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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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“2011) and well-being (Bowler et al. 2010), reduced stress (Hartig et al.”
BackgroundLanki, T., Siponen, T., Ojala, A., Korpela, K., Pennanen, A. S., Tiittanen, P., Tsunetsugu, Y., Kagawa, T., & Tyrväinen, L. (2017) · Environmental Research · doi:10.1016/j.envres.2017.07.039 · Cited by 155
“Several of the studies have reported positive effects, most often for HRV, but drawing solid conclusions has been hampered by the heterogeneity of study designs and results (Bowler et al., 2010).”
BackgroundResultStieger, S., Lewetz, D., & Swami, V. (2021) · Journal of Happiness Studies · doi:10.1007/s10902-020-00337-2 · Cited by 161
Ecosystem Approach to Human Health
Brereton, F., & Lennon, M. (2021) · Springer eBooks · doi:10.1007/978-3-319-69909-7_830-2 · Cited by 151
Impact of Residential Greenness on Preschool Children’s Emotional and Behavioral Problems
Balsevičienė, B., Šinkariova, L., Gražulevičienė, R., Andrušaitytė, S., Uždanavičiūtė, I., Dėdelė, A., & Nieuwenhuijsen, M. J. (2014) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph110706757 · Cited by 167
“Some studies have confirmed these associations, but others have reported no or very weak associations [14,21,31].”
InfluentialMarchant, E., Todd, C., Cooksey, R., Dredge, S., Jones, H., Reynolds, D., Stratton, G., Dwyer, R., Lyons, R. A., & Brophy, S. T. (2019) · PLoS ONE · doi:10.1371/journal.pone.0212242 · Cited by 194
Huang, T., Li, J., Xie, Y., Niu, J., & Mak, C. M. (2017) · Building and Environment · doi:10.1016/j.buildenv.2017.09.015 · Cited by 149
Contrasting distributions of urban green infrastructure across social and ethno-racial groups
Ferguson, M., Roberts, H., McEachan, R., & Dallimer, M. (2018) · Landscape and Urban Planning · doi:10.1016/j.landurbplan.2018.03.020 · Cited by 149
Lifelong Residential Exposure to Green Space and Attention: A Population-based Prospective Study
Dadvand, P., Tischer, C., Estarlich, M., Llop, S., Dalmau-Bueno, A., López-Vicente, M., Valentín, A., de Keijzer, C., Fernández-Somoano, A., Lertxundi, N., et al. (2017) · Environmental Health Perspectives · doi:10.1289/ehp694 · Cited by 148
“…the child’s sense of self; in addition, they also may inspire basic emotional states (including a sense of wonder) and enhance psychological restoration, all of which may positively influence cognitive development and attention (Kahn and Kellert 2002; Kellert 2005; Bowler et al. 2010).”
Psychological responses to natural patterns in architecture
Coburn, A., Kardan, O., Kotabe, H., Steinberg, J., Hout, M. C., Robbins, A., MacDonald, J. A., Hayn-Leichsenring, G. U., & Berman, M. G. (2019) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2019.02.007 · Cited by 148
“The salubrious effects of exposure to nature include improved mood (Barton & Pretty, 2010; Bowler et al., 2010; Valtchanov, Barton, & Ellard, 2010), reduced stress (Valtchanov et al.”
BackgroundAnderson, J., Ruggeri, K., Steemers, K., & Huppert, F. A. (2016) · Environment and Behavior · doi:10.1177/0013916516659108 · Cited by 146
Green space and mortality following ischemic stroke
Wilker, E. H., Wu, C., McNeely, E., Mostofsky, E., Spengler, J. D., Wellenius, G. A., & Mittleman, M. A. (2014) · Environmental Research · doi:10.1016/j.envres.2014.05.005 · Cited by 143
“Proximity to green space may also offer more opportunities for physical activity and social interactions (Bowler et al., 2010; Coombes et al., 2010; Giles-Corti and Donovan, 2002).”
BackgroundRogerson, M., Gladwell, V., Gallagher, D., & Barton, J. (2016) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph13040363 · Cited by 142
Mygind, L., Kjeldsted, E., Hartmeyer, R., Mygind, E., Stevenson, M. P., Quintana, D. S., & Bentsen, P. (2019) · Environment and Behavior · doi:10.1177/0013916519873376 · Cited by 157
“Bowler et al. (2010) found that these self-reported constructs were more consistently 212 Environment and Behavior 53(2) improved than physiological indicators such as cortisol or diastolic and systolic blood pressure.”
BackgroundResultInfluentialLiu, Q., Yu Qing, W. U., Xiao, Y., Fu, W., Zhuo, Z., Konijnendijk, C. C., Huang, Q., & Lan, S. (2020) · Landscape and Urban Planning · doi:10.1016/j.landurbplan.2020.103763 · Cited by 142
Wright, L. J., Williams, S. E., & Zanten, J. V. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.580511 · Cited by 151
“Outdoor physical activity is generally associated with lower depression, tension, anger, and confusion compared to indoor physical activity (Bowler et al., 2010; Dunton et al., 2015), and has been associated with improved emotional well-being, including in adolescents (Pasanen et al.”
BackgroundRomagosa, F., Eagles, P. F. J., & Lemieux, C. J. (2015) · Journal of Outdoor Recreation and Tourism · doi:10.1016/j.jort.2015.06.009 · Cited by 140
Nature-related mood effects: Season and type of nature contact
Brooks, A. M., Ottley, K. M., Arbuthnott, K. D., & Sevigny, P. R. (2017) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2017.10.004 · Cited by 156
Threats to mental health and wellbeing associated with climate change
Manning, C. M., & Clayton, S. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-813130-5.00009-6 · Cited by 154
Simkin, J., Ojala, A., & Tyrväinen, L. (2019) · Urban forestry & urban greening · doi:10.1016/j.ufug.2019.126567 · Cited by 163
Neighborhood Blight, Stress, and Health: A Walking Trial of Urban Greening and Ambulatory Heart Rate
South, E. C., Kondo, M. C., Cheney, R., & Branas, C. C. (2015) · American Journal of Public Health · doi:10.2105/ajph.2014.302526 · Cited by 139
“Using georeferenced heart rate monitoring in an experimental study of an individual’s native environment is a unique approach to field studies of neighborhood blight on acute stress.(22)”
MethodChiabai, A., Quiroga, S., Martínez-Juárez, P., Higgins, S., & Taylor, T. (2018) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2018.03.323 · Cited by 152
Research challenges for cultural ecosystem services and public health in (peri-)urban environments
Chen, X., de Vries, S., Assmuth, T., Dick, J., Hermans, T., Hertel, O., Jensen, A., Jones, L., Kabisch, S., Lanki, T., et al. (2019) · Science of The Total Environment · doi:10.1016/j.scitotenv.2018.09.030 · Cited by 141
“On the other hand, specific short-term effects such as stress relief and lower blood pressure from contact with nature (Bowler et al., 2010; Tyrväinen et al., 2014) are difficult to translate tomore long-term health outcomes.”
BackgroundGreener living environment healthier people?
Picavet, H. S. J., Milder, I. E. J., Kruize, H., de Vries, S., Hermans, T., & Wendel‐Vos, W. (2016) · Preventive Medicine · doi:10.1016/j.ypmed.2016.04.021 · Cited by 139
Environmental Determinants of Aggression in Adolescents: Role of Urban Neighborhood Greenspace
Younan, D., Tuvblad, C., Li, L., Wu, J. Y., Lurmann, F. W., Franklin, M., Berhane, K. T., McConnell, R., Wu, A. H., Baker, L. A., et al. (2016) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2016.05.002 · Cited by 146
Enhancing quality of life through the lens of green spaces: A systematic review approach
Mensah, C. A., Andres, L., Perera, U., & Roji, A. (2016) · International Journal of Wellbeing · doi:10.5502/ijw.v6i1.445 · Cited by 145
“3) Assessing the quality of selected publications: After identifying the specific publications for inclusion in the study, their level of quality was assessed according to the six quality assessment criteria as described by Bowler et al (2010).”
MethodNatural Environments and their Impact on Activity, Health, and Quality of Life
Thompson, C. W., & Aspinall, P. (2011) · Applied Psychology Health and Well-Being · doi:10.1111/j.1758-0854.2011.01053.x · Cited by 137
Behavioral trainings and manipulations to reduce delay discounting: A systematic review
Scholten, H., Scheres, A., de Water, E., Graf, U., Granic, I., & Luijten, M. (2019) · Psychonomic Bulletin & Review · doi:10.3758/s13423-019-01629-2 · Cited by 135
Association between residential greenness and birth weight: Systematic review and meta-analysis
Dzhambov, A. M., Dimitrova, D., & Dimitrakova, E. D. (2014) · Urban forestry & urban greening · doi:10.1016/j.ufug.2014.09.004 · Cited by 146
Marselle, M. R., Irvine, K. N., Lorenzo-Arribas, A., & Warber, S. L. (2014) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph120100106 · Cited by 138
“considered in studies of Nature and health [25,26,78].”
BackgroundJaneczko, E., Bielinis, E., Wójcik, R., Woźnicka, M., Kędziora, W., Łukowski, A., Elsadek, M., Szyc, K., & Janeczko, K. (2020) · Forests · doi:10.3390/f11050591 · Cited by 135
van den Berg, M., Maas, J., Muller, R., Braun, A., Kaandorp, W., van Lien, R., van Poppel, M. N. M., van Mechelen, W., & den Berg, A. E. V. (2015) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph121215026 · Cited by 135
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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