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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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“The Mentro Allan Programme sought to draw on the benefits of the ‘natural’ environment’ and ‘green space’ for physical health (Maas 2006, Barton et al. 2009) and also for mental health (Bowler et al. 2010).”
BackgroundCan Simulated Green Exercise Improve Recovery From Acute Mental Stress?
Wooller, J.-J., Rogerson, M., Barton, J., Micklewright, D. P., & Gladwell, V. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.02167 · Cited by 39
Massey, H. C., Kandala, N.-B., Davis, C., Harper, C. M., Gorczynski, P. F., & Denton, H. (2020) · Lifestyle Medicine · doi:10.1002/lim2.12 · Cited by 46
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Mental Health and Environmental Exposures: An Editorial
Helbich, M. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15102207 · Cited by 40
“, park, bodies of water, weather) [3], social (e.”
Razani, N., Kohn, M. A., Wells, N. M., Thompson, D., Hamilton Flores, H., & Rutherford, G. W. (2016) · Contemporary Clinical Trials · doi:10.1016/j.cct.2016.09.007 · Cited by 39
Wearables and Location Tracking Technologies for Mental-State Sensing in Outdoor Environments
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“This is based on the premise that spending time in nature reduces negative emotions and stress levels (Bloomfield, 2017; Bowler et al., 2010; Frumkin, 2001; Hartig et al., 2014; Irvine & Warber, 2002; Marselle et al., 2019), which thereby decrease mental stress and enhance the visitor’s perception…”
BackgroundAssociations Between Urban Green Space Quality and Mental Wellbeing: Systematic Review
Xu, Z., Marini, S., Mauro, M., Latessa, P. M., Grigoletto, A., & Toselli, S. (2025) · Land · doi:10.3390/land14020381 · Cited by 60
Development and validation of the attitudes toward outdoor play scales for children
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“A systematic review of 25 studies relating time outdoors to health benefits found that exposure to natural environments consistently reduced negative emotions (e.g., anger, fatigue, and sadness), while having a positive impact on energy levels and attention (Bowler et al., 2010).”
BackgroundGreenspace and Place Attachment: Do Greener Suburbs Lead to Greater Residential Place Attachment?
Kimpton, A., Wickes, R. L., & Corcoran, J. (2014) · Urban Policy and Research · doi:10.1080/08111146.2014.908769 · Cited by 39
“Parks, or ‘public greenspaces’, represent an important public amenity in urban areas as they provide residents with access to spaces conducive to health-related activities and encourage community sociability (Coley et al., 1997; Takano et al., 2002; Kaplan & Kim, 2004; Giles-Corti et al., 2005; Cohen et al., 2007; Pre…”
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The Prevalence and Use of Walking Loops in Neighborhood Parks: A National Study
Cohen, D. A., Han, B., Evenson, K. R., Nagel, C. J., McKenzie, T. L., Marsh, T., Williamson, S. L., & Harnik, P. (2016) · Environmental Health Perspectives · doi:10.1289/ehp293 · Cited by 39
“170 volume 125 | number 2 | February 2017 • Environmental Health Perspectives Research A Section 508–conformant HTML version of this article is available at http://dx.doi.org/10.1289/EHP293.”
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Elderly Health Inequality in China and its Determinants: A Geographical Perspective
Fan, C., Ouyang, W., Tian, L., Song, Y., & Miao, W. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16162953 · Cited by 39
Sacchelli, S., Grilli, G., Capecchi, I., Bambi, L., Barbierato, E., & Borghini, T. (2020) · Forests · doi:10.3390/f11020190 · Cited by 43
“[9] carried out a systematic review to assess whether an association exists between health and exposure to natural environments, finding that almost all papers suggested a positive relationship although they concluded that more research is needed.”
BackgroundZwierzchowska, I., Haase, D., & Dushkova, D. (2020) · Landscape and Urban Planning · doi:10.1016/j.landurbplan.2020.103975 · Cited by 43
Taheri, S., Sichani, M. G., & Shabani, A. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.113820 · Cited by 40
The Role of Environmental Risk Factors on the Development of Childhood Allergic Rhinitis
Wu, A. C., Dahlin, A., & Wang, A. L. (2021) · Children · doi:10.3390/children8080708 · Cited by 39
“5 to 6 tons of excess atmospheric CO2 can be consumed [67].”
BackgroundKorcz, N., Janeczko, E., Bielinis, E., Urban, D., Koba, J., Szabat, P., & Małecki, M. (2021) · Forests · doi:10.3390/f12080993 · Cited by 38
“However, the stress associated with living in urban areas [3] is exacerbated by stressors in the workplace [4,5].”
BackgroundSu, J. G., Barrett, M., Henderson, K., Humblet, O., Smith, T., Sublett, J. W., Nesbitt, L., Hogg, C., Sickle, D. V., & Sublett, J. L. (2016) · Environmental Health Perspectives · doi:10.1289/ehp266 · Cited by 38
“…outcomes, such as increased physical activity and social interaction in green spaces, reduced psychophysiological stress and depression, ameliorated noise and air pollution levels, and regulated microclimates (i.e., moderating ambient temperature and urban heat island effects) (Bowler et al. 2010).”
BackgroundDifficult Family Relationships, Residential Greenspace, and Childhood Asthma
Chen, E., Miller, G. E., Shalowitz, M. U., Story, R. E., Levine, C. S., Hayen, R., Sbihi, H., & Brauer, M. D. (2017) · PEDIATRICS · doi:10.1542/peds.2016-3056 · Cited by 40
“In the primary analyses, we conducted hierarchical multiple regression analyses according to the recommendations of Aiken and West, 44 in which asthma measures were predicted from (1) covariates described previously, (2) main effects of greenspace and family relationships, and (3) the interaction between greenspace an…”
Method‘Farming on the Edge’: Wellbeing and Participation in Agri‐Environmental Schemes
Saxby, H., Gkartzios, M., & Scott, K. (2017) · Sociologia Ruralis · doi:10.1111/soru.12180 · Cited by 38
The Development of Three Questionnaires to Assess Beliefs about Green Exercise
Flowers, E. P., Freeman, P., & Gladwell, V. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph14101172 · Cited by 49
Battaglia, G., Giustino, V., Messina, G., Faraone, M., Brusa, J., Bordonali, A., Barbagallo, M., Palma, A., & Dominguez, L. J. (2020) · Sustainability · doi:10.3390/su12072684 · Cited by 38
Developing academic wellbeing through writing retreats
Stevenson, N. (2020) · Journal of Further and Higher Education · doi:10.1080/0309877x.2020.1812549 · Cited by 38
“…draw from Sen’s Capability Approach (1992, 1999, 2009) which encompasses notions of agency, freedom, self-respect and social integration (Sen 1992), emphasising ‘what people are actually able to do and be’ (Brunner and Watson 2015, 3 – Italics in original) rather than the resources that they have.”
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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