RESEARCH By Denise Hewlett with Debra Gray, Richard Gunton, Sheela Agarwal, Chris Skelly, Philip Weinstein and Martin Breed and Tom Munro.
Exploring research requirements Green spaces and natural environments are known to be beneficial to our health, but research gaps remain to be explored.
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or decades, there has been a rise in the number of pandemics globally. These have had significant impacts on people’s health and wellbeing, on health services, and on national economies. This crisis is made all the more urgent with the unfolding outcomes of COVID-19, which has accelerated the importance of well-planned natural environments in rural and urban areas, and their positive impact on health and wellbeing. UK policies emphasise the use of green space to improve people’s health and wellbeing, in part reflecting financial imperatives to reduce pressure on the National Health Service, but this approach can also be related to important economic consequences, since any decrease in people’s ill-health is also likely to enhance productivity.1 The idea that nature is good for our health has long been recognised. Together with concerns about widening health inequalities, an ageing population, and the sheer concentration of people living in cities, research worldwide has produced increasing evidence, particularly in urban contexts, about the importance of green space to people’s health.2 Despite more limited research in rural areas, it is now widely accepted that green space, characterised by openness, presence of water, sounds of nature, lessdisturbed environments, certain habitats, and (as an emerging hypothesis) biodiverse soils, can all have a positive effect on people’s health and wellbeing.3 Understanding the relationship between health, wellbeing and green spaces is imperative for contributing to evidence-based decision making, and is particularly important in health 50
1
Isham, A., Mair, S. and Jackson, T. (2020) Wellbeing and Productivity: A Review of the Literature. Centre for Understanding Social Prosperity Working Paper, No. 22. Guildford: University of Surrey.
2
Richard, L., Gauvin, L., Raine, K. (2010) Ecological models revisited: their uses and evolution in health promotion over two decades. Annual Review of Public Health. 32, 307–26.
3
Liddicoat, C., Sydnor, H., Cando-Dumancela, C., Dresken, R., Lie, J., Gellie, N., Mills, J.G., Young, J.M., Weyrich, L.S., Hutchinson, M.R., Weinstein, P., Breed, M.F.(2020). Naturally-diverse airborne environmental microbial exposures modulate the gut microbiome and may provide anxiolytic benefits in mice. Science of the Total Environment. 701, 134684
4
Dahlgren, G. & Whitehead, M. (1991). Policies and Strategies to Promote Social Equity in Health. Stockholm, Sweden: Institute for Futures Studies
5
Van den Berg, A.E. (2017) From green space to green prescription. Challenges and opportunities for research and practice. Frontiers in Psychology. 8, 268
6
Lovell, R., Depledge, M. & Maxwell, S. (2018) Health and the Natural Environment: A Review of Evidence, Policy, Practice and Opportunities for the Future. London: Defra Lovell et al., 2018)
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professions, most notably in the realm of social prescribing. However, determining just how green spaces affect people’s health is hugely complex, challenged by factors including people’s lifestyles, their behaviours, where they live, and how leisure time is spent. The complexity of such social, economic, and environmental determinants of health, warrants inter- and cross-disciplinary enquiries among planning professionals, landscape managers, public health practitioners, and scientists.4 Such collaborations can lead not only to assessments of the value of green spaces to our health, but could also provide for findings that can be applied in professional practice. From some perspectives, however, the links between green spaces and health have been considered to have reached maturity.5 Nonetheless, determining ‘cause and effect’ is still beyond our scientific reach, and additional research gaps remain:
• Simplistic conceptualisations of ‘greenspace’ are often evident in research on the relationship between green spaces and health, resulting in indistinguishable forms of green space being reported. This hinders our understanding of geographical complexities, such as the relative effects of different types of green spaces, of their environmental characteristics and ecological condition.6 We have limited knowledge of the importance of biodiversity, particularly in rural spaces, and how the range of landscape characters, configurations, and uses (e.g. agricultural, pastoral), or how their microbial diversity, or ecological condition, specifically affect people’s health and wellbeing; • Simplistic or limited measurements of health used are also evident. For example, single measures of psychological distress have been used. This approach hinders our understanding of the
