Abstract Compilation

Outdoor recreation and public health

Lisa Bergström, FRIFO - Friluftslivets fellesorganisasjon, Norway

”Frisk i Naturen” (stay healthy in nature) is a co-operation between the outdoor recreation organizations and the Health- and the Environmental sector in each Nordic country - financed by the Nordic Council of Ministers.
The reason why the project started up was the lack of attention, within the Nordic countries but also within the Nordic Council of Ministers, on nature and its resources when it comes to public health issues.

The aim of this project is to develop and make visible the Nordic outdoor policy with a
clear public health profile, share best practice in the four focus areas (see below), create a knowledge platform and to communicate evidence-based-research in popular science.

A Nordic Evidence Based Information Central (E- BIC) is an aim for the future. E- BIC creates an opportunities to quickly get an overview of the latest news when it comes to nature and health within the Nordic countries. A co-operation between Skov og Landskab, Dr Ulrika Stigsdotter and this project “Frisk i nature”.

The project has four focus areas:
Prevention, Physical health, Outdoor education, and Green open spaces (urban)
Keywords
Evidence based information, Knowledge platform, Make information more accessible, and Networking.

Biodiversity & Environmental Salutogenicity: A gap in the nature-health evidence base?

Rebecca Lovell¹, Benedict W Wheeler², Katherine N Irvine³ & Michael H Depledge⁴

^{1, 2, 4}  European Centre for Environment & Human Health, Peninsula College of Medicine & Dentistry, Universities of Exeter & Plymouth. ³ Institute of Energy and Sustainable Development, De Montfort University.

Abstract: Increasing attention is being paid to how global and local losses of biodiversity are having negative consequences for human health and wellbeing. Effects range from rises in zoonotic disease to instability in the ecological structures that underpin ecosystem services. Although there is a perception that biologically diverse natural environments that support ecosystems, economies and populations, can also have salutogenic impacts, there has been little research on the health effects of different types or qualities of natural environments. Furthermore, in many studies the green/natural environments referred to have often not been well or consistently defined or described, meaning that cross-study comparisons are difficult. Through applying systematic review methodology to this issue, we confirm and highlight this weakness in the nature-health evidence base. We have however, found research work that does suggest that more biodiverse environments – including urban greenspaces – may indeed provide increased health and wellbeing benefits. We have also identified potential key research questions for future study.

Keywords: Biodiversity; Ecosystem health; Salutogenic environments; Systematic review

Perceived sensory dimensions that promote mental restoration

Anna María Pálsdóttir¹, Ulrika Stigsdotter², Patrik Grahn¹

¹Work Science, Business Economics, and Environmental Psychology, Swedish University of Agricultural Science, SE. ² Forest & Landscape, Faculty of Life Sciences, University of Copenhagen

Abstract: According to the World Health Organization it is estimated that by the year 2020 the largest health problem in the world will be stress-related illnesses caused by prolonged stress and the lack of opportunities to rest and recover. Studies have shown that people perceive outdoor environments in terms of eight certain dimensions, Perceived Sensory Dimensions (PSD) and there is a beneficial relationship between PSD and perceived level of stress. The aim of the study was to identify which PSDs in a therapy garden for clients with stress-related illnesses that promotes stress restoration. In this study we used in-depth interviews with 43 clients and a questionnaire on PSD qualities for a place in the garden where the clients used for stress restoration. The results from the questionnaire show that the most preferred PSDs are Refuge, Prospect, Serene. Additionally, from the interviews, the clients identified two PSDs; Nature and Rich in species. Individuals suffering from stress-related illnesses are hyper sensitive to stimuli and frequently avoid public green places with many different stimuli and impressions. In order to meet the needs a fast growing group of users with we recommend the dimensions Refuge, Prospect Nature, Serene and Rich in species are included in design of public green spaces.

Keywords: stress recovery, therapy garden, public green spaces, health promotion.

Health benefits of nature elements in a residential rehabilitation centre

Grete Grindal Patil¹, Ruth Kjærsti Raanaas¹ and Terry Hartig^2
1Dept of Plant and Environmental Sciences, Norwegian University of Life Sciences, Norway.
²Institute of Housing and Urban Research, Uppsala University, Sweden.

Abstract: People undergoing rehabilitation may benefit from physical environments that support their coping efforts. The present study aimed to examine whether health is promoted by introducing live foliage plants in the common indoor area of a residential rehabilitation center, as well as by viewing nature through the patients’ bedroom windows. The study site was the Røros Rehabilitation center, which is located in the mountains of mid-Norway and hosts patients with cardiovascular or pulmonary diseases who participate in a four-week rehabilitation program. Self-report measures of health and well-being were collected before and during the stay and after returning to home both before and after the introduction of many non-allergic foliage plants ranging from basket types to 180 cm tall plant installations. The patients were more satisfied with the plants and the interior after the intervention and the pulmonary patients reported an improvement in well-being (N=282)¹. Separate analysis of window views across the time period before and after the plant intervention revealed that a view to nature influenced change in physical health among women and mental health among men (N=278)². Patients with a view to the mountain landscape more often chose to use their bed room for being alone than those without.

Keywords: Indoor foliage plants, physical and mental health, well-being, window view.

¹ Raanaas, R.K., Patil, G.G. and Hartig, T. 2010. Effects of an indoor foliage plant intervention on patient well-being during a residential rehabilitation program. HortScience, 45(3): 387-392.
² Raanaas, R.K., Patil, G.G. and Hartig, T. Health benefits of a view to nature through the window: a quasi-experimental study of patient in a residential rehabilitation center. Clin. Rehab., in press (DOI: 10.1177/0269215511412800).

Just add water: aquatic environments and good public health

Benedict W. Wheeler, Mathew White & Michael H. Depledge

Affiliation: European Centre for Environment & Human Health, Peninsula College of Medicine & Dentistry, Universities of Exeter and Plymouth

Abstract: Research regarding the positive role of natural environments in supporting good health has primarily focussed on greenspace and woodlands, and there have been few attempts to differentiate health and wellbeing effects of different environments. As part of a programme of research around aquatic environments (“bluespace”) health and wellbeing, we investigated relationships between proximity to aquatic environments and self-reported health.

Using methods similar to those used in greenspace and health research, we calculated the proportion of the population rating their health as ‘Good’ in the 2001 UK census, for 32,482 small areas in England. These data have previously been used to produce rates of poor health; here we consider good health as the outcome, reflecting interest in salutogenic environments. We used GIS and multivariate regression models to investigate associations between good health and proximity to both inland waters and the coast. Analyses were adjusted for potential confounders including greenspace, age, sex and socio-economic deprivation, and were stratified by urban-rural status.  Proximity to the coast was associated positively with good health, with effects strongest in urban areas. Inland water was positively associated with good health in town/periurban areas. There were indications of interactions with area deprivation, with consequent implications for health inequalities.

Keywords: Blue space; aquatic environments; GIS; UK

Relationships Between Nearby Green Space and Physiological Stress for Residents of Deprived Urban Areas

Catharine Ward Thompson¹, Jenny Roe², Peter A. Aspinall¹, Angela Clow³, Richard Mitchell⁴, David Miller^5
1OPENspace Research Centre, Edinburgh College of Art, University of Edinburgh, UK; ²School of Built Environment, Heriot-Watt University, UK; ³Department of Psychology, University of Westminster, UK; ⁴Centre of Population Health Sciences, University of Glasgow, UK;  ⁵James Hutton Institute, Craigiebuckler, Aberdeen, UK.

Abstract: Green space in the environment is associated with a wide range of health benefits, including stress reduction, but much of the research relies on either self-reported indicators or has been undertaken in artificially controlled conditions.  Use of biomarkers as independent measures offers scope for better understanding of the mechanisms behind links between green space and health. This study sets out the results of both a pilot study (n=25) and subsequent larger study (n=78) in a deprived city area (in Scotland), using cortisol as a biomarker of stress. 

The paper will present the rationale and methodology for measuring cortisol and analyzing it in relation to the amount of green space in the residential environment.  In addition to cortisol measures, self-reported stress and general wellbeing indicators were used as secondary outcome measures.  Since some studies have shown stronger relationships between green space and health for those at home the most (older people, children, unemployed people) (de Vries et al 2003), this study focused on people not in work in order to maximise exposure to the residential environment.  Results from the pilot study indicate statistically significant relationships between self-reported wellbeing and cortisol measures and percentage green space in the living environment.  These findings are confirmed by a larger study which has found effects of gender on self-reported stress, with stress being higher in women.   Significant interaction effects between gender and percentage green space were found on mean cortisol concentrations, showing a positive effect of increasing green space on cortisol levels in women, but not for men.   Our studies indicate that higher levels of green space close to home are associated with better health and that this effect may be particularly pertinent to women and/or those experiencing poorer mental health.  The concluding discussion will identify the benefits and challenges of the methodology in exploring relationships between mental wellbeing and green space in deprived urban areas.  

Keywords: woodlands, urban green, deprivation, activity levels, frequency of use, quality of life.

References:
de Vries, S., Verheij, R. A., Groenewegen, P. P., Spreeuwenberg, P.(2003), Natural environments - healthy environments?  An exploratory analysis of the relationship between green space and health. Environment and Planning A, 35: 1717-1731.

The impact of urban woodland improvements on physical activity, use patterns and quality of life indicators in deprived communities - a longitudinal study.

Catharine Ward Thompson, Jenny Roe, Peter Aspinall, Susana Alves

OPENspace Research Centre, Edinburgh College of Art, University of Edinburgh and Heriot-Watt University.

Abstract: Green space in the residential environment is associated with a wide range of health benefits, including improved ‘walkability’ of a neighbourhood (Humpel et al 2002), but there is very little longitudinal evidence showing how an environmental intervention to improve the quality of, and access to, a nearby green space can impact on physical activity, use patterns (e.g. frequency of use), or overall perceptions of quality of the neighbourhood environment over time. This paper presents the results of a pilot study involving a natural experiment.  A longitudinal research project studied perceptions and use of local urban woodlands pre and post an environmental improvement programme (Woods In and Around Town (WIAT)) in an area of very high deprivation in Glasgow, Scotland.  A key component of the study methodology was the inclusion of a control site in order to detect any changes in attitudes, perceptions and values over time (2006 to 2009) that might reflect broader societal influences or other interventions within the general urban area.    Results show significant (p<0.05) increases in physical activity and woodland use over time in the intervention site, compared with negative or no change over time in the control site.  The research also found substantial positive change over time in the intervention site in relation to quality of life indicators and an increased awareness of the social potential of urban woodlands.  We conclude that environmental interventions in deprived urban locations can positively impact on physical activity, use patterns and perceptions of quality of life.  Our findings are substantiated by a review of contextual factors in each case study site, suggesting our control site had stayed reasonably stable over time in relation to environmental and societal factors.  

References:
Humpel, N., N. Owen, and E. Leslie, 2002, Environmental factors associated with adults' participation in physical activity: a review: Am J Prev Med, v. 22, p. 188-99