**Background:** The dual crises of climate change and non-communicable diseases (NCDs) require both policy action and individual behavior change. Individual behavior is a modifiable factor affecting both environmental change and chronic disease. Health consciousness—a psychological state of awareness and involvement in one's own health—has been poorly investigated in relation to pro-environmental behaviors, and no such study had been conducted in Italy. This study aimed to examine the relationship between health consciousness and five clusters of pro-environmental behaviors: sustainable food consumption, recycling, green purchasing, sustainable mobility, and energy saving.
**Methods:** A cross-sectional survey was conducted via CAWI (Computer Assisted Web Interviewing) between 09 May 2022 and 13 May 2022. The sample included 1,011 participants randomly selected from a consumer panel managed by Norstat srl, stratified by sex, age, profession, education, size of center, and geographical area to be representative of the Italian population. Gender was equally distributed (49.8% males, 50.2% females). Age distribution: 26.2% below 35 years, 43.5% between 35 and 54 years, 30.3% above 54 years. Participants were from North-West (25.3%), North-East (18.7%), Center (20.4%), and South and Islands (35.6%). Education was stratified: 0.8% no title, 1.1% elementary, 16.8% lower secondary, 56.9% higher secondary, 24.4% academic diploma or higher. 16.8% were unemployed. The questionnaire included socio-demographic items, 21 questions on frequency of sustainable behaviors (7-point Likert scale, 1=never to 7=always), and the Health Consciousness Scale (11 items, 7-point Likert scale) with three subscales: self-health awareness, personal responsibility, and health motivation. Repeated-measures ANOVA was used to compare behavior frequencies. Pearson correlations assessed associations between health consciousness and behaviors. Stepwise linear regression models tested the predictive role of health consciousness on each behavior class, controlling for gender and age, with interactive effects. A conservative threshold of p<0.01 and moderate-to-high r>0.35 was adopted.
**Key Results:** Statistically significant differences emerged in the frequency of pro-environmental behaviors (F(4,4028)=1047.48, p<0.001, η²p=0.51). Energy saving (mean=5.82, SD=1.07) and recycling (mean=5.60, SD=1.08) had the highest frequencies, followed by sustainable food consumption (mean=5.16, SD=1.01), green purchasing (mean=4.57, SD=1.00), and sustainable mobility (mean=3.83, SD=1.24). Significant moderate-to-robust correlations were found between health consciousness total score and: sustainable food consumption (r=0.46, p<0.001), energy saving (r=0.39, p<0.001), and recycling (r=0.41, p<0.001). No significant correlations emerged for green purchasing or sustainable mobility. The final regression models explained 27% of variance for sustainable food consumption (F(7,1003)=55.49, p<0.001), 20% for energy saving (F(7,1003)=37.04, p<0.001), 11% for green purchasing (F(7,1003)=19.73, p<0.001), 20% for recycling (F(7,1003)=38.04, p<0.001), and 3% for sustainable mobility (F(7,1003)=5.22, p<0.001). Health consciousness total score was a significant positive independent predictor for all five behavior classes. Age was significantly associated with sustainable food consumption, energy saving, and recycling, with older respondents (>54 years) scoring higher than younger counterparts (<35 years). No significant interactive effects (p<0.01) emerged.
**Clinical Implications:** The study demonstrates a consistent positive association between health consciousness and multiple pro-environmental behaviors, suggesting that interventions promoting health engagement may yield co-benefits for environmental sustainability. The weak link between health consciousness and sustainable mobility highlights the role of external barriers (e.g., infrastructure, cost, comfort) that may override individual attitudes. These findings support the development of integrated educational, sensitization, and structural programs that simultaneously target health and environmental awareness. Limitations include the cross-sectional design (precluding causal inference), self-reported behaviors, and ad-hoc behavior items. Future research should use structural equation modeling and real-world behavioral monitoring to confirm causal pathways.