Climate change related knowledge awareness preparedness health vulnerability and forgone-healthcare among engineering youth in the Himalayan region of India

Climate change poses growing health risks, particularly for populations in ecologically sensitive regions like Himachal Pradesh. Young people, especially students, face both direct and indirect impacts but are often overlooked in climate-health research. A cross-sectional survey was conducted among 304 engineering students at the National Institute of Technology (NIT), Hamirpur, Himachal Pradesh. A structured online questionnaire assessed climate-health knowledge, awareness, preparedness, health vulnerabilities, and healthcare-seeking behavior. Descriptive and inferential statistics including chi-square tests and correlation analysis were used. Out of all the respondents, 73.36% demonstrated high knowledge scores and 64.80% had moderate awareness, but only 12.83% showed high preparedness. Around 64.80% of students believed their illness was linked to climate change, yet 40.13% did not seek medical care. Reasons such as cost, distance, and mild symptoms, contributed to forgone cost of care as about half of the respondents reported lost academic days due to illness, and many incurred OOPE for medicine, travel, and doctor consultations. A significant association was found between health vulnerability levels and various indicators like number of academic days lost (p < 0.001), cost of medicine (p = 0.025) and doctors consultation fees (p = 0.003). Despite relatively high knowledge and awareness levels, students showed low preparedness and limited access to institutional health support. These gaps highlight the urgent need for integrating climate-health education into engineering curricula and improving campus infrastructure, training, and emergency preparedness. Strengthening these areas is critical for reducing health vulnerabilities and mitigating economic burdens among youth in climate-sensitive regions.