Health Literacy and Environmental Risks Focusing Air Pollution: Results from a Cross-Sectional Study in Germany.

(1) Background: Environmental risks such as air pollutants pose a threat to human health and must be communicated to the affected population to create awareness, such as via health literacy (HL); (2) Methods: We analyzed HL in the context of environmental health risks, including sources of information and prior knowledge, in a sample from the German general population using Kendall's rank correlations, regression analyses, and explorative parallel mediation analysis; (3) Results: The survey included 412 German participants aged between 18 and 77. HL was found to be problematic to inadequate. The internet, family and friends, and newspapers were the most frequently cited sources of information. Mobile apps were mostly unknown but were requested by sample subjects. Although subjects expressed environmental concerns and exhibited rather good levels of knowledge, the majority perceived no risk to human health and rated air quality quite positively. Knowledge on particulate matter, the term "ultrafine particles", and protective measures was found to be rather low. HL was associated with the use of newspapers and commercials as sources of information. The relationship between age and HL is fully mediated by the use of newspapers and information from TV commercials; (4) Conclusions: HL should be promoted by raising awareness of the health effects of environmental pollutants. In particular, the information channels preferred by the affected population should be used and further information opportunities such as apps should be publicized, e.g., through campaigns. An improved HL can assist policy makers in creating a healthier environment by empowering individuals to become more environmentally aware and protect their own health. This, in turn, has the potential to reduce health-related costs.