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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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“, exposure to virtual urban environments [2,48,92].”
The impacts of nature connectedness on children's well-being: Systematic literature review
Arola, T., Aulake, M., Ott, A., Lindholm, M., Kouvonen, P., Virtanen, P., & Paloniemi, R. (2022) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2022.101913 · Cited by 128
Sing, L., Metzger, M. J., Paterson, J., & Ray, D. (2017) · Forestry An International Journal of Forest Research · doi:10.1093/forestry/cpx042 · Cited by 102
Zijlema, W. L., Ávila-Palència, I., Mas, M. T., Gidlow, C. J., Maas, J., Kruize, H., Andrušaitytė, S., Gražulevičienė, R., & Nieuwenhuijsen, M. J. (2018) · Environment International · doi:10.1016/j.envint.2018.10.002 · Cited by 112
Sobko, T., Liang, S., Cheng, W. H. G., & Tun, H. M. (2020) · Scientific Reports · doi:10.1038/s41598-020-78642-2 · Cited by 113
Challenges and Opportunities in the Use of Nature-Based Solutions for Urban Adaptation
Castelo, S., Amado, M., & Ferreira, F. (2023) · Sustainability · doi:10.3390/su15097243 · Cited by 127
Gaekwad, J. S., Moslehian, A. S., & Roös, P. B. (2023) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2023.102085 · Cited by 119
Defining and measuring the social-ecological quality of urban greenspace: a semi-systematic review
Hunter, A., & Luck, G. (2015) · Urban Ecosystems · doi:10.1007/s11252-015-0456-6 · Cited by 101
“The positive values of UGS (as broadly defined) have been widely reviewed (Abraham et al. 2010; Bell et al. 2007; Bowler et al. 2010; Bratman et al. 2012; Haq 2011; Keniger et al. 2013; Knecht 2004; Konijnendijk et al. 2013; Luck et al. 2009; Smardon 1988).”
BackgroundReinhard, E., Courtin, É., van Lenthe, F. J., & Avendaño, M. (2018) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2017-210038 · Cited by 102
“29 30 Additionally, there is evidence that driving cessation is associated with increased depressive symptoms among older people.”
Mygind, L., Kjeldsted, E., Hartmeyer, R., Mygind, E., Bølling, M., & Bentsen, P. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00943 · Cited by 116
“While reviews have synthesized the wealth of predominantly correlational literature exploring nature contact and benefits for health (Bowler et al., 2010; Bratman et al., 2012; Hartig et al., 2014; Twohig-Bennett and Jones, 2018), the evidence is both diverse and dispersed.”
BackgroundMarine Biota and Psychological Well-Being
Cracknell, D., White, M. P., Pahl, S., Nichols, W. J., & Depledge, M. H. (2015) · Environment and Behavior · doi:10.1177/0013916515597512 · Cited by 103
Carrus, G., Scopelliti, M., Panno, A., Lafortezza, R., Colangelo, G., Pirchio, S., Ferrini, F., Salbitano, F., Agrimi, M., Portoghesi, L., et al. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00914 · Cited by 103
“These results are also in line with previous literature on the benefits of contact with nature in general, be they physical (Bodin and Hartig, 2003; Bowler et al., 2010; Thompson Coon et al., 2011) or psychological (Ulrich et al.”
ResultDoherty, S. T., Lemieux, C. J., & Canally, C. (2014) · Social Science & Medicine · doi:10.1016/j.socscimed.2014.01.048 · Cited by 110
Does awareness affect the restorative function and perception of street trees?
Lin, Y.-H., Tsai, C.-C., SULLIVAN, W. C., Chang, P.-J., & Chang, C. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.00906 · Cited by 100
“ORIGINAL RESEARCH ARTICLE published: 15 August 2014 doi: 10.3389/fpsyg.2014.00906 Does awareness affect the restorative function and perception of street trees?”
BackgroundInfluentialZhang, L., & Tan, P. Y. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16040578 · Cited by 99
“First, although this cross-sectional study showed certain statistical associations at different buffers, it is still difficult to provide explanation of mechanisms leading to these outcomes, since correlation does not equal a causal relationship [67,68].”
BackgroundTowards a better future for biodiversity and people: Modelling Nature Futures
Kim, H., Peterson, G., Cheung, W. W. L., Ferrier, S., Alkemade, R., Arneth, A., Kuiper, J. J., Okayasu, S., Pereira, L. M., Acosta, L. A., et al. (2023) · Global Environmental Change · doi:10.1016/j.gloenvcha.2023.102681 · Cited by 133
Examining fear-evoking factors in urban parks in Hong Kong
Mak, B. K. L., & Jim, C. Y. (2017) · Landscape and Urban Planning · doi:10.1016/j.landurbplan.2017.11.012 · Cited by 99
Lymeus, F., Lindberg, P., & Hartig, T. (2018) · Consciousness and Cognition · doi:10.1016/j.concog.2018.01.008 · Cited by 119
Greenspace exposure and children behavior: A systematic review
Sakhvidi, M. J. Z., Knobel, P., Bauwelinck, M., de Keijzer, C., Boll, L. M., Spano, G., Ubalde-López, M., Sanesi, G., Mehrparvar, A. H., Jacquemin, B., et al. (2022) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2022.153608 · Cited by 106
Calogiuri, G., & Elliott, L. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph14040377 · Cited by 99
“Systematic reviews of literature show that nature experiences can lead to positive psychophysiological states such as perceived stress relief and more positive states of wellbeing [7].”
BackgroundLiveable for whom? Prospects of urban liveability to address health inequities
Badland, H. M., & Pearce, J. R. (2019) · Social Science & Medicine · doi:10.1016/j.socscimed.2019.05.001 · Cited by 103
“Consequently, green space provision has received much attention in the built environment and public health fields, see for example [49-51, 98].”
BackgroundMethodLöf, M., Brunet, J., Filyushkina, A., Lindbladh, M., Skovsgaard, J. P., & Felton, A. (2015) · International Journal of Biodiversity Science Ecosystems Services & Management · doi:10.1080/21513732.2015.1120780 · Cited by 97
“Their importance for society and thus need for integration into decision-making has been increasingly acknowledged (Bowler et al. 2010; Daniel et al. 2012).”
BackgroundDeelen, I., Janssen, M., Vos, S. B., Kamphuis, C. B. M., & Ettema, D. (2019) · BMC Public Health · doi:10.1186/s12889-019-6676-6 · Cited by 116
Greenspace Interventions, Stress and Cortisol: A Scoping Review
Jones, R., Tarter, R. R., & Ross, A. M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18062802 · Cited by 113
“GSIs are considered dynamic, community-based, and involve human exposure to uncontrolled, natural, green, outdoor environs through unique procedures and processes [4,10,29].”
BackgroundFactors that enhance or hinder social cohesion in urban greenspaces: A literature review
Clarke, M. K., Cadaval, S., Wallace, C. E., Anderson, E. C., Egerer, M., Dinkins, L., & Platero, R. (2023) · Urban forestry & urban greening · doi:10.1016/j.ufug.2023.127936 · Cited by 113
Does biodiversity improve mental health in urban settings?
Dean, J., van Dooren, K., & Weinstein, P. (2011) · Medical Hypotheses · doi:10.1016/j.mehy.2011.02.040 · Cited by 101
“Several authors have called for further research on the ‘quality’ of the green space as measured by for example biodiversity richness, and associated benefits to health or well-being [31,35].”
Everyday green space and experienced well-being: the significance of wildlife encounters
Bell, S., Westley, M., Lovell, R., & Wheeler, B. W. (2017) · Landscape Research · doi:10.1080/01426397.2016.1267721 · Cited by 98
Coppel, G., & Wüstemann, H. (2017) · Landscape and Urban Planning · doi:10.1016/j.landurbplan.2017.06.015 · Cited by 97
The Restorative Environment: A Complementary Concept for Salutogenesis Studies
von Lindern, E., Lymeus, F., & Hartig, T. (2016) · Springer eBooks · doi:10.1007/978-3-319-04600-6_19 · Cited by 106
“In their meta-analysis, however, Bowler et al. (2010) could not reliably affirm attentional benefits of nature experiences on the basis of the results available at that stage in the development of the literature.”
BackgroundHall, C., & Knuth, M. J. (2019) · Journal of Environmental Horticulture · doi:10.24266/0738-2898-37.1.30 · Cited by 95
Restorative benefits of everyday green exercise: A spatial approach
Kajosaari, A., & Pasanen, T. (2020) · Landscape and Urban Planning · doi:10.1016/j.landurbplan.2020.103978 · Cited by 96
Kang, Y., Jia, Q., Gao, S., Zeng, X., Wang, Y., Angsüsser, S., Liu, Y., Ye, X., & Fei, T. (2019) · Transactions in GIS · doi:10.1111/tgis.12552 · Cited by 94
“Our findings are consistent with several existing theory in psychology (Kaplan, 1995), that exposure to nature has a positive impact on human moods (Bowler et al., 2010), which also supports the theoretical foundation of the framework and proves the validity of this study to some extent.”
ResultYu, Z., Yang, G., Lin, T., Zhao, B., Xu, Y., Yao, X., Ma, W., Vejre, H., & Jiang, B. (2024) · Ecosystem Health and Sustainability · doi:10.34133/ehs.0165 · Cited by 97
Environmental Strategies of Affect Regulation and Their Associations With Subjective Well-Being
Korpela, K., Pasanen, T., Repo, V., Hartig, T., Staats, H., Mason, M. J., Alves, S. M., Fornara, F., Marks, T., Saini, S., et al. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.00562 · Cited by 109
“…(MacKerron and Mourato, 2013) and positive emotional and mood change (improvement in the feelings of anxiety, anger, fatigue, energy and sadness) (Bowler et al., 2010) and studies of motives for outdoor recreation have commonly referred to escape from stressors as well as a search for positive…”
BackgroundResultForest therapy can prevent and treat depression: Evidence from meta-analyses
Rosa, C. D., Larson, L. R., Collado, S., & Profice, C. C. (2020) · Urban forestry & urban greening · doi:10.1016/j.ufug.2020.126943 · Cited by 106
Nature-Based Strategies for Improving Urban Health and Safety
Kondo, M. C., South, E. C., & Branas, C. C. (2015) · Journal of Urban Health · doi:10.1007/s11524-015-9983-y · Cited by 102
“Two prior reviews have focused on evidence of the role of nature in changing rates of physical activity as a mechanism to improve health.(64,77) While numerous studies on the link between green space and physical activity exist, many use cross-sectional ecologic study designs and find nonsignificant or negative associ…”
Background
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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