Environment and health: Risk perception and its determinants among Italian university students

Among the determinants of environmental health risk perception, health literacy and social media messageshave been generally neglected. This study details the environmental health risk perception and its determinantsin Italian university students, including a measure of functional health literacy and an analysis of newspapers andsocial media. A cross sectional survey was carried out among students from 15 Italian universities and differentdisciplines (grouped into Scientific-Health and Humanistic-Legal-Social sectors) using a self-administered anon-ymous questionnaire, divided into six sections: socio-demographic characteristics, information on health and en-vironment, environmental health risk perception, trust, attitudes and behaviors and functional health literacy.Local newspapers and tweets in the same areas and period were analyzed in relation to quantity and topics.The study population included 4778 students (65.1% female) aged 21 ± 4.3 years, and functional health literacywas low (below the cutoff value) for 44.4% of students.A new outcome of the survey is that the detected association between high functional health literacy a higherglobal health risk perception and trust in institutions both as sources of information and as actors for protectionagainst environmental risks.The internet and social networks were the most frequently consulted sources of information (77.7%), which waspredictive of a higher risk perception. The possible relation between environmental health risk perception andtweet communication was highlighted by a comparison between the risk perception in the city with the highestnumber of tweets (Modena) and another one similar for socio-demographic characteristics (Pisa). In conclusion,the results of our study may be of help to strengthen information and education programs: functional health lit-eracy should be taken into account in school programs, to produce a basic knowledge for a better understandingof health and environment. Moreover, mass and social media should be included in planning communication in-tervention and in verifying their results.