced bushfires, floods and extreme heat can help governments and health services understand what information was useful, what arrived too late and what was missing altogether.
Role of health professionals
There is also an obvious messenger already embedded in communities: the health professional.
Doctors, nurses, pharmacists and other health workers are trusted – and well placed to help people translate the broad concept of climate change into an understanding of their own health risk.
For a patient with cardiovascular disease, severe asthma or diabetes, a conversation about extreme heat or bushfire smoke may be much more meaningful when linked directly to their existing condition and medications.
But busy, pressurised health professionals cannot be expected to take on this role without support.
They need reliable information, training, practical resources and systems that make these conversations part of routine preventive care rather than another unfunded task added to an already stretched workforce.
We also need to tell the story of what climate change costs. One reason Australians may underestimate the health system implications of climate change is that those costs are often largely invisible.
When a bushfire, flood or heatwave occurs, the news understandably focuses on the immediate disaster.
Less visible are the additional ambulance call-outs, emergency department visits, hospital admissions, disrupted services, mental health consequences, lost productivity and deterioration in chronic illness that may continue long after the event itself.
Making those consequences clearer could change the public conversation. Instead of treating climate adaptation simply as another government expenditure, we should also be asking what it costs not to prepare.
There is an important distinction between spending money strengthening hospitals, communities and public-health systems before disaster strikes, and spending far larger sums responding once people are sick, infrastructure has failed and services are overwhelmed.
Australia’s National Adaptation Plan and National Health and Climate Strategy recognise that climate change poses risks to health and health systems.
That policy architecture matters. But plans and strategies will not be enough on their own.
Sustained adaptation will require governments, health organisations, professional bodies and community groups to communicate much more clearly and consistently about what climate change means for health.
Organisations including the Climate and Health Alliance and Doctors for the Environment Australia have helped put these issues on the public agenda.
The next task is to make climate and health literacy much more mainstream.
We should not have to experience disaster to understand the danger. Perhaps the most important message from our study is the disconnect it exposes. Australians largely accept that climate change is real, human-caused and already affecting the country. Yet many remain much less certain that it will affect their own health or put serious pressure on the health system.
That gap is no longer sustainable.
Climate change is not simply a future environmental threat. Its health consequences are already being seen in Australian communities and health services, and they will become more important as the planet continues to warm.
The challenge now is to turn general concern about climate change into a much clearer understanding of what it means for our health. We should not have to wait for the next catastrophic bushfire, flood or heatwave to learn that lesson again.
Author details
Professor Jeffrey Braithwaite is an internationally recognised health services and systems researcher and Founding Director of the Australian Institute of Health Innovation at Macquarie University. His research focuses on improving healthcare through patient safety, leadership, organisational culture, governance, resilience, and large-scale system reform. Renowned for integrating management and organisational science into healthcare, he has led understanding of how health systems function and evolve. Braithwaite has published extensively, influenced policy and international debate, and founded the Observatory on the Future of Healthcare to develop sustainable models of care. He is also lead editor of the 2025 Routledge Handbook on Climate Change and Health System Sustainability.
Dr K-lynn Smith is a research fellow with the Australian Institute of Health Innovation, Macquarie University. She has a diverse research background, including work in conservation biology, sociology, and healthcare, with a focus on the interactions between climate change and health system sustainability. Her research has generated substantial media interest, including being featured in three books, three films, two museum exhibits, and in over 100 popular press articles and other media appearances. She is co-editor of the 2025 Routledge Handbook on Climate Change and Health System Sustainability.
The authors declare no conflicts of interest. The study was supported by philanthropic funding through Macquarie University. The funder played no role in the interpretation of the results.
See Croakey’s archive of articles on health communications, and on climate health matters
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