Assessing the role of education level on climate change belief, concern and action: a multinational survey of healthcare professionals in nephrology

Background: Climate change poses a significant risk to kidney health, and countries with lower national wealth are more vulnerable. Yet, citizens from lower-income countries demonstrate less concern for climate change than those from higher-income countries. Education is a key covariate. To examine its role in explaining this perception gap, we obtained the perspectives of a highly educated cohort of healthcare professionals. Methods: This was a cross-sectional survey of healthcare professionals involved in kidney care. Responses were compared by the income level of the participant's country (per World Bank). Results: Of the 849 healthcare professionals from 107 countries (63.4% from lower and middle-income countries) that participated, most believed climate change was happening (97.9%), displayed a high level of concern (73.3%), and took personal action to combat climate change (62.0%). While the proportion who believed in climate change did not vary by income level (high:98.1%, upper-middle:97.2%, lower-middle:97.8%, low:100%, p = 0.73), the proportion with a higher level of concern (high:80.7%, upper-middle:74.9%, lower-middle:67.5%, low:53.8%, p < 0.001), and who took climate action (high:76.2%, upper-middle:63.1%, lower-middle:51.2%, low:30.8%, p < 0.001) decreased by national wealth. Barriers to involvement in sustainable kidney care were lack of time (54.4%), knowledge (39.7%), and peer support (30.3%). Only 34.0% were aware of national mitigation plans and barriers related to finances, technologies, tools, methods, research, and evidence were perceived as greater obstacles in lower-income countries. Conclusions: Our results highlight that predictors and correlates of climate change risk perception vary across countries. Education alone is unlikely to increase individual and group engagement in climate change. A better understanding of these factors can inform strategies towards climate action in different settings.