TÜRKİYE'DEKİ ÜNİVERSİTE ÖĞRENCİLERİNDE ÇEVRE SAĞLIĞI OKURYAZARLIĞI: GENEL, HAVA, GIDA VE SU ALANLARINDA KESİTSEL BİR ÇALIŞMA

Öz

Bu çalışma, üniversite öğrencilerinde genel, hava, gıda ve su alanlarındaki çevre sağlığı okuryazarlığı (EHL) düzeylerini ve bu düzeylerin sosyodemografik ve yaşam tarzı özellikleriyle ilişkisini incelemek amacıyla yürütülmüştür. Tanımlayıcı ve kesitsel tasarıma sahip araştırmanın örneklemini, Mersin’deki üniversitelere kayıtlı 970 öğrenci oluşturmuştur. Veriler, sosyodemografik anket ve Çevre Sağlığı Okuryazarlığı Anketi’nin Türkçe versiyonu ile toplanmış; analizlerde tanımlayıcı istatistikler, bağımsız örneklem t-testi, tek yönlü ANOVA ve Pearson korelasyon kullanılmıştır. Çevre Sağlığı Okuryazarlığı puanlarının alt boyutlara göre farklılaştığı belirlenmiştir (Genel: 3,72±0,65; Hava: 2,10±0,63; Gıda: 4,19±0,66; Su: 3,66±0,60). Kadın öğrencilerin gıda ve su boyutlarında, 21 yaş ve üzerindekilerin genel ve su boyutlarında, sağlıkla ilgili programlardaki öğrencilerin ise hava ve su boyutlarında daha yüksek puanlara sahip olduğu saptanmıştır (p ≤ 0,05). Ayrıca evde pişirilmiş besin tüketimi ve daha yüksek fiziksel aktivite düzeyleri, birden fazla boyutta daha yüksek Çevre Sağlığı Okuryazarlığı ile ilişkilidir. Alt boyutlar arasında en güçlü ilişki gıda ve su okuryazarlığı arasında bulunmuştur (r = 0,591; p < 0,01). Sonuç olarak, üniversite öğrencilerinde çevre sağlığı okuryazarlığı alanlara göre farklılık gösteren çok boyutlu bir yapı sergilemektedir. Bu durum, yükseköğretimde genel yaklaşımlar yerine alana özgü müdahalelerin daha etkili olabileceğine işaret etmektedir.

Anahtar Kelimeler

• Çevre sağlığı okuryazarlığı
• çevre sağlığı
• hava kirliliği
• gıda güvenliği
• su kalitesi

Etik Beyan

Araştırma, Süleyman Demirel Üniversitesi Sosyal ve Beşeri Bilimler Etik Kurulu'ndan etik onay almıştır (tarih: 02.10.2025, karar no: 177/29).

Teşekkür

Bu çalışmaya katılan öğrencilere teşekkür ederiz.

ENVIRONMENTAL HEALTH LITERACY IN UNIVERSITY STUDENTS IN TÜRKİYE: GENERAL, AIR, FOOD, AND WATER DOMAINS IN A CROSS-SECTIONAL STUDY

Öz

This study was conducted to examine the levels of environmental health literacy (EHL) among university students in the areas of general, air, food and water health, and to investigate the relationship between these levels and sociodemographic and lifestyle characteristics. The sample for this descriptive, cross-sectional study consisted of 970 students enrolled at universities in Mersin. Data were collected using a sociodemographic questionnaire and the Turkish version of the Environmental Health Literacy Questionnaire; analyses utilised descriptive statistics, the independent samples t-test, one-way ANOVA and Pearson correlation. It was determined that Environmental Health Literacy scores varied across sub-dimensions (General: 3.72±0.65; Air: 2.10±0.63; Food: 4.19±0.66; Water: 3.66±0.60). It was found that female students scored higher on the food and water dimensions, those aged 21 and over scored higher on the general and water dimensions, and students in health-related programmes scored higher on the air and water dimensions (p ≤ 0.05). Furthermore, consumption of home-cooked food and higher levels of physical activity were associated with higher Environmental Health Literacy across multiple dimensions. The strongest correlation among the sub-dimensions was found between food and water literacy (r = 0.591; p < 0.01). In conclusion, environmental health literacy among university students exhibits a multidimensional structure that varies by field of study. This suggests that field-specific interventions may be more effective than general approaches in higher education.

Anahtar Kelimeler

• Environmental health literacy
• environmental health
• air pollution
• food safety
• water quality

Etik Beyan

The research received ethical approval from the Ethics Committee of Social and Human Sciences at Süleyman Demirel University (dated 02.10.2025, decision no: 177/29).

Teşekkür

We thank the students who participated in this study.

Kaynakça

1. Akyol Güner, T., & Kuzlu Ayyıldız, T. (2026). Sustainability among university students: The relationship between carbon footprint awareness and environmental health literacy. Journal of Higher Education and Science (Yükseköğretim ve Bilim Dergisi), 16(1), 139-146. https://doi.org/10.5961/higheredusci.1835507
2. Akyuz, S., Donmez, E., Kılıç, B., Jama, N. A., & Eker, H. H. (2025). The relationship between healthy lifestyle behaviours and levels of health literacy of university students in Mogadishu, Somalia. International Journal of Environmental Research and Public Health, 22(8), Article 1259. https://doi.org/10.3390/ijerph22081259
3. Alengebawy, A., Abdelkhalek, S. T., Qureshi, S. R., & Wang, M.-Q. (2021). Heavy metals and pesticides toxicity in agricultural soil and plants: Ecological risks and human health implications. Toxics, 9(3), Article 42. https://doi.org/10.3390/toxics9030042
4. Alqahtani, N., Bashatah, A., Asiri, S., Syed, W., & Al-Rawi, B. A. (2024). Understanding of health literacy among healthcare students in Saudi Arabia: A cross-sectional study. BMC Medical Education, 24(1), Article 1269. https://doi.org/10.1186/s12909-024-06263-8
5. Brunner, T. A., Van der Horst, K., & Siegrist, M. (2010). Convenience food products: Drivers for consumption. Appetite, 55(3), 498-506. https://doi.org/10.1016/j.appet.2010.08.017
6. Budak, S. N., Yapar, D., Budak, B., Tüzün, H., & Özkan, S. (2025). Validity and reliability study of the Turkish version of the Environmental Health Literacy Survey Instrument. ESTUDAM Public Health Journal, 10(2), 202-222. https://doi.org/10.35232/estudamhsd.1624996
7. Buta, B. O., Froner, M. B., & Tabak, B. M. (2025). Scale validation and prediction of environmental health literacy in Brazil. Scientific Reports, 15, Article 14703. https://doi.org/10.1038/s41598-025-98435-9
8. Centers for Disease Control and Prevention. (2024, October 16). What is health literacy? U.S. Department of Health and Human Services. https://www.cdc.gov/health-literacy/php/about/index.html

9. Cevheroğlu, S., & Fırat Kılıç, H. (2025). Environmental health literacy levels of nursing students. BMC Nursing, 24, Article 1425. https://doi.org/10.1186/s12912-025-04078-6
10. Chen, J., Zhou, M., Yang, J., Yin, P., Wang, B., Ou, C.-Q., & Liu, O. (2020). The modifying effects of heat and cold wave characteristics on cardiovascular mortality in 31 major Chinese cities. Environmental Research Letters, 15(10), 105009. https://doi.org/10.1088/1748-9326/abaea0
11. Cohen, J. (1969). Statistical power analysis for the behavioural sciences. (1st Edition) New York: Academic Press.
12. Dauletkaliyeva, Z., Bolatova, Z., Yerdessov, N., Nukeshtayeva, K., Zhamantayev, O., Takuadina, A., & Kayupova, G. (2025). Health literacy and influencing factors in university students across diverse educational fields in Kazakhstan. Scientific Reports, 15, Article 3197. https://doi.org/10.1038/s41598-025-87049-w
13. Davis, L. F., Ramirez-Andreotta, M. D., McLain, J. E. T., Kilungo, A., Abrell, L., & Buxner, S. (2018). Increasing environmental health literacy through contextual learning in communities at risk. International Journal of Environmental Research and Public Health, 15(10), Article 2203. https://doi.org/10.3390/ijerph15102203
14. Deng, F., Wen, X., Dong, G., Wang, X., He, H., Zhu, R., Qiao, L., & Han, J. (2025). The environmental health literacy level was effectively improved of residents in Shaanxi Province, China, 2022. Frontiers in Public Health, 12, Article 1499349. https://doi.org/10.3389/fpubh.2024.1499349
15. Ebi, K. L., Vanos, J., Baldwin, J. W., Bell, J. E., Hondula, D. M., Errett, N. A., Hayes, K., Reid, C. E., Saha, S., Spector, J., & Berry, P. (2021). Extreme weather and climate change: Population health and health system implications. Annual Review of Public Health, 42, 293-315. https://doi.org/10.1146/annurev-publhealth-012420-105026
16. Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191. https://doi.org/10.3758/BF03193146
17. Fidan, N. K., & Ay, T. S. (2016). Acquisition of operational environmental literacy in social studies course. International Journal of Environmental and Science Education, 11(13), 5951-5968. https://doi.org/10.12973/ijese.2014.22a
18. Finn, S., & O’Fallon, L. (2017). The emergence of environmental health literacy: From its roots to its future potential. Environmental Health Perspectives, 125(4), 495-501. https://doi.org/10.1289/EHP1409337
19. Fiore, M., Lorini, C., Bonaccorsi, G., Paoli, S., Vaccaro, G., Verani, M., Federigi, I., Ferrante, M., & Carducci, A. (2024). Development and validation of the Environmental Health Literacy Index: A new tool to assess the environmental health literacy among university students. European Journal of Public Health, 34(5), 1001-1007. https://doi.org/10.1093/eurpub/ckae120
20. Gray, K. (2018). From content knowledge to community change: A review of representations of environmental health literacy. International Journal of Environmental Research and Public Health, 15(3), Article 466. https://doi.org/10.3390/ijerph15030466
21. Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2019). Multivariate data analysis (8th ed.). Cengage Learning.
22. Hoover, A. G. (2019). Defining environmental health literacy. In S. Finn & L. O’Fallon (Eds.), Environmental health literacy (pp. 3-18). Springer International Publishing.
23. Hoover, A. G., Koempel, A., Christian, W. J., Tumlin, K. I., Pennell, K. G., Evans, S., McAlister, M., Ormsbee, L. E., & Brewer, D. (2020). Appalachian environmental health literacy: Building knowledge and skills to protect health. Journal of Appalachian Health, 2(1), 47-53. https://doi.org/10.13023/JAH.0201.06
24. Interagency Working Group on Climate Change and Health. (2010). A human health perspective on climate change. Environmental Health Perspectives & National Institute of Environmental Health Sciences.
25. Intergovernmental Panel on Climate Change (IPCC). (2023). Climate change 2023: Synthesis report. Contribution of Working Groups I, II and III to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change (Core Writing Team, H. Lee, & J. Romero, Eds.). IPCC. https://doi.org/10.59327/IPCC/AR6-9789291691647
26. İlhan, M., & Çetin, B. (2014). LISREL ve AMOS Programları Kullanılarak Gerçekleştirilen Yapısal Eşitlik Modeli (YEM) Analizlerine İlişkin Sonuçların Karşılaştırılması. Journal of Measurement and Evaluation in Education and Psychology, 5(2), 26-42. https://doi.org/10.21031/epod.31126
27. Kabasakal-Cetin, A., Aksaray, B., & Sen, G. (2024). The role of food literacy and sustainable and healthy eating behaviors in ultra-processed foods consumption of undergraduate students. Food Quality and Preference, 119. https://doi.org/10.1016/j.foodqual.2024.105232
28. Kaiser, F. G., & Fuhrer, U. (2003). Ecological behavior’s dependency on different forms of knowledge. Applied Psychology, 52(4), 598-613. https://doi.org/10.1111/1464-0597.00153
29. Kim, H. Y. (2013). Statistical notes for clinical researchers: Assessing normal distribution (2) using skewness and kurtosis. Restorative Dentistry & Endodontics, 38(1), 52-54. https://doi.org/10.5395/rde.2013.38.1.52
30. Kurata, M., Hibiki, A., Takahashi, K., & Matsumi, Y. (2025). Urban-rural differences in indoor and outdoor air quality: A comparative study in Bangladesh. Toxics, 13(6), Article 509. https://doi.org/10.3390/toxics13060509
31. Kwak, J.-M., & Kim, J.-H. (2022). Psychometric properties of the Korean version of the environmental health literacy scale. International Journal of Environmental Research and Public Health, 19(7), Article 4079. https://doi.org/10.3390/ijerph19074079
32. Lee, Y., Kim, T., & Jung, H. (2022). The relationships between food literacy, health promotion literacy, and healthy eating habits among young adults in South Korea. Foods, 11(16), Article 2467. https://doi.org/10.3390/foods11162467
33. Lichtveld, M. Y., Covert, H. H., Sherman, M., Shankar, A., Wickliffe, J. K., & Alcala, C. S. (2019). Advancing Environmental Health Literacy: Validated Scales of General Environmental Health and Environmental Media-Specific Knowledge, Attitudes and Behaviors. International Journal of Environmental Research and Public Health, 16(21), 4157. https://doi.org/10.3390/ijerph16214157
34. Lindsey, M., Chen, S., Richmond, B., Manoogian, M., & Spradlin, J. (2021). Defining environmental health literacy. International Journal of Environmental Research and Public Health, 18(21), Article 11626. https://doi.org/10.3390/ijerph182111626
35. Matos, M. G. d., Branquinho, C., Domingos, L., Botelho Guedes, F., Cerqueira, A., & Gaspar, T. (2025). Bridging the gap: Environmental health literacy as key to adolescent well-being and sustainable behaviors. Sustainability, 17(8), Article 3594. https://doi.org/10.3390/su17083594
36. Mengi Çelik, Ö., Güler, Ü., Ekici, E. M., & Aytekin Şahin, G. (2025). Factors associated with ultra-processed foods consumption: Cooking and food preparation skills and food literacy. BMC Public Health, 25(1), Article 3078. https://doi.org/10.1186/s12889-025-23196-z
37. Michel, J. O., Adnan, M., Zhan, Y., & Qureshi, M. I. (2022). Sustainability competencies in higher education. In R. C. Brears (Ed.), The Palgrave encyclopedia of urban and regional futures. Palgrave Macmillan. https://doi.org/10.1007/978-3-030-87745-3_342
38. Ni, X., Xu, N., & Wang, Q. (2018). Meta-analysis and systematic review of environmental tobacco smoke risk of female lung cancer by research type. International Journal of Environmental Research and Public Health, 15(7), Article 1348. https://doi.org/10.3390/ijerph15071348
39. Örs, M. (2022). A measurement of the environmental literacy of nursing students for a sustainable environment. Sustainability, 14(17), Article 11003. https://doi.org/10.3390/su141711003
40. Pansakun, N., Naksen, W., Boonchieng, W., Ong-Artborirak, P., & Prapamontol, T. (2024). Environmental health literacy regarding fine particulate matter and related factors among village health volunteers in upper northern Thailand. Journal of Preventive Medicine and Public Health, 57(2), 138-147. https://doi.org/10.3961/jpmph.23.434
41. Raufman, J., Blansky, D., Lounsbury, D. W., Mwangi, E. W., Lan, Q., Olloquequi, J., & Hosgood, H. D., III. (2020). Environmental health literacy and household air pollution-associated symptoms in Kenya: A cross-sectional study. Environmental Health, 19, Article 89. https://doi.org/10.1186/s12940-020-00643-5
42. Rojas-Rueda, D., Morales-Zamora, E., Alsufyani, W. A., Herbst, C. H., AlBalawi, S. M., Alsukait, R., & Alomran, M. (2021). Environmental risk factors and health: An umbrella review of meta-analyses. International Journal of Environmental Research and Public Health, 18(2), Article 704. https://doi.org/10.3390/ijerph18020704
43. Rosário, R., Silva, M., Duarte, A., Martins, J., Martins, S., Lopes, C., & Augusto, C. (2023). Is the education of the parents differently associated with their children’s health literacy? European Journal of Public Health, 33(Suppl. 2), ckad160.1430. https://doi.org/10.1093/eurpub/ckad160.1430
44. Şen, M. A., Arslan, Ü., & Tanrıkulu, A. (2025). Evaluation of university students' health literacy status and healthy lifestyle behaviors. Akdeniz Medical Journal, 11(2), 198-207. https://doi.org/10.53394/akd.1438055
45. Shabani Isenaj, Z., Moshammer, H., Berisha, M., & Weitensfelder, L. (2024). Determinants of knowledge, attitudes, perceptions, and behaviors regarding air pollution in schoolchildren in Pristina, Kosovo. Children, 11(1), Article 128. https://doi.org/10.3390/children11010128
46. Svendsen, K., Torheim, L. E., Fjelberg, V., Sorprud, A., Narverud, I., Retterstøl, K., Bogsrud, M. P., Holven, K. B., Myhrstad, M. C. W., & Telle-Hansen, V. H. (2021). Gender differences in nutrition literacy levels among university students and employees: A descriptive study. Journal of Nutritional Science, 10, Article e56. https://doi.org/10.1017/jns.2021.47
47. Tao, Z., Xu, Q., Zhu, Y., Jin, Q., Chen, L., Ding, S., Zhao, S., & Dong, Y. (2025). The impact of health literacy on smoking patterns among male residents: Insights from Ningbo City. Frontiers in Public Health, 13, Article 1487400. https://doi.org/10.3389/fpubh.2025.1487400
48. Ucar, M., Mirze, F., Eroglu, O., & Gul, E. (2025). Investigation of the relationship between healthy lifestyle behaviours and health literacy in university students. Medicine Science, 14(1), 103-110. https://doi.org/10.5455/medscience.2024.11.152
49. Van Kempen, E., Casas, M., Pershagen, G., & Foraster, M. (2018). WHO environmental noise guidelines for the European region: A systematic review on environmental noise and cardiovascular and metabolic effects: A summary. International Journal of Environmental Research and Public Health, 15(2), Article 379. https://doi.org/10.3390/ijerph15020379
50. Wang, Y., Sommier, M., & Vasques, A. (2022). Sustainability education at higher education institutions: Pedagogies and students’ competences. International Journal of Sustainability in Higher Education, 23(8), 174-193. https://doi.org/10.1108/IJSHE-11-2021-0465
51. Wiek, A., Withycombe, L., & Redman, C. L. (2011). Key competencies in sustainability: A reference framework for academic program development. Sustainability Science, 6(2), 203-218. https://doi.org/10.1007/s11625-011-0132-6
52. World Health Organization. (2024, December 6). Food safety. https://www.who.int/news-room/fact-sheets/detail/food-safety
53. Yang, T. (2020). Association between perceived environmental pollution and health among urban and rural residents: A Chinese national study. BMC Public Health, 20, Article 194. https://doi.org/10.1186/s12889-020-8204-0
54. Yin, M., Somdee, T., Yao, S., Yin, H., & Yangyuen, S. (2024). The effect of a health literacy program on alcohol use among medical students in Hubei Province, China: A randomized controlled trial. Asian Journal of Social Health and Behavior, 7(4), 180-188. https://doi.org/10.4103/shb.shb_132_24
55. Zhang, X., Zhang, X., Zhang, S., Ge, L., Xu, Y., Yao, D., Hu, X., Huang, Z., Zhu, T., Wang, Z., & Chen, C. (2024). The association between health literacy and e-cigarette use: Evidence from Zhejiang, China. Frontiers in Public Health, 11, Article 1321457. https://doi.org/10.3389/fpubh.2023.1321457
56. Zhao, Y., Sheng, Y., Zhou, J., Wang, H., Chilufya, M. M., Liu, X., Mohamed, A. O., Han, J. & Qu, C. (2022). Influencing factors of residents’ environmental health literacy in Shaanxi province, China: A cross-sectional study. BMC Public Health, 22, Article 114. https://doi.org/10.1186/s12889-022-12561-x