Communicating the health implications of global environmental change: a mixed-methods systematic review of health framing in environmental messaging

BACKGROUND: Global environmental change poses a significant threat to human health, necessitating effective communication strategies to raise public awareness and motivate mitigation and adaptation actions. Previous studies have examined whether framing climate change and other environmental issues as health problems can increase public engagement, with mixed results. PURPOSE: This mixed-methods systematic review synthesizes existing evidence on the effectiveness of health framing in text-based environmental communication interventions. METHODS: We searched 5 electronic databases (Web of Science, Scopus, PubMed, PsycINFO, and Communication and Mass Media Complete) from inception to May 9, 2025, and identified 46 relevant articles (54 studies). The Mixed Methods Appraisal Tool was used to assess study quality, and qualitative narrative synthesis was performed. RESULTS: Most studies were randomized controlled trials conducted among the general public in high-income, English-speaking countries. Key findings indicate that health-framed environmental messages are generally perceived as clear and helpful, particularly when employing a gain frame and emphasizing mitigation benefits. Health framing also effectively increases threat perception, policy support, and health-protective intentions, although its impacts on sustainable lifestyle changes and advocacy behaviors are less consistent. CONCLUSIONS: Future research should incorporate rigorous designs and diverse populations and focus on long-term, real-world outcomes to obtain a clearer understanding of effective communication strategies at the intersection of global environmental change and health. REGISTRATION: The systematic review protocol was registered within the PROSPERO database (CRD420251050978).