Before the COVID-19 pandemic, the tourism industry had always struggled with concerns such as environmental hazards, which affected travelers’ opinions and choices to visit locations affected by natural disasters ^{[1][2][3][4][5][6]}[11,12,13,14,15,16]. According to some authors, the COVID-19 epidemic provided relief to destinations, allowing them to at least partially recover from the damage caused by excessive tourism to natural resources ^[7][17]. Natural processes can also impact the environment, contributing to environmental degradation. Unlike all other species, humans today have the ability to change and control nature ^[8][9][18,19]. Pollutants can originate from various sources, including anthropogenic (caused by human actions) factors such as population growth, urbanization, resource consumption, industry, traffic, and agricultural production, as well as natural causes like climate change, earthquakes, volcanoes, floods, fires, storms, and soil erosion ^[10][20]. The 2004 tsunami in Thailand serves as an example of how ecological disasters can have wide-ranging implications for society and practice. Despite the rapid reconstruction of tourism facilities, the consequences of the tsunami led to significant developments in both theory and practice. For instance, travelers increasingly inquire about a destination’s “eco-sensitivity” before making decisions about whether to visit ^[11][21]. Furthermore, environmental disasters like hurricanes, such as the one that struck the Gulf of Mexico, not only affect the population by increasing property insurance costs but also influence tourists’ awareness and decisions regarding travel to risky coastal destinations due to safety concerns. According to the same study, approximately 35% of travelers now consider a destination’s environmental sensitivity when making travel plans ^[12][22]. Environmental factors are increasingly being integrated into tourist offerings and arrangements. This trend has been facilitated by events such as the 2004 Indian Ocean earthquake and tsunami and the 2010 Haiti earthquake, which serve as stark reminders of the devastating impact of natural disasters and their influence on tourist awareness and decisions to visit such destinations ^[13][23].

Tourism is declining as a result of weather occurrences that have severely harmed the ecosystem and tourist attractions. Environmental concerns, in particular, represent major threats to tourist destinations that rely on natural resources and ecosystem services ^{[14][15][16][17]}[24,25,26,27]. Establishing a resilient and sustainable tourism industry is especially challenging for communities in high-risk areas, as evidenced by historical examples of tsunamis, earthquakes, and volcanic eruptions worldwide. Addressing planning and development goals becomes critical in an era of increasing climate unpredictability ^{[18][19][20][21]}[28,29,30,31]. The association between excellent climatic conditions for tourism and favorable conditions for infectious diseases, which is one of the largest potentials for economic contribution, hinders the growth of the tourism business in some undeveloped nations ^[22][23][24][32,33,34]. Regarding this subject, Rossello et al. ^[25][35] emphasize that the elimination of malaria, dengue fever, yellow fever, and Ebola in travel destinations has a significant economic impact on traveler spending. Natural catastrophes are thought to be negatively correlated with both economic revenue and a destination’s reputation since they immediately lower economic income in a given area ^[26][36] and decrease the attractiveness of tourism-related activities ^[27][37]. Natural disasters, on the other hand, can promote and affirm low-visited locations such as medical destinations, as well as enhance local activities, future investments, and other forms of social benefits ^[28][29][38,39].

Environmental crises have become a significant driver in tourists’ decisions to relocate to safer destinations, including medical destinations ^[30][40]. According to research from the same study safety, access to quality healthcare, resilience, sustainability, and financial considerations are among the key factors that shape these choices. Further, as environmental challenges continue to evolve, destinations that prioritize safety, healthcare, and sustainability are likely to see an increasing influx of individuals and families seeking refuge from the uncertainties of our changing world ^[31][41]. According to Page ^[32][42], tourists are reluctant to visit locations with a history of specific environmental concerns and countries that are prone to infectious diseases ^[33][34][43,44]. The aforementioned ecological crises not only had profound effects on the environment and the local population but also significantly influenced the decisions of tourists looking for safer and more sustainable destinations ^[35][36][45,46]. This trend has led to a growing interest in medical destinations, places that offer not only safety but also access to quality healthcare services ^[37][47]. Medical locations, which are frequently equipped with cutting-edge healthcare infrastructure and amenities, have grown appealing to tourists who value access to high-quality healthcare services ^[38][48]. The COVID-19 pandemic, in particular, highlighted the necessity of healthcare availability and quality when deciding where to travel ^[39][49]. Tourists are becoming more aware of destinations that have shown resilience and sustainability in dealing with environmental issues, and they are drawn to places that have embraced environmental practices and initiatives because they believe they are more responsible and prepared to deal with disasters ^[40][50]. Because the cost of home insurance in high-risk areas is growing, tourists are looking for destinations that offer less expensive coverage, which medical destinations can provide ^[41][42][43][51,52,53]. During these uncertain times, medical destinations provide tourists with a sense of protection and comfort, prompting them to visit such locations ^[44][45][46][54,55,56]. Medical destinations are typically outfitted with cutting-edge medical technology and highly trained medical personnel ^{[47][48][49][50]}[57,58,59,60]. This means that tourists receive the greatest health care possible in the event of health problems induced by environmental crises ^{[51][52][53][54][55]}[61,62,63,64,65]. Many medical destinations provide health packages and programs that are targeted to the needs of travelers ^{[56][57][58][59][60]}[66,67,68,69,70]. These also include strategies for specific health demands in the event of environmental crises such as pandemics or natural catastrophes ^[61][62][71,72], as well as health packages and programs targeted to tourist needs ^{[63][64][65][66]}[73,74,75,76]. This includes plans for specific health needs in the event of environmental crises, such as pandemics or natural disasters ^{[67][68][69][70]}[77,78,79,80]. Medical destinations provide information and advice to tourists about safety during environmental crises through various media channels, including ways to protect themselves and how to prepare for crisis situations ^[71][72][73][81,82,83]. Any exposure to the influence of the media, stress, emergency situations, and traumatic situations can have the potential for long-term effects on a person’s psychophysical functioning ^[74][75][84,85]. However, the very personality traits and abilities of the individual determine whether the consequences will materialize and how serious and disruptive they will be for ongoing functioning ^[76][77][86,87], and to what extent tourists will be (un)resistant to environmental influences ^[78][79][80][88,89,90].

Despite the environmental risks associated with some destinations, tourists continue to be drawn to these locations, driven by various motivations and desires ^[81][82][91,92]. Despite the presence of significant environmental threats or hazards like air pollution or ozone depletion in many locations, tourists still find these destinations alluring ^[83][84][85][93,94,95]. According to the same research, tourists often prioritize adventure and unique experiences over safety concerns. This leads them to venture into risky destinations where they can explore pristine natural beauty and engage in exciting activities. Some tourists are drawn to untouched and remote areas, seeking a respite from the crowds and an opportunity to connect with nature in a pristine environment, even when it entails encountering environmental risks ^{[86][87][88][89][90]}[96,97,98,99,100]. People’s decisions to travel to regions with bad environmental conditions are influenced by their anticipated emotional responses, and travelers’ perceptions of their quality of life might change as a result of experiencing environmental issues while on the road ^[91][101]. Despite the urgent need for new frameworks and applications, the concept of tourists’ resilience to media influence has not yet been widely adopted by professionals in the tourism industry ^[92][102]. Furthermore, tourists’ resilience to media-driven environmental concerns can bolster the sustainability of a medical destination by ensuring a consistent flow of visitors seeking safety and healthcare, thereby contributing to the economic viability of the destination. When tourists resist media-induced fears related to environmental risks and opt for medical destinations, it fosters destination stability, stimulates investment in healthcare infrastructure, and enhances the overall sustainability of these vital healthcare hubs ^[93][103].

The amount of study and specialized literature on the role social media plays in helping travelers choose their travel destinations is limited. Mass media has a significant impact on the formation and growth of medical tourism. It shapes people’s attitudes and behaviors, particularly those connected to health, and reroutes intentions in response to environmental and social dangers in the world ^[94][104]. The primary objectives of mass media organizations (publishing houses, TV and radio stations, etc.) are the collecting, processing, and open public dissemination of various types of information to the general public ^[95][105]. The majority of the health information that adults receive comes from the media, according to studies in the field of social medicine ^[96][106]. Furthermore, traditional studies of health communication demonstrate that mass media may be even more crucial for raising public awareness and knowledge about health issues than interpersonal communication ^[97][98][99][107,108,109]. Taking into account all social factors, it is important to understand the influences of the media in spreading stereotypes about environmental risks and the need for medical tourism ^[100][110]. More concretely, it is most important to understand the cognitive, emotional, physiological, and behavioral impact of these media messages on the behavior of tourists ^[101][111]. Thus, under the influence of the mass media, a sense of safety in medical destinations appears in the human mind after any kind of environmental disaster ^[102][112]. It is possible to effectively create an advertisement for medical destinations, which will contribute to the formation of a unique algorithm for providing such a well-liked and expanding service, especially after some specific events like environmental risks or social unrest, thanks to the logistical components in the media’s work ^[103][113]. The extent to which the media influences tourists’ intentions to raise awareness about the safety of destinations providing medical services, mental and physical treatment, and the perception of safety relative to other destinations is uncertain ^[104][114]. The question is how effective the development of this phenomenon, the reorientation to medical destinations, will be if two social groups are included in the field of interaction: the media and tourists ^[105][106][115,116].

According to Sultan et al. ^[93][103] the paradigm of user-generated social media content pertains to traveler behavior and safe destination choice. The same authors also contend that user-generated media content affects travelers’ attitudes and worries through cognitive and affective factors. According to Kaosiri et al. ^[94][104], when some form of environmental concern has been observed, user-generated media content has a favorable and even substantial impact on the formulation of tourists’ decisions and intentions to reorient to another location. By increasing the importance placed on the health and safety of a tourist destination, social media plays a more active role in travel as a tool for creating trust in obtaining information about sanitary safety ^[107][117]. People who intend to use social media to find information about the health and safety of a tourist destination are more likely to choose that destination for their vacation ^[108][118]. Travel decisions made by visitors are significantly influenced by particularly negatively unfavorable media coverage. This study discovered that in the Pakistani setting, perceived risk is believed to be higher than real risk since making the option to travel to a new location is inherently riskier ^[38][48]. Țuclea et al. ^[58][68] investigated the role of social media in determining a tourist destination’s desirability, placing particular attention on the location’s safety and health. The findings show that respondents became more interested in communication via social media channels when they trusted social media for travel information. The more a traveler pays attention to the media, the more likely he is to change his decision on choosing a destination ^[109][110][119,120]. Furthermore, the greater the extent to which a traveler is influenced by media, the more likely it is that their destination choice will be altered. This has a direct impact on the viability of a medical destination, as the media’s influence can sway travelers towards or away from such destinations based on the portrayal of safety, healthcare quality, and environmental risks. The fluctuation in traveler decisions driven by media attention can significantly affect the sustainability and economic stability of medical destinations.