Prevalence and measurement of climate anxiety in youth: A systematic review and meta-analysis

Abstract Background Climate anxiety is a growing concern, especially for young people. However, varied definitions and measurement approaches complicate understanding its scope, leading to inconsistent prevalence estimates. This systematic review assessed climate anxiety prevalence among youth (≤ 29 years) and documented measurement methods to clarify public health relevance and address research gaps. Methods Following PRISMA guidelines, we systematically reviewed PubMed, PsycINFO, & Web of Science (Oct 2024) for peer-reviewed English-language studies on youth climate anxiety prevalence. Duplicate screening, data extraction, & quality assessment occurred. Narrative synthesis & random-effects meta-analyses yielded pooled estimates (prevalence/means using appropriate methods). Heterogeneity (I2) was quantified & subgroup analyses conducted. Results Thirteen cross-sectional studies, mostly from High-income countries (HICs) and rated moderate risk of bias, were included. Definitions of climate anxiety varied widely. Single-item questions, which were not validated, were common for prevalence estimation (pooled prevalence from 14 estimates: 59%, 95% CI: 50%-67%; I2=98.8%). Validated scale (CCAS) assessing levels indicated infrequent symptoms on average (pooled mean from 4 studies: 1.68, 95% CI: 1.35-2.02; I2=98.5%). High heterogeneity was present in both analyses. No significant prevalence difference was found between Low- and Middle-income countries (LMICs) (63%) and High-income countries (HICs) (57%) (p = 0.49). Conclusions Youth climate anxiety prevalence estimates differ starkly based on measurement (high via single items, low average frequency via scales), likely from psychometric variations. Inconsistent definitions and geographical research bias also limit understanding. Standardized, validated measures and clear definitions are crucial for accurate public health monitoring, differentiating concern from distress, and guiding interventions. Key messages • Youth climate anxiety estimates diverge sharply: 59% report anxiety via single items, yet validated scale shows low average symptom levels. Measurement matters. • Standard definitions & validated tools are vital for tracking youth climate anxiety accurately, guiding public health action & improving research quality globally.