Rural healthcare providers' attitudes on climate change in the Northwestern US.

INTRODUCTION: Climate change is a growing source of concern for rural public health. Despite rural healthcare providers' vital roles in promoting community resilience, their views on climate change and its impacts on their patients' health are not well understood. METHODS: Using a 38-question online survey, we collected opinion data from rural providers in five states in the Northwestern US, aiming to understand the multifaceted perceptions rural providers have of climate change and its patient-level impacts. Data were aggregated and stratified by variables of interest. Broad trends and effects from demographic variables were modeled using ANOVA analyses and graphical representations, as well as a random forest model. RESULTS: A total of 115 providers responded to the survey (seven were dropped per exclusion criteria) with comparable populations across several states, age groups, and professions. Nearly all providers believed that climate change is occurring, and most felt that it is impacting patients' health, yet many were unsure of their ability to integrate climate consciousness into clinical practice. Interest in the clinical relevance of climate change was best explained by provider political affiliation and education level. Random forest modeling also suggested effects due to age, tenure, and state of residence, which were masked by confounding factors in the other models. CONCLUSION: These findings suggest that some providers struggle to make connections between changes in climate and community health outcomes, while others lack the resources and preparation to integrate what they do know into clinical practice. Bridging this gap will likely require institutional investment in continuing education.