Abstract
Engagement with nature is an important part of many people’s lives, and the health and wellbeing benefits of nature–based activities are becoming increasingly recognised across disciplines from city planning to medicine. Despite this, urbanisation, challenges of modern life and environmental degradation are leading to a reduction in both the quantity and the quality of nature experiences. Nature–based health interventions (NBIs) can facilitate behavioural change through a somewhat structured promotion of nature–based experiences and, in doing so, promote improved physical, mental and social health and wellbeing. We conducted a Delphi expert elicitation process with 19 experts from seven countries (all named authors on this paper) to identify the different forms that such interventions take, the potential health outcomes and the target beneficiaries. In total, 27 NBIs were identified, aiming to prevent illness, promote wellbeing and treat specific physical, mental or social health and wellbeing conditions. These interventions were broadly categorized into those that change the environment in which people live, work, learn, recreate or heal (for example, the provision of gardens in hospitals or parks in cities) and those that change behaviour (for example, engaging people through organized programmes or other activities). We also noted the range of factors (such as socioeconomic variation) that will inevitably influence the extent to which these interventions succeed. We conclude with a call for research to identify the drivers influencing the effectiveness of NBIs in enhancing health and wellbeing.
Highlights
There are many pressing public health and environmental challenges associated with modern living, with rapidly growing levels of chronic, non–communicable physical and mental health conditions [1–4] and global recognition of serious health risks posed by stressful living conditions [5]
Environmental manipulations where green and blue spaces are incorporated into cities can have positive outcomes associated with the management of habitats and flow of ecosystem services to people [13,14], but there is a growing body of evidence highlighting the potential of green space for the treatment and prevention of physical, mental and social health and wellbeing challenges [8,15–19]
Nineteen of 30 invited experts who were identified from across the world actively engaged with a Delphi expert elicitation process to review a compilation of nature–based health interventions (NBIs) identified through a literature search conducted by D.F.S
Summary
There are many pressing public health and environmental challenges associated with modern living, with rapidly growing levels of chronic, non–communicable physical and mental health conditions [1–4] and global recognition of serious health risks posed by stressful living conditions [5].Engagement with nature is a common pursuit in cities [6] and it is becoming increasingly recognised as a means to alleviate many of these challenges. Environmental manipulations where green and blue spaces are incorporated into cities can have positive outcomes associated with the management of habitats and flow of ecosystem services to people [13,14], but there is a growing body of evidence highlighting the potential of green space for the treatment and prevention of physical, mental and social health and wellbeing challenges [8,15–19] This recognition that experiences of nature can provide benefits for people represents a major shift in public health thinking for both the prevention and the treatment of health issues, beyond considering nature solely as a risk–factor (e.g., through the transmission of insect–borne diseases [20–23])
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