Nurses' experiences of change fatigue during healthcare reforms: a qualitative study of psychological distress, impacts, and adaptation.

Growing pressure on the global environment, along with environmental challenges, poses significant threats to human health. The World Health Organization (WHO) estimates that approximately 24% of global deaths are attributable to modifiable environmental factors. Major risk factors include air pollution, unsafe water and hygiene conditions, and chemical pollution – all linked to serious health conditions. In this context, the ability to make informed health decisions relies on individuals’ capacity to access, understand, evaluate, and apply information about environmental risks—a competency known as Environmental Health Literacy (EHL). EHL integrates elements from health literacy (HL), environmental literacy (EL), environmental justice, and environmental and health sciences. HL refers to the ability to access, understand, and use health information to make informed decisions. This includes interpreting medical instructions, following doctors’ advice, and navigating healthcare systems. EL, first introduced by Charles Roth in 1968, involves recognizing, understanding, and addressing environmental issues. United Nations Educational, Scientific, and Cultural Organization (UNESCO) later advanced environmental literacy through global environmental education initiatives. EHL also has its origins in the environmental justice movement, highlighting how marginalized communities face higher exposure to pollution and related health risks. Expanding on HL and EL, EHL emphasizes the environmental factors affecting health. Its goal is to raise awareness of environmental risks and develop strategies to reduce health hazards. A model by Finn and O'Fallon and another by Gray emphasize that EHL goes beyond mere knowledge and requires its active application in everyday life. Finn and O'Fallon describe EHL as a dynamic, multi-stage process with varying levels of competence. Drawing from Bloom’s taxonomy, they introduce EHL as a hierarchy of skills, from basic hazard recognition to the ability to develop independent solutions. This model underscores EHL’s non-linear, context-dependent nature and serves as a foundation for education and research, particularly in vulnerable communities.