What does this research mean for the field?

The literature on health literacy in environmental and planetary contexts is fragmented into four distinct clusters, revealing a lack of standardized terminology and conceptual differences between Environmental Health Literacy and Planetary Health Literacy. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to explore and map the current understanding of health literacy within the context of environmental, planetary, and one health.

July 22, 2026Open Access

Understanding health literacy within the nexus of environmental, planetary, and one health : Mapping the evidence via bibliometric content analysis

LRLydia ReismannUniversity of Bayreuth JKJennifer KallenbachMSH Medical School Hamburg – University of Applied Sciences and Medical University CJCarmen JochemUniversity of Bayreuth

Key Points

This research aims to explore and map the current understanding of health literacy within the context of environmental, planetary, and one health.
Conducted a bibliometric content analysis using co-occurrence analysis (COA) on 135 peer-reviewed studies from 1444 screened publications.
Utilized VOSviewer to identify distinct clusters in health literacy themes.
Analyzed patterns to verify distinctions between literacy concepts.
Identified four distinct clusters: competencies in planetary health education, environmental health literacy, one health competencies, and food literacy.
Confirmed conceptual differences between environmental health literacy and planetary health literacy, while distinctions between one health and planetary health were omitted.
Highlighted the need for standardized terminology to improve clarity in educational research.

Abstract

Background: Amidst an anthropogenic climate and ecological crisis, the conventional understanding of Health Literacy has been expanded to address socio-ecological determinants of health through the Planetary Health Literacy, Climate and Health Literacy, or One Health Literacy concepts. However, the ﬁeld's interdisciplinary character and its recent evolutionary status have led to theoretical fragmentation and a lack of conceptual debate. Methodology: To test three expectations regarding the conceptual underpinnings of literacy and competency concepts and to systematically map the evidence, a bibliometric content analysis is conducted using co-occurrence analysis (COA). Findings: A total of 135 peer-reviewed studies meeting the inclusion criteria are analyzed from 1444 screened publications. COA via bibliometric network viewer VOSviewer yields the formation of four distinct clusters: 1) Competencies in Planetary Health Education and sustainable healthcare; 2) Environmental Health Literacy and environmental risk and exposure awareness; 3) Competencies regarding One Health, the animal-human-health nexus and interdisciplinary education; 4) Food Literacy, nutrition, and sustainability. Analyzing patterns of single items underscored One Health and Planetary Health as broadly integrative themes, whereas other concepts remained cluster-speciﬁc. The hypothesized distinction between One Health and Planetary Health Literacy is omitted, whereas conceptual differences between Environmental Health Literacy and Planetary Health Literacy are conﬁrmed. Conclusion: The ﬁndings contribute to theoretical and methodological research trajectories and reveal the widespread use of vague terms such as knowledge, skill, or attitude over differentiated literacy constructs. The results underscore the need for standardized terminology and conceptual underpinnings, particularly within educational research.

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