{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T10:06:02Z","timestamp":1790330762249,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001230","name":"Macquarie University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001230","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Climate change, associated with heat spikes, floods, wildfires and changing patterns of vector\u2010borne diseases, is a major determinant of health, and health system functioning. Understanding public perceptions of climate\u2010related health risks and system preparedness can support equitable policy responses and effective health messaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Type<\/jats:title>\n                    <jats:p>Cross\u2010sectional.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Online survey from 20 June to 27 August 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>6030 adults, aged \u2265\u200918\u2009years, broadly representative of the Australian population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>The AUstralian\u2010CLimate and Health Attitudes, RIsk and Trust in the sYstem (AU\u2010CLARITY) survey collected data on demographics, health status, experiences of climate\u2010related events, and views on climate change and health system preparedness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Respondents (65%, 3910\/6030) were concerned about climate change, yet only 45% (2735\/6030) perceived it as a serious risk to their own health. Personal risk perception declined with age (odds ratio [OR]\u2009=\u20090.98; 95% confidence interval [CI], 0.98\u20130.98) and was higher among females (OR\u2009=\u20091.28; 95% CI, 1.15\u20131.43), First Nations people (OR\u2009=\u20091.44; 95% CI, 1.22\u20131.71), multilingual individuals (OR\u2009=\u20091.44; 95% CI, 1.22\u20131.71) and those with higher education (OR\u2009=\u20091.28; 95% CI, 1.12\u20131.46). Personal experience of a climate\u2010related event increased perceived risk (OR\u2009=\u20091.97; 95% CI, 1.73\u20132.24). Regional and remote residents were less likely to perceive health risk (OR\u2009=\u20090.76; 95% CI, 0.65\u20130.89). A third (37%; 2209\/6030) of respondents believed that the healthcare system was prepared for climate change. Being female (OR\u2009=\u20092.35; 95% CI, 2.10\u20132.65), having a chronic condition (OR\u2009=\u20091.47; 95% CI, 1.28\u20131.68) and older age (OR\u2009=\u20091.01; 95% CI, 1.01\u20131.01) increased perceptions that the system was unprepared. Those with higher education, who had been personally impacted, or identified as First Nations had more confidence in the system's preparedness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Many Australians recognise climate change as a health challenge; personal risk perception and confidence in system preparedness vary. Targeted health policies are needed to effectively communicate health risks and support healthcare's climate change resilience.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5694\/mja2.70293","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:41Z","timestamp":1789084841000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The\n                    <scp>AUstralian<\/scp>\n                    \u2010\n                    <scp>CLimate<\/scp>\n                    and Health Attitudes,\n                    <scp>RIsk<\/scp>\n                    and Trust in the\n                    <scp>sYstem<\/scp>\n                    (\n                    <scp>AU<\/scp>\n                    \u2010\n                    <scp>CLARITY<\/scp>\n                    ) Study: A National, Representative Survey"],"prefix":"10.5694","volume":"224","author":[{"given":"Jeffrey","family":"Braithwaite","sequence":"first","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"},{"name":"Observatory on the Future of Healthcare, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4377-5490","authenticated-orcid":false,"given":"Carolynn L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"},{"name":"Observatory on the Future of Healthcare, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne A.","family":"Zurynski","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"},{"name":"Observatory on the Future of Healthcare, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6902-4578","authenticated-orcid":false,"given":"Louise A.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"},{"name":"Observatory on the Future of Healthcare, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7252-7800","authenticated-orcid":false,"given":"Georgia","family":"Fisher","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"},{"name":"Observatory on the Future of Healthcare, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9923-3116","authenticated-orcid":false,"given":"Kate","family":"Churruca","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"},{"name":"Observatory on the Future of Healthcare, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2869-5671","authenticated-orcid":false,"given":"Lisa","family":"Pagano","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"},{"name":"Observatory on the Future of Healthcare, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3734-3907","authenticated-orcid":false,"given":"Samantha","family":"Spanos","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"},{"name":"Observatory on the Future of Healthcare, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0553-682X","authenticated-orcid":false,"given":"Janet C.","family":"Long","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"},{"name":"Observatory on the Future of Healthcare, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9148-0431","authenticated-orcid":false,"given":"Christina","family":"Rojas","sequence":"additional","affiliation":[{"name":"Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"},{"name":"Observatory on the Future of Healthcare, Australian Institute of Health Innovation Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0828-1073","authenticated-orcid":false,"given":"S. Bruce","family":"Dowton","sequence":"additional","affiliation":[{"name":"Office of the Vice\u2010Chancellor Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41558-024-01994-4"},{"key":"e_1_2_12_3_1","volume-title":"National Adaptation Plan","author":"Australian Government, Department of Climate Change, Energy, the Environment and Water","year":"2025"},{"key":"e_1_2_12_4_1","volume-title":"The Impact of Climate Change on Our Health and Health Systems","author":"Seervai S.","year":"2022"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.16528"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph7062559"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20010815"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1813145116"},{"key":"e_1_2_12_9_1","volume-title":"Public Polling on Climate Change and Health: Conducted by Ipsos MORI for the Health Foundation","author":"Duxbury K.","year":"2021"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19042246"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-15105-z"},{"key":"e_1_2_12_12_1","volume-title":"Climate Action Survey 2023: Summary for Policy and Decision Making","author":"Paas K.","year":"2024"},{"key":"e_1_2_12_13_1","volume-title":"Australia's National Climate Risk Assessment","author":"Australian Climate Service","year":"2025"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/acrefore\/9780190228620.013.428"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41562-022-01463-y"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2007.04448.x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-06737-1"},{"key":"e_1_2_12_18_1","volume-title":"National, State and Territory Population","author":"Australian Bureau of Statistics","year":"2025"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.15172"},{"key":"e_1_2_12_20_1","volume-title":"Remoteness Areas: Australian Statistical Geography Standard (ASGS) Edition 3","author":"Australian Bureau of Statistics","year":"2023"},{"key":"e_1_2_12_21_1","volume-title":"Chronic Disease","author":"Australian Institute of Health and Welfare","year":"2025"},{"key":"e_1_2_12_22_1","volume-title":"Regional Population: Statistics About the Population and Components of Change (Births, Deaths, Migration) for Australia's Capital Cities and Regions","author":"Australian Bureau of Statistics","year":"2025"},{"key":"e_1_2_12_23_1","volume-title":"Cultural Diversity of Australia: Information on Country of Birth, Year of Arrival, Ancestry, Language and Religion","author":"Australian Bureau of Statistics","year":"2022"},{"key":"e_1_2_12_24_1","volume-title":"Australia Joins First Global Health Survey on Chronic Conditions [Media Release]","author":"Australian Commission on Safety and Quality in Health Care","year":"2023"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00103-019-02930-0"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01787-6"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph21081093"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jenvp.2023.102064"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/09603123.2020.1777948"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmac151"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(21)00053-X"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.3769"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-13256-z"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-020-01334-w"},{"key":"e_1_2_12_35_1","volume-title":"First Nations People and the Health System","author":"Australian Institute of Health and Welfare","year":"2024"},{"key":"e_1_2_12_36_1","volume-title":"The Insight Series \u2010 Aboriginal People's Experiences of Hospital Care, 2019\u20132024","author":"The Bureau of Health Information","year":"2025"},{"key":"e_1_2_12_37_1","volume-title":"Census of Population and Housing \u2010 Counts of Aboriginal and Torres Strait Islander Australians. 2021, 2016 and 2011 Aboriginal and Torres Strait Islander Census Counts and Age Distributions for Selected Geographies and National Counts to 1971","author":"Australian Bureau of Statistics","year":"2022"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(21)00255-3"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1215\/03616878-2334656"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.52552"},{"key":"e_1_2_12_41_1","volume-title":"Healthcare in Focus: New South Wales Health System Performance (May 2025)","author":"Bureau of Health Information","year":"2025"}],"container-title":["Medical Journal of Australia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.5694\/mja2.70293","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.5694\/mja2.70293","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.5694\/mja2.70293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:37:47Z","timestamp":1790329067000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.5694\/mja2.70293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":40,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.5694\/mja2.70293"],"URL":"https:\/\/doi.org\/10.5694\/mja2.70293","archive":["Portico"],"relation":{},"ISSN":["0025-729X","1326-5377"],"issn-type":[{"value":"0025-729X","type":"print"},{"value":"1326-5377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-02-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70293"}}