Healthy parks, healthy people – What is the connection?

The context: parks and people

When parks were first designed in the nineteenth century, city officials had strong belief in the possible health advantages that would result from open (Rohde and Kendle, 1997; Hamilton-Smith and Mercer, 1991). It was hoped space that parks would reduce disease, crime, and social unrest as well as providing green lungs’ for the city and areas for recreation (Rohde and Kendle, 1997). At this time, it was also believed that exposure to nature fostered psychological wellbeing, reduced the stresses associated with urban living and promoted physical health (Ulrich, 1993). These assumptions were used as justification for providing parks and other natural areas in cities, and preserving wilderness areas outside of cities
for public use (Ulrich, 1993; Parsons, 1991).

Although parks have not entirely lost their connection with health, the modern emphasis is almost exclusively on their use as a venue for leisure and sport (Rohde and Kendle, 1997). The importance of physical activity for health is well known, yet physical inactivity contributes significantly to the burden of disease and is on the rise in developed countries (Duncan, Spence and Mummery 2005). A wealth of literature exists, linking parks with varying levels and types of physical activity. For example, Wendel-Vos et al. (2004) used GIS databases to objectively measure the amount of green and recreational space in neighbourhoods, and found that there was an association between greater amounts of parks and sports grounds in an area and increased levels of cycling. Similarly, a study by Zlot and Schmid (2005) found that there was a significant correlation between parkland acreage and walking and cycling for transportation. However, other research has shown that it is not only the size but the quality of parkland and public open space (eg. Giles-Corti et al. 2005), as well as its physical and economic accessibility (eg. Bengoechea, Spence and McGannon 2005), that influences people’s use of such areas). As Lee et al. (2005) note: ‘merely building a park in a deprived area may be insufficient for insuring its intended use .. .It is critical to provide ongoing support for maintenance and
civic improvements’. Exploring the role of personal, social and environmental attributes as mediating factors in socioeconomic variations in women’s walking behaviours, Ball et al. (2006) found that while all three elements play a part, access to environments conducive to walking is a key factor which needs to be taken into account. Two aspects of parks and open spaces which influence their use are perceptions of safety and aesthetic appeal (Evenson et al. 2006).

Aside from this recent focus on parks as venues for physical activity, parks tend to be viewed as optional amenities rather than as necessary components of urban (as well as rural) infrastructure (Kaplan and Kaplan, 1989). Moreover, there is a prevailing lack of awareness about opportunities for enhancing health provided by larger, wilderness parks such as National Parks. Why the benefits of parks understood by early landscape designers and park engineers have been overlooked is a mystery. Yet, research on the benefits of nature carried out over the last two decades is indicating that in fact, they may have been right. Amongst other evidence, data so far has shown that ‘green nature’ can reduce crime (Kuo, 2001), foster psychological wellbeing (Kaplan and Kaplan, 1989; Kaplan, 1992a), reduce stress (Ulrich et al., 1991b; Parsons, 1991), boost immunity (Rohde and Kendle, 1994; Parsons et al., 1998) enhance productivity (Tennessen and Cimprich, 1995) promote healing in psychiatric and other patients (Beck et al., 1986; Katcher and Beck, 1983), and is most likely essential for human development and long- term health and wellbeing (Driver et al., 1996).

Despite the prevailing emphasis on sport and leisure, park management agencies have recently focused on the social and environmental values of parks. For example, the Canadian Parks/Recreation Association recently published ‘The Benefits Catalogue’ (1997) documenting the health and wellbeing benefits of all aspects of recreation, including that carried out in parks. In Australia, the recent repositioning of Parks Victoria’s key message to ‘Healthy parks, healthy people’ acknowledges the symbiotic relationship between parks and people (de Kievit, 2001). However, although the government and much of the community are aware of how people can benefit parks (e.g. by legislation, activism, or Friends of Parks groups), the benefits that parks can bestow on people (in terms of health and wellbeing) through contact with nature have, until recently, gone largely unrecognised.

As summarised in this review, the evidence from recent research demonstrates clearly that there are many and varied health effects to be derived from contact with nature, and that, in urban environments in particular, experiencing nature through parks may in fact be a vital component of human health that for too long has been ignored.

Parks, public health and wellbeing

The ecosystem is the fundamental capital on which all life is dependent (Suzuki 1990). Because our water quality, air quality, economic vitality, and personal wellbeing are as dependent on natural resources as they are on transportation, communications, and public safety systems, parks, by providing access to nature and protecting ecosystems, are an essential part of the infrastructure of our cities and communities (Gutowski, 1994 in Lewis, 1996). The threat of climate change has heightened awareness of the ecosystem services provided by parks and other green spaces. Yet, despite a growth in conservation activities over recent years, there still appears to be a lack of acknowledgement and acceptance on the part of planners, decision-makers and developers of the need for ‘a healthy and diverse natural environment in the modern city’ (Kellert 2004 p. 9).

In addition to their contribution to public health and wellbeing through
ecosystem services, parks also contribute to health and wellbeing through the provision of settings for community engagement. Baum (1999) states that healthy communities should provide varied opportunities for their citizens to meet and interact in both formal and informal settings. Recent research has shown that parks make a key contribution to meeting this requirement (eg. Krenichyn 2005). However, it has been asserted that, if not well maintained and used, parks which form boundaries between neighbourhoods of different cultural, ethnic and socio- economic characteristics may become ‘green walls’ dividing communities, rather than places of community interaction (Solecki and Welch 1995).

In the urban environment, the best access that people have to nature (apart
from that available in their homes and gardens) is via parkland. Parks vary in size, shape, quality, and character and hence satisfy the whole spectrum of opportunities for contact with the natural world at various levels. Yet, Wilson’s (1984) biophilia hypothesis (see section titled ‘Understanding the Human- Nature Relationship’) has prompted many researchers to re-evaluate their understanding that plants and engineered ecosystems, such as parks, please people only on cultural (Stilgoe, 2001) or superficial level (Driver et al., 1996). From an evolutionary perspective, parks are ideal environments in which to reap some of the positive contributions to personal health that are inseparable from our evolutionary history, but which are virtually impossible to obtain in modern society (Furnass, 1979). These contributions include the physiological and psychological benefits derived from physical activity over varied terrain, the dramatic change in sensory input, and the spiritual values which can accrue from direct contact with the natural world (Furnass, 1979). A common conclusion in the literature is that humans may not be fully adapted to an urban existence (Burns, 1998; Kellert, 1997; Kellert and Wilson, 1993; Glendinning, 1995). Hence, they live in an environment so different to that from which they evolved that natural selection has not had time to revise human bodies for coping with many aspects of modern life, including fatty diets, vehicles, drugs, artificial lights, and central heating (Nesse and Williams, 1996 in Burns, 1998). The reasoning for this argument is that humans have spent many thousands of years adapting to natural environments, yet have only inhabited urban ones for relatively few generations (Suzuki, 1997; Roszak et al., 1995; Glendinning, 1995; Gullone, 2000). Moreover, although humans may have all of their physical needs well satisfied by the urban environment of large cities, our internal psyche is profoundly disturbed (Suzuki, 1997; Gullone, 2000).

Frederick Law Olmstead, a famous 19th century American landscape architect, believed in the restorative quality of green nature that ‘operates by unconscious processes to relax and relieve tensions created by the artificial surroundings of urban life’ (Lewis, 1992). Olmstead (1870 in Lewis, 1996) also believed that parks improved health and vigour and extended the life expectancy of citizens. These ideas are now being confirmed by research in psychology and geography, as well as in many other fields. Examples of how parks and nature can contribute to some of the components of health are displayed in Table 1. Although the physical, mental, and social components of health have been identified by health authorities, such as the Victorian Health Promotion Foundation (VicHealth, 1999), this review advocates an ecological definition of health by also including the spiritual and environmental components.

Table 1: A Summary of the Contribution of Parks to Human Health and Wellbeing

Component of health Contribution of parks
Physical Provide a variety of settings and infrastructure for various levels
of formal and informal sport and recreation, for all skill levels and
abilities e.g. picnicking, walking, dog training, running, cycling, ball
games, sailing, surfing, photography, birdwatching, bushwalking, rock
climbing, camping
Mental Make nature available for restoration from mental fatigue;
solitude and quiet; artistic inspiration and expression; educational
development (e.g. natural and cultural history)
Spiritual Preserve the natural environment for contemplation, reflection and
inspiration; invoke a sense of place; facilitate feeling a connection to
something beyond human concerns
Social Provide settings for people to enhance their social networks and
personal relationships from couples and families, to social clubs and
organisations of all sizes, from casual picnicking to events days and
Environmental Preserve ecosystems and biodiversity, provide clean air and water,
maintain ecosystem function, and foster human involvement in the
natural environment (Friends of Parks groups, etc.)

Parks and nature have enormous untapped health potential as they provide an opportunity for people to re-establish and maintain their health in a holistic manner. Recent developments in public health and health promotion have recognised the benefits of a holistic approach. For example, it has been stated that the major determinants of health have little to do with the health care system (Hancock, 1999), and that public health needs to focus on the environmental and social aspects of health (Chu and Simpson, 1994). Parks are in an ideal position to address both these, and other aspects, of human health and wellbeing.

Repositioning parks

Parks and nature are currently undervalued as a means of improving and
maintaining health. Although most people are aware of the health benefits of sport and recreation, the range of other health and wellbeing benefits arising from contact with nature are virtually unknown. Although further research is required, the findings summarised in this report are sufficient to warrant the repositioning of parks in the minds of both the community and government as a positive health resource. Parks need recognition for the essential role they play in preserving, maintaining, and promoting the health of the humans, as well as that of their environment.

Parks, in fact, are an ideal catalyst for the integration of environment, society, and health (which have been demonstrated to be inextricably linked) by promoting an ecological approach to human health and wellbeing based on contact with nature. The potential exists for parks to gain an expanded role, scope, and influence in society, especially in terms of public health, as well as changing the way park management bodies relate to other organisations and agencies (by advocating an integrated approach to government). This would also bring together several disciplines and/or agencies already moving in this direction as well as value-add to the status of parks in the community.

In order to reposition parks, it is necessary for park management agencies to:

1 Communicate to governments and the wider community that:
• a growing body of evidence shows that access to, and interaction with, nature is essential to human health and wellbeing;
• through providing access to nature, parks improve and maintain human
health and wellbeing (both at an individual and community level);
• by improving and maintaining human health and wellbeing, parks have the potential to reduce the burden on the health care system;
• parks facilitate an holistic/ecological approach to health and wellbeing that is beneficial (and essential) to individuals, society, and the environment;
• through providing a holistic/ecological approach to health, parks reinstate people with a sense of empowerment and control over their own health and wellbeing.

2 Educate governments and the wider community:

  • as to how the above can be applied for improved health and wellbeing;
  • about how to incorporate this knowledge into public health policy and health promotion;
  • about how to collaborate in the pursuit of common goals;
  • about the need for broadening the knowledge base in this area (via further research) for future dissemination.

Facilitate the engagement of the community with nature in order to re-

establish the importance of nature in people’s lives and the cultivation of a

holistic and sustainable attitude towards life and health:

• by the communication and education as outlined above;

• by continued exploration of the benefits to individuals and communities to be gained from contact with, and preservation of, nature;

• by fostering park management practices which support community engagement with nature.

To accomplish the above will require the cooperation of multiple government departments and/or other agencies (i.e. those whose portfolios/core business relate to any aspect of society, health or the environment). This in itself would be groundbreaking since traditionally (as is commonly known) government departments (and other similar entities such as university faculties, or research institutes) tend to work in isolation, despite opportunities that may exist for mutual benefit. An interdisciplinary approach would reflect a recent insight in health promotion that modern health issues are usually multi-faceted and complex, arising from social and environmental conditions of the individual or community concerned (e.g. socio-economic status, access to basic health and educational services, family issues, social cohesion, and un-polluted environment).

Mowen (2003) offers seven hints for park professionals in attempting to align with health agencies, including: 1. Infant health partnerships require baby steps; 2. Know the lingo of the health profession; 3. Integrate health benefits into all communications; 4. Use solid evidence to justify the link between park use and health; 5. Don’t reinvent the health promotion wheel; 6. Create partnerships that provide an incentive for physical activity, and; 7. Attempt collaboration not competition.

To reposition parks in this way will mirror other international attempts, such as those in Canada. The Canadian Parks/Recreation Association state in their Benefits Catalogue (1997) that in the future parks will be: recognised as champions of personal and community wellbeing, central to the quest for human potential, builders of social foundations, catalysts for Canada’s green movement, and be a cornerstone for economic renewal. This is possible for parks everywhere.


Healthy parks, healthy people
The health benefits of contact with nature in a park context
A review of relevant literature
2nd edition
March 2008
School of Health and Social Development Faculty of Health, Medicine, Nursing and Behavioural Sciences
Deakin University
Burwood, Melbourne

© Deakin University and Parks Victoria 2008
Authors Dr. Cecily Maller Associate Professor Mardie Townsend Associate Professor Lawrence St Leger Dr Claire Henderson-Wilson Ms Anita Pryor Ms Lauren Prosser Dr Megan Moore

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