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Article

The Interplay Between Climate Change Exposure, Awareness, Coping, and Anxiety Among Individuals with and Without a Chronic Illness

by
Shiri Shinan-Altman
1,* and
Yaira Hamama-Raz
2
1
Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat-Gan 52900, Israel
2
School of Social Work, Ariel University, Ariel 40700, Israel
*
Author to whom correspondence should be addressed.
Climate 2025, 13(6), 124; https://doi.org/10.3390/cli13060124
Submission received: 24 April 2025 / Revised: 7 June 2025 / Accepted: 9 June 2025 / Published: 11 June 2025
(This article belongs to the Special Issue Confronting the Climate Change and Health Nexus: Interactions, Impacts, and Adaptation Strategies)
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Abstract

:
Climate change poses a significant threat to mental health, including the emergence of climate change anxiety (CCA). In this study, we examined whether exposure to climate-related events was associated with higher CCA through the mediating roles of climate change awareness and ecological coping strategies and whether these pathways differed by chronic illness status. In February 2025, 600 Israeli adults (50% female; mean age ≈ 50) completed an online self-report questionnaire assessing climate change exposure, awareness, coping, and anxiety. Data were analyzed using moderated mediation models, controlling for gender, age, and education. Greater climate change exposure was associated with an increased awareness and higher use of problem-focused coping, which, in turn, predicted elevated CCA. Meaning-focused coping was not associated with anxiety overall; however, among the participants without a chronic illness, it was linked to higher CCA. Climate change awareness alone was not associated with anxiety. A significant serial mediation was found via awareness and problem-focused coping, and a moderated mediation was found via meaning-focused coping among those without a chronic illness. Coping strategies play a key role in climate change anxiety. Although health status may influence this process, tailored interventions should prioritize coping styles in climate adaptation efforts.

1. Introduction

Climate change is widely recognized as one of the most significant global challenges of the 21st century, with profound implications not only for ecosystems and economies but also for human mental health and psychological well-being [1,2]. As the frequency and intensity of climate-related phenomena—such as extreme heatwaves, droughts, floods, and wildfires—continue to rise, so too does public concern, contributing to the emergence of climate change anxiety (CCA) [3]. This form of anxiety is characterized by persistent worry, fear, and distress related to the anticipated and ongoing impacts of climate change and has been associated with functional impairments and diminished well-being [4].
Growing awareness of climate change and its consequences can heighten people’s emotional and cognitive responses, particularly when individuals perceive themselves or their communities as being at risk [5]. Studies have shown that exposure to climate-related events is associated with greater climate change awareness [6] and anxiety [7]. At the same time, psychological adaptation and resilience depend heavily on how individuals cope with the stress posed by such global environmental threats [8].
The current study was grounded in the transactional model of stress and coping developed by Lazarus and Folkman [9], which conceptualizes stress as a dynamic process arising from the interaction between individuals and their environment. According to this model, when individuals perceive a threat (primary appraisal), they evaluate their coping resources (secondary appraisal) and adopt strategies accordingly. In the context of climate change, exposure to environmental stressors serves as the initiating condition (primary appraisal), which has been hypothesized to increase awareness of climate-related threats. This awareness can influence individuals’ emotional responses (e.g., anxiety) both directly and indirectly through their coping strategies, such as meaning-focused or problem-focused coping. However, theories such as the Extended Parallel Process Model (EPPM) [10] and the Risk Perception Attitude (RPA) framework [11] emphasize that threat perception alone is insufficient to determine emotional outcomes—that is, self-efficacy and the type of coping strategy employed moderate this relationship. Building on these models, we hypothesized that individuals who were more exposed to climate-related events would report greater awareness and engagement in coping strategies, which would, in turn, influence their experience of CCA. We incorporated chronic illness as a moderating variable, given that individuals with chronic health conditions may appraise climate threats differently due to heightened vulnerability, potentially altering both coping styles and emotional outcomes.
Ecological coping strategies, including meaning-focused coping (e.g., deriving hope from collective environmental efforts), de-emphasizing the seriousness of climate change (e.g., minimizing the perceived severity or personal relevance of climate threats), and problem-focused coping (e.g., engaging in environmentally responsible behaviors), have emerged as crucial psychological mechanisms in response to climate-related stressors [12,13]. However, the impact of coping strategies on CCA is not uniform. Although some strategies may alleviate distress, others may inadvertently intensify it [13,14]. For example, engaging in problem-focused coping without sufficient environmental efficacy or societal support can lead to increased anxiety and feelings of helplessness [15].
Moreover, recent studies have emphasized the importance of considering individual vulnerability factors, such as physical health status [16,17]. People living with chronic illnesses may be more psychologically sensitive to environmental disruptions due to their heightened health risks and higher perceived threat [17,18]. These individuals often rely on ongoing health-related coping efforts, which may amplify emotional responses to additional stressors such as climate change. This intersection between physical and mental vulnerability suggests that chronic illnesses may act as a moderating factor in the relationship between climate-related variables and psychological outcomes [17].
Despite increasing interest in climate change-related psychological responses [19,20,21], empirical studies exploring the relationships among climate change exposure, awareness, coping strategies, and anxiety remain limited. Moreover, few studies have examined how these relationships might differ among individuals with chronic health conditions—a population likely to be disproportionately affected by climate-related stressors [17,22]. Understanding these dynamics is critical for developing effective mental health interventions and communication strategies tailored to diverse subgroups within the population.
The aim of the current study was to address this gap by investigating the associations between climate change exposure, climate change awareness, and coping strategies (problem-focused coping, meaning-focused coping, and de-emphasizing the seriousness of climate change) in relation to CCA. Furthermore, we examined whether having a chronic illness moderated these relationships. By applying a moderated mediation model and drawing on Lazarus and Folkman’s [9] theoretical framework, this study provides a perspective on the psychological processes underlying CCA and offers evidence-based insights for supporting vulnerable groups. This study’s theoretical model is illustrated in Figure 1.
We hypothesized that:
  • Higher climate change exposure would be associated with higher climate change awareness, which, in turn, would be associated with higher CCA.
  • Higher climate change exposure would be associated with a greater use of meaning-focused and problem-focused coping, which, in turn, would be associated with higher CCA. However, higher climate change exposure would be associated with a lower use of de-emphasizing the seriousness of climate change, which, in turn, would be associated with higher CCA.
  • Higher climate change exposure would be associated with higher climate change awareness, which, in turn, would be associated with a greater use of meaning-focused and problem-focused coping and a lower use of de-emphasizing the seriousness of climate change, all of which would subsequently be associated with higher CCA.
  • Having a chronic illness would moderate the associations between climate change awareness and coping strategies on the one hand and CCA on the other hand, such that these associations would be stronger for people with a chronic illness than for people without one.

2. Materials and Methods

2.1. Participants and Procedure

Participants were recruited from an Israeli internet panel (iPanel) consisting of about 100,000 Israelis. This panel adheres to Israel’s Central Bureau of Statistics (CBS) in key demographic factors, including age, gender, marital status, and education, which represent the general population [23]. A quota sampling approach was used with quotas meeting the Israeli national census data for sex, employment status, and self-reported health as specified by the CBS census data (see Supplementary Table S1 for the Israeli population demographic values [24]). Furthermore, to ensure a gender balance, stratified sampling by biological sex was employed. The research team requested an equal distribution of male and female participants (50% each), consistent with the national census data provided by the CBS. The inclusion criteria were being 18 years of age or older and being fluent in Hebrew. This study was approved by the second author’s university’s institutional review board (IRB; approval No. 20241226). Data collection took place during February 2025.
The sample size was calculated using Kenny’s calculation [25] for a mediation analysis. Assuming a minimum β = 0.15 for the direct effects in the model, α = 0.05, and power = 0.80, a sample of 451 participants was required for the indirect effect. According to G*Power 3 [26], for multiple regression analysis with a moderate-low effect size of f2 = 0.10, α = 0.05, and power = 0.90, and up to 20 predictors (including interactions), the minimum required sample size was N = 278.
The study sample included 600 Israeli citizens, half men and half women, with an average age of about 50 years. About three-fourths were married or in a relationship, and about three-fourths had children. The participants had an average of about 15 years of education. About three-fourths of the participants were employed, with perceived income levels ranging from below the national average to above the national average. About half of the participants were secular (hiloni), and most of the others were traditional (masorti), reflecting common identity categories in Israel, which vary by degree of religious practice [27]. Most participants assessed their health status as good to excellent, and yet over half reported having a chronic illness (Table 1). Of those with chronic illnesses, about a third had more than one illness. Common chronic illnesses were allergies (20%), high blood pressure (19%), diabetes (10%), asthma (9%), and cancer (6%). A chronic illness was diagnosed on average at about 18 years of age (SD = 14.08), and most participants received medications for their illnesses.

2.2. Measures

The participants completed the following battery of self-report questionnaires:
Climate change exposure was assessed through seven questions composed by the researchers. These questions referred to climate change-related events in Israel to which the participants had been exposed in the past year. The listed events, specifically, were extreme heat waves, severe floods, prolonged droughts, sand and dust storms, heavy rainfall and thunderstorms, wildfires/vegetation fires due to hot and dry weather, and sharp temperature fluctuations (i.e., extreme differences between hot and cold days). Responses were coded as 0—no, 1—yes, and the total score was the sum of the events to which the participant had been exposed, ranging from 0–7.
Climate change awareness was assessed by the Climate Change Awareness scale [6]. This questionnaire includes 13 items (e.g., “I am aware that floods will occur if the temperatures of the world increase”) scored on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Higher scores reflect higher climate change awareness. Cronbach’s alpha of the original questionnaire was 0.88 [6], and in the present study, it was 0.90.
Ecological coping was assessed with a questionnaire developed by Ojala [12]. It consists of 15 items divided into three sub-scales: problem-focused coping (three items, e.g., “I think about what I myself can do”); de-emphasizing the seriousness of climate change (six items, e.g., “I can’t be bothered to care about climate change”); and meaning-focused coping (six items, e.g., “I have faith in people engaged in environmental organizations”). Answers are rated on a five-point Likert scale ranging from 1 (not true at all) to 5 (completely true). A mean item score was calculated for each coping strategy. Cronbach’s alphas of the original questionnaire were 0.76 for problem-focused coping, 0.75 for de-emphasizing the seriousness of climate change, and 0.76 for meaning-focused coping [12]. In the present study, Cronbach’s alphas were 0.80 for problem-focused coping, 0.72 for de-emphasizing the seriousness of climate change, and 0.67 for meaning-focused coping.
Climate change anxiety was assessed via the CCA Scale (CCAS) [3]. This scale includes 13 items (e.g., “Thinking about climate change makes it difficult for me to concentrate”) scored on a 5-point Likert scale, from 1 (never) to 5 (almost always). A higher score reflects higher climate change anxiety. Cronbach’s alpha of the original questionnaire was 0.87 [3], and in the present study, it was 0.94.
Sociodemographic characteristics were gender, age (years), marital status (single, married, in a relationship, divorced, widowed, other), number of children, years of education, employment status (yes/no), income (participants’ perceived income levels), and religiosity (secular, traditional, religious/Orthodox). Self-rated health was assessed with one question: “In general, how would you rate your health?” Responses ranged from 1 (bad) to 4 (excellent) [28]. In addition, the participants were asked to mark from a list of chronic diseases whether they had been diagnosed with any of these diseases (yes/no) and, if so, in what year they had received the diagnosis.

3. Data Analysis

Data were analyzed with SPSS version 29. Descriptive statistics were used for participants’ demographic and background characteristics and for the study variables. Cronbach’s α was calculated for internal consistency. Climate change exposure was positively skewed (skewness = 0.71, SE = 0.10), as was CCA (skewness = 2.17, SE = 0.10). Both were logarithmically transformed. Pearson correlations were calculated between the study variables. Associations between the background variables and the study variables were analyzed with Pearson correlations and t-tests to identify the variables that should be controlled for when assessing the study model. The study model was examined with the PROCESS procedure custom model [29], controlling for gender, age, and years of education. The independent variable was climate change exposure; the mediators were climate change awareness and coping strategies; the moderator was chronic illness (yes/no); and the dependent variable was CCA. The variables were standardized, and mediation and moderation were examined within the model using 5000 bootstrap samples and a 95% confidence interval. Significant interactions were interpreted with simple slopes.

4. Results

4.1. Descriptive Results

Climate change exposure varied. One-fifth of the participants reported no exposure (n = 129, 21.5%), another one-fifth reported being exposed to one phenomenon (n = 133, 22.2%), close to one quarter reported being exposed to two phenomena (n = 143, 23.8%), one quarter was exposed to three or four phenomena (n = 153, 25.5%), and the others were exposed to at least five phenomena (n = 42, 7.0%).
The mean of climate change awareness was moderate, but the mean of CCA was low. The means for ecological coping strategies were moderate to moderate-low (Table 2). Having a chronic illness was associated only with higher CCA. Higher climate change exposure was associated with higher climate change awareness, higher use of problem-focused strategies, lower de-emphasizing of the seriousness of climate change, and higher CCA. Climate change awareness was positively associated with meaning-focused and problem-focused coping, negatively associated with de-emphasizing the seriousness of climate change, and positively associated with CCA. Finally, meaning-focused and problem-focused coping were positively associated with CCA, and de-emphasizing the seriousness of climate change was negatively associated with CCA.
It should be noted that de-emphasizing the seriousness of climate change was rather highly associated with climate change awareness (r = −0.56, p < 0.001). Indeed, both variables had rather high variance inflation factor (VIF) values in the regression model (de-emphasizing VIF = 1.65, awareness VIF = 1.89), rather low tolerance values (0.60 and 0.53), and a high condition index (index = 31.87), indicating possible collinearity. Further, the negative association between de-emphasizing and CCA in the correlation matrix turned positive in the regression model (β = 0.08, p = 0.082), suggesting a suppressor variable. In order to verify the suppressor variable, another regression model was calculated, showing that the contribution of de-emphasizing the seriousness of climate change to anxiety beyond the demographic and background variables (i.e., gender, age, years of education, chronic illness, and climate change exposure) was indeed negative (β = −0.08, p = 0.059) and not significant. Thus, de-emphasizing the seriousness of climate change was excluded from further analyses.

4.1.1. Associations with the Demographic Variables

Gender was associated with problem-focused coping such that women reported using these strategies (M = 2.46, SD = 0.81) more than men (M = 2.32, SD = 0.81), t(598) = 2.24, p = 0.026, and d = 0.18. Age was negatively associated with exposure (r = −0.17, p < 0.001) and positively associated with awareness (r = 0.10, p = 0.011), meaning-focused coping (r = 0.16, p < 0.001), problem-focused coping (r = 0.11, p = 0.008), and CCA (r = 0.13, p = 0.001). Years of education were positively associated with exposure (r = 0.12, p = 0.003) and negatively associated with meaning-focused coping (r = −0.11, p = 0.008). To a small extent, years of education were negatively associated with CCA, as well (r = −0.08, p = 0.047). Other demographic variables had low variances or were not meaningfully associated with the study variables. Thus, the study model was analyzed while controlling for gender (1—male, 0—female), age, and years of education.

4.1.2. The Study Model

The results of the study’s model are shown in Figure 2.
The results showed that higher climate change exposure was associated with higher climate change awareness (p < 0.001), but climate change awareness was not significantly associated with CCA (p = 0.302). Indeed, the indirect effect was not significant (for those with a chronic illness, effect = 0.002, SE = 0.019, 95% CI = −0.037, 0.038; and for those without a chronic illness, effect = −0.034, SE = 0.022, 95% CI = −0.083, 0.006). The first hypothesis was thus not supported.
Further, higher climate change exposure was associated with a higher use of problem-focused coping (p = 0.006), which, in turn, was associated with higher CCA (p < 0.001). In this case, the indirect effect was significant (for those with a chronic illness, effect = 0.062, SE = 0.025, 95% CI = 0.014, 0.112; and for those without a chronic illness, effect = 0.050, SE = 0.020, 95% CI = 0.012, 0.091). This part of the second hypothesis was thus supported. Climate change exposure was not associated with the use of meaning-focused coping (p = 0.305), and meaning-focused coping was not associated with CCA (p = 0.485), leaving this indirect effect non-significant (for those with a chronic illness, effect = 0.002, SE = 0.004, 95% CI = −0.004, 0.013; and for those without a chronic illness, effect = −0.005, SE = 0.007, 95% CI = −0.020, 0.007). This part of the second hypothesis was thus not supported.
As shown in Figure 2, higher climate change exposure was associated with higher climate change awareness (p < 0.001), which, in turn, was associated with a higher use of both meaning-focused and problem-focused coping (p < 0.001). Subsequently, a higher use of problem-focused coping was associated with higher CCA (p < 0.001), yet the association between meaning-focused coping and anxiety was not significant (p = 0.485). As a result, the total indirect effect for problem-focused coping was significant (for those with a chronic illness, effect = 0.094, SE = 0.016, 95% CI = 0.064, 0.127; and for those without a chronic illness, effect = 0.075, SE = 0.016, 95% CI = 0.048, 0.111), and the indirect effect for meaning-focused coping was dependent on the moderating role of chronic illness. The third hypothesis was thus partly supported.
The moderating role of chronic illness was found to be significant regarding the association between meaning-focused coping and CCA (β = −0.091, SE = 0.037, p = 0.014, 95% CI = −0.164, −0.018). Interpreting the significant interaction with simple slopes revealed that the association between meaning-focused coping and CCA was significant among participants without a chronic illness (effect = 0.124, SE = 0.055, p = 0.024, 95% CI = 0.016, 0.233) and was not significant among participants with a chronic illness (effect = −0.058, SE = 0.051, p = 0.257, 95% CI = −0.158, 0.042) (see Figure 3).
The interactions for climate change awareness and problem-focused coping were not significant (p = 0.185, 95% CI = −0.025, 0.128, and p = 0.152, 95% CI = −0.022, 0.140, respectively), leaving the direct association between awareness and anxiety insignificant for the whole sample, and the association between problem-focused coping and anxiety positive and significant for the whole sample. Given that the fourth hypothesis was that the association between meaning-focused coping and CCA would be stronger for participants with a chronic illness, this hypothesis was not supported.
In sum, a significant serial mediation was found for climate change exposure, climate change awareness, problem-focused coping, and CCA regarding the whole sample (for those with a chronic illness, effect = 0.094, SE = 0.016, 95% CI = 0.064, 0.127; and for those without a chronic illness, effect = 0.075, SE = 0.016, 95% CI = 0.048, 0.111). A significant moderated serial mediation was found for climate change exposure, climate change awareness, meaning-focused coping, and CCA (effect = −0.019, SE = 0.008, 95% CI = −0.037, −0.004), where higher climate change exposure was associated with higher climate change awareness, thereby being associated with a higher use of meaning-focused coping, and subsequently being associated with higher CCA among participants without a chronic illness.

5. Discussion

In the current study, we aimed to explore the interplay between climate change exposure, climate change awareness, and climate change coping strategies in reference to CCA while also examining the differences between individuals with and without a chronic illness. The findings reveal a complex picture in which greater climate change exposure was found to be associated with higher climate change awareness. However, awareness alone did not predict CCA, suggesting that the use of coping strategies, particularly problem-focused coping, was a key mechanism linking exposure to CCA. Notably, the role of meaning-focused coping varied by health status, with its association with CCA reaching significance only among participants without a chronic illness.
The study’s findings did not support our first hypothesis: Although greater climate change exposure was associated with higher climate change awareness, awareness was not significantly related to CCA. This finding contradicts previous findings showing that individuals who are more aware of the consequences of climate change tend to experience higher levels of climate concern [30] and anxiety [31]. A possible explanation might be related to Israel’s regional context and weather, especially considering that this study was conducted in February 2025. During this period, participants were unlikely to be exposed to extreme weather events, such as heatwaves or wildfires, which are more common in the summer. Without immediate environmental stressors, climate change may be felt as less threatening, reducing emotional responses [22]. Additionally, ongoing sociopolitical and security concerns in Israel may have competed for emotional resources, diminishing the salience of climate-related worries [8]. This phenomenon, referred to as the “finite pool of worry,” suggests that individuals have a limited emotional capacity to respond to multiple concurrent threats [32]. Consistent with this explanation, our data showed relatively low levels of climate change anxiety and limited variability in this variable, which may have constrained the detection of expected associations in our hypothesized model. Finally, climate change may be perceived by many Israelis as a global rather than local issue, further distancing this phenomenon from personal emotional impact [33]. In this context, climate change awareness might not uniformly translate into emotional responses such as CCA.
The study’s findings partially supported our second hypothesis. Specifically, greater climate change exposure was associated with a higher use of problem-focused coping, which, in turn, was linked to higher levels of CCA. This pattern aligns with previous research [12,34], which has shown that attempts to take action in the face of a global and overwhelming threat (as identified with problem-focused coping) may amplify emotional distress rather than reduce it. A possible explanation for this finding is that problem-focused coping, although generally effective in controllable situations, may backfire in the context of a vast and persistent issue such as climate change. When individuals engage in concrete actions (e.g., recycling, reducing carbon use) but perceive little systemic change or global impact, feelings of helplessness and emotional burden can intensify [12,35]. Thus, greater engagement may paradoxically increase distress, particularly among those who are more informed or emotionally invested. This explanation is supported by Lazarus and Folkman’s transactional theory of stress and coping [9], which states that problem-focused coping is adaptive in the short run but might be maladaptive in the long run. Continuous attempts to “solve” an unsolvable issue can lead to frustration and emotional fatigue while limiting opportunities for emotional processing or acceptance, which are essential for long-term psychological adjustment.
In contrast, the part of the second hypothesis regarding an indirect path through meaning-focused coping was not supported: Namely, climate change exposure did not predict meaning-focused coping, nor was this coping strategy significantly associated with CCA. This finding differs from prior studies suggesting that meaning-focused coping can promote resilience and psychological well-being in the context of climate-related concerns [35,36]. It could be that meaning-focused coping requires a deeper level of cognitive and emotional processing that is not necessarily triggered by exposure alone. Cultural context may also play a role; the ongoing sociopolitical stressors in Israel may have overshadowed abstract, global threats such as climate change, rendering meaning-focused coping less accessible or less commonly used in relation to climate change. From a theoretical standpoint, Lazarus and Folkman’s [9] model suggests that meaning-focused coping is more likely to emerge when individuals appraise the stressor as uncontrollable and have moved beyond efforts to manage the stressor directly. If participants in the current study had still been oriented toward problem-solving, they may not have shifted toward meaning-focused coping.
Our third hypothesis was partially confirmed: Namely, greater climate change exposure was associated with greater climate change awareness, which, in turn, was associated with an increased use of meaning-focused coping strategies (e.g., reframing and meaning-making) and problem-focused coping strategies (e.g., direct actions to mitigate stressors). This finding aligns with recent findings suggesting that direct experiences with climate change phenomena (e.g., extreme weather) can enhance individuals’ environmental awareness and perception of risk [37,38] and that heightened climate change awareness is associated with an increased use of meaning-focused coping strategies and problem-focused coping strategies [39]. Interestingly, our results revealed distinct outcomes for these coping strategies. Namely, problem-focused coping was associated with elevated CCA, reflecting that direct engagement with climate issues seems to expose individuals to the severity of environmental threats, thereby increasing their anxiety due to a heightened perception of urgency and potential consequences [12,35]. On the other hand, we found no significant relationship between meaning-focused coping and CCA. This finding might suggest that individuals employing meaning-focused coping strategies do not show heightened anxiety despite an increased awareness of climate threats. The indication may be that meaning-focused coping strategies contribute to emotional resilience that buffers against heightened emotional distress [40,41].
Finally, contrary to our expectations, the fourth hypothesis was not confirmed: A significant serial mediation emerged between climate change exposure, climate change awareness, problem-focused coping, and climate change anxiety for the entire sample (and not for a specific group). A possible explanation stems from Daeninck and colleagues’ [35] finding among university students, which demonstrated that problem-focused coping was the most commonly endorsed strategy, although the prior literature on coping suggested that problem-focused coping might not be sustainable for individually intractable problems. Thus, it might be that both participants with and without chronic illnesses used problem-focused coping to address the problem directly, such as taking action (e.g., activism, lifestyle changes, pro-environmental behaviors) or seeking information. Interestingly, among participants without a chronic illness, our findings revealed that higher climate change exposure led to increased climate change awareness, subsequently fostering greater use of meaning-focused coping strategies, which unexpectedly was associated with higher CCA. This finding contrasts with the previously discussed protective or buffering role often attributed to meaning-focused coping strategies [12]. One possible explanation for this finding is that individuals without chronic illnesses might have less experience in regularly employing coping strategies to handle ongoing health-related stressors, making them potentially less skilled at effectively mitigating anxiety. Alternatively, it is possible that meaning-focused coping initially increases anxiety due to heightened cognitive engagement with existential dimensions of climate threats, which healthy individuals might find particularly disruptive. In contrast, for chronically ill individuals, meaning-focused coping may serve as a more adaptive strategy, perhaps because physical limitations reduce the feasibility of problem-focused coping, thereby increasing reliance on meaning-based approaches that they are more practiced in using.

6. Limitations

Several limitations should be noted. First, this study’s cross-sectional design limits the ability to determine causality. Although we modeled coping as a predictor of anxiety, it is also plausible to suggest that anxiety triggers coping. Alternative models [42,43] should be explored in future longitudinal research to clarify the directionality of these relationships. Second, the study sample was drawn from an online panel, which, despite being structured to reflect the national population in key demographics, may not have fully represented the broader Israeli public. Participants in online panels may differ from the general population in terms of digital literacy, years of education, and motivation to participate in research. Notably, the sample had a slightly higher average age and education level than national averages, which may have introduced some sampling bias and limited the generalizability of the findings. Third, we do not have data on the extent of climate change denial in Israel. Although such denial is not believed to be widespread, varying levels of belief and engagement may have influenced participants’ responses and should be considered a potential limitation. Moreover, participants who engage in online surveys could have different personal characteristics from those who do not participate in such panels. In line with this notion, a previous systematic review and meta-analysis showed that personality traits were related to climate change attitudes [44]. Thus, it might be that those people who are willing to participate in online panels have specific personality traits; therefore, caution, again, is required in generalizing the present findings. Fourth, all data were collected through self-reported measures, which can introduce biases such as social desirability or recall. Fifth, this study was conducted during a specific season (winter), in a specific regional weather context (Israel), and in a specific sociopolitical context (wartime), thus potentially limiting the generalizability of the findings to other regions or seasons. Different cultural, political, and environmental contexts may yield different results, suggesting the replication of the present study model. Finally, we did not assess participants’ perceptions of self-efficacy, which has been shown in models such as the EPPM [10] and RPA framework [11] to moderate the relationship between risk perception and anxiety. This omission may have limited our understanding of the mechanisms underlying individual responses to climate threats.

7. Implications

The present findings have several implications. First, the consistent link found between greater climate change exposure and greater climate change awareness underscores the critical importance of enhancing public awareness through transparent communication about environmental risks.
Second, the observed positive association between problem-focused coping and CCA highlights the need for design interventions promoting coping strategies to manage climate anxiety. These interventions should carefully balance encouragement of direct action (e.g., pro-environmental behavior) with strategies to emotionally manage the anxiety that arises from confronting an overwhelming global issue. Moreover, the lack of a significant direct link between meaning-focused coping and CCA suggests a potentially protective or stabilizing function for this coping strategy. Meaning-focused coping strategies such as reframing, acceptance, or finding personal meaning may help individuals maintain emotional balance when confronting climate threats.
Third, the moderated serial mediation found specifically among participants without a chronic illness highlights the need for differentiated intervention strategies between populations. Public health messaging is recommended to be sensitive to individual differences, potentially offering tailored guidance and psychological support to healthy populations who might otherwise appear less vulnerable to climate-related distress. Policymakers and practitioners are advised to recognize that one-size-fits-all coping strategies are insufficient and potentially harmful. Future policies should integrate multi-dimensional approaches combining awareness enhancement with diversified coping skills training, explicitly addressing the emotional complexities and paradoxical outcomes identified in the current study.

8. Conclusions

The present study highlights the complex relationships among climate change exposure, awareness, coping strategies, and anxiety. Our results show that climate change awareness was not associated with CCA. Coping strategies play critical and sometimes paradoxical roles: problem-focused coping may heighten anxiety, whereas meaning-focused coping might offer emotional stability but could also amplify anxiety among specific populations, such as individuals without chronic illnesses. Thus, tailored and differentiated psychological interventions and educational programs are essential for effectively addressing the emotional impacts of climate change across diverse population groups. Further research is recommended to explore the long-term psychological trajectories of different coping strategies across varied population groups.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/cli13060124/s1: Table S1. Demographic Comparison Table.

Author Contributions

Conceptualization, S.S.-A. and Y.H.-R.; methodology, S.S.-A. and Y.H.-R.; writing—original draft preparation, S.S.-A. and Y.H.-R.; writing—review and editing, S.S.-A. and Y.H.-R.; supervision, S.S.-A. and Y.H.-R. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon request.

Conflicts of Interest

The authors declare no conflicts of interest.

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Climate 13 00124 g001
Figure 1. The study’s theoretical model.
Figure 1. The study’s theoretical model.
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Climate 13 00124 g002
Figure 2. The mediating role of climate change awareness and coping strategies, and the moderating role of chronic illness in the association between climate change exposure and climate change anxiety. Note: Values on arrows: β, values within rectangles: R2. * p < 0.05, ** p < 0.01, *** p < 0.001.
Figure 2. The mediating role of climate change awareness and coping strategies, and the moderating role of chronic illness in the association between climate change exposure and climate change anxiety. Note: Values on arrows: β, values within rectangles: R2. * p < 0.05, ** p < 0.01, *** p < 0.001.
Climate 13 00124 g002
Climate 13 00124 g003
Figure 3. The moderating effect of chronic illness on meaning-focused coping and climate change anxiety. Note. Mean anxiety, logarithmically transformed and standardized.
Figure 3. The moderating effect of chronic illness on meaning-focused coping and climate change anxiety. Note. Mean anxiety, logarithmically transformed and standardized.
Climate 13 00124 g003
Table 1. Demographic characteristics (N = 600).
Table 1. Demographic characteristics (N = 600).
VariableCategoriesValues
Gender, n (%)Male300 (50.0)
Female300 (50.0)
Age, M (SD), range 49.83 (16.71), 20–80
Marital status, n (%)Single96 (16.0)
Married, in a relationship438 (73.0)
Divorced, widowed, other66 (11.0)
Children, n (%)Yes
Number of children, M (SD), range 2.20 (1.72), 0–11
Years of education, M (SD), range 14.85 (2.80), 8–26
Employment, n (%)Yes450 (75.0)
Income, compared to the general Israeli population n (%) (n = 586)Below average204 (34.8)
Average159 (27.1)
Above average233 (38.1)
Religiosity, n (%)Secular311 (51.8)
Traditional187 (31.2)
Religious102 (17.0)
Health status, n (%)Bad or not so good73 (12.2)
Good402 (67.0)
Excellent125 (20.8)
Chronic illness, n (%)Yes323 (53.8)
Table 2. Means, standard deviations, and Pearson correlations for the study variables (N = 600).
Table 2. Means, standard deviations, and Pearson correlations for the study variables (N = 600).
VariablesM (SD)1.2.3.4.5.6.7.
1. Chronic illness (yes)0.54 (0.50)1
2. Climate change exposure 1.95 (1.60)0.071
3. Climate change awareness 3.48 (0.70)0.050.33 ***1
4. Meaning-focused coping2.87 (0.56)−0.020.010.28 ***1
5. Problem-focused coping2.39 (0.81)0.040.24 ***0.49 ***0.39 ***1
6. De-emphasizing seriousness2.31 (0.64)−0.01−0.31 ***−0.56 ***0.02−0.35 ***1
7. Climate change anxiety1.32 (0.49)0.13 **0.15 **0.25 ***0.24 ***0.54 ***−0.12 **1
** p < 0.01, *** p < 0.001 Note. Ranges: Chronic illness 0/1; climate change exposure 0–7; climate change awareness 1–5; ecological coping 1–5; climate change anxiety 1–4. The Bonferroni criterion was applied- p = 0.002.
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Shinan-Altman, S.; Hamama-Raz, Y. The Interplay Between Climate Change Exposure, Awareness, Coping, and Anxiety Among Individuals with and Without a Chronic Illness. Climate 2025, 13, 124. https://doi.org/10.3390/cli13060124

AMA Style

Shinan-Altman S, Hamama-Raz Y. The Interplay Between Climate Change Exposure, Awareness, Coping, and Anxiety Among Individuals with and Without a Chronic Illness. Climate. 2025; 13(6):124. https://doi.org/10.3390/cli13060124

Chicago/Turabian Style

Shinan-Altman, Shiri, and Yaira Hamama-Raz. 2025. "The Interplay Between Climate Change Exposure, Awareness, Coping, and Anxiety Among Individuals with and Without a Chronic Illness" Climate 13, no. 6: 124. https://doi.org/10.3390/cli13060124

APA Style

Shinan-Altman, S., & Hamama-Raz, Y. (2025). The Interplay Between Climate Change Exposure, Awareness, Coping, and Anxiety Among Individuals with and Without a Chronic Illness. Climate, 13(6), 124. https://doi.org/10.3390/cli13060124

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