The AUstralian-CLimate and Health Attitudes, RIsk and Trust in the sYstem (AU-CLARITY) Study: A National, Representative Survey.

OBJECTIVES: Climate change, associated with heat spikes, floods, wildfires and changing patterns of vector-borne diseases, is a major determinant of health, and health system functioning. Understanding public perceptions of climate-related health risks and system preparedness can support equitable policy responses and effective health messaging. STUDY TYPE: Cross-sectional. SETTING: Online survey from 20 June to 27 August 2025. PARTICIPANTS: 6030 adults, aged ≥ 18 years, broadly representative of the Australian population. MAIN OUTCOME MEASURES: The AUstralian-CLimate and Health Attitudes, RIsk and Trust in the sYstem (AU-CLARITY) survey collected data on demographics, health status, experiences of climate-related events, and views on climate change and health system preparedness. RESULTS: 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] = 0.98; 95% confidence interval [CI], 0.98-0.98) and was higher among females (OR = 1.28; 95% CI, 1.15-1.43), First Nations people (OR = 1.44; 95% CI, 1.22-1.71), multilingual individuals (OR = 1.44; 95% CI, 1.22-1.71) and those with higher education (OR = 1.28; 95% CI, 1.12-1.46). Personal experience of a climate-related event increased perceived risk (OR = 1.97; 95% CI, 1.73-2.24). Regional and remote residents were less likely to perceive health risk (OR = 0.76; 95% CI, 0.65-0.89). A third (37%; 2209/6030) of respondents believed that the healthcare system was prepared for climate change. Being female (OR = 2.35; 95% CI, 2.10-2.65), having a chronic condition (OR = 1.47; 95% CI, 1.28-1.68) and older age (OR = 1.01; 95% CI, 1.01-1.01) 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. CONCLUSIONS: 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.