This cross-sectional study investigated whether physical activity, social cohesion, and loneliness mediate the association between time spent visiting green spaces and perceived mental health and ...vitality. Questionnaire data were collected from 3,948 residents from 124 neighborhoods across four European cities. Multilevel linear regression analysis revealed positive, but weak, associations between time spent visiting green space and Medical Outcome Study Short Form (SF-36) mental health and vitality score, which suggest small mental health benefits. Single mediation analyses showed that different indicators of physical activity (total, during leisure time, and walking during leisure time), social cohesion, and loneliness were mediators. Multiple mediation analyses showed that physical activity during leisure time and loneliness may explain about 25% of the relationship. The unmediated part of the association suggests that other mediators may explain the association.
•This is the first systematic review on health benefits of green spaces.•Living in greener environments is associated with better mental health and lower all-cause mortality.•More research on ...specific health outcomes and different population groups is recommended.•The focus should shift from quantity to quality of green space.•The greening of living environments seems a promising tool for enhancing public health.
The objective was to systematically review the literature examining the relationship between quantity and quality of green spaces in the living environment and three health outcomes: perceived general health, perceived mental health, and (all-cause) mortality.
An online search was followed by a selection process applying eligibility criteria. Three levels of evidence were defined based on the number and quality of the studies, and the consistency of the findings. Fourteen studies on perceived general health, 19 on mental health and seven on all-cause mortality were included in the review.
The evidence synthesis showed strong evidence for significant positive associations between the quantity of green space (objectively measured around the residence) and perceived mental health and all-cause mortality, and moderate evidence for an association with perceived general health. There were insufficient studies on the quality of green spaces to conduct an evidence synthesis. A few studies provided indications that associations depend on subgroups such as gender, age groups and groups with different social economic status, but the findings were mixed.
Further research should focus on exploring relationships between more detailed characteristics of green space and more specific health outcomes in different population subgroups and in different countries. To strengthen the evidence-base, studies with more sophisticated designs, e.g. “natural experiments”, are needed.
The aim of this study was to investigate whether physical activity (in general, and more specifically, walking and cycling during leisure time and for commuting purposes, sports and gardening) is an ...underlying mechanism in the relationship between the amount of green space in people's direct living environment and self-perceived health. To study this, we first investigated whether the amount of green space in the living environment is related to the level of physical activity. When an association between green space and physical activity was found, we analysed whether this could explain the relationship between green space and health.
The study includes 4.899 Dutch people who were interviewed about physical activity, self-perceived health and demographic and socioeconomic background. The amount of green space within a one-kilometre and a three-kilometre radius around the postal code coordinates was calculated for each individual. Multivariate multilevel analyses and multilevel logistic regression analyses were performed at two levels and with controls for socio-demographic characteristics and urbanicity.
No relationship was found between the amount of green space in the living environment and whether or not people meet the Dutch public health recommendations for physical activity, sports and walking for commuting purposes. People with more green space in their living environment walked and cycled less often and fewer minutes during leisure time; people with more green space garden more often and spend more time on gardening. Furthermore, if people cycle for commuting purposes they spend more time on this if they live in a greener living environment. Whether or not people garden, the time spent on gardening and time spent on cycling for commuting purposes did not explain the relationship between green space and health.
Our study indicates that the amount of green space in the living environment is scarcely related to the level of physical activity. Furthermore, the amount of physical activity undertaken in greener living environments does not explain the relationship between green space and health.
A large body of evidence shows that interaction with greenery can be beneficial for human stress reduction, emotional states, and improved cognitive function. It can, therefore, be expected that ...university students might benefit from greenery in the university environment. Before investing in real-life interventions in a university environment, it is necessary to first explore students' perceptions of greenery in the university environment. This study examined (1) preference for university indoor and outdoor spaces with and without greenery (2) perceived restoration likelihood of university outdoor spaces with and without greenery and (3) if preference and perceived restoration likelihood ratings were modified by demographic characteristics or connectedness to nature in Dutch university students (N = 722). Digital photographic stimuli represented four university spaces (lecture hall, classroom, study area, university outdoor space). For each of the three indoor spaces there were four or five stimuli conditions: (1) the standard design (2) the standard design with a colorful poster (3) the standard design with a nature poster (4) the standard design with a green wall (5) the standard design with a green wall plus interior plants. The university outdoor space included: (1) the standard design (2) the standard design with seating (3) the standard design with colorful artifacts (4) the standard design with green elements (5) the standard design with extensive greenery. Multi-level analyses showed that students gave higher preference ratings to the indoor spaces with a nature poster, a green wall, or a green wall plus interior plants than to the standard designs and the designs with the colorful posters. Students also rated preference and perceived restoration likelihood of the outdoor spaces that included greenery higher than those without. Preference and perceived restoration likelihood were not modified by demographic characteristics, but students with strong connectedness to nature rated preference and perceived restoration likelihood overall higher than students with weak connectedness to nature. The findings suggest that students would appreciate the integration of greenery in the university environment.
With a growing number of primary schools around the globe greening their schoolyards, opportunities arise to realize outdoor learning in natural areas on the school's premises. Despite their ...promising potential, green schoolyards as outdoor learning environments remain mostly unintegrated in teachers' educational practices. In the current study, teachers of five primary schools in Netherlands were followed for two consecutive years during a participatory action research project. Based on their experiences in this project, teachers identified barriers when integrating the green schoolyard as a learning environment and found practice-based solutions to overcome these barriers. Across schools, a total of 20 meetings were organized, with 75 teachers participating in the project. Results revealed four broad themes encompassing barriers and solutions. Teachers feel hindered by outdoor learning having no formal status in their current educational practice, experience barriers related to a lack of confidence in their own outdoor teaching expertise, find it difficult to get started, and experience barriers related to physical constraints. Teachers, professionals, and researchers together found solutions to overcome each specific barrier. These solutions can be translated to general recommendations: just do it, get educated and inspired, engage in real-life experiences, get an outdoor pedagogical mindset, and follow a tailored process. The findings can be used by primary schools and other institutions to develop interventions that support teachers to further integrate the green schoolyard as a learning environment.
Visiting a natural environment such as a garden or park helps people to recover from stressful circumstances. Women’s shelters and homeless shelters have started to integrate nature in their work, ...especially for families who seek temporary refuge, with the aim to support parents’ functioning and resilience. For professionals who want to facilitate engagement with nature among their clients, it may be helpful to learn how other professionals choose nature activities for the support of parents. The current study was aimed to uncover how social workers choose a nature activity for the support of parents, resulting in a model that can be used as a reflective tool among shelter professionals. The model is based on an analysis of actions of professionals, captured in case descriptions written by shelter professionals about parenting supportive nature activities that they facilitated for families under their care. The model shows that social workers promoted a back-and-forth between children’s exploration away from the parent and being with the parent. In facilitating these interactions, social workers used nature as an environment with stress reducing and strengthening capacities for parents and as an environment with supportive qualities for children’s play. A dimensional framework was extracted that described how professionals may choose activities.
This study explored whether social contacts are an underlying mechanism behind the relationship between green space and health. We measured social contacts and health in 10,089 residents of the ...Netherlands and calculated the percentage of green within 1 and a 3km radius around the postal code coordinates for each individual's address. After adjustment for socio-economic and demographic characteristics, less green space in people's living environment coincided with feelings of loneliness and with perceived shortage of social support. Loneliness and perceived shortage of social support partly mediated the relation between green space and health.
Commuting routes with natural features could promote walking or cycling for commuting. Commuting through natural environments (NE) could have mental health benefits as exposure to NE can reduce ...stress and improve mental health, but there is little evidence. This study evaluates the association between NE and commuting, whether active or not, and the association between commuting (through NE), whether active or not, and mental health. We also evaluate the moderating effect of NE quality on the association between NE commuting and mental health.
This cross-sectional study was based on adult respondents (n = 3599) of the Positive Health Effects of the Natural Outdoor Environment in Typical Populations in Different Regions in Europe (PHENOTYPE) project. Data were collected in four European cities in Spain, the Netherlands, Lithuania and the United Kingdom. Data on commuting behavior (active commuting at least one day/week, daily NE commuting) and mental health were collected with questionnaires. Associations were estimated with multilevel analyses including random intercepts at city- and neighborhood level.
Adjusted multilevel analyses showed that daily NE commuters were more often active commuters (OR 1.42; 95% CI 1.19, 1.70). There was no association between active commuting and mental health, but daily NE commuters had on average a 2.74 (95% CI 1.66, 3.82) point higher mental health score than those not commuting through NE. The association with mental health was stronger among active commuters (4.03, 95% CI 2.13, 5.94) compared to non-active commuters (2.21; 95% CI 0.90, 3.51) when daily commuting through NE, but NE quality did not have a moderating effect.
Daily NE commuting was associated with better mental health, especially for active commuters. Daily NE commuters were likely to be active commuters. Active commuting itself was not associated with mental health. These findings suggest that cities should invest in commuting routes with nature for cycling and walking.
•Daily natural environment commuters were likely to be active commuters.•Daily natural environment commuting was associated with better mental health, especially for active commuters.•Active commuting itself was not associated with mental health.
•Conducted ecological momentary assessment with residents of four European cities.•Positive mood improved within 10 min of natural environment exposure.•Findings varied by city, gender, age and ...residential green space exposure.•Negative mood declined within 10 min of natural environment exposure.•Weaker associations were found within 30 min of natural environment exposure.
Exposure to natural outdoor environments (NOE) has been shown in population-level studies to reduce anxiety and psychological distress. This study investigated how exposure to one’s everyday natural outdoor environments over one week influenced mood among residents of four European cities including Barcelona (Spain), Stoke-on-Trent (United Kingdom), Doetinchem (The Netherlands) and Kaunas (Lithuania). Participants (n = 368) wore a smartphone equipped with software applications to track location and mood (using mobile ecological momentary assessment (EMA) software), for seven consecutive days. We estimated random-effects ordered logistic regression models to examine the association between mood (positive and negative affect), and exposure to green space, represented by two binary variables indicating exposure versus no exposure to NOE using GPS tracking and satellite and aerial imagery, 10 and 30 min prior to participants’ completing the EMA. Models were adjusted for home city, day of the week, hour of the day, EMA survey type, residential NOE exposure, and sex, age, education level, mental health status and neighbourhood socioeconomic status. In addition, we tested for heterogeneity of effect by city, sex, age, residential NOE exposure and mental health status. Within 10 min of NOE exposure, compared to non-exposure, we found that overall there was a positive relationship with positive affect (OR: 1.39, 95% CI: 1.06, 1.81) of EMA surveys, and non-significant negative association with negative affect (OR: 0.80, 95% CI: 0.58, 1.10). When stratifying, associations were consistently found for Stoke-on-Trent inhabitants and men, while findings by age group were inconsistent. Weaker and less consistent associations were found for exposure 30 min prior to EMA. Our findings support increasing evidence of psychological and mental health benefits of exposure to natural outdoor environments, especially among urban populations such as those included in our study.
•Use and experience important predictors for beneficial effects of NOE.•No consistent patterns for amount and quality of NOE with outcome measures.•Differences between four European cities indicate ...the importance of local context.
Despite the large number of studies on beneficial effects of the natural outdoor environment (NOE) on health, the underlying mechanisms are not fully understood.
This study explored the relations between amount, quality, use and experience of the NOE; and physical activity, social contacts and mental well-being.
In this cross-sectional study, data on GIS-derived measures of residential surrounding greenness (NDVI), NOE within 300 m, and audit data on quality of the streetscape were combined with questionnaire data from 3947 adults in four European cities. These included time spent in NOE (use); and perceived greenness, and satisfaction with and importance given to the NOE (experience). Physical activity, social contacts and mental health were selected as key outcome indicators. Descriptive and multilevel analyses were conducted both on pooled data and for individual cities.
More minutes spent in the NOE were associated with more minutes of physical activity, a higher frequency of social contacts with neighbors, and better mental well-being. Perceived greenness, satisfaction with and importance of the NOE, were other strong predictors of the outcomes, while GIS measures of NOE and streetscape quality were not. We found clear differences between the four cities.
Use and experience of the natural outdoor environment are important predictors for beneficial effects of the natural outdoor environment and health. Future research should focus more on these aspects to further increase our understanding of these mechanisms, and needs to take the local context into account.
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