Healthy parks, healthy people – Principal health outcomes

Below is a summary of the main benefits to the health and wellbeing for
individuals and communities that arise from contact with nature. The benefits are summarised into the Australian Institute of Health and Welfare’s seven dimensions of holistic health (Australian Institute of Health and Welfare, 1998), including: 1) biological/mental wellbeing; 2) social/community wellbeing; 3) economic wellbeing; 4) environmental wellbeing; 5) life satisfaction; 6) spiritual/existential wellbeing; and 7) ‘other characteristics valued by humans’. As the components of health are interrelated, there is some overlap.

1 Biological and mental wellbeing

• Contact with nature provides a sense of wellbeing and positively influences immunity and cardiovascular function;
• Contact with nature reduces the magnitude of the physiological response to stress and enhances the ability to cope with, and recover from, stressful episodes;
• Some positive physiological effects of viewing nature include reduction of heart rate, muscle tension, blood pressure, and skin conductance;
• Viewing or touching a pet or animals reduces stress, decreases blood pressure and heart rate;
• Views of nature improve psychological health, particularly emotional and cognitive;
• Natural surroundings assist cognitive functioning in children (including
reducing the symptoms of attention deficit disorder);
• Views of nature improve performance in attention demanding tasks and can restore concentration/attention;
• Nature and parks promote healing in patients suffering from severe trauma, cancer, depression, anxiety, and other life-altering afflictions;
• Pet ownership can reduce the risk factors for heart disease (systolic blood pressure, plasma cholesterol, plasma triglycerides) independently of lifestyle and other health factors;
• Views of nature reduce self-reports of illnesses, such as headaches and
digestive disorders, in people who live or work in confined, indoor spaces
(such as offices and prisons);
• Nurturing living organisms may have distinct beneficial physiological (and emotional) responses that improve overall health and wellbeing;
• Contact with nature improves self-awareness, self-esteem, self-concept,
and positively affects mood state, which have positive flow-on effects to
physiological state (such as boosting immunity);
• Contact with nature is effective in alleviating the symptoms of anxiety,
depression, and psychosomatic illness (including irritability, restlessness,
insomnia, tension, headaches, and indigestion);
• Pet ownership and interacting with plants (i.e. via gardening) encourages individuals to undertake physical exercise;
• Pet-ownership can improve mental health by providing companionship
(regardless of overall health, socio-economic status, or physical exercise).

Giant swing on the way up astGlenhaven Park Camps

Social and community wellbeing

• Interacting with nature or participating in nature-based activities in one’s local neighbourhood (such as Friends of Parks groups) can promote a sense of community, foster a sense of belonging or sense of place, and enhance social ties/relationships;
• Pet ownership can foster social relationships through contact with other pet owners (or park users), thereby expanding social networks;
• Contact with nature reduces the stresses associated with urban living (such as crowding, noise, pollution, etc).
• Natural environments foster social capital within neighbourhoods by
providing settings for groups to meet formally and informally for recreational or leisure pursuits;
• Where community members are engaged in civic environmentalism (for
example, Friends of Parks and other community volunteer groups) there are significant spin-offs for social connectedness and social capital;
• Residents who have nature nearby, or who regularly pursue nature related activities have greater neighbourhood satisfaction, and have better overall health than residents who do not;
• Nature in high density urban living can reduce vandalism, violence, crime rates, ease racial tension or prejudices, and result in neighbourhood and personal transformation;
• Contact with nature can foster a sense of identity and ownership, and provide a sense of integration rather than isolation for newly arrived migrants;
• Horticultural therapy and animal-assisted therapy programs in prisons (via contact with plants or animals) can reduce aggression and vandalism in inmates, provide job training, and enhance self-esteem.

Economic wellbeing

• Views of nature from detention centres and prisons have the potential to reduce the incidence of illness (particularly stress related illness) in inmates, reducing health care costs in prisons;
• Views of nature from hospitals and other care facilities (such as nursing
homes) have the potential to reduce recovery time (number of days spent in hospital), reduce the quantities of medication required to treat patients, and reduce incidences of post-operative surgery in patients;
• Contact with nature improves job satisfaction, overall health, and reduces job stress in the workforce as well as reducing number of sick days and employee absences;
• Parks and natural features attract businesses;
• Trees in urban streets attract consumers and tourists to business districts, and are seen to increase appeal;
• Tourism is the third largest industry worldwide, with growth occurring
particularly in wilderness or nature-based tourism;
• Parks and nature tourism generate employment in regional areas;
• Significant natural features, including parks and gardens, raise real estate values;
• Contact with nature can potentially reduce the burden of disease on the
current health care system. For example, for pet ownership alone preliminary estimates of savings to the health care system are between AUD$790 million to AUD$1.5 billion annually (Headey and Anderson, 1995);
• Views of nature from detention centres and prisons have the potential to reduce the incidence of illness (particularly stress related illness) in inmates, also reducing health care costs in prisons;
• Interaction with nature encourages a holistic/ecological approach to health, giving people a sense of control over their own health and wellbeing which may lead to less reliance on health care services.

Environmental wellbeing

• Greater financial and in kind support for parks will assist conservation and improvement of the natural (indigenous) values of parks;
• Increased participation in ‘Friends of Parks’ and other volunteer groups may improve natural values/capital within parks
• Improved understanding of the need for natural areas may lead to green corridors and extended conservation areas
• Greater awareness of the human health and wellbeing benefits of nature may improve conservation of additional natural spaces (such as those set aside for industry, for example).

Life satisfaction

• Contact with nature reduces the incidence of negative feelings such as anger, fear, anxiety, and frustration, and induces peace of mind;
• Contact with nature, or having nature nearby, improves quality of life, work satisfaction, and the coping ability of residents in urban areas;
• Natural environments foster a state of reflection, enabling one to gain
perspective on life, and create an awareness of one’s surroundings;
• Knowing that nature is nearby (particularly animals) improves quality of life and neighbourhood satisfaction of residents;
• Contact with wilderness can develop leadership abilities, which translate positively into other areas of life;

Spiritual / existential wellbeing

• Nature provides spiritual inspiration, enabling people to gain a different or deeper perspective on life, for example by the realisation that they are part of something larger and universal;
• Contact with nature can inspire feelings of peace, oneness, connectedness, and strength;
• Nature is important to all people/cultures, in ‘developed’ and ‘undeveloped’ nations, for providing spiritual inspiration;
• Contemplation of nature can inspire a sense of freedom, reverence, encourage humility, prompt introspection and reflection on personal values, and lead to spiritual growth or enlightenment;
• Spirituality arising from contact with nature can reduce psychosis, substance abuse, and heal those suffering from violence and/or injury.

Other characteristics valued by humans

• Parks and nature are an affordable, non-elitist, highly accessible means of improving community health that may help people reach their full potential;
• Parks are a public resource yet to be fully utilised for individual and
community health and wellbeing.

Citation

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

Healthy parks, healthy people – In practice

Introduction

Further evidence for the positive effects on health and wellbeing from contact with nature is found in some unique forms of therapy based on the human relationship with nature. These forms of treatment, discussed in the proceeding pages, have proven to be successful where conventional treatments have often had limited success.

Ecopsychology or nature-guided therapy

Glenhaven Park June 2018

Ecopsychology or nature-guided therapy considers every aspect of the human-nature relationship. It is primarily concerned with the fundamental alienation of humans from nature and the effects on human health (Scull, 2001; Burns, 1998; Gullone, 2000). The person-environment relationship is both the unit of analysis and the basis of treatment (Burns, 1998). Although only relatively recently adopted in modern western society, ecopsychology is essentially modern interpretation of ancient views of humans and nature held by many indigenous peoples. In essence, most native cultures view humans as part of the rest of nature by believing that human beings are intricately linked to all life forms and life-like processes, and that by harming nature we harm ourselves (Burns, 1998; Martin, 1996; Knudtson
and Suzuki, 1994; Suzuki, 1990; Rockefeller and Elder, 1992; Orr, 1993) (refer to earlier section on Spirituality ,Religion and Nature).

As echoed by researchers in other fields, ecopsychologists believe that
disconnection from nature has a heavy cost in impaired health and increased stress (Scull, 2001; Burns, 1998; Glendinning, 1995; Katcher and Beck, 1987; Gullone, 2000). Clinical ecopsychology operates on the premise that many psychological and physical afflictions can be due to withdrawal from the healing forces of the natural world (Scull, 2001; Roszak et al., 1995; Levinson, 1969). No longer able to identify with nature and its representatives, humans find themselves in a psychological void (Nasr, 1968). However, people may be able to regain some emotional harmony by re-establishing a bond with the animate and inanimate world (Levinson, 1969; 1983).

Many western psychologists are now readily adopting ecopsychology as a
form of treatment or are subscribing to its views (Burns, 1998; Durning, 1995; Hillman, 1995; Roszak et al., 1995). In fact, the field of mainstream psychology is undergoing a paradigm shift as a result of new problems brought about by urban existence and the destruction of the natural environment that are proving difficult to treat (Hillman, 1995). Australian psychologist George selection of nature-based interventions. The work cited
Burns (1998) reviewed by Burns (1998) included the following beneficial effects from contact with nature: enhancement of positive affect; stress reduction; improvement in parasympathetic nervous system functioning; and enhancement of self-concept, self-esteem, and self-confidence.

Although ecopsychological treatment usually involves excursions into wilderness, it is now recognised that any exposure to nature, such as spending time with plants and animals, or going to a park, can have positive benefits (Scull, 2001; Cohen, 2000). Burns (1998) has documented his success treating patients with simple nature-based assignments. These assignments use natural objects or natural processes that have in the past, or are likely to in the future, assist the patient with achieving a therapeutic goal. Burns (1998) has successfully treated patients suffering from a variety of negative psychological states associated with severe trauma, cancer, depression and anxiety, using nature as the basis for treatment.

Although there is a lack of scientific research in this area, in a similar way that wilderness therapy and outdoor adventure therapy also lack research evidence of their efficacy, anecdotal evidence suggests that ecopsychology is particularly successful in treating stress-related illness. However, unlike wilderness therapy and outdoor education from which the benefits may be short-term, ecopsychological treatment is believed to have more lasting positive benefits than ordinary outdoor recreation (Scull, 2001).

Stainbrook (1973, in Lewis, 1996) states that an over-urbanised, dirty environment, and a lack of natural surroundings confirms the negative self-appraisal a person may have developed through other negative contacts with society. Since self-esteem is the keystone to emotional wellbeing, a poor self-appraisal, among other factors, determines how one treats his/her surroundings and how destructive he or she will be towards themselves and others (Stainbrook, 1973 in Lewis, 1996). If the self were expanded to include the natural world, behaviour leading to destruction of natural systems would be interpreted as self-destruction (Roszak, 1995).

Hence, to suggest with the full weight of professional psychological authority that people are bonded emotionally to the earth gives a powerful new meaning into our understanding of the term ‘sanity’ (Roszak, 1995; Orr, 1993). Furthermore, as Levinson (1969; 1983) states, humans must remain in contact with nature throughout life if they are to maintain good mental health, not too mention their humanity. It has been proposed that the modern life as prescribed by Western Society results in adverse outcomes on the human psyche (Gullone, 2000), the full impacts of which are yet to be realised.

Attention restoration

Attention restoration theory suggests that contact with nature improves the
ability to concentrate and aids recovery from mental fatigue. Mental fatigue, as mentioned earlier, can arise from extended periods of directed attention on a particular task, while shutting out distractions (Herzog et al., 1997). Symptoms include a lack of concentration, increased irritability, and a proneness to mistakes or accidents. The effect of nature on children’s capacity for concentration was studied by Taylor et al. (2001) who tested the ability of nature to improve the concentration of children diagnosed with Attention Deficit Disorder (ADD). They found that children functioned better after activities were carried out in natural play settings, and that the ‘greener’ a play setting the less severe were the attention deficit symptoms (Taylor et al., 2001). ADD affects many children and can have a detrimental effect on most aspects of life (including school, interpersonal relationships, personal growth etc.) (Taylor et al., 2001). It is not an easy disorder to treat, but natural settings could be used to improve children’s concentration, thereby somewhat alleviating the need for drugs (that have serious side effects and do not aid children’s long-term health or development) (Taylor et al., 2001). This research highlights the importance of ‘green’ playgrounds and the availability and access to parks and nature for childcare centres, kindergartens, and schools.

However, attention restoration is not just relevant for children, but has increasing relevance for adults in the current social and economic environment in which people are working longer hours and spending long periods of time looking at computer screens. While Hartig et al. (2003) demonstrated that natural environments have both stress reducing and attention restoration benefits for young adults (university students), a study by Herzog et al. (2002), also involving university students in the USA, found that recognition of the restorative effects of natural environments was limited. Herzog et al. (2002) suggest that strategies to address this lack of awareness should include communication of the benefits through images and narratives, and urban design which brings people closer to nature.

Wilderness experience and wilderness therapy

As well as being restorative in terms of attention enhancement and stress
reduction, natural environments can also be used educationally and therapeutically for other purposes. The terminology for such activities varies, and includes ‘outdoor education’, ‘outdoor adventure’, ‘wilderness experience’, ‘wilderness therapy’, ‘wilderness adventure therapy’ and ‘bush adventure therapy’. Whatever the terminology, participation in such activities is typically undertaken for physical, emotional and/or psychological health reasons (Mitten, 2004). However, its potential as a population-wide health promotion tool has only recently been recognised (Pryor, Carpenter and Townsend, 2005).

Challenges presented by wilderness are used in wilderness experience programs such as Outward Bound and other wilderness therapy programs to boost the self-confidence and self-esteem of participants. These programs encourage leadership ability, social cohesiveness, and facilitate an increased awareness of, and respect for, nature (Furnass, 1979). Although these benefits can be substantial and have a long-term effect on individuals, it has been claimed that they are somewhat superficial compared to the psychological and spiritual benefits that can arise from contact with wilderness itself (Cumes, 1998).

At least one wilderness program, however, draws on this aspect, namely the
Wilderness Vision Quest Program, run in the United States (Easley, 1991). This program, founded in 1976, emphasises the spiritual dimensions of contact with the natural world and focuses on fostering conscious efforts to heal, enrich, and expand the human spirit (Brown, 1984 in Easely, 1991). Deeper experiences with wilderness are used in the emotional and psychological treatment of patients suffering from any number of conditions, including psychosis, substance abuse (Bennett et al., 1997) or violence, and injury (Beringer, 1999; Crisp and O’Donnell, 1998). The combination of physical activity and social connection in the context of the natural environment has been found to be effective in preventing both the
onset and the escalation of depression (Crisp and Hinch, 2004). However, the multifaceted nature of the outcomes of such programs (particularly their broader social and environmental wellbeing outcomes) is often forgotten in the intense focus on the outcomes for individual participants. ‘When small groups of people adventure together in natural environments, the health and wellbeing of humans, communities and the natural environment are enhanced’ (Pryor, Carpenter and Townsend, 2005 p. 11).

activities at Glenhaven Park
Campsite (Accommodation Type)

This area is only just beginning to be understood and no appropriate terms
exist for the powerful effect of nature on the human psyche, although the term ‘wilderness rapture’ has recently been suggested by Cumes (1998). More thorough research on wilderness therapy programs is required, particularly to determine whether beneficial effects on participant’s lives are long-term. One commonly reported outcome of wilderness therapy is that self perceptions and perceptions about the one’s relationship to the natural world change (Kaplan and Kaplan, 1989). This can assist people in finding meaning or higher purpose in life.

Some of the most important wilderness areas worldwide are contained in parks. Those parks that have minimum facilities or infrastructure are ideal settings for wilderness therapy or wilderness adventure. For example, many National Parks and all of the Wilderness parks in Victoria (like Big Desert and Wabba Wilderness Park) although designed for conservation, are also ideal for self-reliant recreation and the use of wilderness for therapeutic purposes.

Citation

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

Healthy parks, healthy people – Leisure and recreation benefits

Some Known Health Benefits of Contact with Nature in a Park Context

Health benefit Key references Park example
Viewing Nature
Improves concentration, remedies mental fatigue, improves psychological health (particularly emotional and cognitive aspects), and positively affects mood state (Kaplan, 1995; Rohde and Kendle, 1994; Ulrich et al., 1991b; Kaplan and Kaplan, 1989) Parks,such as Tarr Bulga National Park or Sugarloaf Reservoi, are ideal spots for picnicking as a way to view the natural environment to renew body and mind
Reduces stress and tension and improves self-reports of wellbeing (positively influencing the immune system by reducing production of stress hormones such as cortisol and corticosterone)(Leather et al., 1998; Lewis, 1996; Rohde and Kendle, 1994; Kaplan, 1992a)Apart from active exploration, many parks can be experienced from within a vehicle, particularly those with scenic drives such as Macedon Regional Park or Angahook-Lorne State Park
When exposed to scenes of natural environments subjects recover faster and are more resistant to subsequent stress, which also is likely to boost immunity(Parsons et al., 1998)All parks provide ready views of nature and parks like Albert Park and Yarra Bend Park are especially important in urban areas for stress release and wellbeing
Recovery from a stressful event is faster and more complete when subjects are exposed to natural rather than urban scenes, and heart rate and muscle tension decreases (yet it increases when viewing urban scenes)(Ulrich et al., 1991b)Parks near places of high stress such as prisons, hospitals, and nursing homes most likely provide many more benefits beyond purely aesthetic ones
Viewing nature improves performance in attention demanding tasks (Tennessen and Cimprich, 1995)Natural views are provided in urban areas courtesy of local, neighbourhood, and regional parks (many of which are managed by local as well as State government)
Viewing nature aids recovery from mental fatigue (attention restoration) and encourages reflection by requiring involuntary attention (Herzog et al., 1997; Kaplan, 1995; 1992b; Hartig et al., 1991; Kaplan and Kaplan, 1989; Furnass, 1979)Some parks can provide close up views of nature to aid in attention restoration, while others like Port Campbell provide views of wide, open spaces encouraging a fresh perspective on life
Views of flowers and trees in the workplace reduce perceived job stress, improve job satisfaction, and reduce the incidence of reported illness and headaches of office workers (Kaplan and Kaplan, 1989) As well as providing a natural view, parks in urban areas are used by office workers to take a break from being indoors, to breath fresh air, view nature, and
absorb sunshine
Trees nearby: decrease levels of fear, incivilities, and violence amongst residents; decrease crime rates in public housing; and improve the life satisfaction of residents (Kuo and Sullivan, 2001; Kuo, 2001) The positive effects of vegetation on communities could have an impact on future park planning and park placement.
Parks preserve and maintain
essential habitat and ecosystems,
(including trees and other
vegetation)
Health benefit Key references Park example
Being in Nature
Natural play settings reduce the severity of symptoms of children diagnosed with Attention Deficit Disorder (ADD) and improve concentration (Taylor et al., 2001) Parks within urban areas such as Yarra Bend Park or Wattle Park are easily accessible to educational groups such as schools and family or community organisations
Viewing nature enhances residents’ satisfaction and makes higher density living more acceptable (Kaplan, 2001; Rodiek and Fried, 2005; Kearney, 2006)Parks near residential developments may provide a range of social and emotional benefits to residents
Natural surroundings assist cognitive functioning in children ells, 2000) Parks have special significance to schools, kindergartens, and childcare centres with limited green space
Wilderness areas provide spiritual inspiration, enable people to gain a fresh perspective on life, and provide an opportunity to ‘get away’(Ward Thompson et al, 2005; Cumes, 1998; Cordell et al., 1998; Martin, 1996; Kaplan and Kaplan, 1989) Parks of intact wilderness, such as Grampians National Park or Bay of Islands Coastal Park, can provide spiritual inspiration for local, interstate, and international visitors
Therapy in a wilderness setting heals
emotional and psychological conditions and
can aid those recovering from substance abuse
and violence
(Russell et al., 1999;
Crisp and O’Donnell,
1998; Crisp and
Aunger, 1998;
Bennett et al., 1997;
Byers, 1979)
Large, rugged National Parks such
as Wilson’s Promontory are ideal
for wilderness therapy excursions
and Outward Bound programs
where there can be many
physical and mental challenges
to overcome, as well as much to
inspire
Outward Bound and similar programs use wilderness challenges to boost self-confidence and self-esteem (Cumes, 1998; Furnass, 1979)Many National Parks have minimal visitor infrastructure which is ideal for wilderness challenges or for those seeking adventure
Observing Plants andGardens, or Gardening
Community gardens increase community cohesion, reduce graffiti and violence and enhance self-image of residents (Lewis, 1996; Reuter and Reuter, 1992; Lewis, 1992; 1990; Bartolomei, Corkery, Judd, and Thompson, 2003; Glover, Shinew and Parry, 2004; Parry and Shinew, 2005; Glover, Shinew and Parry, 2005.)The most significant aspect of community gardens is the sense of ownership residents’ gain. This could also apply to Friends of Parks groups who care for their local park
Gardening and gardens help people to feel tranquil and at peace (Butterfield and Relf, 1992) Sculptured gardens such as the National Rhododendron Gardens
Health benefit Key references Park example
In habitat restoration people see a metaphor for their own personal transformation and growth, enhancing psychological wellbeing (Shapiro, 1995) Many of the Friends of Parks groups regularly carry out habitat restoration via planting and weeding workshops
Gardens improve psychological wellbeing, provide environmental stimulation, a means of self-expression, physical exercise, and social interaction for residents of retirement communities (Browne, 1992) Retirement communities without gardens can readily access urban parks and gardens whether highly manicured (e.g. National Rhododendron Gardens) or more natural parks (e.g. Yarra Bend Park)
Residents who have nature nearby or regularly pursue nature-related activities (e.g. gardening, birdwatching) have greater neighbourhood satisfaction, overall health and life satisfaction than residents who do notFrey, 1981 in Kaplan and Kaplan, 1989; Kaplan and Kaplan, 1989; (Kaplan, 2001; Kearney, 2006) Many residents in urban areas are in close proximity to a park, yet as housing density increases, increased pressure will be placed on existing parklands

Citation

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

Healthy parks, healthy people – Leisure and recreation

Although many benefits arise from the act of recreation itself, whether it be a hobby or playing a team sport, the concern here is with the types of recreation that occur in natural or semi-natural settings and the particular benefits that may arise from carrying out the activity in those settings.

Leisure and recreation experiences in natural environments probably reduce stress through a number of mechanisms, including a sense of control through active coping or escape, and the therapeutic effects of exposure to natural environments that most likely have learned as well as biological origins (Ulrich et al., 1991a). For example, many people each year flock to parks and wilderness areas for their annual holiday to ‘experience’ the wilderness, and the number of people seeking these experiences is increasing (Freimund and Cole, 2001). Associated with this is a rise in the number of people pursuing non-consumptive nature-related recreational activities, such as birdwatching. This is often referred to as ‘wildlife-watching’ or ‘watchable-wildlife’ and includes observing, feeding, or photographing wildlife (U.S. Department of the Interior et al., 1996). Much work has been carried out on this topic in the United States and although similar trends are likely in Australia, there is almost no data on wildlife watching by Australians or visitors to Australia (D. Jones personal communication).

Recreation in the natural settings provided by parks is becoming increasingly important as our lives become dominated by indoor activities. Some authors anticipate that allowing people to interact with nature (such as spending time in parks during the working week) to reduce tension and increase competence and productivity, will eventually become socially accepted and actively encouraged (S. Kaplan in Lewis, 1996). Pursuing recreation in a park setting enables people to develop a clearer understanding of their relatedness to nature, which can influence their everyday lives and preferences (Martin, 1996). This can have quite
a powerful effect as a form of intervention treatment, for example as used in wilderness therapy (see section titled ‘Health Benefits of Nature in Practice’).

Wilderness and related studies clearly demonstrate that being in a natural environment affects people positively, although the exact benefits are still largely unknown. There are also multiple benefits from brief encounters with nature or experiencing nature on a smaller scale, such as in urban parks. As outlined by Woolley (2003), the most obvious benefits and opportunities that urban green spaces may provide for inner city living are social benefits – that is opportunities for people to participate in events and activities. Similarly, the Sydney Urban Parks Education Research (SUPER) Group (2001), stated that urban green space, in particular parks and gardens, may generate a range of social and economic values for the Australian community.

These benefits may include:
• opportunities for activity for older people;
• supervised child-care;
• health improvement and fitness motivation;
• education in sport, environment and other endeavours;and
• individual personal development.

Survey work has shown that nature is important to people, and numbers of
people seeking nature-related recreation overseas is increasing. Similarly, research indicates that in Sydney, Australia, inner city residents have the highest visitation rate to urban parks, no doubt due to small or non-existent personal gardens or backyards (Veal, 2001). Some of the benefits of being in nature in a park context are presented in Table 2.

Contact with plants


Gardens and gardening

Gardening and gardens are central features of societies throughout the world. It is claimed by some researchers that, across the world, gardening is the most common nature-based activity (Lewis 1996; Kaplan and Kaplan 1989). The American College of Sports Medicine (2004) goes further, suggesting that gardening is among the most popular leisure pursuits (not just among pursuits which are nature-based). Moreover, research indicates that gardening is good for human health and wellbeing in many ways. For example, gardening allows people to interact with the natural environment, which has psychological, physiological and social benefits (Frumkin 2003; Pretty et al. 2007).

As well as the leisure aspects of gardening noted above, gardening provides
opportunities for beneficial physical activity (Nieman 2003), can be used
therapeutically in drug rehabilitation centres, prisons and hospitals(Frumkin 2001; Lewis 1996; Relf 1992), fosters recovery from the stresses and strains of everyday living (Kaplan and Kaplan 1990), and can enhance community cohesion and transform neighbourhood relationships (Lewis 1990, 1992, 1996).

The physiological benefits of gardening are fairly obvious, but the benefits have also been verified by research (including research on gardening and diabetes by Armstrong 2000, and research on gardening and general health maintenance by Galloway and Jokl 2000). Other more recent claims of physical health benefits of gardening include Rothert (2007 p. 26) who states that ‘the lifting and reaching motions of gardening can strengthen weak muscles and increase limited joint flexibility ranges. Physical stamina and skills such as balance and coordination can be improved’. Gardening has also been cited as a means of prevention for osteoporosis. According to Kovach (2006 p.56), researchers at the University of Arkansas ‘found that women 50 and older, who gardened at least once a week, showed higher bone density readings than those who engaged in other types of exercise including jogging, swimming, walking and aerobics’. Gardening has also
been found to be beneficial in reducing another age-related condition dementia. A recent Australian study of nursing home admissions to identify risk factors for dementia (Simons et al. 2006) found a 36% reduction in risk associated with daily gardening. A garden has been likened to a gymnasium: ‘Turning compost is essentially lifting weights, raking is like using a rowing machine’ says Dan Hickey (2004) of the (US) National Gardening Association.

One of the most passionate advocates for the psychological health benefits of plants is Charles Lewis. Lewis (Lewis, 1990; 1992; 1996) believes that vegetation, whether part of a garden, park or wilderness setting has great potential for healing. According to Lewis (1990), when humans first view it, a park or garden is a visual experience. However, the image is then transmitted from the eye to the brain where it is decoded, recognised, and can be transferred to a deeper level of being (Lewis, 1990).

A recent article in a newsletter from the Nursery and Garden Industry Australia Limited (2006 p. 1), citing the 9th annual Ipsos Mackay ‘Mind and Mood’ report, highlights the importance of the restorative and community building aspects of gardening, saying: ‘Australians consistently report higher levels of anxiety, irritability, grumpiness—all associated with what is assumed to be a rising level of tension in the community. … Gardens and gardening may offer one of the few antidotes to a community so frenzied.’

Lewis (1990) also points out that the benefits of gardening are not dependent on age or on physical strength, but are available to the young and the old alike, to those who can be actively involved and those who can only observe or even interact with gardens only through their sense of smell. According to Lewis (1990), plants heal via two modes: observational mode and participatory mode. Observational mode occurs when viewing vegetation in a garden or wilderness, but the observer has no responsibility for its care (e.g. in a park or wilderness area). Participatory mode occurs when an individual is responsible for nurturing a plant or garden (or even wilderness), and it is through their efforts that the plant/s thrive. Lewis (1990) has stated that the act of nurturing and being responsible for plants at a more intimate level is a more intense experience than that gained
through observation alone, however, both observation and participation produce wellbeing (Lewis, 1990). Interestingly, a questionnaire sent to members of the American Horticultural Society and readers of an organic gardening magazine found that the most beneficial aspects of gardening cited by respondents were peacefulness and tranquillity, rather than the tangible benefits of food or flower production (Kaplan and Kaplan, 1989).

The Kaplans’ notion of restorative experiences was an idea that emerged from their work in wilderness research, but they found that it is also relevant to the experience of gardening (Kaplan and Kaplan, 1990). As noted previously, restorative experiences are based on the fact that mental effort, stress, and the demand of everyday living cause fatigue and affect one’s capacity to concentrate, or direct attention to one particular task (Kaplan and Kaplan, 1990). A restorative environment fosters recovery from this state. It requires four elements: fascination, a sense of being away, extent or scope, and compatibility with an individual’s inclinations (Kaplan and Kaplan, 1989). These four factors are found in natural places such as parks and gardens, or in the act of gardening itself.

The importance of the health benefits of gardening in relation to parks and nature is apparent when considering environment groups like ‘Friends of Parks’. These groups regularly volunteer their time to restore and rehabilitate parks (i.e. public gardens) by planting, watering, and weeding, among other activities. Although the health of people who have private gardens has been investigated somewhat, there was until recently little known about the potential health benefits from membership and participation in a ‘public gardening’ group. In many urban areas, particularly with recent increases in high density housing, contact with nature and natural environments, typically gained through the ‘Australian birthright of owning a free-standing bungalow on a quarter-acre block surrounded by leafy gardens’ (Mayne-Wilson 2005 p. 3) is available only via public parks.

Research by Bhatti and Church (2000) suggests that gardening may be experienced differently by males and females. Other research suggests that socio-economic status influences the amount of time spent in gardens (Armstrong 2000). For children, school gardens have been found to enrich teaching and learning experiences, increase scientific knowledge and environmental awareness, and foster positive relationships between children, adults and the local community (Maller and Townsend 2006).

For older people, especially those living in retirement communities, the
availability of a garden not only enables residents to actively garden but also encourages and supports informal activities ‘such as walking and talking with friends’ (Browne 1992 p. 78). Sifton (2004 p. 89) tells the story of John Angus:

Glenhaven Park Stockport
John Angus had worked all of his life with the land and plants; for John Angus, growing things was more than a way to earn a living, it was his life. … Tragically, when I met John Angus, independently tending a garden or plants was out of the question due to the symptoms of advanced Alzheimer’s disease. His language skills were quite well preserved, but he was particularly troubled by motor co-ordination and movement difficulties. He had so little command or sense of his body that he required full assistance to get dressed or even to sit in a chair. And distress with his losses often led to behavioural symptoms such as agitation. 
John Angus had been living in various institutions for several months when I suggested that he come with me to help with some potting up. The very suggestion brightened him up immensely. As I guided his hands to the potting soil, tears began to run down his smiling cheeks.
With hands immersed in his beloved soil, John Angus said: ‘This is just heaven, just heaven, and I had no idea that it was so handy to home’.

For asylum seekers and refugees, the opportunity to participate in gardening has been shown to assist in dealing with the traumas they have experienced prior to resettlement (Hodge 2003).

Because of the diverse and widely applicable benefits they offer, gardens are increasingly being used for therapeutic reasons

Citation

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

Healthy parks, healthy people – Being in nature

Being in natural environments, whether hiking in a World Heritage area or sitting in a local urban park, has many psychophysiological beneficial effects on health (i.e. positive psychological effects that translate into positive physiological effects). Although there is much anecdotal evidence documenting the benefits of ‘being in nature’, the exact effects (for example by using psychophysiological measures) on the human mind, body, and spirit are still largely unknown. It has been suggested that some of the benefits from being in natural settings arise from a mood state of pleasant arousal and relaxation, resulting from returning to a more cyclical, and slower sense of time (Nettleton, 1992; Furnass, 1979).

Nettleton (1992) reviewed some of the literature describing positive emotional states arising out of time spent in natural settings. A study by Russell and Pratt (1980 in Nettleton, 1992) found that parks and gardens were perceived as relaxing and peaceful and were associated with a positive mood state, while supermarkets were perceived as distressing and associated with a negative mood state. A later study conducted at one of the train stations in the Melbourne underground railway system (Parliament Station) found that when asked about what they liked about the station, commuters mentioned a small park (MacArthur Gardens) located just outside the exit of the station that they walked through on their way to the train, whereas the station itself was viewed as sterile, daunting, and stark (Joske et al., 1989 in Nettleton, 1992).

outside education

City life is dominated by mechanical time (punctuality, deadlines, etc) yet our bodies and minds are dominated by biological time. Conflicts between mechanical and biological time can result in a variety of unpleasant psychosomatic symptoms including irritability, restlessness, depression,
insomnia, tension and headaches, and indigestion (Furnass, 1979). If unaddressed, these problems have the potential to eventuate into illnesses that are more serious. The experience of nature in a neurological sense can help strengthen the activities of the right hemisphere of the brain, and restore harmony to the functions of the brain as a whole (Furnass, 1979). This is perhaps a technical explanation of the process that occurs when people ‘clear their head’ by going for a walk in a park and emphasises the importance of parks in providing communities with access to nature. Furthermore, in the act of contemplating nature, researchers have found that the brain is relieved of ‘excess’ circulation (or activity), and nervous system activity is also reduced (Yogendra, 1958).

Nature does have great importance to people. In a survey of 1,900 adults in the US, Cordell et al. (1998) found that approximately 45% of respondents rated wilderness as ‘very important’ or ‘extremely important’ for spiritual inspiration, and a further 56% stated that just knowing it exists was ‘very important’ or ‘extremely important’. This confirms the conceptual importance of nature to people described by Kaplan and Kaplan (1989).

Being in natural environments invokes a sense of ‘oneness’ with nature and the universe, and can lead to transcendental experiences (Rohde and Kendle, 1994). This is more likely to occur in wilderness settings, although as it relates to subjective experience it is probable that nature in urban environments could produce the same effect.

In order to encourage people to be in nature, the accessibility of urban green spaces should be considered. With current trends in Australia and other Western countries towards an ageing demographic, it is important to make urban green space accessible to all. Furthermore, urban green spaces should be created as beautiful places in cities – places that are socially cohesive and promote social solidarity (Ward Thompson, 2002).

Restorative settings

The increasing complexity of both technological tasks and the built environment is generally a source of many negative stress response patterns for the majority of people (West, 1986 in Lewis, 1996). In contrast, the natural environment has been found to have a restorative quality, particularly for people who live in urban environments. Natural places such as parks offer an opportunity to become revitalised and refreshed. Living in urban areas often means dealing with environmental demands such as crowds, noise, pollution, and primarily uniformed structures. It has been demonstrated that these factors can cause mental fatigue and exhaustion (Furnass, 1979; Rohde and Kendle, 1994), whereas exposure to nature has been demonstrated to have the opposite effect. Symptoms of mental fatigue include: decreased ability to concentrate and solve problems, heightened irritability, and a greater susceptibility to make mistakes or cause accidents (Herzog et al., 1997).

South Australian Camps Adults and children

The Kaplans (Kaplan and Kaplan, 1989; Kaplan and Kaplan, 1990; Kaplan,
1992a; Kaplan, 1992b; Kaplan, 1995) have developed the notion of ‘restorative environments’ that foster recovery from this state of mental fatigue. Restorative environments require four elements: fascination (an involuntary form of attention requiring effortless interest, or curiosity); a sense of being away (temporary escape from one’s usual setting or situation); extent or scope (a sense of being part of a larger whole); and compatibility with an individual’s inclinations (opportunities provided by the setting and whether they satisfy the individual’s purposes) (Kaplan
and Kaplan, 1989; Hartig et al., 1991). For a more detailed discussion, see Hartig et al. (1991) or Kaplan and Kaplan (1989). Parks are ideal for restorative experiences due to their ability to satisfy the four elements described above (Kaplan and Kaplan, 1989; Kaplan and Kaplan, 1990; Kaplan, 1992a; Kaplan, 1992b; Kaplan, 1995). When comparing a walk in a natural setting (a park), a walk in an urban setting, and relaxing in a comfortable chair, Hartig et al. (1991) found that mental fatigue was most successfully relieved by a walk in a park.

Furthermore, Kaplan et al. (1998) suggest that the implications for design and management of natural environments to be restorative are vast and vital. They suggested that the natural setting may be beneficial to not only its immediate users but also to those who view it from afar. In addition, Kaplan et al. (1998, p.77) stated that ‘if treated as the opportunity for increasing the sanity and welfare of those who can see it, it becomes every bit as important as hallways and lighting’. Herzog, Chen and Primeau (2002 p. 295), reporting on a study of undergraduate students in the USA, concluded that ‘the restorative potential of natural settings is probably underappreciated’. This is supported by results of research by Hartig
et al. (2003), also involving university students, in which the restorative effects of natural settings were accentuated by the negative effects associated with the urban surroundings and windowless room that acted as ‘controls’.

low ropes course Glenhaven Park

In recent years, Frances Kuo and her colleagues (2001; 2002) have conducted research to examine the effectiveness of the Attention Restoration Theory in the inner city context. Their work has focussed on high-rise residents and the effects of nearby nature on a range of factors including: the ability to cope with major life issues, Attention Deficit Disorder and children’s self-discipline. For example, a study conducted by Taylor, Kuo and Sullivan (2002) examined the relationship between nearby views of ‘green’ nature and children’s ability to concentrate, inhibit impulses and delay gratification. They found that the more ‘green’ a girl’s
view from her high-rise window was, the better able to concentrate and the more self-disciplined she was.

Similarly, Kuo (2001) examined whether nearby nature effects high-rise residents’ ability to cope with poverty and life issues. She found that residents with ‘green’ surroundings were able to pay attention more effectively and found their major life issues to be less difficult to deal with than their counterparts with ‘barren’ surroundings. Furthermore, Taylor, Kuo and Sullivan (2001) tested whether the Attention Restoration Theory could be applied to children and their capacity to deal with Attention Deficit Disorder (ADD). Through the use of parental surveys, children were tested for their attentional functioning in a range of play settings, and green settings were found to be most effective in enhancing attention. The authors concluded that the ‘greener’ a child’s play setting, the less severe her ADD symptoms appeared (Taylor et al., 2001).

Citation

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

Healthy parks, healthy people – Health benefits of nature: The evidence

Introduction

The belief that contact with nature fosters psychological wellbeing and reduces the stress of urban living seems to be as old as urbanisation itself (Ulrich and Parsons, 1992; Ulrich, 1993), and as mentioned, was the guiding principle behind the first parks. There are many ways that humans come into contact with nature, including viewing natural scenes, being in natural settings, or encountering plants and animals. Some of these occurrences are ‘everyday’ interactions, and others are more specific and affect people at a deeper level. This section briefly examines everyday human-nature interactions, as well as those interactions with landscapes, wilderness, plants and animals (Frumkin, 2001).

 Note: We have included here only those human relationships with animals and plants where no economic benefit is to be gained from the relationship (so the interactions between farmers and their stock and/or crops are not included, nor are other commercial nature-based industries). This is not to say that the same benefits as described here may not also arise from these relationships. However, there have been virtually no studies examining the potential health benefits of people working with nature in these industries and as the majority are now large-scale operations; whatever benefits to be gained in terms of health are likely to be overshadowed by the impersonal nature of any interactions that may occur.
Glenhaven Park June 2018

Viewing nature

In recent decades, landscape researchers have conducted studies to investigate individuals’ preferences for natural scenery (eg. Kaplan and Talbot, 1988; Talbot, 1988; Talbot, Bardwell, and Kaplan, 1987; Talbot and Kaplan, 1984; 1986; 1991). Since the early work of Talbot and Kaplan (1984) through to more recent work by Kaplan (2001), studies generally indicate that people prefer viewing natural landscapes rather than the built environment. Furthermore, there is now considerable empirical and theoretical evidence for the positive effects that simply viewing natural scenes can have on human health.

The healing effects of a natural view (such as those provided by parks) are
increasingly being understood in stressful environments such as hospitals,
nursing homes, remote military sites, space ships and space stations (Lewis, 1996). In these environments particularly, as well as for people who work in windowless offices, studies show that seeing nature is important to people and is an effective means of relieving stress and improving wellbeing (Leather et al., 1998; Lewis, 1996; Kaplan, 1992a). Research such as this could have important implications for the placement and planning of parks in urban areas.

One famous study examining recovery rates of patients who underwent gall bladder surgery found that those with a natural view recovered faster, spent less time in hospital, had better evaluation from nurses, required fewer painkillers, and had less postoperative complications compared to those that viewed an urban scene (Ulrich, 1984). Similarly, Ulrich and colleagues (1991b) studied the effects of different natural and urban scenes on subjects who had just watched a stressful film (horror genre). Measuring a whole array of physiological measures (including heart rate, skin conductance, muscle tension and pulse transit time (a non-invasive measure that correlates with systolic blood pressure)) they found that recovery was faster and more complete when subjects were exposed to natural rather than urban scenes (Ulrich et al., 1991b). The physiological
data measured by this study suggests that natural settings elicit a response that includes a component of the parasympathetic nervous system associated with the restoration of physical energy (Ulrich et al., 1991a).

Similar research conducted in prison environments suggests that cell window views of nature are associated with a lower frequency of stress symptoms in inmates, including digestive illnesses and headaches, and with fewer sick calls overall by prisoners (Moore, 1981). Natural views can also result in better performance in attention demanding tasks (Tennessen and Cimprich, 1995). Tennessen and Cimprich (1995) gave university students a test and compared scores of students who had natural views to those that did not. They found that those with a view of nature scored better on the test than those with non-natural views. Furthermore, a study by Heerwagen and Orians (1986, in Lewis, 1996) compared the preferences of office workers for visual decor (i.e. photographs or posters) in windowed and window-less offices. Findings showed that people who worked in offices without windows were four times more likely to choose photographs or posters of outdoor/natural scenes than those who worked in offices with windows; more than 75% of scenes represented in window-less offices
contained no buildings or human-made artefacts at all (Heerwagen and Orians, 1986 in Lewis, 1996).

Glenhaven Park June 2018

Further evidence shows that access to nature in the workplace is related to lower levels of perceived job stress and higher levels of job satisfaction (Kaplan and Kaplan, 1989). Workers with a view of trees and flowers felt that their jobs were less stressful and they were more satisfied with their jobs than others who could only see built environments from their window. In addition, employees with views of nature reported fewer illnesses and headaches (Kaplan and Kaplan, 1989). A similar study found that a view of natural elements (trees and other vegetation) buffered the negative impact of job stress on intention to quit (Leather et al., 1998). Parsons et al. (1998) reviewed the literature on commuter stress in car drivers and the mitigating effects of roadside environments. Driving is known to be a
stressful activity, and causes several physiological changes in the body, including: activation of the sympathetic nervous system, increased blood pressure, increased heart rate, and an increase in heart rate variability (Parsons et al., 1998). Stress recovery and immunisation were measured in subjects exposed to one of four simulated drives (drives with forest/rural scenery, drives along the outside of golf courses, drives through urban scenes, and drives through mixed roadside scenery), immediately following and preceding mildly stressful events. Findings demonstrated that participants who viewed nature-dominated drives experienced quicker recovery from stress and greater immunisation to subsequent stress than
participants who viewed artifact-dominated drives (Parsons et al., 1998).

Kaplan (2001) found that apartment residents had enhanced wellbeing and
greater neighbourhood satisfaction when they could look out onto more natural rather than more built settings. However, satisfaction was far greater when residents could see even a few trees than when their view was of large open spaces (Kaplan, 2001). Similarly, results from a study by Kaplan (1985) suggested that urban residents who could see gardens found their neighbours to be friendlier and felt their housing development had a stronger sense of community, thus contributing to their neighbourhood satisfaction. Furthermore, Kearney (2006) found that having a view of natural environments (particularly forests and landscaping) increased residents’ neighbourhood satisfaction and suggested that higher density living, such as highrise living, could be more acceptable if residents have a natural view.

The beneficial effects of viewing nature on psychological state, and in particular mood affect were examined by Ulrich (1979, 1982, in Rohde and Kendle, 1994). Ulrich (1979 in Rohde and Kendle, 1994) found that participants who viewed slides of unspectacular scenes of nature had an increase in positive mood affect, while those who viewed scenes of urban areas experienced a decline in positive mood affect. In this and a later study, Ulrich (1982, in Rohde and Kendle, 1994) concluded that scenes of nature, particularly those depicting water, had a beneficial influence on the psychological state of humans. In their review of the literature, Rohde and Kendle (1994) state that the positive psychological response to nature involves feelings of pleasure, sustained attention or interest, ‘relaxed
wakefulness’, and diminution of negative emotions, such as anger and anxiety.

Glenhaven Park June 2018

Kaplan and Kaplan (1989) point out that observing or viewing nature is an
important form of involvement with it. Much of the pleasure that people derive out of nature comes from opportunities to observe, and much of this observation occurs, not when people are in nature itself, but when they are looking out a window (Kaplan and Kaplan, 1989). This type of observation lets the mind wander and provides an opportunity for reflection. It can also aid recovery from mental fatigue. ‘Mental fatigue’ is a term coined by Stephen Kaplan (1987b in Kaplan and Kaplan, 1989) and arises from an intense period of concentration or directed attention (whether pleasant or unpleasant) that eventually results in a worn-out mental state with symptoms including irritability and a lack of concentration. It has been shown that natural environments are ideal environments to foster recovery from this state (see below). The reason for this is that the act of viewing
or observing nature does not require directed or focussed attention, but instead requires undirected or effortless attention, which is non-taxing and can restore mental capabilities.

Evidence presented here has demonstrated that just by viewing nature many aspects of human health and development can be markedly improved. Some of these benefits in a park context are summarised in Table 2. Although the benefits are mostly psychological, flow-on effects to physical health have also been documented in the literature. Viewing nature is positive for health, particularly in terms of recovering from stress, improving concentration and productivity, and improving psychological state, particularly of people in confined circumstances such as prisons, hospitals and high-rise apartments/high density living. From these findings, it is clear that visual access to nature in urban settings should be taken into account and given appropriate priority when planning urban areas. As well as viewing landscapes, however, many therapeutic effects can be gained from being in nature.

Conclusion

As discussed above there are many ways of examining the human-nature
relationship, yet knowledge about our relationship with nature is still incomplete. Despite this, the importance of the natural environment is apparent across cultures and varying population groups. Overall, there is a strengthening perception that contact with nature is beneficial to adults and children alike, and is perhaps an antidote to health and wellbeing problems associated with an increasingly urbanised modern lifestyle. Some of the evidence is discussed in the following section titled ‘Health Benefits of Contact with Nature: The Evidence.’

Citation

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

activities at Glenhaven Park

Healthy parks, healthy people – Understanding the human-nature relationship, Part 3

Gender and nature

Although much has been published in philosophy and sociology linking the
concepts of gender and nature, this is not the focus of the discussion here (e.g. Wilson, 2005; Norgaard, 2000). Although some reference is made to the philosophical literature, this review is concerned more with human perceptions of day-to-day contact with nature and how it can influence health and wellbeing. Yet research in this area on gender remains undeveloped, and what little is published relates mostly to women.

The Ecofeminist literature offers some interesting insights into conceptualisations of gender and nature. Norgaard (2000) provides numerous historical examples of the assignment of ‘male’ and ‘female’ genders to certain aspects of nature. For example, she attempts to explain gender-nature relationships by examining symbolic references from history, where Gaia, Eve and Isis were considered ‘female nature’, and Pan, Neptune and Thor were considered ‘male nature’ (Norgaard, 2000). Filemyr (1997) argues that nature as ‘the outdoors’ is gendered as a male space, racialised as a white space (see section entitled ‘Ethnicity and Nature’
above), and sexualised as a heterosexual space. Although a personal account, her article raises some important issues that could be tackled in future research.

In their study on gender, ethnicity, and urban park preferences, Ho et al. (2005) review some of the available literature on gender and nature. They cite the work of Hutchison (1994 in Ho et al., 2005) who found that in parks women were more likely than men to engage in stationary activities (i.e. associated with child care or as a member of a mixed gender social group), whereas men were more likely to participate in mobile activities such as sport, and to do so as individuals or with peers. Furthermore, new immigrant women have been found to be less likely than Western women to engage in activities outdoors, including the use of urban parks (Eyler et al., 2002 in Ho et al., 2005), let alone other ‘less tamed’ natural environments such as wilderness areas.

The work by Virden and Walker (1999) on forest environments also found that women perceived forests as more threatening than men. Virden and Walker (1999) explain that this is most likely due to women’s fear of their own species, particularly men, rather than fear of other animals. Indeed, the work by Wesley and Gardner (2004) seems to confirm this. They studied women partaking in a wilderness adventure program in the United States, who despite feeling empowered by their wilderness experience, still considered themselves vulnerable to violence in outdoor environments, particularly from men (Wesely and Gardner, 2004). Conversely, work by Pohl et al. (2000) found that rather than simply feeling empowered, women’s wilderness recreation resulted in feelings of increased self-confidence, assertiveness, problem-solving skills, self-trust, and self-worth outcomes which were transferred to their daily life and which enabled them to challenge norms and the restrictive worldviews of those around them. For their own findings on women, fear, and forest environments, Virden and Walker (2004) offer an alternative explanation by describing the possibility of a distinct, but not necessarily exclusive, feminine view of forested environments that perceives forests as threatening, but also as more mysterious and awe-inspiring that men do, where nature is considered an entity or organism in it’s own right (Virden and Walker, 1999).

Interestingly, in an early study by Kellert and Berry (1984) which investigated gender variations in human relationships to animals and nature, female participants scored higher on the humanistic and moralistic attitude scales than men, which Kellert and Berry (1984) reported was indicative of greater emotional attachment to individual animals and more concern for their ethical treatment. Along similar lines, Kruse (1999) studied gender, perceptions of nature and support for animal rights. He too found that women displayed greater support for animal rights than men. However, Kalof (2003) cites work by Peek et al. (1997) which showed that women’s devotion to animal rights is not explained by an ethic of care, but is instead explained by women’s subordination in the social hierarchy whereby an experience of oppression results in empathy for other oppressed groups, including animals. In terms of men, Kellert and Berry’s (1984) findings suggested, as did Virden and Walker’s (1999) research, that men demonstrated greater interest in wildlife and direct contact with the outdoors, and showed substantially less fear and indifference to wild animals (Kellert and Berry, 1984).

Bhatti and Church (2000) explore gendered meanings of contemporary gardens. In reviewing the literature, they conclude that for much of the twentieth century, the garden, particularly in working class households, was portrayed as the man’s domain and as a masculine source of leisure (Bhatti and Church, 2000). Yet their own work suggests that although men expressed a desire to control the garden by imposing their own personal order, for women the garden was a creative outlet, more so than inside the house (Bhatti and Church, 2000). Their findings show that for both genders gardening is a major leisure activity and that gardens have multiple meanings, including: as a private retreat; a social place for sharing; a connection to personal history; a reflection of one’s identity; and a status symbol (Bhatti and Church, 2000). Bhatti and Church (2000 p. 195) conclude ‘… that the garden often reveals hidden (or not so hidden) social relations and can be seen as a negotiated realm that highlights deeper gender relations.’ It is clear that the gender-nature relationship is complex, and that more work is needed to unravel this fascinating aspect of the human-nature relationship.

Children and nature

Humans’ perception of the natural world and the meanings they attach to nature are shaped by the influence of learning, culture and experience, despite their presumed biological origins (Kellert 2002). Kellert (2002) observes that there is a paucity of available literature on the role played by childhood contact with natural systems in character and personality formation. He comments that the literature that does exist almost exclusively employs the terms ‘ecology’ and ‘environment’ in considering family relationships, human social contexts, and the built rather than the natural environment (e.g. Bronfenbrenner, 1979; Kellert, 2002). Hence, the underlying assumption in the existing literature is that these are the predominant settings of modern childhood, or alternatively the more defining settings (i.e. more important). This assumption excludes the natural environment and its influence on human development entirely. As Kellert (2002, p.118) states, ‘.. .the relative absence of published material on this subject may be indicative of society so estranged from its natural origins it has failed to recognise our species’ basic dependence on nature as a condition of growth and development.’

So how does the natural environment affect childrens health and wellbeing? Tuan (1978) states that posed in this way the question is largely meaningless children’s health depends more on the quality of parental care, nutrition, access to medical services, and the socioeconomic environment than on whether they live surrounded by the built or the natural environment. As Tuan (1978) argues, in romanticising nature it is easy to forget that infant mortality is higher in many indigenous cultures that have close contact with the natural world than in developed countries where children live in almost entirely in urban environments. Nevertheless, this is most likely due to differences in culture, socioeconomic factors, access to and level of education, and access to health care services between richer and poorer nations. Any positive effects on the health and wellbeing of indigenous peoples obtained from contact with nature are likely to be ineffectual due to the dominance of these other factors. Yet, according to the
research presented in this review, the natural environment can and does have a positive impact on human health and wellbeing. Perhaps surprisingly however, there is not an expansive amount of scientific literature on children and youth and their relationships with the natural world. Despite this, there are some interesting publications that adopt an ecological or evolutionary approach.

Glenhaven Park June 2018

Heerwagen and Orians (2002) explore the ecological world of children. Their aim was to show how conditions experienced in ancestral environments still exert considerable pressure on humans today. Adopting an ecological-evolutionary perspective they predicted age-related patterns of behavioural responses to the environment or environmental stimuli. For example, as children develop physical skills and are able to gain some independence from the primary caregiver they begin to explore their environment (Heerwagen and Orians, 2002). In doing so, they should be motivated to seek out spaces that afford safety and protection, as children’s play at this age is highly focused on their activities and not on the surrounding environment (Heerwagen and Orians, 2002). But this type of play can leave them vulnerable to hostile people, animals, or other dangers (Heerwagen and Orians, 2002). As examples of natural refuges, Heerwagen and Orians (2002) describe a tree with a wide canopy, or a shrub open enough for a child to sit and play within it, while offering a view of the nearby surroundings. Heerwagen and Orians (2002) predict that young children, particularly of preschool age will seek out naturally occurring shelters in the environment and that older children (i.e. those old enough to attend school) will actively shape or construct shelters.

In fact, when playing outside research has shown that children do seek ‘refuge’ in certain elements found in the natural environment (Kirkby, 1989). Kirkby (1989) also predicted that children would engage in more dramatic and imaginative play in a natural refuge as opposed to a built refuge in school playgrounds. Her reasoning was that natural refuges offer a greater sense of enclosure and more opportunities to manipulate objects (Kirkby, 1989). She found that dramatic play ranged from 42% of the total play content in the built refuge to 68% in the natural refuge settings (Kirkby, 1989). Similarly, Heerwagen and Orians’ (2002) analysis of young children’s attraction to natural refuges in playgrounds showed that play behaviours in natural refuges differed significantly from play behaviours in built refuge or traditional playground equipment ((Heerwagen and Orians, 2002). They
cite evidence that natural refuges and natural materials (such as flowers, sticks and stones) facilitated long bouts of imaginary play, a behaviour known to have high social and cognitive benefits (Heerwagen and Orians, 2002).

In their overview of the literature, Heerwagen and Orians (2002) state that the design of day-care centres, playgrounds, schools, homes, and hospitals could benefit from a better understanding of children’s natural play behaviours. They state ‘Even a cursory investigation of schools and playgrounds shows that little has changed over the past 50 years. Children still sit in desks facing a teacher or sometimes in clusters of desks. And they still play in environments dominated by swings and slides or other fixed play equipment that does little to capture their imagination’ (Heerwagen and Orians, 2002 p.52). Disconnection from the natural environment has prompted some researchers to implore policy and other decision makers to remember their own youth (e.g. Nabhan and Trimble, 1994) and Louv (2005) has coined the phrase ‘nature-deficit disorder’ to capture ‘modern’
children’s lack of contact with nature.

Glenhaven Park Stockport

In terms of children’s contact with nature, Kellert (2002) has described three types of experiences—direct, indirect, and vicarious experiences. Kellert (2002) defines direct experiences with nature as actual physical contact with natural settings and nonhuman species (i.e. animals and plants). However, he restricts these direct encounters to creatures and environments occurring mostly outside and independent of the human built environment, where plants, animals, and ecosystems function without continuous human intervention and control. Kellert (2002 p.119) states ‘The child’s direct experience of nature is viewed as largely unplanned rather than formally organised into structured programs and activities…’ Examples of direct experience of nature are spontaneous play or activity in one’s backyard, in a nearby forest, creek, neighbourhood park, or vacant lot (Kellert, 2002) where the child is likely to encounter mostly native, wild species of plants, animals, and insects.

Kellert (2002) defines a child’s indirect experience of nature as involving actual physical contact but in more restricted, programmed, and managed contexts. Included here are examples of nature that are usually the product of deliberate and extensive human mastery and manipulation, such as animals, plants, and habitats encountered in zoos, aquariums, and botanical gardens (Kellert, 2002). Indirect experiences of nature also include domesticated species and habitats such as farm and companion animals (pets), vegetable gardens, and cultivated crops. As Kellert (2002) asserts these are all habitats and creatures dependent on (or the result of) extensive human intervention and control.

The final type of experience with nature described by Kellert (2002) is vicarious or symbolic experience. This is defined as ‘.representations or depicted scenes of nature that sometimes are realistic but that also, depending on circumstance, can be highly symbolic, metaphorical, or stylised characterisations’ (Kellert, 2002 p.119). This type of experience of nature has become more predominant in modern living through various technologies (such as books and other print media, radio, television, film, and computers) (Kellert, 2002). Yet, the depiction of the natural world through symbols is something that the human species has explored throughout our history, as supported by extensive archaeological and palaeontological evidence. Kellert (2002) argues that because humans have
symbolically experienced nature since ancient times this counters any inclination to treat vicarious experiences of nature as specific to modern humans. What has changed, however, is the proliferation of these images via technology and the mass media (Kellert, 2002). Furthermore, and perhaps more disconcerting is the concurrent decline in children’s direct experience with healthy and abundant natural systems’ (Kellert, 2002 p.120).

Some important research has been conducted on the potential effects of contact with nature on children’s health and wellbeing in a variety of contexts including the home and school environments. Wells and Evans (2003) examine the notion that nature might buffer or moderate the effects of stress or adversity in children living in rural upstate New York. Their research is part of a growing number of studies investigating children’s relationship with the natural environment and the potential for nature to positively influence child health. As Wells and Evans (2003) state, although some research has investigated the direct effects of nature on children’s functioning or wellbeing (e.g. Taylor, Kuo, and Sullivan, 2001; 2002; Wells, 2001; Taylor et al., 1998) very little work has investigated the potential for nature to buffer the effects of stress. Despite this, several studies have
demonstrated the positive effects of contact with nature on stress reduction and resilience to stress in adults (e.g. Parsons et al., 1998; Ulrich et al., 1991b).

Wells and Evans (2003) highlighted a number of studies demonstrating that
children have a preference for green natural settings. Included was a study by Moore (1986), who reported that 96% of urban children illustrated outdoor places when asked to make a map or drawing of all their favourite places. From this and other evidence, Wells and Evans (2003) state that it is reasonable to expect that green natural settings preferred by children would also have a beneficial effect on children’s wellbeing. In fact research in children has shown that children function better cognitively and emotionally in ‘green environments’ (i.e. those with higher amounts of vegetation) than those without (Taylor et al., 2001; Wells, 2000); have more creative play in ‘green areas’ (Taylor et al., 1998); and develop better interpersonal relationships and a more positive attitude to school (Crisp
and Aunger, 1998). Furthermore, other research has demonstrated that children have an abiding affiliation with nature, even in economically impoverished urban communities and across cultures (Kellert, 2002; Taylor et al., 1998; Kahn, 1997). Related work using companion animals and/or wilderness experiences to treat children and adolescents suffering from behavioural and/or psychological disorders has also indicated positive outcomes (Fawcett and Gullone, 2001; Ross, 1999; Crisp and Aunger, 1998; Beck and Katcher, 1996; Levinson, 1969).

Wells and Evans (2003) report however, that the majority of work investigating the beneficial effects of nature on children has been conducted since the mid- 1990s, and nearly all of this has been on children living in urban environments. Although this work is in the early stages there is significant incentive to explore the relationship that children have with the natural environment, and to look for ways this relationship can be used to maximise health and wellbeing. As Kellert (2002) writes, direct experience of nature plays a significant, vital, and perhaps irreplaceable role in affective, cognitive, and evaluative development but further study is needed.

Conclusion

As discussed above there are many ways of examining the human-nature
relationship, yet knowledge about our relationship with nature is still incomplete. Despite this, the importance of the natural environment is apparent across cultures and varying population groups. Overall, there is a strengthening perception that contact with nature is beneficial to adults and children alike, and is perhaps an antidote to health and wellbeing problems associated with an increasingly urbanised modern lifestyle. Some of the evidence is discussed in the following section titled ‘Health Benefits of Contact with Nature: The Evidence.’

Citation

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

activities at Glenhaven Park

Healthy parks, healthy people – Understanding the human-nature relationship, Part 2

Spirituality, religion and nature

A symposium held in 1990 titled ‘Spirit and Nature: Religion, Ethics and the
Environmental Crisis’ brought together speakers from Buddhist, Christian, Islamic, Jewish, Native American, and liberal democratic traditions to discuss why the environmental crisis is fundamentally a moral and religious problem (Rockefeller and Elder, 1992). Its purpose was to foster ways of living that promote sustainable development, and to join scientific understanding with life-affirming, and world-affirming moral and religious values (Rockefeller and Elder, 1992). In the introduction to the published proceedings, Rockefeller and Elder (1992) state that the great issue for the 1990s and the twenty-first century is to channel the freedom and power modern humanity has acquired into new creative directions by spiritual awareness and a moral commitment that transcends, among other things, the dualism between human culture and nature.

Conversely, the original teachings of most world religions including Judaism, Christianity, Islam, and Hinduism are based on a deep reverence for nature, and a profound understanding of the relationship between humans and the natural world around them (Suzuki, 1997). For example, in classical Islamic thought, the Koran (or Quran) does not regard humans and nature, or the natural and the supernatural, as separate from one another but as an integral part of the same universe, ‘sharing in its earthly life and also in its ultimate destiny’ (Nasr, 1992). Malinski (2004 p. 92) puts it this way:

Experiencing wholeness and unity with all living beings and the natural
environment, finding meaning and purpose in living and dying, transforming, and transcending, such are the hallmarks of spirituality. Spirituality is a unitive experience, without boundaries or divisions.

Suzuki (1997) claims, however, that most religions have changed their beliefs over time to consider the individual as an entity separate from family, clan, and nature. As a result, people are increasingly finding themselves alienated from their cultural and natural surroundings.

Every worldview of indigenous humans describes a universe in which everything is connected with everything else: stars, clouds, forests, oceans, and human beings are interconnected components of a single system in which nothing can exist in isolation (Suzuki, 1997). Indigenous cultures around the world regard nature as the realm of the spirit and the sacred; the natural world is seen as inherently spiritual, and humans are seen as an integral part of it (Metzner, 1995). From this perspective follows an attitude of respect, and an instinctive understanding of the need to consider future generations and the future health of our ecosystem; in other words, a sustainable approach to life and health (Metzner, 1995).

A study on health promotion and illness prevention in Chinese elders revealed that the elders believed conformity with nature was the key to health and wellness (Yeou- Lan, 1996). This comes from the teachings of Taoism, Confucianism, and Buddhism, which emphasise harmony with nature, simplicity, and love as the way to achieve ‘ultimate wellbeing’ (Yeou-Lan, 1996). The study by Yeou-Lan (1996) defined nature as all things and events that surround an individual, such as air, mountains, plants, animals, people, society, and belief in a higher force, identified as ‘Supreme Nature’.
To conform with nature, Chinese spirituality requires three interrelating categories: harmonising with the environment, following bliss, and ‘listening to heaven’ (Yeou- Lan, 1996). Harmonising with the environment is the process of allowing oneself to gain access to experience of, interact with, and be aware of nature. In agreement with recent findings (e.g. by Parsons et al., 1998; Ulrich et al., 1991b; Kaplan and Kaplan, 1989), the Chinese elders believed that exposure to natural scenes gave them peace of mind, and promoted health and wellbeing (Yeou-Lan, 1996).

The 14th Dalai Lama refers to the Buddhist understanding of interdependence in order to understand the human relationship with nature (Gyatso, 1992). This principle essentially implies the interdependence of all life, matter, and consciousness, as well as the interdependence between causes and conditions (Gyatso, 1992). This is practised also by the Australian Aborigines, who believe that each person is not only the offspring of their physical parents, but also that they are in some essential way a spirit of the land with an eternal and intimate connection with it (Kingsley, 1995 in Suzuki, 1997). This connectedness of people to country and kin (both present relatives and ancestors), to that which is outside of time, is integral to the Aboriginal sense of wellbeing (Anderson, 1996), and it implies that when harm is done to the land or to people, the other is adversely affected. Leal (2004 p. 93), reflecting on the Australian Indigenous belief in a ‘creator Spirit ^located not in a remote heaven above but deep in the earth’, states that ‘such a conception immediately confers on the earth and its contents a value inaccessible to the dualistic thinking of the Western mind. It spiritualises the earth and serves to explain why access to land is of such overriding importance to the
Aboriginal people’. It is this concept of a creator Spirit which is expressed in the totems and creation stories that typify Australian Indigenous culture (Isaacs, 2005; Indigenous Law Research, Reconciliation and Social Justice Library, n.d.).

Traditionally, Hindu theology reflects similar attitudes to those expressed within ‘traditional Chinese and Aboriginal views and practices’ (Coward, 1997 p. 50). The Hindu belief in non-violence reflects the belief that ‘humans, along with everything else in nature, are but a part’ of God’s creation (Coward p. 50). This philosophy underpins the ecological orientation of Hinduism, which is set out in a key Hindu scripture, the Bhagavad Gita (Coward p.56). Reflecting on the tsunami of December 2004, Vandana Shiva reminds us of this traditional Hindu belief, stating: ‘The tsunami reminds us we are not mere consumers in a marketplace driven by profits: we are fragile, interconnected beings inhabiting a fragile planet. The tsunami reminds us that we are all interconnected through the earth’ (Shiva, 2005 p. 24).

school trip

In a similar vein, Wilson (1992) observes that humans have forgotten how much the natural world means to them. Yet, as Wilson (1992) states, signals abound that the loss of life’s diversity endangers not just the body but also the spirit. If that much is true, the changes occurring now will visit harm on all generations to come (Wilson 1992). It has been reported that modern people are experiencing a spiritual famine. Alcohol, food, and drug addictions are futile attempts to fill the spiritual emptiness that has arisen from loss of contact with nature (Nasr, 1968; Glendinning, 1995; Canadian Parks/Recreation Association, 1997). Along a similar line of thought, Metzner (1995) states that human beings have forgotten how to empathise and identify with non-human life, have lost respect for the mysterious, and lack humility in the relationship to the infinite complexities of the natural world (Metzner, 1995). Shiva (2005 p. 24) concurs, stating: ‘Above all, it [the tsunami] brings a message of humility: that in the face of nature’s fury, we are powerless. The tsunami calls on us to give up arrogance and to recognise our fragility’. The evidence irrefutably demonstrates that both the cultural and natural history of the human species is entirely based upon an intimate relationship with, understanding of, and respect for the natural world. Recognising and respecting worldviews and spiritual practices that are based on oneness with nature, and searching for similarities in the dominant religions is, according to Metzner (1995) perhaps the best antidote to ‘the West’s fixation on the life-destroying disassociation between
spirit and nature’. Similarly, Nasr (1992) states that to rediscover the spirit in oneself and then see its reflection in nature is essential to reverse the humanity’s current destructive attitude towards the natural environment.

A small study conducted on a random sample of residents in New York also
demonstrates the spiritual effect that nature can have on people. The study by Mausner (1996) revealed that respondents viewed themselves as separate from nature, but felt ‘compelled to re-insert themselves’. The author interpreted this yearning for reintegration with nature as a reaction to the separation from the natural world deeply ingrained in Western culture (Mausner, 1996). When the respondents were in natural environments, they claimed to be more perceptive of their surroundings, to have an increased awareness of themselves, to feel at one with the world, and simultaneously detached from the people in their everyday lives (Mausner, 1996). Mausner (1996) concluded that the experience of being in
nature appeared to give people the opportunity to transcend the fundamental dualism of people vs. nature. To understand the human relationship with nature by looking to traditions of spirituality and religion confirms that by harming nature, humans harm themselves.

There is no doubt that nature can evoke powerful responses in people, and can sometimes be responsible for life-changing experiences. Katcher and Beck (1987) describe one such response: ‘.. .[it] generated a feeling of being intact, complete, as if the solid distinct otherness of that natural world had acted as a mirror reflecting myself back to myself. That sense of being intact and comfortable in myself crystallized precisely at the moment when the sense of being a separate self was lost in contemplation’ (page 175). A second example concerns the Stein Valley Festival held in Lytton, British Columbia, which celebrates the physical and spiritual values of the Stein Valley. When two young American Indian men were asked independently describe what the Stein meant to them they both described the valley in terms of a church or a cathedral where they could go to find spiritual
sustenance and restoration (Suzuki 1990).

Although not always formally ‘religious’, many manifestations of modern
environmentalism and the ‘eco-protest lifestyle’ (Letcher, 2002 p. 81) reflect
aspects of spirituality and/or religion. Taylor (2001 p. 175) observes that ‘although participants in countercultural movements often eschew the label religion, these are religious movements, in which these persons find ultimate meaning and transformative power in nature’. Lecher (p. 81), reflecting on the British anti- road protests of the 1990s, comments ‘whilst the actions, and direct-action, of protesters may not always appear outwardly to be religious, many protesters are motivated by their religious convictions such as the paramount belief in the sanctity of nature’. Lecher refers to this religious belief as ‘Eco-Paganism’.

Ethnicity and nature

According to the theory of biophilia, when given a choice people of all cultures should prefer natural environments to urban ones. Newell (1997) studied the favourite places of subjects from Senegal, Ireland, and the United States for cross-cultural comparison of environmental preferences. Participants were asked to identify their favourite place an d give the reason it was chosen, the aim being to test whether people from different cultures shared a preference for certain environments or features, including both built and natural environments. Sixty-one percent of participants identified a part of the natural environment as their favourite place, and across all countries the reasons given were ‘relaxation’ or ‘to recharge’, ‘safety’, or ecological reasons (Newell, 1997). This indicates that across the human population there is a preference for natural environments, regardless of nationality or culture. This clearly supports the
hypothesis of biophilia (Newell, 1997).

Another good example of cross-cultural preferences for nature is the universal attraction humans have for water bodies (Wilson, 1984; Ulrich, 1993; Kellert, 1997; Williams, 1999). Ulrich (1993) proposes that this attraction for water has genetic component tied closely to human evolution, as it signalled the presence or likelihood of finding two survival necessities: water and food. Also, Williams (1999) believes that the general attraction Western cultures have for water is because of a healing or therapeutic meaning assigned to it, dating back to classical Greek and Roman times where water bodies were renowned for their healing powers. Evidence
for this in modern times can be seen in the popularity (and real estate value) of houses built overlooking water. Evidence for the international appeal of water bodies can also be seen in the high volume of tourists and pilgrims who travel each year to rivers, lakes, and beaches at various significant sites around the globe.

However, there are of course different cultural interpretations of what ‘nature’ is, and different ethnic groups relate to nature and natural environments in different ways. In commenting about how people of varying characteristics, including ethnicity, relate to parks and natural environments, Brun (2001, p.20) states that different groups relate to the same place with different meanings, uses and values. These are differences that may give rise to various tensions and conflicts over the use of places.’ Ewert and Kessler (1996 p. 273) highlight the example of indigenous communities which (because they ‘participate in a natural ecosystem as part of their daily lives’) may relate to the natural environment in quite a different way when compared with people who only ‘visit’ a natural environment. Ewert and Kessler (p. 273-4) go on to say: ‘The ecosystem is more than a physical setting for these communities; it is the support system that sustains people physically, culturally, and spiritually.’

Glenhaven Park June 2018

Virden and Walker (1999) studied how ethnicity and gender are related to affective meanings attached to the natural environment and how they might influence preferences for environmental settings in outdoor recreation by surveying African-American, Hispanic and White university students in the United States (for the discussion on gender refer to the section entitled ‘Gender, Nature and Health’ below). Their findings showed that White participants considered a forest environment more pleasing and safer than did African-American or Hispanic participants (Virden and Walker, 1999). African-American participants viewed the forest as more ‘annoying’, and both African-American and Hispanic participants considered the forest as ‘threatening’. The authors discuss a number of explanations for these findings, including that African-American and Hispanic participants had lesser amounts of outdoor childhood experience than Whites, which may have influenced their perceptions of nature and natural environments (Virden and Walker, 1999). Drawing on the literature, Virden and Walker (1999) also discuss the possibility that African-Americans and Hispanics are apprehensive about forest environments because of their perception of experiencing unpleasant encounters with other humans. However, their findings may not be applicable to the broader population because the sample was limited to university students (Ho et al., 2005). Nonetheless, they contribute some interesting data to the exploration of ethnicity and nature, an aspect of human-nature relationship that is understudied.

Culturally, due to their early European ancestry (influenced by Judeo-Christian tradition), American Whites are predisposed to perceive forests or wilderness areas as symbolising freedom, as places of refuge, or as places to test oneself (Nash, 1982 in Virden and Walker, 1999). This indicates there is a strong sense of ownership of these environments in those from a White ethnic background. Conversely, due to the historical suppression of, and discrimination against, those from ethnic backgrounds other than White (Ho et al., 2005; Shinew et al., 2004), forests may be considered by non-Whites as environments that are controlled by Whites and are therefore perceived to be potentially unsafe. Virden and Walker (1999) explain that the perceived freedom of wilderness areas may actually imply a lack of social structure, and therefore it is not surprising that members of African-American and Hispanic ethnic groups may find forest environments to be more threatening than their White counterparts. Martin (2004) however, investigated the concept of a racialised outdoor leisure identity in magazine advertisements. He found that the ‘great outdoors’ is socially constructed as a White space, and that African- American models rarely appeared in advertisements for wilderness leisure experiences and are instead confined to urban and suburban environments. Martin (2004) discusses three consequences of this, including: the stereotype that African-American Americans do not participate in wilderness recreation may become a self-fulfilling prophecy; if wilderness areas are perceived as a ‘White space’ some African-Americans may not participate to avoid a perceived or real increase in the likelihood of discrimination; and lastly, that some African-
Americans may internalise the notion that wilderness recreation is White leisure and therefore avoid participation because of a conflict with their own racial identity and/or they may fear ostracism by other Blacks.

Shinew et al. (2004) tested whether community gardens in urban settings could be perceived as spaces in which people of different ethnicities, in this case those from either an African-American or a White background, can successfully relate. Although further investigation is warranted, their findings showed that majority of African-American and White gardeners felt connected to their community garden and believed that community gardening brought people of different ethnicities, who would not normally socialise, together (Shinew et al., 2004). Compared to the negative connotations of forest and wilderness environments described above, community gardens may be perceived by ethnic groups other than White (particularly African-Americans) as unbiased (Shinew et al., 2004), making them ideal environments for fostering positive interactions among people of varying ethnicities as well as a means to build community in urban/ suburban environments.

activities at Glenhaven Park
rope courses

Community gardening is also a means of building community and enhancing the individual wellbeing of newly arrived migrants. Wong (1997, in Rohde and Kendle, 1997) described the outcomes of a community garden for migrants as: increased sense of identity and ownership of the country they live in; sense of integration rather than isolation; a reunion with nature (i.e. particularly important for first generation immigrants who have rural backgrounds); the reawakening of a sense of possibility; restoration and a relief from daily struggles; and empowerment, skill development and the enabling of opportunity to participate in caring for the environment.

Ravenscroft and Markwell (2000) highlight the potential of parks and open spaces to bring together people of varying social, cultural and ethnic backgrounds. They refer to Carr et al. (1992, p. 10) who note that ‘… successful multicultural spaces add to the richness of the city as a learning environment and give hope to the … dream of cultural integration, or at the very least, cultural understanding.’ Hence, by bringing people in contact with one another, natural environments could be used as means of breaking down racial barriers, or facilitating cooperation and communication between different groups.

In terms of preferences for, and perceptions of, parks and other natural
environments by people from varied ethnicities, Ho et al. (2005) studied people from African-American, Hispanic, Chinese-American, Japanese-American, and Korean-American backgrounds and their use of urban parklands. Although some differences were found in relation to preferences about facilities (refer to Ho et al., 2005 for explanation), there was widespread agreement amongst participants that urban parks and open spaces provided important benefits including improving overall health, increasing social and spiritual wellbeing, and enhancing environmental quality.

In general there is still more research needed on how people of different
ethnicities perceive nature and natural environments, how these perceptions influence their use of these areas, and lastly, their perceptions of the potential benefits and outcomes of contact with nature. On this note, Driver et al. (1996) comment that managers of parks and other open spaces must work towards a fuller understanding of the needs and values of an increasingly ‘multicultural citizenry’.

Citation

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

Healthy parks, healthy people – Understanding the human-nature relationship, Part 1

Introduction

To realise the potential benefits to human health and wellbeing to be gained from interacting with nature, it is important to understand how and why humans relate to nature. The simplest explanation is that humans are part of nature, but more often than not, modern thinking views human beings as separate from, or even above nature, despite our obvious animal status. Although the concept of nature as a human construct is subject to debate and often leads to philosophical, ‘chicken and egg’ type arguments, these are not applicable here.

Generated from numerous disciplines exploring the human relationship with nature (including religion) are a number of theories to explain: why humans interact with nature the way they do; the effect nature has on the human psyche, spirit, and wellbeing; the effect that humans have on the biosphere (both positive and negative); and how this in turn effects human society (particularly human health and wellbeing). This section briefly examines some of these theories and reviews their application in research undertaken on some different population groups.

Biophilia

The Biophilia Hypothesis was developed by Harvard biologist Edward O. Wilson (Wilson, 1984) and has been expanded and debated by Wilson and numerous others (e.g. Gullone, 2000; Fawcett and Gullone, 2001; Takacs, 1996; Kellert, 1993; Kellert and Wilson, 1993; Wilson, 1993; Wilson, 1984). The Hypothesis is based on the assertion that early in human history there was an evolutionary advantage in knowing about the natural world, particularly information concerning plants and animals, and that this knowledge contributed to survival (Kellert, 1997). The essential aspect of biophilia, however, is that apart from knowledge, attraction and respect for nature also contributed to survival (Kellert, 1997). Kellert (1997) believes that an affiliation for nature addresses innate psychological needs such as intellectual capacity, emotional bonding, aesthetic attraction, creativity and imagination that are a product of our evolution and otherwise not easy to
satisfy (Kellert, 1997). It is believed by some that these innate psychological and neurological needs are mismatched with the results of technological progress (Suzuki, 1997; Glendinning, 1995; Lewis, 1996; Gullone, 2000). This notion is not new, and has been expressed by authors as early as 4,600 years ago (Benson, 1976). Advocates of biophilia believe that humans evolved in the company of other living organisms and in a matrix of conditions making human existence possible, and that we continue to rely intellectually, emotionally, physically, and spiritually on our affiliations with nature (Kellert, 1997; Suzuki, 1997; Gullone, 2000; Kellert, 1993). According to the theory therefore, biophilia is: inherent; part of the human
species’ evolutionary heritage; associated with increased chances of urvival via genetic fitness; likely to increase the possibility for achieving meaning in life and personal fulfilment; and a self-interested basis for the care and conservation of nature (especially biodiversity) (Kellert and Wilson, 1993).

Although still in the process of being explored, the biophilia hypothesis is not a romanticised idealisation of nature (Kellert and Wilson, 1993). In fact, multidisciplinary teams of researchers have formed over the past decade or two to support and explore this notion further (Takacs, 1996) and it is now gaining wider acceptance in the scientific community. Suzuki (1997) states that biophilia provides us with a conceptual framework through which human behaviour can be examined, and that it appears to be scientifically verifiable that human beings have a profound need for an intimate bond with the natural world. Evidence for biophilia is slowly building, as shown in some of research findings included in this review.

Wilson (1984) and others (Gullone, 2000; Kellert, 1997) believe that modern
city-dwelling humans still possess this innate tendency to associate with nature (although, they admit, it is more evident in some people than others) and that in modern times it has the potential to give meaning to human life and development, and result in greater health and wellbeing. As Wilson (1993) states, human history began hundreds of thousands or millions of years ago with the evolution of the genus Homo and for more than 99 percent of our history we have lived totally involved with other organisms. Only in the very recent part of human history has the delusion arisen that people can flourish apart from the rest of the living world (Kellert, 1997; Wilson, 1992). Unfortunately, this could prove to be to our detriment. Satisfying our affinity with the natural world, however, may be an effective way to reverse this trend and enhance health (as well as being cheaper and freer of side effects than medication) (Frumkin, 2001). If so, then medicine and other professions will need to articulate a broad vision of environmental health, one that encompasses many disciplines (Frumkin, 2001) and adopts holistic or ecological approach to health.

The modern environmental crisis has been viewed as symptomatic fundamental rupture of the human emotional and spiritual relationship with the natural world (Kellert and Wilson, 1993). Biophilia urges researchers to address the question of what will happen to the human psyche when the natural environment, such a defining part of human evolutionary experience, diminishes or disappears.

Human ecology

The fact that there may be a biophilic basis for the adaptive responses humans have for certain natural stimuli is being used to explain both positive/approach (biophilic) responses and negative/avoidance (biophobic) responses that people have to nature (Ulrich, 1993). It is likely that a predisposition in early humans for biophilic or biophobic responses to certain natural elements and settings contributed to chance of survival (genetic fitness) (Ulrich, 1993). Examples of this include the virtually universal attraction humans have for the round faces and large eyes of infant animals (including humans), and the widespread fear of snakes and spiders (Kellert and Wilson, 1993; Ulrich, 1993).

In animals, choice of habitat exerts a powerful influence on survival and
reproductive success, so behavioural mechanisms involved in habitat selection in humans would have been under strong selection pressure for millennia (Orians, 1986). In all organisms habitat selection presumably involves emotional responses to key features of the environment that produce ‘positive’ or ‘negative’ feelings leading to settling or rejection in a particular place (Orians, 1986). Parsons (1991) suggests that the process of habitat selection is also associated with triggering certain physiological processes that influence the immune system and affect physical wellbeing. These physiological responses are concerned with the release of hormones, which can impair or enhance immunity and cardiovascular function (Parsons, 1991). A positive response to an environmental feature presumably also has a positive effect on physiological state, and a negative response has a negative effect. If this is so, the ability of a habitat to evoke such emotional states should be positively associated with survival and reproductive success of an organism in that habitat (Orians, 1986).

Modern urban environments differ considerably from the natural habitats that have been the home of humans for thousands of years. As humans have lived in cities for relatively few generations it is most likely that adaptation to this environment has not yet occurred, and humans are still dictated by habitat preferences formed by their ancestry (Kellert, 1997; Kellert and Wilson, 1993; Heerwagen and Orians, 1993).

Parsons (1991) considers the stress associated with urban living a direct result of the unsuitability of urban environments as optimum habitat for humans. The features of urban living known to induce stress include crowding, noise, air pollution, and traffic. As mentioned, some authors believe that time spent solely in urban environments is detrimental to human health and wellbeing (Stilgoe, 2001). Although they may not elicit a full-blown stress response once acclimatised to, these features could produce slight elevations in stress hormones which compromise immunocompetence and cardiovascular functioning, resulting in deleterious health effects over time (Rohde and Kendle, 1994; Parsons, 1991).

Biohistory

Stephen Boyden has merged human culture with natural history (or the study of nature, society, and history) in the field of ‘biohistory’, which reflects the broad sequence of events in the history of the biosphere and of human civilisation, from the beginning of life to the present day (Boyden, 1999; Boyden, 1992). Among other aspects of evolution and human history, biohistory pays particular attention to the changing patterns of interplay between cultural and biophysical systems, or the interplay between culture and nature (Boyden, 1992). Biohistory considers human culture as an ecological force, due to its ability to shape the natural world and alter ecological processes. Boyden (1999) asserts that it is impossible to overstate the ecological and health potential of human beliefs, knowledge, and ideas.

Biohistory aims to improve understanding of the human situation and the human place in the natural world by examining interactions between biological and cultural processes (Boyden, 1992). Three important aspects identified by Boyden (1992) are:
• Humans are totally dependent for sustenance, health and wellbeing, and enjoyment of life on the biosphere, and all products of culture are negligible if biologically determined health requirements of the biosphere and of human bodies are not met;
• Every human situation from individuals to societies involves continual
interplay between biological and cultural elements, the effects of which
influence human health and wellbeing, and/or the health of ecosystems on
which humans depend;
• Human culture has influenced biological processes on which humans
depend, and of which they are a part, and although some of these influences are beneficial, others are detrimental and threaten the survival of the human species.

Aspects of culture that have detrimental effects on the environment and/or on human health and wellbeing are referred to as ‘cultural maladaptations’ (Boyden, 1999; 2001). Some of the central assumptions of Western culture that result in cultural arrangements and human activities that are ecologically unsustainable are examples of cultural maladaptations. A more specific example is the current pattern of unsustainable resource/energy use and waste generation and its detrimental effects on the environment and human health. Although cultural maladaptations have been present throughout the history of human culture and civilisation, an essential difference between the past and the present is in the scale of the consequences (Boyden, 1999). The consequences of current cultural maladaptations for the biosphere and human health will potentially
be catastrophic due to the degree and extent that humans now dominate
the environment. Boyden (1999) believes that in order to divert catastrophe, significant cultural reform in the dominant cultures of global society is required: nature once again should be placed at the centre of human culture. In order to achieve this reform, Boyden (1992) states that biohistory should become part of the educational curriculum, and should be used as a framework for integrative research on human situations (particularly health and wellbeing) to achieve wise policy formulation and decision-making. But as well as including biohistory in formal education, Boyden (2001 p. 113) also highlighted the need for broader community education, through ‘places for people who share enthusiasm and respect for the natural…and who care about the health and well-being of human-
kind and of the rest of the living world’ to gather. Such ‘biocentres’ will, according to Boyden (2001 p. 114) ‘provide a new framework for constructive collaboration between community groups, scientific bodies, businesses, schools and other organizations’. In Boyden’s view, ‘the attainment of a truly sustainable, healthy, equitable and peaceful society’ is only achievable if a biohistorical perspective becomes a central feature of cultures (Boyden, 2001 p. 115).

Citation

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

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
festivals
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.

Citation

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

Healthy parks, healthy people – The future of public health

The future of public health

An ecological (or holistic) approach to health encompasses the health of the
whole individual and their environment, and in fact, the whole community. This approach is a logical way of managing health as it accounts for the interplay between all of the elements of health (i.e. mental, physical, environmental, spiritual, social), which can impact either negatively or positively on one another. Yet, more research is required to understand these interrelationships.

As stated by the Australian Institute of Health and Welfare (1998; 2000), national health information is needed by consumers and providers of health services, the health industry, governments, and the community to enable informed decision- making and ensure effectiveness of treatments and interventions. National health information is any information that has national relevance and relates to the health of the whole population, the determinants of population health, health programs or services, and the relationship among these elements (Australian Institute of Health and Welfare, 1998). According to these criteria, the health benefits of contact with nature should be regarded as national health information and be thoroughly investigated. In particular, the health benefits of parks should
have priority as parks constitute public-owned nature, and therefore have more significance nationally.


The initial evidence documenting the positive effects of nature on blood
pressure, cholesterol, outlook on life and stress-reduction is sufficient to warrant incorporation into strategies for the National Health Priority Areas of Mental Health, and Cardiovascular Disease in particular. These two disease categories place a considerable health and economic burden on Australians. However, due to the positive effects of nature on overall health and wellbeing, the health benefits of contact with nature have relevance to all National Health Priority Areas. The extent to which parks can contribute to these areas awaits investigation.

Citation

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

Healthy parks, healthy people – Current Australian public health priorities

Current Australian public health priorities

A collaborative effort involving the Australian Government as well as State and Territory governments has identified the following Australian National Health Priority Areas: Cancer Control, Injury Prevention and Control, Cardiovascular Health, Diabetes mellitus, Mental Health, Asthma, Arthritis and Musculoskeletal Conditions (Australian Institute of Health and Welfare, 2005). Most relevant to parks and nature are Cardiovascular Health and Mental Health. There is, however, considerable overlap between all of the Priority Areas in terms of risk factors and barriers to better prevention. Hence, initiatives targeting risk factors and barriers will bring benefits across all Priority Areas (Commonwealth Department of Health and Aged Care and Australian Institute of Health and Welfare, 1999).

Cardiovascular health

Cardiovascular disease is a major health and economic burden for Australia, and is the country’s greatest health problem (Australian Institute of Health and Welfare, 2000). Recent estimates of annual costs to the health system were at AUD$3.7 billion, accounting for approximately 40% of deaths in 1998 (Australian Institute of Health and Welfare, 2000). Risks of developing the disease are associated with factors including high blood cholesterol, high blood pressure, physical inactivity, obesity, excess alcohol, and smoking (Australian Institute of Health and Welfare, 1998).

Aside from family history, lifestyle greatly influences cardiovascular health. Through adequate education and health promotion, the burden of this disease to individuals and the community could be dramatically reduced. Although campaigns addressing smoking, physical activity, cholesterol, and alcohol consumption are already in place, they could be supplemented by the promotion of the health and wellbeing benefits arising from exposure to nature through visiting a park, interacting with pets, gardening, habitat restoration, or simply contemplating a natural view.

As a result of public awareness, walking for recreation or exercise has increased with 44.9% of men and 53.3% of women reporting walking in 1995, compared with 41% and 49% respectively in 1989-90 (Australian Institute of Health and Welfare, 2000). Through raising public awareness (i.e. via health education and promotion) the same sort of result is possible for the health benefits of contact with nature. There is a synergy between these two outcomes, as recent research has indicated that the availability of parks and high quality public open spaces is associated with increased levels of walking (Giles-Corti and Donovan 2002; Giles-Corti et al. 2005; Mowen et al. 2007).

In fact, if promoted successfully, the health benefits of nature combine with the health benefits of physical activity could be brought together in a joint public campaign. There has been little recent improvement in physical activity levels despite a decline in coronary heart disease, and an increasing percentage of population is becoming overweight (especially children) (Australian Institute of Health and Welfare, 2000). This highlights the pressing nature of this health issue.

Mental health

The Mental Health Priority Area focuses primarily on depression. This is due, firstly, to predictions that depressive disorders will constitute the largest share of the burden of disease in the developing world and the second largest worldwide by 2020, and secondly because it imposes such high social and financial costs on society (Commonwealth Department of Health and Aged Care and Australian Institute of Health and Welfare, 1999). For example, 8.3% of total annual health system expenditure in Australia in 1993-94 was on mental disorders (AUD$2.58 billion) (Australian Institute of Health and Welfare, 2000). The World Bank and the World Health Organization, however, have predicted that by the year 2020 the health burden worldwide attributed to neuropsychiatric disorders could increase by about 50%, from 10.5% of the total burden to almost 15% in the year 2020 (Commonwealth Department of Health and Aged Care and Australian Institute of Health and Welfare, 1999). In an earlier report, Desjarlais et al. (1995) state that mental, behavioural and social health problems are becoming an increasing part of the health burden in all parts of the world. One of the reasons for this is the increase in average life expectancy and the occurrence of an ageing population in developed nations (Desjarlais et al., 1995). But, mental illnesses are also becoming more prevalent in young people and at younger ages (Raphael and Martinek, 1996). This is related to a number of social, ecological and technological processes, including: the polarities of high levels of urbanisation, crowding and social isolation; globalisation of economies, communication and information; human,
social, and economic epidemics related to depression, substance abuse and violence (Raphael and Martinek, 1996); the break-up of families; and perhaps an almost complete disconnection from the natural world (Roszak et al., 1995).

As many depressive symptoms and disorders are treatable as well as preventable, improvements in mental health promotion activities, prevention, and early intervention are likely to have a major impact on the level of depressive symptoms and disorders prevalent in the Australian community (Commonwealth Department of Health and Aged Care and Australian Institute of Health and Welfare, 1999). Furthermore, depressive symptoms and disorders are related to other disorders both mental and physical, including cardiovascular disease (Commonwealth Department of Health and Aged Care and Australian Institute of Health and Welfare, 1999; Hippisley-Fox et al., 1998), potentially magnifying human suffering and adding further costs to the health care system. Hence, effective prevention and treatment targeted at depression is likely to have a much wider impact on individual and community health. It is imperative, however, that action is taken now.

The Commonwealth Department of Health and Aged Care and the Australian Institute of Health and Welfare (1999) state that interventions to impact upon depression are possible across the entire continuum of health care, from promotion, prevention and early intervention, through to treatment and maintenance care. While the effectiveness of many promotion and prevention activities is yet to be demonstrated, interventions that improve people’s mental health literacy, optimistic outlook, resilience to life stress, and social support appear to be helpful (Commonwealth Department of Health and Aged Care and Australian Institute of Health and Welfare, 1999). It is here that parks and contact with nature could have the most impact, particularly in terms of facilitating a more optimistic or positive attitude, enhancing social support (via improvements in social capital), reducing stress and tension, and by providing opportunities for physical exercise.

Physical activity has recently been proved to be equally effective as medication in the treatment of depression in elderly people (Blumenthal et al., 1999). Blumenthal et al. (1999) compared the occurrence of depression in people undertaking indoor aerobic exercise, being treated with antidepressants, or a combination of both. At the end of a four month trial, approximately 65% of patients in all groups had experienced such a reduction in clinical symptoms that they were no longer classified as clinically depressed (Blumenthal et al., 1999). Recent research has investigated the effects on depression and overall mental health of exercising outside in a nature-based setting, such as a park—termed ‘green exercise’. Pretty et al. (2005), reporting on a study involving simulated green exercise (exercise on a treadmill while exposed to photographs of green spaces compared with other spaces), found that green exercise appears to have benefits both for cardiovascular health and mental health. A subsequent study by Peacock, Hine and Pretty (2007) compared exercising outdoors (in a ‘Country Park’) and exercising indoors (in a shopping centre). In comparison to the indoor exercise, the outdoor exercise was found to have more positive outcomes in terms of mood, and to be associated with an increase in the level of vigour or energy.

The term ‘ecotherapy’ has been used to describe the intentional use of nature in a therapeutic way. It involves not simply a two-way relationship between individual and nature (which is often the case in ‘green exercise’), but a three- way relationship between individual, therapist and nature, in which nature plays an active rather than passive role (Burls 2007). Both mental and physical health benefits have been found to flow from this relationship.

Mental health is much more than the absence of mental illness: it is the realisation of one’s potential and the capacity of individuals and groups to interact with one another and the environment in ways that promote wellbeing, and optimise development (Commonwealth Department of Health and Aged Care and Australian Institute of Health and Welfare, 1999). The positive influence that parks could have in terms of mental health presents many exciting opportunities for dovetailing the agendas of local and state governments in terms of health promotion and the use of parks. A recent project undertaken in Australia, involving people experiencing depression, anxiety and/or social isolation taking part in hands-on environmental activities in a park environment, demonstrated positive benefits in terms of mood (Townsend and Ebden 2006). Further work, however, is required to determine the risk factors (environmental, social, biological and psychological) associated with mental illness as well as factors that act in a protective manner (e.g. social support, optimism). Additionally, environments such as parks that enhance mental health need to be investigated
further in residential, educational, workplace, community and social settings (Commonwealth Department of Health and Aged Care and Australian Institute of Health and Welfare, 1999).

Citation

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

Healthy parks, healthy people – Public health and nature

What is health and how is it determined?


Health is one of life’s most valued assets. Practically all people have it in their ‘top three’ of important life factors. In the 5th Century B.C., a Greek statesman by the name of Pericles stated that ‘Health is that state of moral, mental, and physical wellbeing that enables a person to face any crisis in life with the utmost grace and facility’ (Burn, 1956). However, it is only through research carried out in the latter half of the 20th Century that society has discovered the factors that enhance health. Current theories of disease have become more complex and moved away from single cause explanations to ones in which multiple behavioural, environmental, biological and genetic factors combine over time, resulting in one or more of a number of different diseases (House et al., 1988).

The World Health Organization (WHO) states health is ‘A state of complete physical, mental, and social wellbeing, and not merely the absence of disease or infirmity’ (World Health Organization, 1946). The word ‘health’ is derived from the Greek word ‘hal’ or whole. It is this holistic perspective of health which has emerged in the last 50 years. Nevertheless, it is not possible in reality to achieve the WHO goal. Rene Dubos stated, ‘The concept of perfect and positive health is a utopian creation of the human mind. It cannot become reality because man will never be so perfectly adapted to his environment…It is true that the modern ways of life are creating disease that either did not exist a few decades ago or are now more common than in the past…The utopia of positive health [however] constitutes a creative force because like other ideals, it sets goals and helps medical science to chart its course towards them’ (Dubos, 1965 p. 346).

Dubos (1965) was one of the first to explore the interconnections of humans with their environment. Since that time, there has been a great deal of research and the development of models and frameworks about the different factors that shape human life and human health and wellbeing. The physical environment is one of these. Nevertheless, the reductionist approach which has characterised modern science is seen as undermining the capacity to adopt the holistic view which is required to understand and foster optimal outcomes both for humans and the planet.


The Canadian Government produced a major report in 1974, which examined ‘The Health Field Concept’ (Lalonde, 1974). It identified four key factors that shaped people’s health: genetics; the environments in which they live; lifestyle behaviours; and the provision and accessibility of medical services (Lalonde, 1974). Since that time a major shift has occurred in how health is viewed. It is often called ‘an ecological theory of public health’ and has emanated from such writers as Kickbusch (Kickbusch, 1989a), Antonovsky (Antonovsky, 1984), WHO (World Health Organization, 1986), and recently, the World Bank (Murray and Lopez, 1996). Put simply, it is the recognition that health is influenced by many factors and most of them are interrelated.

Hancock and Perkins (1985) mapped this ecological perspective in their Mandala of Health. Their model shows that there are three core aspects of health, namely physical, mental, and spiritual, and the various factors that influence these (Figure 1).

 Figure 1: The Mandala of Health developed by Trevor Hancock and Fran Perkins  (Hancock and Perkins, 1985)
Figure 1: The Mandala of Health developed by Trevor Hancock and Fran Perkins (Hancock and Perkins, 1985)

In industrialised countries chronic disease has increasingly replaced acute infectious disease as the major cause of disability and death (House et al., 1988). These types of afflictions are often long-term and are potentially much more expensive in terms of health care requirements and cost to the community. Some of the health problems facing society include: disease patterns linked to social inequities and ways of life in industrial societies; health problems that are social rather than medical in nature; health problems that tend to be cumulative, longterm, chronic and not amenable to curative measures; and a general public that is changing its social perception of health risks and is expressing new expectations (Kickbusch, 1989b). In Australia, the Commonwealth and State Governments have been proactive in developing frameworks, strategies, priorities, and tactics to improve people’s quality of life and their longevity. It is often referred to as ‘adding years to life and life to years’.

The establishment of Health Promotion and Development Foundations has been just one example of government initiatives. There is now a greater emphasis on working ‘upstream’ (to prevent people ‘falling into’ ill health), than just supplying ‘downstream’ (rescue) services (e.g. medical treatment and rehabilitation). The work done in cardiovascular disease (CVD) prevention through encouraging physical activity, healthy dietary practices, and tobacco reduction programs (e.g. QUIT) are examples of this approach. The ‘upstream’ (health promotion) approach is now happening in most areas of health and is certainly a cornerstone of addressing Australia’s national health priorities (cancer control, injury prevention and control, cardiovascular health, diabetes mellitus, mental health, asthma, and arthritis and musculoskeletal conditions). The environment, however, plays a pivotal role in all of these. Better collection of data and accurate models of future health trends and issues means there can be careful planning for the next 20-30 years. The Victorian Burden of Disease Study (Vos and Begg, 1999) found a number of important changes occurring. This study used similar methods to the WHO/World Bank sponsored Global Burden of Disease study (Murray and Lopez, 1996).

Some key findings were:

Men have a life expectancy six years shorter than women but the gap is narrowing;

  • The gap between the LGA (Local Government Area) with the lowest and
    highest life expectancy is seven years in men and four in women. Socio-
    economic disadvantage is an important predictor of lower life expectancy;
  • The life expectancy of Aboriginal men may be between eight and 18 years shorter than the state average. In women, the gap is estimated to be as large as nine to 18 years;
  • Rural residence, especially in the least populated parts of Victoria, is the most important predictor of premature mortality from injuries. Traffic accidents, suicide, machinery accidents, and drowning are the main types of injury responsible for this difference;
  • Favourable trends in life expectancy and mortality from many causes have been witnessed in the last two decades. The most favourable trends are observed in deaths from cardiovascular disease and injuries, with a mean annual decline of five percent. Tobacco-related illness in young women, diabetes in older men, drug overdose and suicide in young men show unfavourable trends (Vos and Begg, 1999).

Recent figures show little change in those findings.

The WHO/World Bank report identified cardiovascular disease (CVD) and poor mental health as likely to be the two biggest contributors to disease by the year 2020 (Murray and Lopez, 1996). CVD is currently number one, and will remain so, but poor mental health will rise from position number eight to position number two. The environment has a major influence on both of these areas. Evidence cited in this report shows that parks and nature can be a significant contributor to reducing premature death and disease in these two fields. Promising evidence is also emerging that positive influences from park environments, and associated flora and fauna, enhance wellbeing in relation to other health issues.

Parks are one of our most vital health resources. The following sections provide an evidence-based case to support this claim, and suggest that both the health and parks/environment sectors need to act more proactively in collaboration to enrich the role that parks play in improving and sustaining the nation’s (indeed, the world’s) health.

Glenhaven Park Camps
Glenhaven Park Low rope course

Ecological theory of public health


In response to these changes in the way health is being conceptualised and
managed, researchers and health care professionals are adopting a more holistic approach. Although not always referred to as such, this approach is based on an ecological theory of public health. As mentioned, the concept of an ecological public health has emerged recently in response to a new range of health issues and problems (Chu and Simpson, 1994; Kickbusch, 1989a). Traditional modes of public health seem ill prepared for this new reality and the health risks posed to populations, which has led to a reconsideration of the interdependence between people, their health, and their physical and social environments (Kickbusch, 1989a). It is now known that human health cannot be considered in isolation from physical or social environments (Chu and Simpson, 1994; Wilkinson and Marmot, 2003). In fact, some authors state that the separation of the health of the environment and the health of humans is done at the peril of the human species (Brown, 1996).

In recognition of this, the Ottawa Charter for Health Promotion was developed at an international conference sponsored by the WHO in 1986 (World Health Organization, 1986). The Charter identified the importance of environments supportive of health, stating that the inextricable links between people and their environment are the basis for a socio-ecological approach to health (World Health Organization, 1986). It advocated the protection of natural and built environments as well as the conservation of natural resources as essential in any health promotion strategy. The central theme of the conference, however, was the promotion of health through the maximisation of the health values of everyday settings. Settings are places or social contexts where people engage in daily activities in which environmental and personal factors interact to affect health and wellbeing (Chu and Simpson, 1994). This includes where people learn, live, work, play etc. The consequence for public health policy is to strengthen the
health potential of the settings of everyday life, starting where health is created (Kickbusch, 1989b). Parks are settings that may be health creating (perhaps more so than many other settings) yet their health potential currently often remains unacknowledged and under-utilised.

Apart from the identification of the health value of everyday settings, the Australian Institute of Health and Welfare (AIHW) (1998) identifies holistic wellbeing as a crucial concept for understanding health. AIHW nominates seven dimensions of health: biological and mental wellbeing, social wellbeing, economic wellbeing, environmental wellbeing, life satisfaction, spiritual or existential wellbeing, and ‘other characteristics valued by humans (Australian Institute of Health and Welfare, 1998). Although our understanding of these dimensions is slowly increasing, the majority of health statistics still measure illness or the absence of health. Despite this, much data is accumulating for the positive effects of social relationships on health. It has been demonstrated that social relationships provide a buffer for potentially harmful health effects arising from psychological stress in particular (House et al, 1988). However, the significance of sustainable ecosystems for the dimensions of human health needs greater exploration, as well as inclusion and emphasis in the knowledge base of public health (Brown, 1996). Butler and Friel (2006) highlight a paradox: that the emergence of evidence linking ecological and environmental factors to health outcomes has occurred at the same time as a declining acknowledgement by health promoters of the importance of these factors.


An ecological theory of public health recognises that not only is health itself
holistic and multidisciplinary, but also that a holistic or multidisciplinary
approach is needed to promote and manage health successfully. This requires inventive new efforts in the collaboration between environmental scientists and biomedical researchers on one hand, and between health and environmental policy makers on the other (Wilson, 2001). Our objective for the future should be healthy people in a healthy environment, with healthy relations to that environment (Birch, 1993). In terms of parks, not only do they preserve and protect the environment; they also encourage and enable people to relate to the natural world. For these reasons they have a key role in an ecological approach to health.

Social capital, health and the natural environment

The term ‘social capital’ has become increasingly common in the social science literature over recent years. Though there are variations in the way it is defined, the term generally refers to social structures such as networks, trust, and norms which facilitate co-operation and cohesion in communities, and which result in benefits for community members (Kawachi et al., 1997; Putnam et al., 1993; Coleman, 1988; Bourdieu, 1986). There are, therefore, at least two aspects to social capital: the sources or relational aspects of the capital (i.e. the structures and mechanisms by which it is established and maintained), and the consequences or material aspects of the capital (i.e. the flow-on effects or benefits to community members which result from their membership) (Hawe and Shiell, 2000; Portes, 1998; Wilkinson, 1999)

Recent research suggests that differences in social capital may explain differences in morbidity and mortality within and between different population groups (Kawachi et al., 1997; Putnam, 1995; Runyan et al., 1998; Baum, 1999; Leeder and Dominello, 1999; Lynch and Kaplan, 1997). However, there are differing explanations for the ways in which health is influenced by social capital. Hawe and Shiell (2000) point out that while Kawachi et al. (1997) focus on the relational aspects of social capital, arguing that a large gap between rich and poor people leads to higher mortality through the breakdown of social cohesion, Lynch and Kaplan (1997) offer an explanation based on the material aspects of social capital where income inequality may be a marker for a set of other concrete societal characteristics and policies that influence health. This difference in explanations highlights the fact that the relationships between variables may be complex and multi-directional. Nevertheless, whatever the mechanism by which social capital influences health, there is clear evidence that it does have an effect. At a population health level, Baum (1999) highlights the association between ‘the quality and extent of social interaction and relationships’ and the health of populations. This view is supported by Wilkinson and Marmot (2003 p. 22) who state: ‘Social support and good social relations make an important contribution to health’. However, Wilkinson and Marmot (p. 22) go on to point out that there are two aspects to social support—personal and structural. ‘People who get less social and emotional support from others are more likely to experience less well-being, more depression, a greater risk of pregnancy complications and higher levels of disability from chronic diseases. …The amount of emotional and practical social support people get varies by social and economic status. Poverty can contribute to social exclusion and isolation’. Wilkinson (1999) highlights research by Berkman (1995, in Wilkinson, 1999) and House et al. (1988) which ‘reported death rates two or three times as high among people with low levels of social integration compared to people with high levels’. At an individual level, Baum (1999) reports on a US study by Kawachi et al. (1996, in Baum, 1999) which found that, by comparison with ‘people who had many social ties, those who were socially isolated were 6.59 times less likely to survive a stroke, 3.22 times more likely to commit suicide and 1.59 times less likely to survive coronary heart disease’.

While the relationship between social capital and health has been the subject of considerable research and reflection, the relationship between social capital and the biophysical environment is only now beginning to be explored. Hawe and Shiell (2000) highlight the lack of exploration of place-level effects within the literature on social capital, but even they do not specifically refer to the effects of place in terms of biophysical environments. More recently, the role of parks and open spaces in building social capital through recreational activities has been highlighted. For example, DeGraaf and Jordan (2003) draw attention to the opportunity available to professionals working in park management and in recreation and leisure services to promote development of social capital.


Where the link between social capital and the biophysical environment has been explored (Cavaye, 1999; Pretty and Ward, 2001; Pretty and Smith, 2003) the work has largely focused on the impacts of varying levels and types of social capital on environmental management, rather than on the contribution of biophysical environments to social capital. One strand of work linking social capital and the environment has been the work of the Civic Practices Network on ‘civic environmentalism’. However, like the previous example, this also links social capital and the environment in a unidirectional ‘social capital environmental improvement’ model.


Anecdotal evidence, however, suggests that engagement in civic environmentalism (through groups such as Friends of Parks) has spin-off social capital benefits in addition to the benefits that such groups were originally designed to achieve. One of the key elements of social capital is ‘civic engagement’. Putnam (1995) states that dense networks of interaction probably broaden participants’ sense of self, developing the ‘I’ into the ‘we’. Yet, Putnam (1995) observes, America (like many other nations) is experiencing a decline in civic engagement and social connectedness. One of the factors associated with this decline has been ‘the technological transformation of leisure’ (Putnam, 1995). If we consider the anecdotal evidence, and Putnam’s (1995) observations, in the light of Frumkin’s (2001) evidence of the effects of wilderness experience in increasing capacity for cooperation and trust, it seems likely that human interactions with nature through parks may have significant capacity for building social capital.


Emerging empirical evidence confirms the potential for spin-off social capital benefits of civic environmentalism indicated by anecdotal evidence (Townsend, 2006; Moore, Townsend and Oldroyd, 2007). Research by Selman (2001), however, exploring the potential for environmental management projects to contribute to the growth of social capital, suggests that although this potential exists, it may be compromised by the pressures of life in modern society. A study of a local ‘friends of parks’ group in Melbourne found, like Selman, that relatively few young families are involved in such groups (Townsend and Maller, 2003). However, where young families were involved, significant social benefits were found to flow from that involvement, including the widening of their social networks and ‘the increase in confidence in .. .children as a result of interaction with other people in the community’ (Townsend 2006 p. 116). In another Australian study which compared volunteer members of land management groups associated with the Trust for Nature and matched controls, it was found that members of the groups both experienced and contributed to higher levels of social capital than the controls (Moore, Townsend and Oldroyd 2007). It is interesting to note the ‘symbiotic’ relationship between social and natural capital. As one benefits the other it could be worthwhile to investigate the facilitative role that parks could play in linking one to the other. This area needs exploration.

Citation

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

activities at Glenhaven Park

Healthy parks, healthy people – Introduction

That the natural environment is a key determinant of health is unquestioned. A report published by the World Health Organization (Prüss-Üstün and Corvalán, 2006 p. 6) claims that ‘approximately one-quarter of the global disease burden, and more than one-third of the burden among children, is due to modifiable environmental factors’. However, even in its attempt to quantify the environmental burden of disease, WHO has focused on environmental degradation: ‘the amount of death and disease caused by factors such as unsafe drinking-water and sanitation, and indoor and outdoor air pollution’ (Prüss-Üstün and Corvalán, 2006 p. 6), paying little if any attention to the impacts of environmental deprivation. The same focus is reflected more broadly within ‘environmental health’ as a discipline and a profession.

Despite the prevailing attitude in society that humans are separate from, outside of, or above nature (Martin, 1996; Suzuki, 1990), as human understanding of the natural environment has developed, and the massive destruction that human activities can have on natural systems has been observed, a more enlightened view has emerged. This view recognises that plants and animals (including humans) do not exist as independent entities as was once thought, but instead are parts of complex and interconnected ecosystems on which they are entirely dependent, and of which they are fundamentally a part (Driver et al., 1996). In the Foreword to its Millennium Ecosystem Assessment report ‘Ecosystems and Human Well-being: Health Synthesis’, the World Health Organisation (2005 p. iii) stated:

Nature’s goods and services are the ultimate foundations of life and health, even though in modern societies this fundamental dependency may be indirect, displaced in space and time, and therefore poorly recognised.

The human relationship with the natural world is deeply intertwined with the human conscious and subconscious mind and is therefore not easy to access for analysis. Nonetheless, in recent years, there have been concerted attempts, particularly in the disciplines of ecology, biology, environmental psychology, and psychiatry, to empirically examine the human relationship with the natural world.

Many researchers have come to the conclusion that humans are dependent on nature not only for material needs (food, water, shelter, etc) but perhaps more importantly for psychological, emotional and spiritual needs (Wilson, 2001; Frumkin, 2001; Roszak et al., 1995; Friedmann and Thomas, 1995; Katcher and Beck, 1987; Wilson, 1984). Just how dependent on nature humans are, and exactly what benefits can be gained from interacting with nature are issues that have only just begun to be investigated. Findings so far, however, indicate that parks and other natural environments play a vital role in human health and wellbeing through providing access to nature. This is likely to change the way parks and nature are currently viewed and managed by governments and the wider community.

The idea that contact with nature is good for human health and wellbeing is the subject of research in diverse disciplines such as environmental psychology, environmental health, psychiatry, biology, ecology, landscape preferences, horticulture, leisure and recreation, wilderness, and of course public health policy and medicine. Driving these divergent streams is the central notion that contact with nature is beneficial, perhaps even essential, to human health and wellbeing. While the strength of the evidence for this assertion varies, due in part to ‘methodological limitations of [some of] the research’, and the mechanisms by which nature influences health outcomes is generally unknown, nevertheless acceptance of the association of nature with human wellbeing is increasing (Health Council of the Netherlands and Dutch Advisory Council for Research on Spatial Planning, Nature and Environment, 2005 p. 81).

In the last few hundred years, however, there has been an extraordinary disengagement of humans from the natural environment (Beck and Katcher, 1996; Axelrod and Suedfeld, 1995; Katcher and Beck, 1987). This is mostly due to the enormous shift of people away from rural areas into cities (Katcher and Beck, 1987). Here, contact with nature is often only available via parks. Never have humans spent so little time in physical contact with animals and plants and the consequences are unknown (Katcher and Beck, 1987). Further to this, modern society, by its very essence, insulates people from outdoor environmental stimuli (Stilgoe, 2001) and regular contact with nature (Katcher and Beck, 1987). Some researchers believe that too much artificial stimulation and an existence spent in purely human environments may cause exhaustion, or produce a loss of vitality and health (Stilgoe, 2001; Katcher and Beck, 1987) A subject that has attracted some concern is the lack of opportunities for nurturing in urban environments. Nurturing living organisms, such as animals and plants, could be an essential part of human development that if denied could have adverse effects on the health, and perhaps even the long-term survival, of the human species (Kellert, 1997; Bustad, 1996; Wilson, 1993; Lewis, 1992; Katcher and Beck, 1987). Katcher and Beck (1987) state that there is a critical need for continued exploration of the emotional and health value of nurturing living things; they believe it will reveal a human health requirement equal in importance to exercise and touch (Katcher and Beck, 1987).

The idea that isolation from the natural world may be harmful to health is not limited to scientists and researchers but is also seen in the choices of everyday people. For example, it is estimated that 42% of the American public uses some form of complementary medicine (Clark, 2000) and worldwide the use of complementary medicine has doubled in recent decades (New Scientist, 2001). A recent Australian review of the literature on the use of complementary and alternative medicines, with a particular focus on their use in treating asthma, found that ‘20-30% of adults and 50-60% of children with asthma may be using CAM at any one time’ (Slader et al. 2006 p. 386). The rise in popularity of complementary medicines may not only be due to disenchantment with modern techniques, but also the expression of a desire to take a more natural approach to health (Clark, 2000). In fact, many patients cite ‘naturalness’ as the appeal of complementary medicine, yet others are drawn by spiritualism or the emphasis on holism (New Scientist, 2001). Both of these qualities are often assigned to nature. Yet, there is still a lack of understanding in the general populace, governments and institutions about the significance of the human connectedness with nature, and its relevance to current social problems, particularly in terms of health.

The following is a review of the potential and actual health benefits of contact with nature, including but not restricted to nature in a park context. Contact with nature is defined as viewing natural scenes, being in natural environments, or observing, encountering or otherwise interacting with plants and animals. Although the primary interest of this review concerns human contact with nature in a park context, we have examined the literature within the broader context of human health and nature. This has meant the inclusion of fields such as environmental psychology, psychology, psychiatry, medicine, environmental economics, biodiversity conservation, ecology, complementary and alternative medicine, landscape design and urban planning, recreation and leisure, environmental health, public health policy and health promotion, adventure and wilderness therapy, and religion and spirituality.

The emphasis on parks in this document is for the simple reason that they are the chief means of maintaining intact natural ecosystems and preserving biodiversity in a world that is becoming increasingly urbanised. Because of this, parks play an essential role in public health, as they are the most readily available (or sometimes the only) source of nature for the majority of people who live in urban areas. This review is the first step toward collating current knowledge on this topic with the aim of undertaking further empirical research in the near future.

The first part of the review comprises a discussion on public health and nature, as well as the current concerns of public health in Australia. This is followed by the connection between parks, nature and health, how parks can contribute to public health, and the need to reposition parks in terms of health. Next is a discussion on understanding the human-nature relationship that examines some current theories of the human place in nature, as well as in particular reference to some population groups. Evidence for the health benefits of contact with nature is presented in the following section, including the benefits arising from viewing nature, being in nature, contact with plants, and contact with animals. A brief discussion on some unique forms of nature based therapy follows, which is then followed by a summary on the principal health outcomes of interacting with nature on an individual or personal level, and at a community level. Finally, a brief comment on policy outcomes and triple bottom line reporting, and some key recommendations are presented. There are also a number of assertions that can be made about current knowledge of the health and wellbeing benefits of the human relationship with nature. These are included in an Appendix.

Citation

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

Healthy parks, healthy people

Recommendations


Recommendations to government departments, planners, park management bodies, and health policy makers are:

1 Support further research Research is required to: a collect further empirical evidence demonstrating the health and wellbeing benefits of contact with nature; b explore new opportunities for application of the health and wellbeing benefits of contact with nature by investigating nature-based interventions to address existing and emerging health problems; c explore opportunities for using the health and wellbeing benefits of contact with nature as a preventive ‘upstream’ health measure.

2 Encourage and facilitate the repositioning of parks a by communicating to governments and the wider community, the health and wellbeing benefits of nature as provided by parks; b by educating government departments, health professionals, and the wider community as to these benefits; c by facilitating the engagement of the community with nature in order to reestablish awareness of the importance of nature in people’s lives, and cultivate a holistic, sustainable attitude towards life and health.

3 Develop ways of integrating parks and nature into public health

a Cooperation through a partnerships approach is required between government departments, park management agencies, health service agencies, health professionals, and researchers to successfully integrate parks and nature in public health;

b Health promotion agencies have already recognised the need for innovative, ‘upstream’ approaches to health and wellbeing, and are seeking potential alliances/opportunities to this end;

c It may be beneficial to initiate this process by examining how contact with nature via parks could be used as a preventive measure, potentially contributing to, for example, the Australian National Health Priority Areas of Cardiovascular Disease and Mental Health;

d The use of parks and nature to improve health and wellbeing is supported by the Jakarta Declaration (World Health Organization, 1997) and its predecessor, the Ottawa Charter for Health Promotion (World Health Organization, 1986), which call for creating supportive environments (both natural and social) and a reorientation of health services to be shared among individuals, community groups, health professionals, health service institutions, and governments.

Citation

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

Healthy parks, healthy people – Executive summary

In many disciplines, there have been concerted attempts to understand the human relationship with nature and how humans might benefit from nature in terms of health and wellbeing. Although still in the relatively early stages, research indicates that contrary to popular thinking, humans may be dependent on nature for psychological, emotional, and spiritual needs that are difficult to satisfy by other means. Findings so far demonstrate that access to nature plays a vital role in human health, wellbeing, and development that has not been fully recognised. This review is an examination of a broad cross-section of published literature that relates to the potential and actual health benefits of contact with nature, particularly but not only, in a park context.

City living involves an extraordinary disengagement of humans from the natural environment that is likely to be detrimental to health and wellbeing. Parks may be one of the only means of accessing nature for the majority of people in urban areas, yet most people are unaware of their full range of potential health benefits. Humans have forgotten how much the natural world means to them. Yet, signals abound that the loss of life’s diversity endangers not just the body but also the spirit. It has been reported that modern people are experiencing a spiritual famine and that alcohol, food, and drug addictions are futile attempts to fill the spiritual emptiness that has arisen from loss of contact with nature.

In terms of health, parks and other natural environments have been viewed almost exclusively as venues for leisure and sport. Yet recent research shows that ‘green nature’, such as parks, can reduce crime, foster psychological wellbeing, reduce stress, boost immunity, enhance productivity, and promote healing. In fact, the positive effects on human health, particularly in urban environments, cannot be over-stated. As a result, urban planning should ensure that the communities have adequate access to nature.

Evidence in the literature shows that among other benefits viewing nature is positive for health in terms of recovering from stress, improving concentration and productivity, and improving psychological state, particularly of people in confined circumstances such as prisons and hospitals. Furthermore, wilderness and related studies clearly demonstrate that being in a natural environment affects people positively, particularly in terms of mental health. There are also multiple benefits from brief encounters with nature, or experiencing nature on a smaller scale, such as in urban parks. Surveys have shown that nature is important to people, and the numbers of people seeking nature-based recreation are increasing.


Other studies demonstrate that plants and nearby vegetation can have profound effects on individuals, small groups, or even entire neighbourhoods. Some health benefits of interacting with plants include facilitation of healing in the elderly and mentally disadvantaged, improving mental capacity and productivity of office workers, improving job and life satisfaction of residents, attracting consumers and tourists to shopping districts, and aiding community cohesion and identity.

While the relationship between social capital and health has been the subject of considerable research and reflection, the relationship between social capital and the biophysical environment is only now being explored. It seems likely, however, that human contact with nature through parks may have significant capacity for building social capital. As social and natural capital benefit one another, it could be worthwhile investigating the facilitative role parks play in linking one to the other.

A large body of research demonstrates that contact with companion animals has multiple positive physiological and psychological effects on human health including: decreasing blood pressure, heart rate, and cholesterol; reducing anxiety and stress and providing protection against stress-related diseases; provision of companionship and kinship; and the opportunity to nurture. All of these factors improve quality of life and enhance health and wellbeing. Parks and other natural environments such as beaches are important in providing a setting for pet-owners to interact both with their pet and with other pet-owners and parks users, which can positively influence the social aspects of health. In addition, parks are essential in the preservation of habitat for native wildlife, as well as providing people with the opportunity to observe or encounter animals in their natural environment.

Parks and other natural environments are a fundamental health resource, particularly in terms of disease prevention. The initial evidence documenting the positive effects of nature on blood pressure, cholesterol, outlook on life and stressreduction is sufficient to warrant its incorporation into strategies for the Australian National Health Priority Areas of ‘mental health’ and ‘cardiovascular disease’. These two disease categories place a considerable health and economic burden on Australians, and worldwide will be the two biggest contributors to disease by the year 2020. However, due to the positive effects of nature overall on human health and wellbeing, the health benefits of nature may have relevance to all Australian National Health Priority Areas (cancer control, injury prevention and control, cardiovascular health, diabetes mellitus, mental health, asthma, and arthritis and musculoskeletal conditions). The extent to which parks and other contact with nature can contribute to these areas, however, awaits investigation.

There is a clear message for park managers to join public health fora, as not only do parks protect the essential systems of life and biodiversity, but they also are a fundamental setting for health promotion and the creation of wellbeing, that to date has not been fully recognised.

Citation

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

Young children’s contributions to sustainability

The influence of nature play on curiosity, executive function skills, creative thinking, and resilience

Summary

Nature play can contribute dispositions and skills relevant to sustainability

North American guidelines for environmental education at the early childhood level emphasize the importance of using the natural world for open-ended exploration, discovery, and play.  The focus on nature play as an essential component of this approach is not without criticism, especially from the international community. Criticisms about this approach generally focus on the need to address education for sustainability, as it’s believed that nature play without this focus will lack “the transformative power necessary for meaningfully contributing to sustainability issues.” Children attending nature preschools spend a great deal of time engaged in nature play “which is defined as freely chosen, unstructured, and open-ended playful interactions with and in nature.” The aim of the current research was to explore the influence of nature preschools on four outcomes relating to both sustainability and early childhood education goals: curiosity, executive function, creative thinking, and resilience. This research addressed these desired outcomes through four pilot studies, with each study focusing on just one of the outcomes.

Two groups of children participated in this research: one group attending a nature preschool; the other group attending high quality, play-based, non-nature preschools. All of the participants completed pretests at the beginning of the academic year and posttests toward the end of the academic year. The tests measured growth in the four constructs: curiosity, executive function, creative thinking, and resilience. Results were used to compare growth among nature preschool participants with participants in non-nature preschools. The number of participants varied for each pilot study, with the number in the nature preschool group varying from 34 to 78 and the number in the non-nature preschool group varying from 11 to 44.

Results of Study 1, which focused on curiosity, found that children in the nature preschool group were significantly more likely to demonstrate a higher, more mature form of curiosity than children in the non-nature preschool group. This higher level of curiosity “is valued not only from a child development perspective, but also valued in terms of contributions in a sustainability context.”  Study 2 , which focused on executive function skills, found no significant difference between the nature and non-nature participants. However, both groups exceeded what would be expected due to cognitive maturation of typically developing children. Results of Study 3, which focused on creative thinking, showed significantly more growth in the nature preschool group than in the non-nature preschool group. Because there were only eleven children in the non-nature group, results of the nature preschool group were also compared to published data from a fine arts-based preschool program implemented at six sites. Results of the nature preschool group showed significantly more growth in several aspects of creativity than in the fine arts-based programs, though children in the fine arts program exceeded the performance of children in the nature-based program in one other area of creativity. Results of Study 4 showed that the nature preschool group made significantly greater growth in protective factors relating to resilience than children in the non-nature preschool group.

These results suggest that nature play can positively influence curiosity, creative thinking, resilience, and executive function skills. As these dispositions and skills are needed for environmental problem-solving and policy making, the argument can be made that nature play can make a positive contribution to sustainability. As stated by the authors, “These pilot studies offer reasons for not abandoning nature play in the pursuit of sustainability.”

Citation

Ernst, J., Burcak, F., (2019). Young children’s contributions to sustainability: The influence of nature play on curiosity, executive function skills, creative thinking, and resilience. Sustainability, 11(15)

Health Benefits from Nature – Part 6 Statistical Analyses

Statistical Analyses

All analyses outlined here were conducted in the software package R58. We used an exploratory approach to examine the correlation between each health response and potential predictors (outlined in detail in Table S1), including socio-demographic variables, BMI, physical activity (where it was not also the response variable), and the three nature experience measures. We used generalized linear models (binomial) for depression and high blood pressure, linear regression models for social cohesion, and negative binomial generalized linear models for physical activity. The three measures of nature dose were correlated (significant Spearman’s rank test correlations of 0.50–0.57), so to avoid issues associated with multicollinearity we generated four predictor model sets for each health response: (i) all socio-demographic variables (but excluding the frequency, duration and intensity of nature experiences); (ii) socio-demographic variables plus duration of nature experiences; (iii) socio-demographic variables plus frequency of nature experiences; (iv) socio-demographic variables plus nature intensity. Neighbourhood socioeconomic disadvantage (IRSD) was reverse square-root transformed and BMI was log transformed to ensure models met assumptions of normality. We calculated the model averaged coefficient estimates for each predictor variable by generating models with all possible variable combinations, and averaged the coefficient for each across all models in which it was present (using the R package MuMln).

To further explore any relationships which became evident from the analyses above, we conducted dose-response modelling for the two binary health measures (depression and high blood pressure) where there was evidence for an effect of any one of the three nature dose variables. Dose response modelling is readily achieved for binary response variables40; social cohesion and physical activity did not lend themselves readily to this analytical approach because there is no threshold where a score is ‘good’ or ‘bad’. To carry out this approach we first built a logistic regression model where the predictor variables were treated as ‘risk factors’, an established practice in population epidemiology59,60. The relative odds of occurrence of either depression or high blood pressure in an individual were calculated given a person’s specific risk factors (e.g. age) or duration, frequency or intensity of nature experiences. We used only the predictor variables that were statistically significant in the analysis in Table 1, and transformed each into a binary risk factor using existing evidence where possible. For example, for age the risk of being diagnosed with hypertension begins to increase steeply at age 45 years61, and the prevalence of affective mood disorders such as depression begins to decline in Australia at about 4562. We therefore used 45 years to create a binary risk factor above which the risk of having depression was zero, and below one (and vice versa for high blood pressure). Similarly, Australian guidelines recommend physical activity on most, if not all days per week63, and we therefore created a binary risk factor as people who exercised for 30 minutes on 5 days or more (0) and those who did not (1). Respondents who were ‘overweight’ (≥25 BMI64) were categorized as a risk factor of 1, and those under as 0. Where no definitive information was available we used the results from Table 1 to guide the direction of the risk categorization; this includes whether children were present in the home, whether a person works (treated as a binary work or no-work), and income and neighbourhood disadvantage (IRSD; with the binary categorization reflecting whether the respondent fell into the top half or bottom half of the population values). Variables for which no threshold could be estimated were omitted from these analyses (as was the case for social cohesion and nature relatedness).

To create a dose-response curve, we ran the logistic regression models described above with incrementally increased thresholds of nature experiences (e.g. for duration a person’s risk factor was varied based on whether they met incremental thresholds including >0 minutes; ≥15 minutes; ≥30 minutes; ≥45 minutes; ≥1 hour and so forth until the maximum time of 4 hours), and determined the odds ratio that a person who fell within that category would have the condition. We identified the point at which health gains were first recorded as better than the null model on plots of nature dose versus the odds ratio for use in the analysis described below.

A population average attributable fraction analysis was used to estimate the proportion of depression and high blood pressure cases in the population attributable to each of the predictor variables or ‘risk factors’60. Within a multivariate logistic regression environment, each risk factor was removed sequentially from the population by classifying every individual as unexposed (i.e. risk factor of 0). The probability of each person having the disease was then calculated, where the sum of all probabilities across the population was the adjusted number of disease cases expected if the risk factor was not present. The attributable fraction was calculated by subtracting this adjusted number of cases from the observed number of cases. The risk factors were removed in every possible order, and an average attributable fraction from all analyses was obtained.

How to cite this article: Shanahan, D. F. et al. Health Benefits from Nature Experiences Depend on Dose. Sci. Rep. 6, 28551; doi: 10.1038/srep28551 (2016).

Health Benefits from Nature – Part 5 Experiences of nature

Respondents were invited to report on any visit within the previous week to a place they considered ‘outdoor green space’, and were asked to name or describe the location. We manually geo-located these locations based on the descriptions where possible. Three aspects of nature dose were measured, encompassing the duration and frequency of experiences, and nature intensity, through a mixture of self-report and remote sensing analysis. Nature dose questions were asked in the survey before the health questions to avoid any potential priming effects of a person’s health status on self-reported nature dose (e.g. see49).

Duration of experiences of nature

Average duration of green space visits was estimated based on self-reported time spent during each visit across the survey week. We chose this timeframe as it provided a short and recent reference period to improve accuracy49. Note that this measure of duration is necessarily linked to frequency, as to achieve a duration measure the respondent must have visited a green space at least once during the survey week. Duration was selected from a time category (1–29 minutes; 30 minutes to one hour; one to two hours; two to three hours; three to four hours; four or more hours), and the mid-point of each selected category was summed (with four or more hours being treated as ‘four’), and this value was averaged across all visits.

Frequency of experiences of nature

Given that frequency of visitation would be highly correlated with duration if measured on the same time scale, here it was estimated based on the respondent’s self-reported frequency of visits to green spaces where their usual frequency of visits across a year was selected from the following categories: never; once a year; once every three months; two to three times a month; once a month; once or more per week. This approach also allowed us to account for people who use green spaces infrequently (i.e. less than once a week who were missed by the duration measure).

Nature intensity

Here we generated one possible measure of nature intensity, the vegetation complexity within the most complex map-able green space each respondent visited (hypothesizing that more complex vegetation leads to better health outcomes by promoting attention restoration, and increasing the appeal of green spaces; Fig. 1; this measure also tends to correlate with plant and animal diversity56,57). Most (77%) of respondents only visited one or two green space locations so other measures such as the most common, or average complexity were not useful here. Analyses involving nature intensity were limited to respondents for whom the visited green space (a) could be geo-located, and (b) had established boundaries within the Brisbane City limits to ensure we vegetation was measured within the visited area. Complexity was measured using LiDAR-derived maps of vegetation cover at a 5 × 5 m resolution (details provided in the Supplementary material). Five separate vegetation strata were used that have relevance to the human experience of nature, including 0.15–1 m (likely to influence access and egress); 1–2 m (the line of sight may be affected); and three layers likely to provide varying levels of shade and visual vegetation complexity, 2–5 m; 5–10 m; 10 m+. For each of the vegetation strata we created a binary grid layer (where 1 indicated vegetation was present), and we summed all five of these layers for each 5 × 5 m pixel. We calculated the average summed measure across the entire green space. Higher values of vegetation complexity were achieved in green spaces with higher vegetation cover and more complex vegetation structure. This measure was calculated for 664 survey respondents who visited green spaces within the study area, and only these respondents were used in relevant analyses.

Health response measures

Respondents provided information on four health outcomes:

Mental health

A measure of depression was generated based on the depression component of the Depression, Anxiety and Stress scale28. Scores were converted to a binary measure where 0 indicates no depression and 1 indicates mild or worse depression.

Physical health

Respondents reported whether they were currently receiving treatment for high blood pressure, coded as a binary measure where 0 indicates no treatment and 1 indicates treatment.

Social health

Respondent’s perceptions of social cohesion were estimated based on three previously developed questions that measure trust, reciprocal exchange within communities, and general community cohesion29,30,31 (see Supplementary material for details). The scores across all three questions were averaged.

Health behaviour

Respondents provided a self-report indication of physical activity, specifically the number of days they exercised for 30 minutes or more during the survey week (regardless of location; ‘green exercise’ and exercise in other locations were not differentiated). The resulting count variable was between 0 and 7.

How to cite this article: Shanahan, D. F. et al. Health Benefits from Nature Experiences Depend on Dose. Sci. Rep. 6, 28551; doi: 10.1038/srep28551 (2016).