Eco-Wellness in Medical Education: A Cross-Sectional Study of Environmentally Responsible Health-Oriented Behaviours and Their Correlates among Undergraduate Medical Students in Karimnagar, India

Background: Planetary health recognises that human health depends on the stability of natural systems. Medical students are future clinicians and public health leaders, yet environmental knowledge may not translate into sustainable daily practice. This study assessed environmentally responsible health-oriented behaviours and their socio-demographic and knowledge-related correlates among undergraduate medical students. Methods: An institutional cross-sectional analytical study was conducted at Prathima Institute of Medical Sciences, Karimnagar, Telangana, India, from March to June 2024. A total of 320 second- and third-year MBBS students (160 per year) completed a structured self-administered questionnaire on environmental knowledge and attitudes and on behaviours in five domains: active transport, sustainable nutrition, waste management, energy conservation and green consumerism. A high behaviour score was defined as a total above 75 percent of the maximum. Descriptive statistics, Wilson confidence intervals, chi-square tests, prevalence ratios and multivariable binary logistic regression were applied. Results: Mean age was 20.8 years (standard deviation 1.4) and 55.6 percent were female. Overall, 132 students (41.25 percent; 95 percent confidence interval 36.0 to 46.7) achieved a high score. In the adjusted model, female sex (adjusted odds ratio 1.92; 95 percent confidence interval 1.21 to 3.05), hostel residence (2.28; 1.42 to 3.66), third-year status (1.74; 1.09 to 2.78) and higher environmental knowledge (2.49; 1.52 to 4.07) were independently associated with a high score. Reusable bottle use (70.0 percent) and energy conservation (66.6 percent) were reported more often than active travel (36.6 percent) and plant-forward dietary choices (33.4 percent). Conclusion: Fewer than half of the students met the high-score threshold, and behaviours dependent on infrastructure and food systems lagged behind those under individual control. Medical colleges should pair planetary health teaching with campus environments that make sustainable choices easy.