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Cited by 147Urban Green Space and HealthHealth, psychology, and well-beingClimate Change and Health Impacts

Green Prescriptions and Their Co-Benefits: Integrative Strategies for Public and Environmental Health

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Robinson, Jake M., Breed, Martin F.·2019·Challenges
DOI 10.3390/challe10010009
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Abstract

There is a growing recognition of the links between the increasing prevalence of noncommunicable diseases, environmental concerns including biodiversity loss and ecosystem degradation, and socioecological issues such as ecological (in)justice. This has encouraged a number of recent calls for the development of integrative approaches aimed at addressing these issues—also known as nature-based solutions. An example of an emerging nature-based solution is a ‘green prescription’, broadly defined as a nature-based health intervention. Green prescriptions are typically designed for patients with a defined need and they have the potential to supplement orthodox medical treatments, particularly those aimed at addressing noncommunicable diseases. It is also thought that green prescriptions could bring about significant environmental, economic, and social co-benefits. However, researchers have recently expressed concerns over taking the ‘dose of nature’ approach, in that it may be too reductionistic for the complex social settings in which it is provided. Here we frame a holistic philosophical perspective and discuss green prescribing logic, types, mechanisms and fundamental remaining questions and challenges. We place a significant emphasis on the potential co-benefits of green prescriptions, and the importance of taking a planetary health approach. More research is needed to determine how this potential can be realised, and to further understand the complexities of the nature–human health relationship. However, with additional research and support, there is huge potential for green prescriptions to contribute to both reactive (health care) and proactive (health promoting) public health solutions whilst enhancing the natural environment.

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  • Nature activities promote physical activity, mindfulness, social inclusion, emotional wellbeing, connection to place, and pro-environmental attitudes.

    “Nature activities promote physical activity, mindfulness, social inclusion, emotional wellbeing, connection to place, and pro-environmental attitudes. 36”

    From Understanding and managing psychological distress due to climate change (2023) · cites this paper as [36]

    Section 2 describes green exercise and says conservation groups can be sociable and attended by diverse participants. Section 1.3 links disconnection from nature to reduced psychological wellbeing and pro-environmental behaviour, but frames the latter as a likely relationship. The paper does not establish that nature activities promote mindfulness or connection to place, and the claim states the full list of benefits more definitively than the paper does. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Nature-based activities can have benefits to both the environment and health, termed climate 'co-benefits', and include active transport and community gardens.

    “Naturebased activities can have benefits to both the environment and health; these are termed climate 'co-benefits' and include active transport (eg walking) andcommunity gardens. 15,36”

    From Understanding and managing psychological distress due to climate change (2023) · cites this paper as [36]

    Section 3, “Green Prescriptions: Potential Co-Benefits” (page unavailable), says strategic nature-based activities could benefit both public and environmental health. Section 2 lists horticulture, nature walks and biking, but the passages do not identify active transport or community gardens as examples, or call these benefits specifically climate co-benefits. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 64

  1. Peltola, H.; Heinonen, O.P.; Valle, M.; Paunio, M.; Virtanen, M.; Karanko, V.; Cantell, K. The elimination of indigenous measles, mumps, and rubella from Finland by a 12-year, two-dose vaccination program. New Engl. J. Med. 1994, 331, 1397-1402. [CrossRef] [PubMed] · DOI
  2. Vyse, A.J.; Gay, N.J.; White, J.M.; Ramsay, M.E.; Brown, D.W.; Cohen, B.J.; Hesketh, L.M.; Morgan-Capner, P.; Miller, E. Evolution of surveillance of measles, mumps, and rubella in England and Wales: Providing the platform for evidence-based vaccination policy. Epidemiol. Rev. 2002, 24, 125-136. [CrossRef] [PubMed] · DOI
  3. Tabar, L.; Yen, M.F.; Vitak, B.; Chen, H.H.; Smith, R.A.; Duffy, S.W. Mammography service screening and mortality in breast cancer patients: 20-year follow-up before and after introduction of screening. Lancet 2003, 361, 1405-1410. [CrossRef] · DOI · Paper page
  4. Park, J.H.; Anderson, W.F.; Gail, M.H. Improvements in US breast cancer survival and proportion explained by tumor size and estrogen-receptor status. J. Clin. Oncol. 2015, 33, 2870-2876. [CrossRef] [PubMed] · DOI
  5. Von Hertzen, L.; Beutler, B.; Bienenstock, J.; Blaser, M.; Cani, P.D.; Eriksson, J.; Färkkilä, M.; Haahtela, T.; Hanski, I.; Jenmalm, M.C.; et al. Helsinki alert of biodiversity and health. Ann. Med. 2015, 47, 218-225. [CrossRef] · DOI
  6. Raymond, C.M.; Frantzeskaki, N.; Kabisch, N.; Berry, P.; Breil, M.; Nita, M.R.; Geneletti, D.; Calfapietra, C. A framework for assessing and implementing the co-benefits of nature-based solutions in urban areas. Environ. Sci. Policy 2017, 77, 15-24. [CrossRef] · DOI · Paper page
  7. Ostfeld, R.S. Biodiversity loss and the ecology of infectious disease. Lancet Planet. Health 2017, 1, e2-e3. [CrossRef] · DOI
  8. Bloomfield, D. What makes nature-based interventions for mental health successful? BJPsych Int. 2017, 14, 82-85. [CrossRef] · DOI
  9. O'Brien, L.; Townsend, M.; Ebden, M. 'Doing something positive': Volunteers' experiences of the well-being benefits derived from practical conservation activities in nature. VOLUNTAS Int. J. Volunt. Nonprofit Organ. 2010, 21, 525-545. [CrossRef] · DOI
  10. Walsh, D.; Bendel, N.; Jones, R.; Hanlon, P. It's not 'just deprivation': Why do equally deprived UK cities experience different health outcomes? Public Health 2010, 124, 487-495. [CrossRef] [PubMed] · DOI
  11. Marmot, M.; Bell, R. Fair society, healthy lives. Public Health 2012, 126, S4-S10. [CrossRef] [PubMed] · DOI
  12. Scarborough, P.; Bhatnagar, P.; Wickramasinghe, K.K.; Allender, S.; Foster, C.; Rayner, M. The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: An update to 2006-07 NHS costs. J. Public Health 2011, 33, 527-535. [CrossRef] [PubMed] · DOI
  13. Al-Goblan, A.S.; Al-Alfi, M.A.; Khan, M.Z. Mechanism linking diabetes mellitus and obesity. Diabetes Metab. Syndr. Obes. Targets Ther. 2014, 7, 587-591. [CrossRef] [PubMed] · DOI
  14. Riley, L.; Guthold, R.; Cowan, M.; Savin, S.; Bhatti, L.; Armstrong, T.; Bonita, R. The World Health Organization STEPwise approach to noncommunicable disease risk-factor surveillance: Methods, challenges, and opportunities. Am. J. Public Ealth 2016, 106, 74-78. [CrossRef] [PubMed] · DOI
  15. Bridges, A.J.; Andrews, A.R., III; Villalobos, B.T.; Pastrana, F.A.; Cavell, T.A.; Gomez, D. Does integrated behavioral health care reduce mental health disparities for Latinos? Initial findings. J. Lat. Psychol. 2014, 2, 37-53. [CrossRef] [PubMed] · DOI
  16. Varghese, C. Reducing premature mortality from non-communicable diseases, including for people with severe mental disorders. World Psychiatry 2017, 16, 45-47. [CrossRef] · DOI
  17. Allen, L.N.; Feigl, A.B. What's in a name? A call to reframe non-communicable diseases. Lancet Glob. Health 2017, 5, e129-e130. [CrossRef] · DOI
  18. Nethan, S.; Sinha, D.; Mehrotra, R. Non Communicable Disease Risk Factors and their Trends in India. Asian Pac. J. Cancer Prev. 2017, 18, 2005-2010.
  19. Pienkowski, T.; Dickens, B.L.; Sun, H.; Carrasco, L.R. Empirical evidence of the public health benefits of tropical forest conservation in Cambodia: A generalised linear mixed-effects model analysis. Lancet Planet. Health 2017, 1, e180-e187. [CrossRef] · DOI
  20. Oliveira Hagen, E.; Hagen, O.; Ibáñez-Álamo, J.D.; Petchey, O.L.; Evans, K.L. Impacts of urban areas and their characteristics on avian functional diversity. Front. Ecol. Evolut. 2017, 5, 84. [CrossRef] · DOI
  21. Allentoft, M.E.; O'Brien, J. Global amphibian declines, loss of genetic diversity and fitness: A review. Diversity 2010, 2, 47-71. [CrossRef] · DOI
  22. Pinsky, M.L.; Palumbi, S.R. Meta-analysis reveals lower genetic diversity in overfished populations. Mol. Ecol. 2014, 23, 29-39. [CrossRef] · DOI
  23. Ceulemans, T.; Stevens, C.J.; Duchateau, L.; Jacquemyn, H.; Gowing, D.J.; Merckx, R.; Wallace, H.; Van Rooijen, N.; Goethem, T.; Bobbink, R.; et al. Soil phosphorus constrains biodiversity across European grasslands. Glob. Chang. Biol. 2014, 20, 3814-3822. [CrossRef] · DOI
  24. Prescott, S.L.; Logan, A.C. Larger than life: Injecting hope into the planetary health paradigm. Challenges 2018, 9, 13. [CrossRef] · DOI
  25. Myers, S.S. Planetary health: Protecting human health on a rapidly changing planet. Lancet 2017, 390, 2860-2868. [CrossRef] · DOI
  26. Canavan, C.R.; Noor, R.A.; Golden, C.D.; Juma, C.; Fawzi, W. Sustainable food systems for optimal planetary health. Trans. R. Soc. Trop. Med. Hyg. 2017, 111, 238-240. [CrossRef] · DOI
  27. Schwartz, R.M.; Liu, B.; Lieberman-Cribbin, W.; Taioli, E. Displacement and mental health after natural disasters. Lancet Planet. Health 2017, 1, e314. [CrossRef] · DOI
  28. Prescott, S.L.; Logan, A.C. Down to earth: Planetary health and biophilosophy in the symbiocene epoch. Challenges 2017, 8, 19. [CrossRef] · DOI
  29. Albrecht, G. Ecopsychology in the Symbiocene. Ecopsychology 2014, 6, 58-59. [CrossRef] · DOI
  30. Salk, J.E. Biology in the future. Perspect. Biol. Med. 1962, 5, 423-431. [CrossRef] [PubMed] · DOI
  31. Gehlert, S.; Murray, A.; Sohmer, D.; McClintock, M.; Conzen, S.; Olopade, O. The importance of transdisciplinary collaborations for understanding and resolving health disparities. Soc. Work Public Health 2010, 25, 408-422. [CrossRef] [PubMed] · DOI
  32. Nyatanyi, T.; Wilkes, M.; McDermott, H.; Nzietchueng, S.; Gafarasi, I.; Mudakikwa, A.; Kinani, J.F.; Rukelibuga, J.; Omolo, J.; Mupfasoni, D.; et al. Implementing One Health as an integrated approach to health in Rwanda. BMJ Glob. Health 2017, 2, e000121. [CrossRef] · DOI
  33. Kesebir, S.; Kesebir, P. A growing disconnection from nature is evident in cultural products. Perspect. Psychol. Sci. 2017, 12, 258-269. [CrossRef] [PubMed] · DOI
  34. Lederbogen, F.; Kirsch, P.; Haddad, L.; Streit, F.; Tost, H.; Schuch, P.; Wüst, S.; Pruessner, J.C.; Rietschel, M.; Deuschle, M.; et al. City living and urban upbringing affect neural social stress processing in humans. Nature 2011, 474, 498-501. [CrossRef] [PubMed] · DOI · Paper page
  35. Cox, D.T.; Shanahan, D.F.; Hudson, H.L.; Plummer, K.E.; Siriwardena, G.M.; Fuller, R.A.; Anderson, K.; Hancock, S.; Gaston, K.J. Doses of neighborhood nature: The benefits for mental health of living with nature. BioScience 2017, 67, 147-155. [CrossRef] · DOI
  36. Bertram, C.; Rehdanz, K. The role of urban green space for human well-being. Ecol. Econ. 2015, 120, 139-152. [CrossRef] · DOI
  37. Soga, M.; Gaston, K.J. Extinction of experience: The loss of human-nature interactions. Front. Ecol. Environ. 2016, 14, 94-101. [CrossRef] · DOI · Paper page
  38. Kuenzig, M.E.; Barnabe, C.; Seow, C.H.; Eksteen, B.; Negron, M.E.; Rezaie, A.; Panaccione, R.; Benchimol, E.I.; Sadatsafavi, M.; Aviña-Zubieta, J.A.; et al. Asthma is associated with subsequent development of inflammatory bowel disease: A population-based case-control study. Clin. Gastroenterol. Hepatol. 2017, 15, 1405-1412. [CrossRef] [PubMed] · DOI
  39. Earl, C.S.; An, S.Q.; Ryan, R.P. The changing face of asthma and its relation with microbes. Trends Microbiol. 2015, 23, 408-418. [CrossRef] [PubMed] · DOI
  40. Robinson, J.; Mills, J.; Breed, M. Walking Ecosystems in Microbiome-Inspired Green Infrastructure: An Ecological Perspective on Enhancing Personal and Planetary Health. Challenges 2018, 9, 40. [CrossRef] · DOI
  41. Robinson, J.M.; Jorgensen, A. Rekindling Old Friendships in New Landscapes: The Environment-Microbiome-Health Axis in the Realms of Landscape Research. People Nat. 2018, under review.
  42. Wen, L.M.; Kite, J.; Merom, D.; Rissel, C. Time spent playing outdoors after school and its relationship with independent mobility: A cross-sectional survey of children aged 10-12 years in Sydney, Australia. Int. J. Behav. Nutr. Phys. Act. 2009, 6, 15. [CrossRef] [PubMed] · DOI
  43. Rosiek, A.; Maciejewska, N.F.; Leksowski, K.; Rosiek-Kryszewska, A.; Leksowski, Ł. Effect of television on obesity and excess of weight and consequences of health. Int. J. Environ. Res. Public Health 2015, 12, 9408-9426. [CrossRef] · DOI
  44. Bekoff, M.; Bexell, S.M. Ignoring nature: Why we do it, the dire consequences, and the need for a paradigm shift to save animals, habitats, and ourselves. Hum. Ecol. Rev. 2010, 17, 70-74.
  45. Pérez, C.G.; Soutelo, S.G.; Mosqueira, M.M.; Soto, J.L. Spa techniques and technologies: From the past to the present. Sustain. Water Resour. Manag. 2017. [CrossRef] · DOI
  46. van Tubergen, A.; van der Linden, S. A brief history of spa therapy. Ann. Rheum. Dis. 2002, 61, 273-275. [CrossRef] [PubMed] · DOI
  47. Maretzki, T.W. The Kur in West Germany as an interface between naturopathic and allopathic ideologies. Soc. Sci. Med. 1987, 24, 1061-1068. [CrossRef] · DOI
  48. Antonelli, M.; Donelli, D. Effects of balneotherapy and spa therapy on levels of cortisol as a stress biomarker: A systematic review. Int. J. Biometeorol. 2018, 62, 913-924. [CrossRef] [PubMed] · DOI
  49. Patel, A.; Schofield, G.M.; Kolt, G.S.; Keogh, J.W. General practitioners' views and experiences of counselling for physical activity through the New Zealand Green Prescription program. BMC Fam. Pract. 2011, 12, 119. [CrossRef] [PubMed] · DOI
  50. Kolt, G.S.; Schofield, G.M.; Kerse, N.; Garrett, N.; Schluter, P.J.; Ashton, T.; Patel, A. The Healthy Steps Study: A randomized controlled trial of a pedometer-based Green Prescription for older adults. Trial protocol. BMC Public Health 2009, 9, 404. [CrossRef] · DOI
  51. Poulsen, D.; Stigsdotter, U.; Davidsen, A. "That Guy, Is He Really Sick at All?" An Analysis of How Veterans with PTSD Experience Nature-Based Therapy. InHealthcare 2018, 6, 64. [CrossRef] [PubMed] · DOI
  52. Millar, S.L.; Donnelly, M. Promoting mental wellbeing: Developing a theoretically and empirically sound complex intervention. J. Public Health 2013, 36, 275-284. [CrossRef] [PubMed] · DOI
  53. Seymour, V.; King, M.; Antonaci, R. Understanding the impact of volunteering on pro-environmental behavioural change. Volunt. Sect. Rev. 2018, 9, 73-88. [CrossRef] · DOI
  54. Annis, G.M.; Pearsall, D.R.; Kahl, K.J.; Washburn, E.L.; May, C.A.; Taylor, R.F.; Cole, J.B.; Ewert, D.N.; Game, E.T.; Doran, P.J. Designing coastal conservation to deliver ecosystem and human well-being benefits. PLoS ONE 2017, 12, e0172458. [CrossRef] [PubMed] · DOI
  55. Flies, E.J.; Skelly, C.; Lovell, R.; Breed, M.F.; Phillips, D.; Weinstein, P. Cities, biodiversity and health: We need healthy urban microbiome initiatives. Cities Health 2018. [CrossRef] · DOI
  56. Mills, J.G.; Weinstein, P.; Gellie, N.J.; Weyrich, L.S.; Lowe, A.J.; Breed, M.F. Urban habitat restoration provides a human health benefit through microbiome rewilding: The Microbiome Rewilding Hypothesis. Restor. Ecol. 2017, 25, 866-872. [CrossRef] · DOI
  57. Seltenrich, N. Just what the doctor ordered: Using parks to improve children's health. Environ. Health Perspect. 2015, 123, A254-A529. [CrossRef] [PubMed] · DOI
  58. Maier, J.; Jette, S. Promoting nature-based activity for people with mental illness through the US "Exercise Is Medicine" initiative. Am. J. Public Health 2016, 106, 796-799. [CrossRef] [PubMed] · DOI
  59. Swinburn, B.A.; Walter, L.G.; Arroll, B.; Tilyard, M.W.; Russell, D.G. Green prescriptions: Attitudes and perceptions of general practitioners towards prescribing exercise. Br. J. Gen Pr. 1997, 47, 567-569.
  60. Gribben, B.; Goodyear-Smith, F.; Grobbelaar, M.; O'Neill, D.; Walker, S. The early experience of general practitioners using Green Prescription. N. Z. Med. J. 2000, 113, 372-373. [PubMed]
  61. Lovell, R.; Depledge, M.; Maxwell, S. Health and the Natural Environment: A Review of Evidence, Policy, Practice and Opportunities for the Future. 2018. Available online: https://beyondgreenspace.net/2018/09/ 07/defra_health_review/ (accessed on 30 November 2018).
  62. Bell, S.L.; Leyshon, C.; Foley, R.; Kearns, R.A. The "healthy dose" of nature: A cautionary tale. Geogr. Compass. 2018, e12415. [CrossRef] · DOI · Paper page
  63. Husk, K.; Lovell, R.; Garside, R. Prescribing gardening and conservation activities for health and wellbeing in older people. Maturitas 2018, 110, A1-A2. [CrossRef] · DOI
  64. Allen, R.W.; Barn, P.K.; Lanphear, B.P. Randomized controlled trials in environmental health research: Unethical or underutilized? PLoS Med. 2015, 12, e1001775. [CrossRef] · DOI

Cited by

Sorted by citations

Authors
Robinson, J. M., & Breed, M. F.
Affiliations
  • Worldwide Universities Network (GB)
  • The University of Adelaide (AU)
Corresponding author
Robinson, Jake M.
ORCID
Venue
Challenges
Publisher
MDPI AG
Published
2019-01-17
Volume
10
Issue
1
Pages
9
ISSN
2078-1547 (ISSN-L)
DOI
10.3390/challe10010009
OpenAlex
W2909066281
Cited by
147
References
5
Citations by year
2026: 16 · 2025: 22 · 2024: 21 · 2023: 24 · 2022: 22 · 2021: 17 · 2020: 20 · 2019: 5
FWCI
6.92
Type
journal article
Language
en
Open access
Licence
Locations
  • Challenges (publishedVersion, cc-by)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Economic and Social Research Council (1949774)
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Urban Green Space and Health
  • Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
Keywords
green prescriptions, nature-based solutions, non-communicable diseases, co-benefits, planetary health, ecological justice, biodiversity loss, ecosystem degradation, health promotion

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