Objective  To investigate the level of climate change-related health literacy of residents in Zhengding county, Hebei province, China, and analyze its influencing factors, so as to provide a scientific basis for relevant departments to formulate strategies for improving climate change-related health literacy.

Methods  A questionnaire survey on climate change-related health literacy was conducted among 823 residents randomly selected from four villages in Zhengding county in February 2023. The health literacy on climate change in different populations and its influencing factors were analyzed using the chi-squared test and multivariable logistic regression analysis.

Results  In 2023, the climate change-related health literacy level of residents in Zhengding county was 24.8%, among which the level of literacy on healthy lifestyle was the highest (67.9%), followed by the level of individual protection literacy against climate change (52.4%), and the level of climate change-related basic knowledge literacy was the lowest (6.6%), with a statistically significant difference (χ²=686.31, P < 0.001). The multivariable analysis showed that the residents who had experienced extreme weather events, were concerned about climate change, green travel preference, pollution-free environmental behavior, and were not prone to impulsive consumption had higher levels of health literacy, with the odds ratios at 95% confidence intervals being 1.63 (1.01, 2.47), 4.36 (2.01, 9.46), 5.18 (2.31, 11.62), 8.65 (3.43, 21.85), and 3.27 (1.85, 5.78), respectively.

Conclusion  The climate change-related health literacy level of residents in Zhengding county still needs to be improved, especially the basic knowledge literacy level. In the future, it is necessary to further publicize and popularize the basic knowledge of climate change, and comprehensively improve residents'health literacy on climate change.