Evidence and Research

Academic Research

1. Health and the Natural environment: A review of evidence, policy, practice and opportunities for the future. European Centre for environment and human health. University of Exeter.

Mental health and wellbeing:

There is strong and consistent evidence for mental health and wellbeing benefits arising from exposure to natural environments, including reductions in psychological stress, fatigue, anxiety and depression. These benefits may be most significant for marginalised groups. Socioeconomic inequality in mental well-being has been shown to be narrower among those who report good access to green or recreational areas, compared with those with poorer access [6-8]. Although most studies have assessed short term outcomes, the use of longitudinal data and stronger study designs have resulted in more robust evidence and indications of a causal relationship.

Self-rated health:

Several studies have found self-rated health tends to be higher in those with a greater amount of natural environment around the home, and especially so if the environment is good quality.

Mortality:

An extensive and robust body of evidence has shown that living in greener (e.g., greater percentage of natural features around the residence) is associated with reduced mortality. Reduced rates of mortality have been found for specific population groups including men, infants and lower socio-economic groups. There is evidence to suggest that socio-economic health inequalities (in all-cause mortality) may be lower in greener living environments.

Maternal, foetal and child cognitive development:

Exposure to green space during pregnancy is associated with foetal growth and good birth weight outcomes and a number of cognitive development indicators in childhood.

Internal biome:

A newly emerging but robust and relatively consistent body of evidence has demonstrated the importance of direct contact with nature to the development of a healthy internal biome. A relationship has been identified between exposure to natural environments and the maintenance of a healthy immune system and reduction of inflammatory-based diseases such as asthma.

Obesity:

Although mixed, there is evidence to suggest that rates of obesity tend to be lower in populations living in greener environments. Across eight European cities, people were 40% less likely to be obese in the greenest areas, after controlling for a range of relevant factors.

Other physiological outcomes:

Smaller bodies of evidence have shown that exposure to natural environments is linked with more favourable: heart rate; blood pressure; vitamin D levels; recuperation rates; and cortisol levels and is also associated with lower prevalence of diabetes type 2.

Page 8 Health and the Natural environment: A review of evidence, policy, practice and opportunities for the future. European Centre for environment and human health. University of Exeter

Academic Research

1. Health and the Natural environment: A review of evidence, policy, practice and opportunities for the future. European Centre for environment and human health. University of Exeter.

Mental health and wellbeing:

Self-rated health:

Several studies have found self-rated health tends to be higher in those with a greater amount of natural environment around the home, and especially so if the environment is good quality.

Mortality:

Maternal, foetal and child cognitive development:

Exposure to green space during pregnancy is associated with foetal growth and good birth weight outcomes and a number of cognitive development indicators in childhood.

Internal biome:

Obesity:

Other physiological outcomes:

Page 8 Health and the Natural environment: A review of evidence, policy, practice and opportunities for the future. European Centre for environment and human health. University of Exeter

A review of nature-based interventions for mental health care - Natural England Commissioned Report

2.3. Health benefits of contact with nature

2.3.1. Evidence of the health benefits of contact with nature

There is currently a convincing evidence base to show that exposure to the natural environment positively affects physical health and mental wellbeing. Originating from the much-quoted and widely cited studies of Moore (1982) and Ulrich (1984) on ‘viewing’ nature, later studies have demonstrated significant corroborative findings from a variety of ‘natural’ settings and different levels of engagement with nature.

(St Leger, 2003; Tabbush & O'Brien, 2003; Pretty et al., 2004,2005a,b,2007; Louv, 2005; Driver et al., 2006; Van den Berg et al., 2007; Barton et al., 2009; Hansen-Ketchum et al., 2009; Thompson Coon et al., 2011; Ward-Thompson et al., 2012; White et al., 2013; Brown et al., 2013; Gladwell et al, 2013; Bragg, 2014; Alcock et al., 2014).

2.3.2. Mental health benefits of contact with nature

The value of natural, open spaces to our psychological health has long been recognised (Jackson, 1979; Taylor, 1979; Altman & Zube, 1989; Rubinstein, 1997) and more recent studies have explored the effects of nature on mental health, wellbeing and happiness more closely (Hartig et al., 2003; de Vries et al., 2003; Grahn & Stigsdotter, 2003; Ottosson & Grahn, 2005; Berman et al., 2008; Maas et al., 2009; Weinstein et al., 2009 van den Berg et al., 2010; Nisbet & Zelenski, 2011; Ward-Thompson et al., 2012; White et al., 2013, Bragg, 2014; Alcock et al., 2014).

In a recent report looking at the microeconomic evidence for the benefits of investment in the environment (Rolls and Sutherland, 2014), the evidence for the natural environment contributing to mental health is considered as ‘strong’. Rolls and Sutherland conclude that as much of the published research is cross-sectional or longitudinal, when combined this evidence is convincing. Ward Thompson et al. (2012) identify three main pathways that the natural environment provides that contribute to mental health benefits: i) directly through the restorative effect of nature; and then in two indirect ways, ii) through providing opportunities for positive social contact; and iii) through providing opportunities for physical activity. Much of the evidence of the health and wellbeing benefits of nature does indeed highlight the ‘restorative’ effect that natural environments can have on humans. From the published literature three key theories offering explanations relating to the relationship of man with nature have emerged: i) the Biophilia hypothesis (Wilson, 1984); ii) the Attention Restoration Theory (ART) (Kaplan and Kaplan, 1989); and iii) the Psycho-evolutionary stress reduction theory (PET) (Ulrich, 1981), and these all focus on this restorative effect of nature (Barton et al., 2009, Wood, 2012). An overview of these three theories can be found in Appendix D. Specific psychological benefits highlighted in research include reduced stress and anxiety, improvements to mood, increased perceived wellbeing, improved concentration and attention and cognitive restoration. Other implications from research are that gardens and nature in hospitals enhance mood, reduce stress and improve the overall appreciation of the health care provider and quality of care (Cooper Marcus and Barnes, 1999; Whitehouse et al., 2001; Sempik et al., 2003). The design of landscaped grounds is also of great importance to elderly residents in retirement communities (Chalfont and Rodiek, 2005; Chalfont, 2007). The incorporation of natural elements within the setting enhances psychological, social and physical wellbeing among residents and almost all people living in retirement communities say windows facing green landscapes contribute to wellbeing (Browne, 1992; Pretty et al., 2003). The benefits of activities in nature for older people (often suffering with dementia), in care homes has also been highlighted (Chalfont, 2007, 2008). A significant relationship between the proximity of urban open green spaces, visiting frequency, duration of stay and the level of self-reported stress experienced has also been reported (Grahn and Stigsdotter, 2003) and the quantity of available greenspace has been correlated with longevity; a reduced risk of mental ill health and lower levels of income-deprivation related health inequality (Takano et al., 2002; De Vries et al., 2003; Mitchell and Popham, 2008; Alcock et al., 2014). Throughout this published evidence base, there is therefore consensus that nature contributes to enhanced wellbeing, mental development and personal fulfilment. Natural, green environments are places to relax, escape and unwind from the daily stresses of modern life; places to socialise and be physically active, thus having a positive effect on our wellbeing.

(pp.10-11)

Ecotherapy

Ecotherapy (as a specific rather than generic term) uses activities and exercises that emphasise the notion of “mutual healing and growth” (Chalquist, 2009) where the reciprocity between human and nature enhances an individual’s wellbeing, which then promotes positive action towards the environment, which in turn improves community wellbeing (Pedretti-Burls, 2008). Ecotherapists develop and deliver or facilitate specific experiential nature-based activities designed specifically to connect people with individual environmental action (and collective responsibility for the planet) (Burls and Caan, 2005; Burls, 2005, 2007).

(p. 20)

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Reconnecting with nature key for the health of people and the planet

Nature contact, nature connectedness and associations with health, wellbeing and pro-environmental behaviours by Leanne Martin, Mathew P. White, Anne Hunt, Miles Richardson, Sabine Pahl, Jim Burt

Highlights

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Visiting nature ≥ once/week was associated with better health.

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Nature connectedness was positively related to eudaimonic wellbeing.

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Nature connectedness was positively associated with pro-environmental behaviours.

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Nature documentaries were positively associated with pro-environmental behaviour.

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Connectedness moderated relationships between nature contact and outcome variables.

Abstract

Contact with, and psychological connectedness to the natural world are both associated with various health and sustainability-related outcomes. To date, though, the evidence base has been fragmented. Using a representative sample of the adult population of England (N = 4,960), we investigated the relationships between three types of nature contact, psychological connectedness, health, subjective wellbeing and pro-environmental behaviours within a single study. We found that specific types of nature contact, as well as individual differences in nature connectedness, were differentially associated with aspects of health, well-being and pro-environmental behaviours. Living in a greener neighbourhood was, unrelated to any wellbeing or sustainability outcomes. By contrast, visiting nature ≥ once a week was positively associated with general health and household pro-environmental behaviours. Moreover, people who watched/listened to nature documentaries reported higher levels of both pro-environmental behaviours. Nature connectedness was positively related to eudaimonic wellbeing and both types of pro-environmental behaviour. Moreover, connectedness moderated key relationships between nature contact, wellbeing and pro-environmental behaviours. The complexity of our findings suggests that interventions increasing both contact with, and connection to nature, are likely to be needed in order to achieve synergistic improvements to human and planetary health.

Downloaded via University of Plymouth: :https://www.plymouth.ac.uk/news/reconnecting-with-nature-key-for-the-health-of-people-and-the-planet: https://www.sciencedirect.com/science/article/abs/pii/S0272494419301185?via%3Dihub

Polyvagal Theory

Polyvagal Theory: Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation in 2011.The Polyvagal Theory: Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation in 2011.

The Polyvagal theory expands our knowledge of the fight or flight sympathetic nervous system and the rest and digest parasympathetic nervous system into further systems including the dorsal vagal system - which initiates an immediate response of freeze and/or collapse, along with the safe and socially connected ventral vagal system, that initiates social engagement, confidence, flow and joy.

The Polyvagal Theory asserts the innate need for connection in humans and how this is constantly being sought out in order to calm our nervous systems and let us know we are safe and we belong. Porges states that our nervous systems read other people's (neuroception) before we are aware of any obvious physical knowledge (proprioception) of safety or of the danger of attack. When we are traumatised, our nervous system is rewired and cannot bring us back into safety without the support of others (coregulation)

Deb Dana has translated Porges' academic work for therapeutic work (see recommended reading)
Porges work has gone on to influence other academics and trauma therapies across the globe and within ecopsychology we work to coregulate the autonomic nervous system with support from the natural world and the ecotherapist enabling the participant to learn through an experiential experience how to regulate their own emotions and find themselves back into the safety zone.