International Journal of Environmental Research and Public Health

Editorial

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Open AccessEditorial

Landscapes and Human Health

by William C. Sullivan and Chun-Yen Chang

Int. J. Environ. Res. Public Health 2017, 14(10), 1212; https://doi.org/10.3390/ijerph14101212 - 11 Oct 2017

Cited by 10 | Viewed by 4572

Abstract

As urbanization increases around the world and fewer and fewer people have easy access to completely natural places, there is a growing need to understand how the landscapes we design and inhabit impact our health and wellbeing.[...] Full article

(This article belongs to the Special Issue Landscapes and Human Health)

Research

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5633 KiB

Open AccessArticle

A Diagnostic Post-Occupancy Evaluation of the Nacadia® Therapy Garden

by Ulrik Sidenius, Patrik Karlsson Nyed, Victoria Linn Lygum and Ulrika K. Stigsdotter

Int. J. Environ. Res. Public Health 2017, 14(8), 882; https://doi.org/10.3390/ijerph14080882 - 5 Aug 2017

Cited by 24 | Viewed by 6937

Abstract

The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL). One element of the model is a diagnostic post-occupancy evaluation (DPOE), which has not previously been fully developed. The present study develops a [...] Read more.

The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL). One element of the model is a diagnostic post-occupancy evaluation (DPOE), which has not previously been fully developed. The present study develops a generic DPOE for therapy gardens, with a focus on studying the effects of the design on patients’ health outcomes. This is done in order to identify successes and failures in the design. By means of a triangulation approach, the DPOE employs a mixture of methods, and data is interpreted corroborating. The aim of the present study is to apply the DPOE to the Nacadia® therapy garden. The results of the DPOE suggest that the design of the Nacadia® therapy garden fulfills its stated aims and objectives. The overall environment of the Nacadia ® therapy garden was experienced as protective and safe, and successfully incorporated the various elements of the nature-based therapy programme. The participants encountered meaningful spaces and activities which suited their current physical and mental capabilities, and the health outcome measured by EQ-VAS (self-estimated general health) indicated a significant increase. Some design failures were identified, of which visual exposure was the most noteworthy. The DPOE model presented appears to be efficient but would nonetheless profit from being validated by other cases. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessArticle

Experimental Study on the Health Benefits of Garden Landscape

by Juyoung Lee

Int. J. Environ. Res. Public Health 2017, 14(7), 829; https://doi.org/10.3390/ijerph14070829 - 24 Jul 2017

Cited by 44 | Viewed by 7311

Abstract

To mitigate the negative effects of modern cities on health, scientists are focusing on the diverse benefits of natural environments; a conceptual approach to use gardens for promoting human health is being attempted. In this study, the effects of the visual landscape of [...] Read more.

To mitigate the negative effects of modern cities on health, scientists are focusing on the diverse benefits of natural environments; a conceptual approach to use gardens for promoting human health is being attempted. In this study, the effects of the visual landscape of a traditional garden on psychological and physiological activities were investigated. Eighteen male and female adults participated in this indoor experiment (mean age, 26.7 years). Twelve different landscape images for city and garden were presented continuously for 90 s. In the time series changes of oxygenated hemoglobin (O₂Hb), different patterns of changes were observed between the city and garden. The mean O₂Hb values increased for the city landscapes, whereas they decreased for the garden landscapes both in the left and right prefrontal cortices. Significant differences in the negative psychological states of tension, fatigue, confusion, and anxiety were observed between the city and garden landscapes. Important differences in the physiological and psychological responses to the two different landscapes were also detected between male and female participants, providing valuable clues to individual differences in the health benefits of natural landscapes. To validate the use of gardens as a resource for promoting health in urban dwellers, further scientific evidence, active communication, and collaboration among experts in the relevant field are necessary. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessArticle

Into the Woods or a Stroll in the Park: How Virtual Contact with Nature Impacts Positive and Negative Affect

by Elizabeth McAllister, Navjot Bhullar and Nicola S. Schutte

Int. J. Environ. Res. Public Health 2017, 14(7), 786; https://doi.org/10.3390/ijerph14070786 - 14 Jul 2017

Cited by 59 | Viewed by 8974

Abstract

This study examined the effects of virtual contact with nature on positive and negative affect, and investigated the psychological process of perceived restorativeness as a mediator of this relationship. A sample of 220 Australians aged between 18 and 75 years (M = 49.07, [...] Read more.

This study examined the effects of virtual contact with nature on positive and negative affect, and investigated the psychological process of perceived restorativeness as a mediator of this relationship. A sample of 220 Australians aged between 18 and 75 years (M = 49.07, SD = 14.34, female = 72%) participated in the study. Participants were randomly allocated to one of the three experimental conditions experienced through video presentations: (1) ‘wild’ nature, (2) ‘urban’ nature, and (3) non-nature control. They then completed measures of perceived restorativeness as well as positive and negative affect. Compared to the non-nature control condition, the experience of wild nature resulted in significantly higher levels of positive affect and lower levels of negative affect. The experience of urban nature resulted in significantly lower levels of negative affect only compared to the non-nature control video. Experience of wild and urban nature resulted in greater perceptions of restorativeness as compared to the non-nature control video. Restorativeness was a significant underlying psychological mediating path through which nature experience exerted its influence on affect. These results have the potential to inform nature-based green care interventions for mental health as well as for urban planning to maximize beneficial effects of natural environments. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessArticle

Modeling the Effects of Urban Design on Emergency Medical Response Calls during Extreme Heat Events in Toronto, Canada

by Drew A. Graham, Jennifer K. Vanos, Natasha A. Kenny and Robert D. Brown

Int. J. Environ. Res. Public Health 2017, 14(7), 778; https://doi.org/10.3390/ijerph14070778 - 14 Jul 2017

Cited by 10 | Viewed by 6849

Abstract

Urban residents are at risk of health-related illness during extreme heat events but the dangers are not equal in all parts of a city. Previous studies have found a relationship between physical characteristics of neighborhoods and the number of emergency medical response (EMR) [...] Read more.

Urban residents are at risk of health-related illness during extreme heat events but the dangers are not equal in all parts of a city. Previous studies have found a relationship between physical characteristics of neighborhoods and the number of emergency medical response (EMR) calls. We used a human energy budget model to test the effects of landscape modifications that are designed to cool the environment on the expected number of EMR calls in two neighborhoods in Toronto, Canada during extreme heat events. The cooling design strategies reduced the energy overload on people by approximately 20–30 W m⁻², resulting in an estimated 40–50% reduction in heat-related ambulance calls. These findings advance current understanding of the relationship between the urban landscape and human health and suggest straightforward design strategies to positively influence urban heat-health. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessArticle

Green Streets: Urban Green and Birth Outcomes

by Kathryn Abelt and Sara McLafferty

Int. J. Environ. Res. Public Health 2017, 14(7), 771; https://doi.org/10.3390/ijerph14070771 - 13 Jul 2017

Cited by 61 | Viewed by 7978

Abstract

Recent scholarship points to a protective association between green space and birth outcomes as well a positive relationship between blue space and wellbeing. We add to this body of literature by exploring the relationship between expectant mothers’ exposure to green and blue spaces [...] Read more.

Recent scholarship points to a protective association between green space and birth outcomes as well a positive relationship between blue space and wellbeing. We add to this body of literature by exploring the relationship between expectant mothers’ exposure to green and blue spaces and adverse birth outcomes in New York City. The Normalized Difference Vegetation Index (NDVI), the NYC Street Tree Census, and access to major green spaces served as measures of greenness, while proximity to waterfront areas represented access to blue space. Associations between these factors and adverse birth outcomes, including preterm birth, term birthweight, term low birthweight, and small for gestational age, were evaluated via mixed-effects linear and logistic regression models. The analyses were conducted separately for women living in deprived neighborhoods to test for differential effects on mothers in these areas. The results indicate that women in deprived neighborhoods suffer from higher rates adverse birth outcomes and lower levels of residential greenness. In adjusted models, a significant inverse association between nearby street trees and the odds of preterm birth was found for all women. However, we did not identify a consistent significant relationship between adverse birth outcomes and NDVI, access to major green spaces, or waterfront access when individual covariates were taken into account. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessArticle

Urban Green Space Perception and Its Contribution to Well-Being

by Gyula Kothencz, Ronald Kolcsár, Pablo Cabrera-Barona and Péter Szilassi

Int. J. Environ. Res. Public Health 2017, 14(7), 766; https://doi.org/10.3390/ijerph14070766 - 12 Jul 2017

Cited by 148 | Viewed by 16590

Abstract

Individual perceptions are essential when evaluating the well-being benefits from urban green spaces. This study predicted the influence of perceived green space characteristics in the city of Szeged, Hungary, on two well-being variables: the green space visitors’ level of satisfaction and the self-reported [...] Read more.

Individual perceptions are essential when evaluating the well-being benefits from urban green spaces. This study predicted the influence of perceived green space characteristics in the city of Szeged, Hungary, on two well-being variables: the green space visitors’ level of satisfaction and the self-reported quality of life. The applied logistic regression analysis used nine predictors: seven perceived green space characteristics from a questionnaire survey among visitors of five urban green spaces of Szeged; and the frequency of green space visitors’ crowd-sourced recreational running paths and photographs picturing green space aesthetics. Results revealed that perceived green space characteristics with direct well-being benefits were strong predictors of both dependent variables. Perceived green space characteristics with indirect, yet fundamental, well-being benefits, namely, regulating ecosystem services had minor influence on the dependent variables. The crowd-sourced geo-tagged data predicted only the perceived quality of life contributions; but revealed spatial patterns of recreational green space use and aesthetics. This study recommends that regulating ecosystem services should be planned with a focus on residents’ aesthetic and recreational needs. Further research on the combination of green space visitors´ perceptions and crowd-sourced geo-tagged data is suggested to promote planning for well-being and health benefits of urban green spaces. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessArticle

Positive Emotional Effects of Leisure in Green Spaces in Alleviating Work–Family Spillover in Working Mothers

by Po-Ju Chang and So Young Bae

Int. J. Environ. Res. Public Health 2017, 14(7), 757; https://doi.org/10.3390/ijerph14070757 - 11 Jul 2017

Cited by 13 | Viewed by 5812

Abstract

Studies have shown that family and work spillover affects well-being and that leisure activities can alleviate the negative effects of work-related stress on health. However, few studies have focused on investigating the effects of specific leisure activities among specific populations. To examine whether [...] Read more.

Studies have shown that family and work spillover affects well-being and that leisure activities can alleviate the negative effects of work-related stress on health. However, few studies have focused on investigating the effects of specific leisure activities among specific populations. To examine whether leisure activities in green spaces can promote individual recovery processes and alleviate the effects of work and family spillover on positive emotions, this study applied the effort-recovery model to a population of working mothers. Through online and paper questionnaires, sample data were collected from 221 working mothers in Taiwan. Structural equation modeling was used to test the experimental hypothesis, and mediation analysis was used to determine whether leisure in green spaces is a mediating factor. The results indicated that leisure in green spaces is a mediator of the relationship of negative work and family spillover with positive emotions. In addition, strolls and park visits were found to provide greater psychological benefits to working mothers, compared with picnics. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Effect of Wind Farm Noise on Local Residents’ Decision to Adopt Mitigation Measures

by Anabela Botelho, Pedro Arezes, Carlos Bernardo, Hernâni Dias and Lígia M. Costa Pinto

Int. J. Environ. Res. Public Health 2017, 14(7), 753; https://doi.org/10.3390/ijerph14070753 - 11 Jul 2017

Cited by 24 | Viewed by 5494

Abstract

Wind turbines’ noise is frequently pointed out as the reason for local communities’ objection to the installation of wind farms. The literature suggests that local residents feel annoyed by such noise and that, in many instances, this is significant enough to make them [...] Read more.

Wind turbines’ noise is frequently pointed out as the reason for local communities’ objection to the installation of wind farms. The literature suggests that local residents feel annoyed by such noise and that, in many instances, this is significant enough to make them adopt noise-abatement interventions on their homes. Aiming at characterizing the relationship between wind turbine noise, annoyance, and mitigating actions, we propose a novel conceptual framework. The proposed framework posits that actual sound pressure levels of wind turbines determine individual homes’ noise-abatement decisions; in addition, the framework analyzes the role that self-reported annoyance, and perception of noise levels, plays on the relationship between actual noise pressure levels and those decisions. The application of this framework to a particular case study shows that noise perception and annoyance constitutes a link between the two. Importantly, however, noise also directly affects people’s decision to adopt mitigating measures, independently of the reported annoyance. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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The Effects of a Campus Forest-Walking Program on Undergraduate and Graduate Students’ Physical and Psychological Health

by Kyung-Sook Bang, Insook Lee, Sungjae Kim, Chun Soo Lim, Hee-Kyung Joh, Bum-Jin Park and Min Kyung Song

Int. J. Environ. Res. Public Health 2017, 14(7), 728; https://doi.org/10.3390/ijerph14070728 - 5 Jul 2017

Cited by 63 | Viewed by 12544

Abstract

We conducted a campus forest-walking program targeting university and graduate students during their lunchtime and examined the physical and psychological effects of the program. We utilized a quasi-experimental design with a control group and a pretest–posttest design. Forty-seven men (M = 25.5 ± [...] Read more.

We conducted a campus forest-walking program targeting university and graduate students during their lunchtime and examined the physical and psychological effects of the program. We utilized a quasi-experimental design with a control group and a pretest–posttest design. Forty-seven men (M = 25.5 ± 3.8 years) and 52 women (M = 23.3 ± 4.3 years) volunteered to participate (experimental group n = 51, control group n = 48). The intervention group participated in campus forest-walking program once a week for six weeks; they were also asked to walk once a week additionally on an individual basis. Additionally, participants received one lecture on stress management. Post-tests were conducted both just after the program ended and three months after. A chi-square test, t-test, and repeated measures analysis of variance were used to evaluate the effects of the program. Health promoting behaviors (F = 7.27, p = 0.001, ES = 0.27) and parasympathetic nerve activity (F = 3.69, p = 0.027, ES = 0.20) significantly increased and depression (F = 3.15, p = 0.045, ES = 0.18) significantly decreased in the experimental group after the intervention compared to the control group. In conclusion, using the campus walking program to target students during their lunchtime is an efficient strategy to promote their physical and psychological health. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessArticle

Green Mind Theory: How Brain-Body-Behaviour Links into Natural and Social Environments for Healthy Habits

by Jules Pretty, Mike Rogerson and Jo Barton

Int. J. Environ. Res. Public Health 2017, 14(7), 706; https://doi.org/10.3390/ijerph14070706 - 30 Jun 2017

Cited by 54 | Viewed by 18988

Abstract

We propose a Green Mind Theory (GMT) to link the human mind with the brain and body, and connect the body into natural and social environments. The processes are reciprocal: environments shape bodies, brains, and minds; minds change body behaviours that shape the [...] Read more.

We propose a Green Mind Theory (GMT) to link the human mind with the brain and body, and connect the body into natural and social environments. The processes are reciprocal: environments shape bodies, brains, and minds; minds change body behaviours that shape the external environment. GMT offers routes to improved individual well-being whilst building towards greener economies. It builds upon research on green exercise and nature-based therapies, and draws on understanding derived from neuroscience and brain plasticity, spiritual and wisdom traditions, the lifeways of original cultures, and material consumption behaviours. We set out a simple metaphor for brain function: a bottom brain stem that is fast-acting, involuntary, impulsive, and the driver of fight and flight behaviours; a top brain cortex that is slower, voluntary, the centre for learning, and the driver of rest and digest. The bottom brain reacts before thought and directs the sympathetic nervous system. The top brain is calming, directing the parasympathetic nervous system. Here, we call the top brain blue and the bottom brain red; too much red brain is bad for health. In modern high-consumption economies, life has often come to be lived on red alert. An over-active red mode impacts the gastrointestinal, immune, cardiovascular, and endocrine systems. We develop our knowledge of nature-based interventions, and suggest a framework for the blue brain-red brain-green mind. We show how activities involving immersive-attention quieten internal chatter, how habits affect behaviours across the lifecourse, how long habits take to be formed and hard-wired into daily practice, the role of place making, and finally how green minds could foster prosocial and greener economies. We conclude with observations on twelve research priorities and health interventions, and ten calls to action. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessArticle

Is Neighborhood Green Space Protective against Associations between Child Asthma, Neighborhood Traffic Volume and Perceived Lack of Area Safety? Multilevel Analysis of 4447 Australian Children

by Xiaoqi Feng and Thomas Astell-Burt

Int. J. Environ. Res. Public Health 2017, 14(5), 543; https://doi.org/10.3390/ijerph14050543 - 19 May 2017

Cited by 45 | Viewed by 7973

Abstract

Heavy traffic is a source of air pollution and a safety concern with important public health implications. We investigated whether green space lowers child asthma risk by buffering the effects of heavy traffic and a lack of neighborhood safety. Multilevel models were used [...] Read more.

Heavy traffic is a source of air pollution and a safety concern with important public health implications. We investigated whether green space lowers child asthma risk by buffering the effects of heavy traffic and a lack of neighborhood safety. Multilevel models were used to analyze affirmative asthma cases in nationally representative cross-sectional data from 4447 children aged 6–7 years old in Australia. Case-finding was based upon a triangulation of affirmative responses to three questions on doctor-diagnosed asthma, asthma-related medications and illness with wheezing lasting for at least 1 week within the 12 months prior. Among children considered to be exposed to high traffic volumes and areas with 0 to 20% green space quantity, the odds ratio of affirmative asthma was 1.87 (95% CI 1.37 to 2.55). However, the association between heavy traffic and asthma was significantly lower for participants living in areas with over 40% green space coverage (odds ratio for interaction 0.32, 95% CI 0.12 to 0.84). No association between affirmative asthma and green space coverage was observed for participants not exposed to heavy traffic, nor for the area safety variable. Protecting existing and investing in new green space may help to promote child respiratory health through the buffering of traffic-related air pollution. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessArticle

Quality over Quantity: Contribution of Urban Green Space to Neighborhood Satisfaction

by Yang Zhang, Agnes E. Van den Berg, Terry Van Dijk and Gerd Weitkamp

Int. J. Environ. Res. Public Health 2017, 14(5), 535; https://doi.org/10.3390/ijerph14050535 - 16 May 2017

Cited by 176 | Viewed by 13240

Abstract

There is increasing evidence that the quality of green space significantly contributes to neighborhood satisfaction and well-being, independent of the mere amount of green space. In this paper, we examined residents’ perceptions of the quality and beneficial affordances of green space in relation [...] Read more.

There is increasing evidence that the quality of green space significantly contributes to neighborhood satisfaction and well-being, independent of the mere amount of green space. In this paper, we examined residents’ perceptions of the quality and beneficial affordances of green space in relation to objectively assessed accessibility and usability. We used data from a survey in two neighborhoods (N = 223) of a medium-sized city in the Netherlands, which were similar in the amount of green space and other physical and socio-demographic characteristics, but differed in the availability of accessible and usable green spaces. Results show that residents of the neighborhood with a higher availability of accessible and usable green spaces were more satisfied with their neighborhood. This difference was statistically mediated by the higher level of perceived green space quality. Neighborhood satisfaction was significantly positively related to well-being. However, residents of the two neighborhoods did not differ in self-reported well-being and beneficial affordances of green space. These analyses contribute to a further understanding of how the accessibility and usability of green spaces may increase people’s neighborhood satisfaction. It highlights the importance of perceived quality in addition to the amount of green space when examining the beneficial effects of green space. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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The Salutary Influence of Forest Bathing on Elderly Patients with Chronic Heart Failure

by Genxiang Mao, Yongbao Cao, Bozhong Wang, Sanying Wang, Zhuomei Chen, Jirong Wang, Wenmin Xing, Xiaoxu Ren, Xiaoling Lv, Jianhua Dong, Shasha Chen, Xiuyuan Chen, Guofu Wang and Jing Yan

Int. J. Environ. Res. Public Health 2017, 14(4), 368; https://doi.org/10.3390/ijerph14040368 - 31 Mar 2017

Cited by 84 | Viewed by 11496

Abstract

Abstract: The aim of the current study was to test the hypothesis that forest bathing would be beneficial for elderly patients with chronic heart failure (CHF) as an adjunctive therapy. Two groups of participants with CHF were simultaneously sent to the forest or [...] Read more.

Abstract: The aim of the current study was to test the hypothesis that forest bathing would be beneficial for elderly patients with chronic heart failure (CHF) as an adjunctive therapy. Two groups of participants with CHF were simultaneously sent to the forest or an urban control area for a four-day trip, respectively. Subjects exposed to the forest site showed a significant reduction of brain natriuretic peptide (BNP) in comparison to that of the city group and their own baseline levels. The values for the cardiovascular disease related pathological factors, including endothelin-1 (ET-1), and constituents of the renin-angiotensin system (RAS), including renin, angiotensinogen (AGT), angiotensin II (ANGII), and ANGII receptor type 1 or 2 (AT1 or AT2) in subjects exposed to the forest environment were lower than those in the urban control group. Obviously, a decreased level of inflammatory cytokines and improved antioxidant function was observed in the forest group rather than in the city group. The assessment of the profile of mood states (POMS) indicated that the negative emotional mood state was alleviated after forest bathing. As anticipated, a better air quality in the forest site was observed according to the detection of PM_2.5 (particulate matter <2.5 μm) and negative ions. These results provided direct evidence that forest bathing has a beneficial effect on CHF patients, and thus may pave the way for potential development of forest bathing as an effective adjunctive therapy on cardiovascular disorders. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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The Relationship between Neighbourhood Green Space and Child Mental Wellbeing Depends upon Whom You Ask: Multilevel Evidence from 3083 Children Aged 12–13 Years

by Xiaoqi Feng and Thomas Astell-Burt

Int. J. Environ. Res. Public Health 2017, 14(3), 235; https://doi.org/10.3390/ijerph14030235 - 27 Feb 2017

Cited by 61 | Viewed by 10790

Abstract

Recent reviews of the rapidly growing scientific literature on neighbourhood green space and health show strong evidence for protective and restorative effects on mental wellbeing. However, multiple informants are common when reporting mental wellbeing in studies of children. Do different informants lead to [...] Read more.

Recent reviews of the rapidly growing scientific literature on neighbourhood green space and health show strong evidence for protective and restorative effects on mental wellbeing. However, multiple informants are common when reporting mental wellbeing in studies of children. Do different informants lead to different results? This study utilised nationally representative data on Goodman’s 25-item Strengths and Difficulties Questionnaire reported by 3083 children (aged 12–13 years old), and their parents and teachers. Multilevel models were used to investigate whether similar associations between child mental wellbeing (as measured using the total difficulties score and the internalising and externalising subscales) and neighbourhood green space quantity and quality are obtained regardless of the informant. After adjustment for confounders, higher green space quantity and quality were associated with consistently more favourable child mental wellbeing on all three measures, regardless of the informant. However, associations with green space quantity were statistically significant (p < 0.05) only for the parent-reported total difficulties score and the internalising subscale. Significant associations with green space quality were consistently observed for both parent- and child-reported outcomes. Teacher-reported outcomes were not significantly associated with green space exposure. Future studies of green space and child health should acknowledge when different informants of outcomes could lead to different conclusions. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessArticle

Doses of Nearby Nature Simultaneously Associated with Multiple Health Benefits

by Daniel T. C. Cox, Danielle F. Shanahan, Hannah L. Hudson, Richard A. Fuller, Karen Anderson, Steven Hancock and Kevin J. Gaston

Int. J. Environ. Res. Public Health 2017, 14(2), 172; https://doi.org/10.3390/ijerph14020172 - 9 Feb 2017

Cited by 204 | Viewed by 26238

Abstract

Exposure to nature provides a wide range of health benefits. A significant proportion of these are delivered close to home, because this offers an immediate and easily accessible opportunity for people to experience nature. However, there is limited information to guide recommendations on [...] Read more.

Exposure to nature provides a wide range of health benefits. A significant proportion of these are delivered close to home, because this offers an immediate and easily accessible opportunity for people to experience nature. However, there is limited information to guide recommendations on its management and appropriate use. We apply a nature dose-response framework to quantify the simultaneous association between exposure to nearby nature and multiple health benefits. We surveyed ca. 1000 respondents in Southern England, UK, to determine relationships between (a) nature dose type, that is the frequency and duration (time spent in private green space) and intensity (quantity of neighbourhood vegetation cover) of nature exposure and (b) health outcomes, including mental, physical and social health, physical behaviour and nature orientation. We then modelled dose-response relationships between dose type and self-reported depression. We demonstrate positive relationships between nature dose and mental and social health, increased physical activity and nature orientation. Dose-response analysis showed that lower levels of depression were associated with minimum thresholds of weekly nature dose. Nearby nature is associated with quantifiable health benefits, with potential for lowering the human and financial costs of ill health. Dose-response analysis has the potential to guide minimum and optimum recommendations on the management and use of nearby nature for preventative healthcare. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessArticle

The Role of Soundscape in Nature-Based Rehabilitation: A Patient Perspective

by Gunnar Cerwén, Eja Pedersen and Anna-María Pálsdóttir

Int. J. Environ. Res. Public Health 2016, 13(12), 1229; https://doi.org/10.3390/ijerph13121229 - 11 Dec 2016

Cited by 69 | Viewed by 13235

Abstract

Nature-based rehabilitation (NBR) has convincing support in research, yet the underlying mechanisms are not fully understood. The present study sought to increase understanding of the role of soundscapes in NBR, an aspect paid little attention thus far. Transcribed interviews with 59 patients suffering [...] Read more.

Nature-based rehabilitation (NBR) has convincing support in research, yet the underlying mechanisms are not fully understood. The present study sought to increase understanding of the role of soundscapes in NBR, an aspect paid little attention thus far. Transcribed interviews with 59 patients suffering from stress-related mental disorders and undergoing a 12-week therapy programme in the rehabilitation garden in Alnarp, Sweden, were analysed using Interpretative Phenomenology Analysis (IPA). Described sounds were categorised as natural, technological or human. The results showed that patients frequently referred to natural sounds as being part of a pleasant and “quiet” experience that supported recovery and induced “soft fascination”. Technological sounds were experienced as disturbing, while perception of human sounds varied depending on loudness and the social context. The study further uncovered how sound influenced patients’ behaviour and experiences in the garden, through examination of three cross-theme dimensions that materialised in the study; sound in relation to overall perception, sound in relation to garden usage, and increased susceptibility to sound. The findings are discussed in relation to NBR; the need for a more nuanced understanding of susceptibility to sound among people suffering from mental fatigue was identified and design considerations for future rehabilitation gardens were formulated. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Review

Jump to: Editorial, Research

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Open AccessReview

Health-Promoting Nature Access for People with Mobility Impairments: A Systematic Review

by Gaochao Zhang, Dorthe V. Poulsen, Victoria L. Lygum, Sus S. Corazon, Marie C. Gramkow and Ulrika K. Stigsdotter

Int. J. Environ. Res. Public Health 2017, 14(7), 703; https://doi.org/10.3390/ijerph14070703 - 29 Jun 2017

Cited by 47 | Viewed by 9220

Abstract

This study systematically evaluated the scientific evidence for health benefits of natural environments for people with mobility impairments. Literature searches based on five categories of terms—target group, nature type, health-related impacts, nature-related activities and accessibility issues—were conducted in four databases (Web of Science, [...] Read more.

This study systematically evaluated the scientific evidence for health benefits of natural environments for people with mobility impairments. Literature searches based on five categories of terms—target group, nature type, health-related impacts, nature-related activities and accessibility issues—were conducted in four databases (Web of Science, Scopus, CAB ABSTRACT and Medline). Twenty-seven articles from 4196 hits were included in the systematic reviews. We concluded that people with mobility disabilities could gain different health benefits, including physical health benefits, mental health benefits and social health benefits from nature in different kinds of nature contacts ranging from passive contact, active involvement to rehabilitative interventions. Several issues related to the accessibility and use of nature for people with mobility impairments need attention from professionals such as landscape architects, rehabilitative therapists, caregivers and policy makers. The overall quality of methodology of the included studies is not high based on assessment of the Mixed Methods Appraisal Tool (MMAT). Moreover, more randomized controlled trials and longitudinal studies that focus specifically on evidence-based health design of nature for people with mobility impairments in the future are needed. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessReview

Within What Distance Does “Greenness” Best Predict Physical Health? A Systematic Review of Articles with GIS Buffer Analyses across the Lifespan

by Matthew Browning and Kangjae Lee

Int. J. Environ. Res. Public Health 2017, 14(7), 675; https://doi.org/10.3390/ijerph14070675 - 23 Jun 2017

Cited by 220 | Viewed by 12575

Abstract

Is the amount of “greenness” within a 250-m, 500-m, 1000-m or a 2000-m buffer surrounding a person’s home a good predictor of their physical health? The evidence is inconclusive. We reviewed Web of Science articles that used geographic information system buffer analyses to [...] Read more.

Is the amount of “greenness” within a 250-m, 500-m, 1000-m or a 2000-m buffer surrounding a person’s home a good predictor of their physical health? The evidence is inconclusive. We reviewed Web of Science articles that used geographic information system buffer analyses to identify trends between physical health, greenness, and distance within which greenness is measured. Our inclusion criteria were: (1) use of buffers to estimate residential greenness; (2) statistical analyses that calculated significance of the greenness-physical health relationship; and (3) peer-reviewed articles published in English between 2007 and 2017. To capture multiple findings from a single article, we selected our unit of inquiry as the analysis, not the article. Our final sample included 260 analyses in 47 articles. All aspects of the review were in accordance with PRISMA guidelines. Analyses were independently judged as more, less, or least likely to be biased based on the inclusion of objective health measures and income/education controls. We found evidence that larger buffer sizes, up to 2000 m, better predicted physical health than smaller ones. We recommend that future analyses use nested rather than overlapping buffers to evaluate to what extent greenness not immediately around a person’s home (i.e., within 1000–2000 m) predicts physical health. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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Open AccessReview

Effects of Forest Therapy on Depressive Symptoms among Adults: A Systematic Review

by Insook Lee, Heeseung Choi, Kyung-Sook Bang, Sungjae Kim, MinKyung Song and Buhyun Lee

Int. J. Environ. Res. Public Health 2017, 14(3), 321; https://doi.org/10.3390/ijerph14030321 - 20 Mar 2017

Cited by 131 | Viewed by 15966

Abstract

This study systematically reviewed forest therapy programs designed to decrease the level of depression among adults and assessed the methodological rigor and scientific evidence quality of existing research studies to guide future studies. This systematic review was conducted in accordance with the Preferred [...] Read more.

This study systematically reviewed forest therapy programs designed to decrease the level of depression among adults and assessed the methodological rigor and scientific evidence quality of existing research studies to guide future studies. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors independently screened full-text articles from various databases using the following criteria: (1) intervention studies assessing the effects of forest therapy on depressive symptoms in adults aged 18 years and older; (2) studies including at least one control group or condition; (3) peer-reviewed studies; and (4) been published either in English or Korean before July 2016. The Scottish Intercollegiate Guideline Network measurement tool was used to assess the risk of bias in each trial. In the final sample, 28 articles (English: 13, Korean: 15) were included in the systematic review. We concluded that forest therapy is an emerging and effective intervention for decreasing adults’ depression levels. However, the included studies lacked methodological rigor. Future studies assessing the long-term effect of forest therapy on depression using rigorous study designs are needed. Full article

(This article belongs to the Special Issue Landscapes and Human Health)

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