Patient knowledge and views on the health impacts of climate change in primary care: a cross-sectional survey study

Introduction Primary care physicians recognize the health impacts of climate change and are well positioned to counsel patients on these risks, but little is known about patient awareness or willingness to engage in climate-related discussions. Methods We conducted a cross-sectional survey of 289 adults receiving care at three University of Michigan Family Medicine clinics. The survey assessed attitudes toward climate change and health, awareness of specific health effects, barriers to adaptation, preferred resources, and perceived impacts on the patient-provider relationship. Descriptive statistics and comparative analyses (Kruskal-Wallis, chi-squared) were performed. An Attitude Score (1–5) summarized alignment with climate-health concerns. Results Most respondents agreed climate change threatens long-term health (70.6%) and affects the area where they live (76%). Awareness was highest for respiratory and mental health impacts, and lowest for medication stability and cardiovascular risk. Only 25.4% reported knowing how to adapt to the health impacts of climate change, yet 75.6% said they would likely change behaviors if counseled by their provider. Barriers included uncertainty about effective actions (42.5%) and cost (28.5%). Patients expressed strong interest in practical tools (89.8%) and educational materials (78.6%). Higher Attitude Scores were associated with more favorable perceptions of climate change discussions in the patient-provider relationship. Conclusions Patients view climate change as a health concern and express desire for physician counseling that is actionable and specific. Integrating planetary health discussions into primary care encounters may facilitate climate adaptation while preserving trust in the therapeutic relationship.