Main

Climate change is leading to a range of cumulative, interconnected and escalating effects on global health1,2. The associated health impacts include shifts in the incidence and distribution of vector-borne diseases, heat-related morbidity, and mortality linked to extreme weather, among others3. Climate change disproportionately affects children and young people (CYP), who are projected to experience between two and seven times more extreme climatic events over their lifetimes, compared with older generations4. These effects are expected to be most severe in the Global South4. In particular, under Paris Agreement commitments, a child born in 2020 is estimated to face seven times the risk of extreme heatwaves and twice the risk of wildfire exposure compared with a person born in 1960, and this risk is even higher for children living in poverty and in high-climate-risk regions4,5,6. These stressors are likely to have severe consequences for physical health, and also mental health and well-being6. Despite this, children’s mental health is almost invisible within national adaptation policies on climate change7.

Climate change impacts mental health via direct, indirect and overarching pathways8,9. Direct effects arise from exposure to extreme weather events, such as heatwaves10, and slower-onset changes, such as drought11. Indirect effects may occur via disruptions to social, economic and other determinants of mental health, such as food insecurity, displacement and interruptions to education8. In addition, the anticipation, awareness and understanding of climate change threats can also affect mental well-being, even among people without first-hand experience of climate-related events12. This overarching psychological burden may particularly affect CYP, who are increasingly exposed to educational content and media coverage concerning climate change and the lack of sufficient policy action13,14. Adolescence, a developmental period marked by heightened interest in global and environmental issues13, also coincides with the onset of many mental health disorders15. CYP are therefore disproportionately affected not only owing to their increased exposure to climate hazards but also owing to a period marked by rapid brain development, developmental immaturity, vulnerability to disease, and limited capacity to avoid or adapt to climate change16.

A range of terms—such as eco-anxiety, climate worry, climate anxiety, climate distress, solastalgia and ecological grief—have emerged to describe the psychological responses to climate and environmental changes, predominantly within Western contexts9,14,17. Worry reflects apprehensive thoughts and emotional discomfort related to perceived future threats or anticipated negative outcomes18,19. Although often regarded as a negative cognitive-emotional state, worry can serve an adaptive function by motivating individuals to take preparatory or protective action20,21. In relation to climate change, climate worry is typically characterized by verbal-linguistic processing (rather than visual imagery) focused on current or potential changes in the climate system and the anticipated consequences9,22. Importantly, climate worry has been related to increased engagement in pro-environmental behaviors23,24. However, when worry becomes persistent, difficult to control and repetitive, it may signal the presence of anxiety18,22. Eco-anxiety encompasses a broader range of distressing emotions linked to environmental degradation, including—but not limited to—climate change, and reflects concern over the numerous and intersecting threats posed by the ecological crisis25. Climate anxiety, considered a subset of eco-anxiety, specifically denotes psychological distress related to the climate crisis9,16. Here we adopt the term ‘eco-anxiety’, which encompasses both research on climate anxiety and wider anxieties around environmental threats. Eco-anxiety may be adaptive or maladaptive; the former motivating climate action and the latter potentially leading to anxious passivity, helplessness and despair26.

Several psychometric instruments have been developed to assess levels of eco- and climate anxiety, including the Climate Change Anxiety Scale (CCAS)17 and the Hogg Eco-Anxiety Scale (HEAS)27. The CCAS comprises four dimensions: cognitive-emotional impairment (for example, experiencing nightmares about climate change), functional impairment (for example, concerns about climate change that interfere with daily responsibilities, such as work or school), behavioral engagement (for example, taking actions such as recycling or consuming less meat) and personal experience (for example, being directly affected by climate-related events)17. The HEAS also comprises four dimensions—affective symptoms, rumination, behavioral symptoms and anxiety related to personal impacts—but adopts a broader scope by incorporating concerns about a wider range of environmental issues beyond climate change, such as species extinction, pollution and deforestation27. High or chronic levels of eco-anxiety, in the absence of effective coping strategies, could lead to emotional fatigue or psychological burnout, affecting capacity to engage constructively with environmental challenges or participate in collective climate action28; however, research is still in its infancy. A systematic review of 12 studies examining the health implications of eco-anxiety found the evidence base to be of limited methodological quality, but associations with functional impairment, symptoms of depression, anxiety, post-traumatic stress disorder, stress, insomnia and poorer self-rated mental health were suggested29. However, given the dominance of cross-sectional studies, causal evidence is limited and the likelihood of reverse causation is high30. A meta-analysis of 25 studies assessing the relationship between climate anxiety (restricted to studies using the CCAS) and well-being also demonstrated a moderate negative correlation that may be stronger among people with a stronger environmental identity31. Climate worry has also been associated with future risk of clinical levels of anxiety among a large sample of adults across Europe32. Some scholars have suggested there may be a ‘Goldilocks’ zone for climate anxiety, whereby levels of anxiety are ‘just right’ for adaptive coping and engagement in pro-environmental behavior33. This may also represent a tipping point, above which climate anxiety becomes maladaptive and damaging to mental health and well-being33. Identifying and understanding the diverse factors that contribute to eco-anxiety is essential to formulate comprehensive strategies to support psychological well-being and avoid anxiety becoming maladaptive.

The emergence and intensity of eco-anxiety is likely to be shaped by a complex interplay of individual, social, political and environmental factors9,34. A social-ecological approach can help to conceptualize the various factors that may contribute to eco-anxiety among CYP34. Disparities in vulnerability to climate change and differential exposure to environmental threats across sociodemographic groups may contribute to unequal experiences of eco-anxiety. Disadvantaged communities, particularly those residing in regions disproportionately affected by environmental hazards, often experience poorer mental health outcomes—especially in the aftermath of extreme weather events35,36—owing to limited adaptive resources and heightened exposure to adverse social and economic determinants of health. However, little research has examined whether these groups also experience correspondingly high levels of eco-anxiety. Indeed, critiques of the concept highlight the individualized and depoliticized mainstream approach to eco-anxiety, suggesting that it represents a ‘privileged anxiety’37,38, dominated by white experiences39, mainly from the Global North9.

Although eco-anxiety has attracted increasing global attention across media discourse40, clinical settings41,42 and academic research31,43,44, there remains a notable gap in understanding the various social, political and geographic determinants that influence its development and persistence among CYP. Existing literature reviews have focused on defining and measuring eco-anxiety among CYP45, primarily within the Global North setting, or exploring its psychological impacts13,46, with relatively limited investigation into the broader contextual determinants shaping its expression in younger populations34. The objective of this Analysis is to synthesize evidence from a wide range of studies to provide a comprehensive overview of the social, political and geographic factors influencing eco-anxiety experiences among CYP.

Results

Study selection

The database searches yielded a total of 11,782 results. Ninety-nine articles were also identified from other sources (for example, citations and gray literature searches). After removing 1,309 duplicates, 10,572 titles and abstracts were screened for inclusion. Following title and abstract screening, 217 articles were screened using the full texts. Ultimately, 69 met the eligibility criteria after excluding 148 full texts (Fig. 1 provides full details of the search process and reasons for exclusion).

Fig. 1: PRISMA flow diagram of study selection.
Fig. 1: PRISMA flow diagram of study selection.
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A total of 10,572 articles were screened via titles and abstracts, 217 full texts were assessed for eligibility and 69 met the inclusion criteria and were included in the review.

Study characteristics

Sixty-nine articles were included in the systematic review (summarized in Table 1). All selected studies were published between 1995 and 2025, with a notable increase from around 2021. There were 42 quantitative, 16 qualitative and 11 mixed-methods studies. Of the quantitative studies, most were cross-sectional, with only 2 studies identified as longitudinal47,48. The sample size included within studies varied from 7 participants in a qualitative study examining eco-anxiety experiences and coping strategies49, to 139,941 in a cross-sectional study of Norwegian school pupils50. In terms of geographic location, there was a higher representation of countries from the Global North such as Australia, the United Kingdom (UK), Canada, Sweden and the USA compared with those from the Global South. Only two studies that focused on a single country were identified from Africa, these were from Tanzania51 and Kenya52. Only one study was identified concentrating on a country from Southeast Asia, which was based within the Philippines53, and very few were from East Asia (China54) and South America (Brazil55). Among the cross-national studies included, again the Global South was underrepresented, with the USA and European countries, in particular the UK, represented in the greatest number of studies21,56,57,58.

Table 1 Summary of included studies
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Study quality was variable, with the Mixed Methods Appraisal Tool (MMAT) checklist score ranging from 0 to 5, with an average of 3 (full results of the quality appraisal can be found in Supplementary Table 1). Across all studies, most adopted convenience, snowball or quota sampling, which are likely to have a high risk of bias. A few quantitative studies included samples that were believed to be nationally representative of the general population, based on probability sampling21,50,59. The absence of a standard measure of eco-anxiety led to a variety of measurement approaches being implemented within quantitative studies. Among 26 studies that included a validated scale, the HEAS27, the CCAS17, the Climate Change Worry Scale (CCWS)22 and the Climate Distress Scale (CDS)60 were used. Most used the CCAS53,54,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75 and the HEAS76,77,78,79,80,81, with a few using the CDS77,82 and the CCWS83,84,85. In other studies, which tended to be older studies published before validated measures were developed, the authors created their own questions86,87, which were often simple single-item measures. A notable trend was the use of online methods for data collection, both for surveys and qualitative interviews, perhaps reflecting that data collection for many recent studies tended to take place during or after the COVID-19 pandemic period. Most quantitative studies involved survey data collection, with a few analyzing secondary data of an existing dataset21,47,51,88. A couple of studies included an experimental component that tested the effect of media exposure on eco-anxiety54,71. A notable limitation across all studies was the lack of ethnic diversity and inclusion of Indigenous groups56,79,85,89, as well as the over-representation of people from more advantaged socioeconomic backgrounds55,79 and young women71,74,82,90,91,92,93.

Among the qualitative and mixed-methods studies, data were collected via focus groups55,56,70,93,94, in-depth interviews49,61,70,78,85,89,91,95,96,97,98,99,100,101, open-ended survey questions74,79,82,90,102, participatory action research66,103, auto-photography91, diary80,104, drawing96,104, participant observation104 and Q sorts70 methods. Particular limitations concerning the mixed-methods studies were the small sample size of the quantitative components61,79, and the lack of analysis of the divergencies and inconsistencies between the quantitative and qualitative findings. The qualitative studies included also sometimes lacked detail on their analysis approaches89,98,103.

Synthesis of findings

The analysis identified several themes within the three categories of determinants contributing to experiences of eco-anxiety, but studies varied in methodological quality (Table 2 and Supplementary Table 1). Social determinants included factors such as age and developmental stage, gender, media exposure, intergenerational relations, peer and cultural norms, and socioeconomic context. Political determinants encompassed government and institutional inaction, distrust, and individual political views, actions and participation. Geographic determinants captured the influence of place-based experiences, including direct exposure to environmental hazards, cross-country differences, and urban–rural distinctions. Each overarching set of determinants is discussed in detail below (further details in Supplementary Table 2).

Table 2 Subthemes within the categories of social, political and geographic determinants of eco-anxiety
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Social determinants

Age and developmental stage

Age and developmental stage were noted as key predictors of eco-anxiety among CYP. A consistent pattern emerged across multiple studies whereby levels of eco-anxiety tended to increase as age increased into young adulthood. Several studies documented that older adolescents and young adults often engage more deeply with climate issues, with this engagement intensifying as their cognitive and emotional capacities matured87,95,102. This pattern was reinforced within longitudinal studies, which demonstrated an age-related increase in climate worry from 15 to 21 years, indicating that as individuals aged, their perception of environmental threats became more acute48. The 8-year longitudinal study conducted by Sciberras and Fernando found that as age increased from 10–11 years up to 18–19 years, increasing levels of climate worry were observed47. Similarly, in their longitudinal study, Prati et al. observed that climate worry increased from age 15 years to around 23–25 years, after which a small decrease was observed48. In a mixed-methods study focusing on Swedish children and young adults, Ojala noted climate worry was stronger among adolescents (aged around 16–17 years) and young adults (aged around 20–25 years), compared with children (aged around 11–12 years)102. Metsäranta found that eco-anxiety was experienced more strongly among people aged 24–29 years compared with those aged 15–23 years in a sample of Finnish young people105. Similar findings were also observed by Prencipe et al., who found that older youth (aged 23 years) in Tanzania reported the highest levels of climate distress51, and by Donati et al. who found that climate worry was higher among older adolescents than younger adolescents in Italy84.

However, a cross-national study across 23 countries mostly in Europe found little difference in climate worry between age groups21, but differences between countries were not explored. In a Norwegian study of people aged 13–19 years, those aged 15–16 years were more likely to be worried about climate change, but the relationship with age was nonlinear, decreasing among those aged 18–19 years50. In a qualitative study by Chou et al., the authors noted that children aged around 11–12 years may experience more climate distress compared with younger children as they develop and become more able to envisage a hypothetical future55. These results suggest that eco-anxiety may not be uniformly distributed across age groups, but may instead be shaped by psychological development, marking adolescence as a particularly critical period.

Gender

Consistent gender differences in the experience of eco-anxiety were found, with most studies suggesting that young women and girls express higher eco-anxiety levels compared with other genders21,50,51,52,59,67,83,84,87,88,106,107,108. Leonhardt et al. found that adolescent girls were more likely to experience eco-anxiety than boys: 14% of girls reported being very worried about climate change, compared with 7% of boys, and 28% of boys reported being not worried at all, compared with 10% of girls, in their study including 128,484 Norwegian participants50. In their logistic regression models adjusted for sociodemographic factors and leisure activities, girls had 2.60 (95% confidence interval, 2.53–2.67) higher odds of eco-anxiety compared with boys, and this association persisted after further adjustment for mental health and health behaviors50. In a study including 2,652 high-school pupils in Kenya, young women were more likely to report being afraid of climate change compared with men (42.3% compared with 33.8%)52. This gender disparity was also found within several other studies, with a few exceptions.

Comparing climate activists with non-climate activists in Turkey, Ediz and Yanik found no notable differences in climate anxiety between genders69. Hill-Harding et al. found no apparent differences between genders for most results in their study of students at a large UK university74. However, overall findings suggest gender differences in eco-anxiety emerge early and generally persist across developmental stages and different country contexts. Parsons et al. found that even among a relatively gender-progressive country, young women in New Zealand often felt a greater sense of responsibility for pro-climate action compared with men, which was linked to the general feminization of care practices:

“is the emotional and psycho-social burden[s] of caring [for the environment] and [concern about] climate change falls to a huge extent onto women… [This results in] negative impacts [for me and] a lot of women’s psyches, like carrying this burden. I think about [how I can] help fix [the climate challenges faced by] underprivileged women in other countries as well.” (Izadora, FG1; page 1451 in ref. 93)

Ethnicity, race and migration

Very few studies reported on ethnic differences in eco-anxiety and studies generally lacked adequate representation of ethnic minority groups. One study found that students from ethnic minority groups reported lower levels of eco-anxiety compared with those from the white majority group in a study within English secondary schools106. A Swedish study found no difference in climate worry when comparing people from Swedish and foreign national backgrounds59. A number of studies included people from Māori and other ethnic minority groups in Aotearoa (New Zealand), suggesting these group may be particularly affected by eco-anxiety79,89,101.

Socioeconomic context

Several studies highlighted the socioeconomic context as a potential influential factor for eco-anxiety, but findings differed depending on the aspect of socioeconomic position studied (for example, education level, occupation or income) and scale (for example, individual, parental, household or area level). According to Leonhardt et al., adolescents who perceived their family’s financial situation as good had lower risk of being worried about climate change, compared with those who perceived their financial situation as poor, in the large Norwegian study50. They also found that the level of parental education was consistently associated with eco-anxiety; compared with those with no higher education, young people whose parents had higher education had 1.57 (95% CI, 1.52–1.61) higher odds of being worried about climate change50, which was also found in several other studies, including within Sweden59, Portugal76 and Tanzania51. In a study based in Australia, those living in less advantaged areas (according to the Index of Relative Socio-economic Disadvantage) had higher odds of experiencing eco-anxiety compared with those living in more advantaged areas62. Among UK residents, higher socioeconomic status (measured by the Family Affluence Scale109) was associated with higher levels of eco-anxiety82. However, a study in Poland found that young adults in an unfavorable financial situation had higher odds of experiencing stress related to the climate crisis108.

Chou et al. elaborated in their qualitative study using focus groups with participants aged 5–18 years in three areas of Brazil55 that the socioeconomic context shapes awareness and engagement with climate change:

“There are two types of rich and poor people who deal with this situation: the rich ones either don’t care, they only think about money—or are informed and try to do as much as possible, because they have the money for it. There are two types of poor people, who either have no place to find information—or they have information, but they don’t have money to afford organic food.” (12,F; page 260 in ref. 55)

Furthermore, they found that the groups who were more aware and engaged with climate change issues belonged to the wealthier social classes and experienced more eco-anxiety55. This group comprised children and adolescents whose parents were more engaged in environmental action, or who attended private schools that had climate change integrated into their curricula. The influence of parental occupation was also noted by a participant, who noted that as their mother was a journalist, they felt well informed by them55. Working in extreme temperatures was also linked with climate distress in a Tanzanian study51, but there was a general lack of studies examining occupational influences. Another study highlighted how youth climate activists from privileged backgrounds had greater access to emotional and social resources to navigate eco-anxiety, further highlighting inequality in resilience and response capacity89. Other studies noted the educational context; students enrolled in environment-related courses tended to report higher levels of eco-anxiety67,68,81,98. However, these cross-sectional studies do not imply a causal relationship as students likely self-select based on their concern about the environment.

Media exposure

Media exposure emerged in several studies as a potential determinant of eco-anxiety54,61,67,71,72,75,90,96,97,105. In multiple qualitative studies, increased exposure to climate-related news, especially through social and mass media, was mentioned as a key theme. Studies highlighted that media allow the distribution of helpful information that can inform people about environmental issues95, but it can also intensify feelings of helplessness, especially when messaging is fear-based or lacks hopeful framing57,75. The frequency of media use and attention given to climate change news were key predictors of climate anxiety in a study based in the USA, with media exposure variables explaining around a third of the variance in climate anxiety scores75.

Many studies mentioned social media as an important factor affecting how CYP experience eco-anxiety47,50,61,90. A mixed-methods study by Gunasiri et al. including 46 participants aged 18–24 years in Australia found that negative stories about climate change shared on social media can contribute to feelings of hopelessness, guilt, shame and anxiety, which can be overwhelming61.

“I do get a lot of climate anxiety when I read the stuff about how June was the hottest month, I’m like yeah I can’t do anything about that.” (Interview participant 7; page 6 in ref. 61)

However, social media was also reported to have a positive role, providing a platform for young people’s voices and action:

“You can be speaking to people on the other side of the globe that you’d never interact with at any other point in your life and you’re able to build a community and a network.” (page 7 in ref. 61)

In another Australian study by Sciberras and Fernando, greater societal engagement, including consumption of news relating to international affairs, was related to high and increasing levels of climate worry over time47. A study across eight countries also found that participants reported increased climate anxiety due to social media coverage90. In contrast, the large cross-sectional Norwegian study by Leonhardt et al. found that individuals who expressed higher levels of concern about climate change tended to spend less time using social media50. Despite some variation, the overall pattern suggests that media can act as both a conduit for climate awareness and action, as well as a vector for eco-anxiety.

Intergenerational relations

A few studies indicated that intergenerational relations, including trust in older generations and worry about future generations, are potentially related to eco-anxiety49,56,68,91,94. Boyd et al. highlighted a ‘generational misalignment’, where youth report frustration and distress arising from perceived climate inaction by older generations94. This lack of trust in adults’ willingness or ability to mitigate climate threats contributed to feelings of betrayal and powerlessness among young people with pre-existing mental health problems in Australia94. Frustration at the burden of trying to fix previous generations’ actions was similarly highlighted in another qualitative study based in Quebec, Canada85.

“Yeah, I’m also angry at previous generation because actually, it’s us, it’s us who have to live with this… Like people who are 70 will die in like 30 or 20 years even, you know… it’s me who is 11 years old that will live in 40 years, 50 years, 60 years… Probably I’m going to live that again and again because others who are 70 years old today will have passed away when I’ll be 70 years old… But I will be there, I will see everything that degrades.” (Participant 15, 11 years old; page 10 in ref. 85)

Smith et al. also documented how young women expressed eco-anxiety in the context of contemplating future family planning, citing concerns about the environmental legacy being inherited from previous generations91. These findings suggested that diminished intergenerational trust may contribute to eco-anxiety, with eco-anxiety also relating to life choices which will affect future generations49,68.

“I mainly think about my own children that I want to have in the future […] And, you know, since I feel like they will be close to me because they are my family, I feel like I’m already worried about them. And these children don’t even exist and this future that doesn’t even exist. But it’s something that worries me the most. I think about my future family living in a world with climate change.” (Participant 7, female, 23; page 34 in ref. 49)

Peer and cultural norms

The influence of peer and cultural norms emerged as correlates of eco-anxiety in some studies47,56,86,87. Thomas et al. found that young people often described their climate emotions as shaped not only by personal experiences but also by the social environments in which they are embedded, including peer interactions and broader cultural narratives56. Cultural expectations regarding environmental responsibility, particularly in collectivist or activist-oriented communities, may heighten pressure to respond emotionally or behaviorally to the climate crisis. Sciberras and Fernando reported that individual worry profiles may be influenced by shared social and cultural contexts, where normative beliefs about climate change can either validate or suppress eco-anxiety47. In a qualitative study using participatory action methods, young people also highlighted the stigma surrounding climate concern and the unwillingness to talk about these issues in countries such as Jamaica (where some older people considered extreme weather to be a normal occurrence), but also in the UK (where it has been considered a taboo subject)103. They also mentioned struggling with whether to discuss concerns with family, friends and colleagues. A culture of denial was also found to be a source of eco-anxiety in a small mixed-methods study among adolescents participating in environmental groups at the University of Vermont, Canada97. Being ‘shamed’ by peers, belittled and experiencing derision related to their interest in climate issues was highlighted by several participants in a small study based within a Welsh school:

“I was made fun of and called Greta Thunberg for speaking out loud for defending my opinion. I know for a fact that I am not the first one, and sadly will not be the last one to experience it… I believe that is the school’s duty to stop shaming people for their beliefs and start to give better education.” (Sara, YP5, 2166–2174; page 80 in ref. 66)

Political determinants

Distrust

Studies consistently revealed concern from CYP regarding their lack of inclusion and representation in decision-making processes and their lack of trust in government and institutions, which can exacerbate eco-anxiety58,79,82,100,103,110. The cross-sectional study by Hickman et al. with data from 10,000 young people across 10 countries found that participants felt more betrayal (highest in Brazil, India and the Philippines) than reassurance toward the government, which correlated with climate anxiety and distress58. Barnes found that participants expressed pervasive distrust in government actors, associating this with heightened existential concern and hopelessness about the future98. Similar sentiments were reported by Thomas et al. where US participants described disappointment and anger toward political leaders as intensifying their eco-anxiety56, and in a study focused on Australia exploring CYP’s emotional responses to climate change:

“We have a few more Independent politicians in Parliament now […] so I think that is a positive… I feel more hopeful, but the trust is still low due to the previous government when nothing happened.” (young person, age 24; page 9 in ref. 100)

Other studies further elaborated that CYP often perceive political leaders as unresponsive or indifferent to the urgency of the climate crisis, resulting in frustration, alienation and a diminished sense of agency55,56,66,100,103. These studies suggest that eco-anxiety is not merely a reaction to environmental degradation, but a response to political systems perceived as inadequate or disingenuous in addressing the crisis.

Government and institutional inaction

Government and institutional inaction was identified as a recurring theme contributing to eco-anxiety. The large cross-sectional study by Hickman et al. highlighted that young people’s negative perceptions of governmental responses to climate change were associated with increased levels of distress58. Moreover, government inaction was frequently mentioned to be intertwined with political interests and industry lobbying, exemplified by Myers et al. in an Australian study, which highlighted young people’s frustration and anger as they witnessed fossil fuel industries influencing policymaking and distributing misinformation101. This hindered effective climate action, leading to reduced trust and contributing to eco-anxiety, especially when young people felt that their concerns were being dismissed. These findings were corroborated in another study by Boyd et al.:

“They’re really letting us down, like, [the Prime Minister] is putting so much money towards fossil fuels. When we really need to focus on the environment at the moment, because what’s the point of making money if you’re not going to have a planet? You know those politicians who are meant to oversee the stuff, they’re in their like, 60 s, 70 s. So by the time it actually hits really hard, a lot of them will probably not be here anymore. So it’s a bit discouraging as well. Like, it’s sort of been relegated to us.” (Client8; page 1027 in ref. 94)

Several studies revealed that perceived governmental inaction, lack of transparency and symbolic rather than substantive climate policies erode public confidence and contribute to emotional distress49,55,61,62,78,89,91,94,97,98,103,111. Hill-Harding et al. examined students’ emotional responses to climate change among university students in the UK and also found that perceptions of inadequate institutional responses, in this case, the university, may exacerbate eco-anxiety74.

Individual views, participation and actions

The literature consistently highlighted other political factors that may shape eco-anxiety, including political views and participation. Parsons et al. found that youth engaged in climate activism frequently expressed both empowerment and psychological strain, highlighting the emotional weight of taking on political responsibility when institutional responses are seen as inadequate93. Sciberras and Fernando found that adolescents with consistently high or increasing climate worry were more politically engaged47. Gunasiri et al. similarly found that participants who took climate action reported higher levels of worry, but that there were also positive psychological benefits (for example, feeling more in control)61, and in other studies the development of a social network that validated their identity was highlighted95. Some studies also noted concern around the potential repercussions of protest involvement101. Other studies also noted that a more liberal or left-leaning political orientation was associated with higher eco-anxiety among CYP75,98.

Geographic determinants

Direct exposure to environmental hazards

The direct experience of climate-related events was highlighted in several studies that explored CYP’s personal experiences53,55,61,77,92,101. A cross-sectional study by Vercammen et al. in the USA reported that individuals who had direct experience of climate change impacts (particularly wildfires) had higher mean scores for climate distress and eco-anxiety compared with those who had not encountered such impacts, even when taking into account age, gender, education level, family affluence, urban–rural residence and ethnicity77. The cross-sectional study conducted by Lykins et al. investigated Australian youth mental health in the aftermath of the Black Summer bushfires during 2019–2020, highlighting the mental health impact of localized events related to climate change on the individuals affected directly92. Young people directly exposed to the bushfires experienced higher levels of climate distress and concern compared with those who were not directly exposed. The study found that the proximity of the bushfire event, whether in terms of physical distance, social or temporal aspects, did not appear to have an impact on anxiety levels92. Simon et al. similarly found that young people living in the Philippines, where many people constantly experience first-hand the effects of climate change-related typhoons and droughts, were prone to experiencing eco-anxiety, but this also motivated them to take climate action53.

Qualitative research in New Zealand highlighted the potential impact of living in a coastal community, where one participant saw first-hand the erosion of the foreshore on his journey to school101. Chou et al. also highlighted that having family members impacted by climate-related events, such as flooding, led to feelings of fear among some participants in a qualitative study based in Brazil55. People living in low-lying countries, such as the Philippines and Jamaica, reported experiencing despair that their homelands may cease to exist in the future owing to sea-level rise and flooding103. Hearing the rain was also highlighted as a trigger for eco-anxiety among those affected by flooding in an Australian study focusing on young people with mental health problems94.

“And at night time that rain, for me, it was triggering. It was like, ‘Are we going to be flooded’? You know, I’m safe, but it still doesn’t help you not think about it. Think about others and yeah, animals, wildlife, all those things that are put out of place. I think that affects a lot of people too.” (Client 7; page 1028 in ref. 94)

Cross-country differences

The study by Hickman et al. suggested that the climate vulnerability of regions may be an important geographic determinant of eco-anxiety, with notable cross-country differences58. Surveying 10,000 CYP across 10 countries—including both high-risk and less-affected regions—the study found that youth living in areas more vulnerable to climate impacts (for example, Philippines and India) reported higher levels of climate worry and distress58, compared with countries such as Finland and France. In another multi-country study, Lau et al. explored differences in emotional engagement with climate change including climate anxiety, finding that participants in China had the highest levels, compared with Portugal, South Africa, the UK and the USA57. Other cross-national studies found few differences between levels of climate worry between countries87,112. Differences in measurement and scoring approaches used across quantitative studies made it difficult to synthesize results from single-country studies; therefore, we focused on the multi-country studies (Supplementary Table 3). However, these are also limited by the lack of nationally representative samples.

Urban–rural residence

Potential differences in the manifestation of eco-anxiety were found based on the urban or rural residence of the individual, but findings differed by country. For example, Strife et al. conducted interviews with urban American children who expressed heightened environmental anxiety, influenced by their exposure to urban environmental degradation96. In contrast, studies such as Ndetei et al. suggested that youth living in rural or semi-urban regions in Kenya may experience eco-anxiety differently, with their concerns more closely tied to direct interactions with the natural environment and localized climate impacts52. In this study, young people living in rural areas were found to experience a higher level of climate worry compared with those living in urban areas52. Chou et al. also identified regional disparities in Brazilian children’s climate awareness, emphasizing that urban access to information and activism differed from rural lived experiences55. Adolescents living in urban areas of Norway were more prone to eco-anxiety, compared with those living in rural areas50. Similarly, Prati et al. found living in the Italian countryside to be negatively correlated with climate worry48.

Discussion

This systematic review synthesized 69 studies exploring the determinants of eco-anxiety in CYP. While we found a range of factors to be potentially related to eco-anxiety, including social (age and developmental stage, gender, socioeconomic context, media exposure, peer and cultural norms, and intergenerational relations), political (distrust, government inaction, and individual views and participation), and geographic (direct experience of environmental hazards, cross-country differences, and urban–rural status), the review also identifies a number of notable gaps in the literature and the overall lack of methodological quality affecting the evidence base.

The review highlighted the importance of age and developmental stage, with eco-anxiety appearing higher among young adults compared with children and younger adolescents48. This appears to reflect developmental changes in cognitive, emotional and moral reasoning16. Further exploration of the longitudinal development of eco-anxiety throughout the life course is needed to fully understand age and developmental trajectories, as well as differentiating these patterns from secular trends in an evolving climate. Gender also emerged as a strong correlate, with young women and girls more likely to report eco-anxiety across a number of diverse contexts88. Stigma and societal norms relating to emotional expressiveness and empathy might partly account for women and girls exhibiting a greater tendency for heightened eco-anxiety55,90. Socioeconomic context presented a more complex picture, with both higher and lower socioeconomic position linked to increased eco-anxiety, probably through different mechanisms—awareness, exposure and capacity for adaptation. Political determinants, particularly government inaction, were consistently reported as correlates of climate distress58. Many studies highlighted how a lack of trust in leadership and intergenerational inequity contributed to perceptions of helplessness, betrayal and existential worry. At the same time, youth agency and activism emerged as both a response to eco-anxiety and a coping strategy, although one that carries emotional burdens. Geographically, the experience of eco-anxiety seems heightened in climate-vulnerable regions and among populations directly exposed to environmental hazards, such as wildfires58,92 and flooding94. Urban–rural differences were observed, but varied by country48,50,52.

There was a general lack of diversity in the countries included, with several studies from Australia, Europe and the USA, but very few including populations living in Africa, Asia and South America. Further research is needed from countries in the Global South to understand the applicability of eco-anxiety among different cultures and to fully explore differences between countries and cultures. There was an important gap concerning research that linked aspects of the environment, such as air pollution, flood risk and temperature, to experiences of eco-anxiety. While this review covered a diverse range of determinants, evidence on specific factors, such as ethnicity and migration status, were lacking, limiting the depth of synthesis for some aspects. It should also be highlighted that studies sometimes mentioned other factors that were not fully investigated, such as religiosity, spirituality78 and sexual orientation108. Most studies also recruited participants using online methods, which probably excludes those without internet access, such as people who live in more remote areas and Indigenous groups who may be at higher risk from climate change impacts. Studies frequently used non-probability sampling, limiting generalizability and the ability to adequately compare differences in prevalence between countries. Mixed-methods studies were of generally of poorer quality, particularly relating to their quantitative components. A key gap is the lack of studies that took an intersectional approach; there is therefore a need to examine the potentially compounded risks experienced by those with multiple disadvantages.

This systematic review has several strengths that build on existing reviews13,45,46,113. The comprehensive search process covered several interdisciplinary databases and included relevant studies across various contexts and populations. Including qualitative, quantitative and mixed-methods studies further enriched the depth of the review. Moreover, we assessed the quality of studies using the MMAT toolkit, but there may be some limitations with this approach and the quality appraisal process is inherently subjective114. However, most previous reviews have not assessed the quality of existing studies13,46,113. We included studies that were published in English, which may have introduced bias, potentially omitting valuable insights from non-English language literature. Heterogeneity in the definition and measurement of eco-anxiety limited the ability to conduct meta-analysis and made comparisons between studies challenging. There is generally a lack of conceptual clarity around eco-anxiety and related terms; therefore, there is a chance we may have overlooked studies that used other similar terms. Furthermore, our interest was in exploring the determinants of eco-anxiety, rather than attempting to establish causal relationships. This reflects the relatively early development of the evidence base, the need to understand who is most affected and to identify factors that warrant further investigation. While efforts were made to identify gray literature, language and publication biases may have influenced the pool of included studies. The narrative synthesis is also somewhat influenced by the authors’ biases and subjective interpretations. Finally, while we defined young people as aged under 25 years115, the inclusion of a small number of studies that covered participants aged over 25 may have introduced some heterogeneity.

An important research gap pertains to the long-term impacts of eco-anxiety on the mental health and well-being of CYP. There is limited research on how early-life eco-anxiety influences later psychological trajectories, coping strategies and decision-making behaviors over time. There is a need for longitudinal studies that track eco-anxiety, mental health and well-being during youth into adulthood across diverse contexts, currently limited by the lack of available data and measurement tools. The limited exploration of effective coping mechanisms and adaptation strategies for CYP to manage their eco-anxiety may hinder the development of approaches to mitigate its potential adverse impacts and amplify its positive benefits. Furthermore, research is needed to explore the influence of ethnicity, race and migration status and its intersection with other factors such as gender, education and income. Studies that explore environmental and geographic factors, such as living in urban, rural or coastal settings, are also needed to understand eco-anxiety experiences in different places.

Our review underscores the need for climate adaptation and mitigation policies that center the experiences, future and well-being of CYP. Young people increasingly report feeling like their views are not being heard and that they lack a say in important decisions that will affect them the most58. This can foster feelings of disempowerment and hopelessness. Political leaders can take important steps toward more inclusive and equitable decision-making. Reform of voting systems that often exclude young people is one way in which CYP could feel more empowered100,116,117. Teachers, health professionals and parents/carers, among others, could more actively encourage civic engagement among young people, while also taking effective action themselves118.

To conclude, this systematic review demonstrates that eco-anxiety among CYP is probably shaped by a range of social, political and geographic determinants. While experiences of eco-anxiety vary across contexts, certain groups—particularly young adults, women and girls, individuals living in climate-vulnerable regions, and those exposed to government inaction or intense negative media coverage—may be particularly affected. These factors may amplify the risk of experiencing maladaptive eco-anxiety, but further research is required to unpack the mechanisms contributing to eco-anxiety that becomes adaptive and/or maladaptive. The review highlights the need for consistent, validated measures to assess eco-anxiety, as well as greater representation of populations within the Global South and survey data that are nationally representative. It also underscores the importance of examining eco-anxiety not only as an individual psychological response, but as a reflection of broader systemic failures, including political inaction, social inequality and environmental injustice. Managing eco-anxiety probably requires a dual approach: enhancing individual coping and resilience through education, support and open dialog, while simultaneously advancing structural changes that restore trust, and promote intergenerational equity and meaningful involvement of CYP in political decisions. As the climate crisis continues to evolve, understanding and addressing the psychological dimensions of its impact, especially for younger generations, must be a key priority for researchers, policymakers, educators and mental health practitioners.

Methods

The study used a systematic review methodology and took a narrative synthesis approach to analyze literature focused on the determinants of eco-anxiety among CYP. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines119. The review design was guided by the PECO framework120: population included CYP aged under 25 years; exposure related to social, political and geographic determinants; comparator included different levels of the determinant being studied (for example, for gender: young woman, man or other gender); outcome was eco-anxiety. The systematic review was registered on the PROSPERO database (ID CRD42023440162, updated in October 2024).

Eligibility criteria

Studies were eligible for inclusion if they investigated eco-anxiety among children and/or young people, defined as aged under 25 years, consistent with World Health Organization and United Nations classifications115. Studies in which the majority of participants were aged under 25 years (or the median age of participants was <25 years), or where subgroup analyses allowed for extraction of data specific to this age group, were also considered for inclusion. All empirical study designs were considered, including quantitative, qualitative and mixed-methods studies, and systematic reviews and meta-analyses, provided that they included human participants.

To be included, studies had to contain information on the potential social, political or geographic determinants of eco-anxiety. This encompassed quantitative studies that assessed associations between specific variables (for example, gender, political orientation or country of residence) and eco-anxiety, as well as qualitative studies where such factors emerged as relevant themes. Studies that assessed the level or prevalence of eco-anxiety in a particular country or group, or which validated an appropriate measurement tool were also considered for eligibility. Outcome measures included eco- or climate anxiety, operationalized as anxiety, worry, fear or distress in relation to environmental issues or climate change. Studies conducted in any geographic location or setting were eligible, but only English language studies were included.

Articles were excluded if they did not report original research (for example, narrative reviews, opinion pieces or commentaries), did not include human participants, or examined populations predominantly aged 25 years and over without providing disaggregated data for CYP. Studies assessing general mental health outcomes (for example, generalized anxiety or depressive symptoms) in relation to extreme weather or environmental changes without consideration of eco-anxiety were also excluded. Studies published in a language other than English were not considered for inclusion.

Search strategy

A systematic search of electronic databases was conducted during August 2024. A librarian at the University of Glasgow was consulted for advice on the search strategy. Searches (title and abstracts) were performed using EBSCOhost, which included APA PsycArticles, APA PsycInfo, Child Development & Adolescent Studies, CINAHL, EconLit, GreenFILE, Health Source: Nursing/Academic Edition, Psychology and Behavioral Sciences Collection, and SocINDEX. Additional searches were conducted via Ovid MEDLINE (no limiters) and Web of Science (title and abstracts). Google Scholar (first ten pages of results) was also used to search for relevant gray literature (for example, reports). Relevant unpublished academic articles were searched for using pre-print servers (MedRxiv and PsyArxiv). All database searches were last conducted on 5 August 2024. Backward and forward citation searches were also performed to ensure completeness in the search process up to January 2025. An example of the search performed in MEDLINE is included in Supplementary Section 1. The search terms were as follows: (‘eco-anxiety’, ‘ecoanxiety’, ‘climate anxiety’, ‘climate change anxiety’, ‘environmental anxiety’, ‘fear of climate change’, ‘eco-distress’, ‘ecological stress’, ‘climate-related stress’, ‘climate distress’, ‘climate worry’, ‘climate concern’, ‘environmental worry’, ‘environmental concern’, ‘environmental distress’, ‘climate emotions’, ‘ecological emotions’) AND (‘child’, ‘children’, ‘youth’, ‘young people’, ‘teenagers’, ‘teens’, ‘adolescence’, ‘juvenile’, ‘youngster’, ‘adolescent’, ‘minor’, ‘kid’). Searches were not limited by date of publication or language.

Study selection

Search results were exported to Covidence and duplicate articles removed. Zotero was used to manage references. Articles were first screened from titles and abstracts within Covidence, using the inclusion and exclusion criteria to eliminate irrelevant articles. The remaining articles were screened based on their full texts and reasons for exclusion were recorded. Two reviewers (C.L.N. and S.V.K.) independently conducted title and abstract screening, followed by full-text screening. Conflicts were resolved through discussion.

Data extraction

Study characteristics (authors, title, publication year, country, location/setting, sample size, sampling strategy, dates of data collection), study design (for example, quantitative, qualitative, mixed methods, systematic review, meta-analysis, observational or experimental, cross-sectional or longitudinal), participant characteristics (for example, age, gender, ethnicity, socioeconomic position), social determinants of eco-anxiety (for example, gender, education level, income), geographic determinants of eco-anxiety (for example, country, exposure to climate-related events), political determinants of eco-anxiety (for example, voting preference), outcome (for example, eco-anxiety, climate anxiety, climate worry), outcome measurement tool used (for example, CCAS, HEAS), analysis approach, key findings and limitations were extracted from each included study. Under key findings we also extracted summary measures for eco-anxiety if the study reported a mean, percentage or similar summary statistic. We used the artificial intelligence tool Elicit (elicit.com) to facilitate data extraction121,122, the results of which were exported into Excel and thoroughly checked by C.L.N., and further data extraction was performed manually by C.L.N. where required (for example, from supplementary material). Studies for which data were unable to be extracted via Elicit (N = 1)86 were manually extracted by C.L.N. S.V.K. completed data extraction for a random 10% sample and all data extracted were further checked by S.M.K.

Quality appraisal

Given the diverse range of study designs included, MMAT114 was selected as the most appropriate quality assessment instrument to assess risk of bias. MMAT assesses the quality of qualitative, quantitative and mixed-methods studies, focusing on five core methodological quality criteria. For example, qualitative studies are assessed using the following questions. (1) Is the qualitative approach appropriate to answer the research question? (2) Are the qualitative data collection methods adequate to address the research question? (3) Are the findings adequately derived from the data? (4) Is the interpretation of results sufficiently substantiated by data? (5) Is there coherence between qualitative data sources, collection, analysis and interpretation?114 To provide a crude overall quality score, ‘yes’ answers were scored as 1, and ‘no’ or ‘can’t tell’ were scored as 0. The scores for each item were summed to provide an overall quality score ranging from 0 to 5, with those scoring 3 or more classified as moderate to high quality. Quality appraisal was conducted manually by C.L.N. (checked by S.M.K.), recorded in an Excel spreadsheet and a random 10% sample was independently completed by S.V.K. Alongside the quality appraisal, the type of article was also noted (for example, peer-reviewed journal article, dissertation, pre-print, conference abstract).

Data synthesis

The data synthesis involved an iterative process of summarizing and analyzing the quantitative and qualitative findings from included studies using the data extraction spreadsheets, re-reading the articles, and noting key themes, statistics and quotations. A narrative synthesis approach was used to interpret and integrate the evidence on the factors associated with eco-anxiety. Relevant guidelines for narrative synthesis were consulted to improve transparency123. The narrative synthesis involved identifying common themes, patterns and trends across studies. Themes were categorized based on social, political and geographic determinants, allowing for the organization and comparison of findings. Further subgroup themes were identified within the overall themes, some of which were pre-defined based on previous literature—for example, age and gender. Others emerged from the synthesis, for example, if more than one study highlighted the theme. Limitations of the included studies and heterogeneity in findings were noted, paying attention to contradictory results. Synthesized findings were presented in a narrative format, supported by appropriate tables and quotations. Studies considered higher quality were given greater weight in the synthesis. The authors confirm that all data generated or analyzed during this study are included in this published article.

Reporting summary

Further information on research design is available in the Nature Portfolio Reporting Summary linked to this article.