A holistic understanding of literacy approaches at the environment-health-nexus : a scoping review and framework for health professionals

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Kallenbach, Jennifer ; Reismann, Lydia ; Pfeffer, Ines ; Jochem, Carmen:
A holistic understanding of literacy approaches at the environment-health-nexus : a scoping review and framework for health professionals.
In: Frontiers in Public Health. Bd. 14 (2026) . - 1960284.
ISSN 2296-2565
DOI: https://doi.org/10.3389/fpubh.2026.1960284

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Abstract

Introduction: The health literacy of health professionals regarding planetary, climate, and environmental issues is crucial for protecting, promoting, and preserving human and planetary health, especially in the face of increasing environmental risks. To date, no systematic review of the existing literature has been conducted. This scoping review aimed to cluster and analyze scientific evidence on health literacy and competence concepts in the context of planetary, climate, and environmental health as applied to health professionals. Based on these findings, the aim was to develop a new, comprehensive, evidence-informed educational framework to promote professional planetary health literacy (PROF-PHL), to support the professional literacy development in addressing the growing challenges of planetary health.
Methods: The scoping review was conducted in accordance with the JBI and PRISMA-ScR guidelines. Systematic searches were conducted in MEDLINE, CINAHL, and Web of Science, supplemented by manual searches. The results were evaluated using a combination of descriptive and deductive-inductive content analysis, in line with Kuckartz’s typification approach.
Results: The review synthesized 17 health literacy and competence concepts from 28 existing studies on planetary, climate and environmental health. The review examined the concepts’ definitions, theoretical foundations, and environmental-health nexus, as well as their determinants across eight domains: knowledge, competences, attributes, competence dimensions, objectives, context, development processes, and proximal and distal antecedents. These were then integrated into an evidence-informed PROF-PHL framework through a conceptual synthesis. This framework embeds core competences across four dimensions—access, understand, appraise, and apply. The framework highlights the critical roles of systemic conditions, interprofessional education, and transformative action in advancing PROF-PHL.
Discussion: The field of environment-related health literacy is characterized by conceptual heterogeneity and overlap, with a focus on individual competences. There has been a shift from one-sided environment-to-health concepts towards systemic, bidirectional approaches. Based on the available evidence, we have developed an integrative PROF-PHL framework that combines core competences, systemic determinants, and transformative action. This framework could support the integration of environment-related health competences into professional training programs, providing a foundation for initiatives that empower health professionals to promote planetary health in clinical, social, and political contexts. As a conceptual synthesis, however, the framework requires empirical validation.
Systematic review registration: https://doi.org/10.17605/OSF.IO/HYNJR