Dr Jo Barton University of Essex

1. How Does Greenspace Contribute to Healthy, Thriving Communities? Dr Jo BartonUniversity of Essex

2. 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

3. Our relationship with nature has changed....

4. Wilson (1984) 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

5. Kaplan & Kaplan (1989) Attention Restoration Theory • We engage in 2 types of attention • Involuntary – requires minimal effort • 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

6. 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

7. Greenspaces and Healthy Communities • Reduces property crime • violent crime • levels of aggression Provides a sense of belonging Reduces health inequalities • Improves mental health and wellbeing • Self-esteem • Mood • Reduces stress • Perceived • Cortisol • Restores mental fatigue Greenspace • Facilitates activity • Improves physical health • Lowers BP • Increases HRV • Reduces obesity • Enhances social cohesion • Reduces social isolation • Improves social networking • Encourages intergenerational links

8. Mitchell & Popham (2008) Greenspace Reduces Health Inequalities

9. Ellaway & Macintyre (2005) Is Greenery Associated with Obesity? (N = 6919) > x3 Odds Ratio 40% less Greenery

10. Kuo & Sullivan (2001) Greenspaces and Crime • Highest vegetation: • 52% less total crimes • 48% less property crimes • 56% less violent crimes • Supports ART hypothesis

11. Pretty et al., (2005) 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

12. Gladwell et al., (2012) 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

13. Akers 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) Green (unedited) Grey (achromatic) Red (filter)

14. Barton & Pretty (2012) 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?

15. TMD = Total Mood Disturbance (indicator of overall mood)

17. Barton et al., (2011) Therapeutic Intervention - Longer Term Shifts in Self-Esteem

18. Barton et al., (2012) TurnAround and Control Group Mindfulness and Self-Esteem Scores Note: A higher score=more mindful qualities, error bars represent =1SD. * indicates a significantly higher mindfulness score in the TA group (P<0.05) Note: A lower score= better self-esteem, error bars represent =1SD. * indicates a better self-esteem in the turnaround group (P<0.05)

19. 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

20. 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)

21. Wood et al., (2012) Greenspaces Facilitate Physical Activity Adolescents Children * 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)

22. 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)).

23. Brown and Gladwell (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

24. 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?

25. 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

26. Conclusion - Research Findings to Date • Acute GE has mental health benefits: • Self-esteem & mood • 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) • Green spaces facilitate activity & improve social capital: • Need accessible green spaces in towns & cities

27. Conclusions • Need to think of Natural Health Service to complement NHS - Green places can be therapeutic, self-medicate with nature? • 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

28. www.greenexercise.org “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?