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A systematic review of evidence for the added benefits to health of exposure to natural environments
Open accessAbstract
Background: There is increasing interest in the potential role of the natural environment in human health and well-being. However, the evidence-base for specific and direct health or well-being benefits of activity within natural compared to more synthetic environments has not been systematically assessed. Methods: We conducted a systematic review to collate and synthesise the findings of studies that compare measurements of health or well-being in natural and synthetic environments. Effect sizes of the differences between environments were calculated and meta-analysis used to synthesise data from studies measuring similar outcomes. Results: Twenty-five studies met the review inclusion criteria. Most of these studies were crossover or controlled trials that investigated the effects of short-term exposure to each environment during a walk or run. This included 'natural' environments, such as public parks and green university campuses, and synthetic environments, such as indoor and outdoor built environments. The most common outcome measures were scores of different self-reported emotions. Based on these data, a meta-analysis provided some evidence of a positive benefit of a walk or run in a natural environment in comparison to a synthetic environment. There was also some support for greater attention after exposure to a natural environment but not after adjusting effect sizes for pretest differences. Meta-analysis of data on blood pressure and cortisol concentrations found less evidence of a consistent difference between environments across studies. Conclusions: Overall, the studies are suggestive that natural environments may have direct and positive impacts on well-being, but support the need for investment in further research on this question to understand the general significance for public health.
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“Although a previous meta-analysis has been published that examined whether exposure to natural environments has a positive impact on health and well-being (Bowler et al., 2010)”
From The relationship between nature connectedness and happiness: a meta-analysis (2014) · cites this paper as Bowler et al., 2010
In the citing paper
“For example, exposure to natural environments decreases stress, increases happiness, improves mood, and restores attention (Berto, 2005; Bowler, Buyung-Ali, Knight, & Pullin, 2010; White, Alcock, Wheeler, & Depledge, 2013).”
From Behavioral trainings and manipulations to reduce delay discounting: A systematic review (2019) · cites this paper as Bowler, Buyung-Ali, Knight, & Pullin, 2010
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“Natural spaces have been shown to provide individuals with well-being benefits [47]”
From Understanding How Virtual Reality Can Support Mindfulness Practice: Mixed Methods Study (2020) · cites this paper as [47]
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Madsen, L. S., Handberg, C., Jensen, C. M., & Nielsen, C. V. (2020) · Disability & Society · doi:10.1080/09687599.2020.1783206 · Cited by 13
Chan, C. S., & Hazan, H. (2022) · SSM - Mental Health · doi:10.1016/j.ssmmh.2022.100071 · Cited by 13
“…al., 2013), regular physical activity (e.g., Josefsson et al., 2014; Matricciani et al., 2018; Saunders et al., 2016), closeness with nature (e.g., Bowler et al., 2010; Capaldi et al., 2014), supportive kinships and friendships (e.g., Holt-Lunstad et al., 2010; Uchino et al., 2018; Wittig et al.,…”
BackgroundThe Role of the Campus Outdoor Environment on University Student Mental Health
Koning, M., Kim, J., Saeidi-Rizi, F., & Durst, N. J. (2022) · Journal of people, plants, and environment · doi:10.11628/ksppe.2022.25.3.263 · Cited by 17
“The idea that natural environments are beneficial to human health and wellbeing has been carefully considered and studied for many years (Bowler et al., 2010).”
BackgroundThe Role of Courtyards within Acute Mental Health Wards: Designing with Recovery in Mind
McIntosh, J., Marques, B., & Jenkin, G. L. S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191811414 · Cited by 24
“Exposure to nature is one key aspect of participation in outdoor activities that provides a range of health benefits, including the perception of barriers and relief from stress [3,55–61], improved physical health [62,63] and mental wellbeing [64,65].”
BackgroundAranda, N. R., Waegemaeker, J. D., & de Weghe, N. V. (2023) · Journal of Environmental Planning and Management · doi:10.1080/09640568.2023.2177141 · Cited by 14
“2012; V € olker and Kistemann 2015; Bowler et al .”
BackgroundWang, M., Hai, H., Xiong, J., Yuan, Z., & Zeng, K. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116186 · Cited by 13
Janeczko, E., Gorski, J., Woźnicka, M., Czyżyk, K., Kędziora, W., & Korcz, N. (2023) · Forests · doi:10.3390/f14091904 · Cited by 13
Samaan, L., Klock, L., Weber, S., Reidick, M. C., Ascone, L., & Kühn, S. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21050598 · Cited by 16
“These benefits have been shown for healthy (e.g., [1,3]) and for patient populations, including patients with depression or anxiety [5,6] as well as patients with physical illnesses such as cancer [7].”
BackgroundPoortinga, W., Denney, J., Kelly, K. M., Oates, R., Phillips, R., Oliver, H., & Hallingberg, B. (2024) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2024.102376 · Cited by 15
“Green exercise is demonstrated to significantly improve physical and mental health above the same activity in urban settings (Barton et al., 2012; Bowler et al., 2010), and these benefits may be gained from any size and type of green space, from small urban parks to vast wilderness (Pretty et al.,…”
BackgroundBressane, A., Ferreira, M. E. G., Garcia, A. J. D. S., & Medeiros, L. C. D. C. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21070937 · Cited by 14
“A systematic review by Bowler et al. [11] analyzed various studies assessing the impact of natural environments on stress.”
BackgroundA blueprint for overcoming barriers to the use of nature-based coastal protection in Australia
Morris, R. L., Pomeroy, A., Boxshall, A., Colleter, G., Dack, D., Dunlop, A. R., Hanslow, D. J., King, S., Magini, A. G., O’Malley-Jones, K., et al. (2024) · Frontiers in Environmental Science · doi:10.3389/fenvs.2024.1435833 · Cited by 13
Zhu, B.-W., Feng, C.-W., Xiong, L., Zheng, W., Wang, G., Zhang, X., & Tzeng, G. (2024) · Journal of Urban Planning and Development · doi:10.1061/jupddm.upeng-5194 · Cited by 13
Estimating and mapping the value of cultural ecosystem services in an urban landscape context
Adhikary, M., Ghosh, D., Mandal, B., & Das, S. (2025) · Applied Geography · doi:10.1016/j.apgeog.2025.103556 · Cited by 13
Green Streets Social and Aesthetic Aspects
Sabbion, P. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-812150-4.00026-4 · Cited by 13
Flynn, E., Denson, E. B., Mueller, M. K., Gandenberger, J., & Morris, K. N. (2020) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2020.101223 · Cited by 13
Marić, J., Đjukić, A., Antonić, B., Furundžić, D. S., & Parežanin, V. (2021) · Sustainability · doi:10.3390/su13010336 · Cited by 13
Mental Health Outcome Measures in Environmental Design Research: A Critical Review
Shin, J., Dennis, S. F., & Mohammed, H. (2021) · HERD Health Environments Research & Design Journal · doi:10.1177/1937586721999787 · Cited by 15
“This observation aligns with the result from a recent metaanalysis conducted on the impact of nature on physiological measures (Bowler et al., 2010).”
ResultViewing Natural vs. Urban Images and Emotional Facial Expressions: An Exploratory Study
Franěk, M., & Petružálek, J. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147651 · Cited by 14
Can the Biophilia Hypothesis Be Applied to Long-Duration Human Space Flight? A Mini-Review
Neilson, B. N., Craig, C. M., Altman, G. C., Travis, A. T., Vance, J. A., & Klein, M. I. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.703766 · Cited by 14
Panno, A., Theodorou, A., Carbone, G. A., Longis, E. D., Massullo, C., Cepale, G., Carrus, G., Imperatori, C., & Sanesi, G. (2021) · Sustainability · doi:10.3390/su131910807 · Cited by 14
Marois, A., & Lafond, D. (2022) · Cognition Technology & Work · doi:10.1007/s10111-022-00715-1 · Cited by 16
Digital and Strategic Innovation for Alpine Health Tourism
Spoladore, D., Pessot, E., & Sacco, M. (2022) · SpringerBriefs in applied sciences and technology · doi:10.1007/978-3-031-15457-7 · Cited by 13
Does Taking a Walk in Nature Enhance Long-Term Memory?
Rider, N. D., & Bodner, G. E. (2016) · Ecopsychology · doi:10.1089/eco.2015.0042 · Cited by 14
Travel and child wellbeing: The psychological and cognitive domains
Westman, J., Friman, M., & Olsson, L. E. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-814694-1.00003-8 · Cited by 13
Insect herbivory on urban trees: Complementary effects of tree neighbours and predationPreprint
Stemmelen, A., Paquette, A., Benot, M., Kadiri, Y., Jactel, H., & Castagneyrol, B. (2020) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2020.04.15.042317 · Cited by 13
Aras, S. G., Runyon, J. R., Kazman, J. B., Thayer, J. F., Sternberg, E. M., & Deuster, P. A. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21111491 · Cited by 17
Metadata
- Authors
- Bowler, D. E., Buyung-Ali, L. M., Knight, T. M., & Pullin, A. S.
- Affiliations
- Bangor University (GB)
- Corresponding author
- Pullin, Andrew S
- Venue
- BMC Public Health
- Published
- 2010-08-04
- Volume
- 10
- Issue
- 1
- Pages
- 456-456
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC2924288
- OpenAlex
- W2115180584
- Cited by
- 1,993
- References
- 57
- Citations by year
- 2026: 108 · 2025: 146 · 2024: 206 · 2023: 172 · 2022: 176 · 2021: 184 · 2020: 227 · 2019: 167 · 2018: 138 · 2017: 103 · 2016: 112 · 2015: 80 · 2014: 78 · 2013: 54 · 2012: 24
- FWCI
- 3.06
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Natural England
- Topics
- Social Sciences › Urban Studies › Urban Green Space and Health
- Physical Sciences › Physics and Astronomy › Acoustics and Ultrasonics › Noise Effects and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- natural environment, synthetic environments, built environment, well-being, self-reported emotion, attention, blood pressure, cortisol, walking, running, green spaces, public parks, urban green space, nature exposure
- MeSH terms
- Health Status, Humans, Personal Satisfaction, Nature
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