Dr Jo BartonUniversity of Essex

How Does Greenspace Contribute to Healthy, Thriving Communities?

Outline• Theories linking nature and health• Greenspaces and healthy

communities – what does the evidence show?• Reducing health inequalities• Obesity• Crime• Facilitates activity – ‘Green exercise’

• Green Exercise research findings• Opportunities for new public health

delivery structures

Our relationship with nature has changed....

Theory Linking Nature and Health• “an innate sensitivity to and need

for other living things – as we have co-existed for thousands of generations”

• Hardwired into our genetic makeup• Evolved with affiliation for nature,

urban settings not part of our genetic history

Wilson (1984)

Attention Restoration Theory• We engage in 2 types of attention1. Involuntary – requires minimal effort2. Voluntary (directed)– requires focus &

energy, is susceptible to mental fatigue • Nature – conducive to involuntary

engagement, replenishes our mental fatigue, helps us recover from stress, restores concentration levels

Kaplan & Kaplan (1989)

Health Value of Greenspaces

• 80% of worlds population live in urban areas

• Quality of physical environment promotes good health and wellbeing

• Protect and improve natural environment = protect and enhance people’s health

• Accessibility and design affects behaviour

Greenspaces and Healthy Communities

Greenspace

Reduces property crimeviolent crime levels of aggression

Provides a sense of belonging

Enhances social cohesionReduces social isolationImproves social networkingEncourages intergenerational links

Reduces stressPerceivedCortisolRestores mental fatigue

Improves mental health and wellbeingSelf-esteemMood

Reduces health inequalities

Facilitates activityImproves physical healthLowers BPIncreases HRVReduces obesity

Greenspace Reduces Health Inequalities

Mitchell & Popham (2008)

Is Greenery Associated with Obesity? (N = 6919)

Greenery

Ellaway & Macintyre (2005)

> x3

40% less

Greenspaces and CrimeHighest vegetation:•52% less total crimes•48% less property crimes•56% less violent crimes•Supports ART hypothesis

Kuo & Sullivan (2001)

Greenspace Facilitates Activity - ‘Green Exercise’

• Good access to greenspace increases likelihood of being physically active by 24%

• Green Exercise – synergistic health benefit?Laboratory studies

— Analysing concept in controlled setting— Rural vs. urban views— SE, mood improve more with green views

Pretty et al., (2005)

Viewing Nature Improves Recovery From Stress

• Viewing nature prior to a stressor can increase HRV (indicator of better health and an adaptable CV system)

• Enhances recovery from a stressor

Gladwell et al., (2012)

Underlying Cognitive Mechanisms?• Visual sensation study –

to what extent does the colour green contribute to the GE effect?

• Better mood & lower ratings of perceived exertion in green condition (even though exercise intensity the same)

Akers et al., (2012)

Green (unedited)

Grey (achromatic)

Red (filter)

A ‘Dose of Nature’• Multi-study analysis on change in

SE & mood, 10 case studies, n=1252

• Aim: Assess the optimal dose(s) of GE for mental well-being

• Type, duration and intensity of activity?

• Type of green space?• Participant characteristics?

Barton & Pretty (2012)

TMD = Total Mood Disturbance (indicator of

overall mood)

Dose response data for the effect of exposure duration

on TMD(*p<0.01; **p<0.001; ***p<0.0001,

bars=95% Cis; TMD=Total Mood Disturbance)

Dose response data for the effect of exposure duration

on self-esteem(*p<0.01; **p<0.001; ***p<0.0001,

bars=95% CIs;

Figure 7: Change in self-esteem scores over the duration of the project (*indicates significantly different from pre-wilderness trail, p<0.05)

N.B. Low scores=high self-esteem

Therapeutic Intervention - Longer Term Shifts in Self-Esteem

Barton et al., (2011)

TurnAround and Control Group Mindfulness and Self-Esteem Scores

Note: A lower score= better self-esteem, error bars represent

=1SD. * indicates a better self-esteem in the turnaround group

(P<0.05)

Note: A higher score=more mindful qualities, error bars represent =1SD. *

indicates a significantly higher mindfulness score in the TA group

(P<0.05)

Barton et al., (2012)

What are the Opportunities for New Public Health Delivery Structures?

• Using the environment to promote WB & initiate behaviour change

• Greening communities• Schools • Workplace • Retirement/care homes• New housing developments

• Engaging vulnerable groups• Responsibility still with individual but we can provide them with

the tools and environment to facilitate behaviour change

Green Infrastructure for Children

• Early encounters vital for creating meaning and establishing identity

• Concerns that children today spend too little time outside

• Disconnections mean– Reductions in ecological literacy– Misunderstandings about food– Reductions in cognitive capacity

The virtual is replacing the real (Pyle 2002)

Greenspaces Facilitate Physical Activity

Figure 1: Mean + SD of time spent in MVPA on the school playground and field (* indicates a higher MVPA on the field (P<0.001)

Figure 2: Mean + SD of time spent in MVPA during urban and rural orienteering (* indicates a higher rural MVPA (P<0.01)

Children Adolescents *

Wood et al., (2012)

Mean + SD of time spent in MVPA during indoor and outdoor cycling (*MVPA significantly greater outdoors compared to indoors

(P<0.05)).

Wood et al., (2012)

Workplace Health – Walks4Work

• Lunchtime walking interventions – nature/built• Nature walks:

• ↓ heart age by 1.5 yr, built ↓ 0.15 yrs• Significantly ↓ BP & ↑ negative mood compared to built• Significantly ↓ perceived stress (i.e. people thought

they were coping better with stress)• Active lunch break (walking & socialising in greenspaces) increases productivity and workplace wellness

Brown and Gladwell (2012)

Nature Deprivation....

• If nature is important, then deprivation will create problems....

• Physical benefits of nature in urban areas (microclimate effects)

• Design of built & natural environment matters for mental health

• The ‘green’ element often not considered essential in urban planning & regeneration

• Perception of the importance of nature?

Losing Connections....• In urban areas – nearby nature is important

(e.g. Parks & open spaces, street trees, gardens, allotments, community gardens)• Source of stress• Malign influence on social networks & social

mechanisms• Sense of place - Important part of personal

identity created through interactions in specific places

Conclusion - Research Findings to Date1. Acute GE has mental health benefits:

• Self-esteem & mood

2. Benefits for all types of:• Green spaces (imp of nearby nature)• Activities• Durations (5 mins – all day)• People (Vulnerable, ill, disaffected &

disadvantaged seem to benefit more)

3. Green spaces facilitate activity & improve social capital:

• Need accessible green spaces in towns & cities

Conclusions4. Need to think of Natural Health Service to complement

NHS - Green places can be therapeutic, self-medicate with nature?

5. Green exercise & green care suggest increasing need for:

• Green Design/ Infrastructure - Incorporate more green views and greenspace in urban design. Create memories (future benchmarks to behaviour)

• Green Education – Ecoliteracy, creative unstructured play (free-range children), sense of place

“I can go into the hills and enjoy peace and quiet, the exercise and relax. My troubles take a back seat on a day like today”

Any questions?

www.greenexercise.org