Assessing Public Knowledge and Perceived Health Impacts of Climate Change: A Cross-Sectional Study in Pakistan

Background: Climate change poses serious health threats worldwide, and low- and middle-income countries such as Pakistan are particularly at risk. Yet public understanding of climate-related health impacts remains limited. Objectives: To measure climate-change knowledge, especially health impacts, among the Pakistani population and to identify demographic predictors of awareness and adaptive behaviour.Methods: A 12-month cross-sectional survey of 120 adults, stratified by urban (n = 68) and rural (n = 52) residence, captured demographics, climate-health knowledge, and self-reported adaptive actions. Logistic regression evaluated predictors of high biomarker awareness (≥ 70 % correct answers) and related behaviours. Results: College education (OR = 3.9, 95 % CI 2.5–6.1) and urban residence (OR = 2.2, 95 % CI 1.4–3.3) markedly increased biomarker knowledge. Participants who recognised key biomarkers—e.g., particulate-matter risks for asthma—were nearly twice as likely to adopt protective measures (OR = 1.9, 95 % CI 1.3–2.9). Urban respondents excelled in recognising air-pollution markers, whereas rural residents were more aware of water-borne-disease indicators. Conclusions: Education and place of residence strongly shape climate-health literacy in Pakistan. Targeted public-health programmes that emphasise region-specific biomarkers—air-quality messaging for cities and water-safety guidance for rural communities—could enhance adaptive behaviours and strengthen national climate resilience.