Good news, bad news: natural environments

and health

Rich Mitchell
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
20/11/19

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

Contact with nature is healthy, for kids and adults. The variety
in how it works, and what it affects is remarkable.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

Seeing it is good for you. Being in it is even better.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
The association between access to natural environments
and population health.
Death rate

Increasingly green

Data are for English urban areas only, deaths from heart disease, ages 30+
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Twohig-Bennett C, Jones A. The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health
outcomes. Environmental research. 2018 Oct 1;166:628-37.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

 Better access to / more contact with nature seems to benefit
disadvantaged groups to a greater extent.

2.4
Incidence rate ratio (relative to 1.0)

2.2 In the most

2.0 green areas,
1.8
the health gap
is
1.6
dramatically
1.4 smaller
1.2

1.0
Least green areas Most green areas

Income group 2 Income group 3 Income group 4 (poorest)

Source: Re-drawn from Mitchell R, Popham F. Effect of exposure to natural environment on health inequalities: an observational population study. The
Lancet 372(9650):1655-1660.
 Better access to / more contact with nature seems to benefit
disadvantaged groups to a greater extent.

2.4
Incidence rate ratio (relative to 1.0)

2.2 In the most green areas,

the health gap is
2.0 dramatically smaller
1.8

1.6

1.4

1.2

1.0
Least green areas Most green areas

Income group 2 Income group 3 Income group 4 (poorest)

Source: Re-drawn from Mitchell R, Popham F. Effect of exposure to natural environment on health inequalities: an observational population study. The
Lancet 372(9650):1655-1660.
 Nature seems to make us better decision makers

van der Wal, Arianne J., et al. "Do natural landscapes reduce future discounting in humans?." Proceedings of the Royal Society
B: Biological Sciences 280.1773 (2013): 20132295.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

“The evidence consistently suggests a beneficial association
between green space exposure and children’s emotional and
behavioural difficulties, particularly with hyperactivity and
inattention problems.”

Vanaken GJ, Danckaerts M. Impact of green space exposure on children’s and adolescents’ mental health: A systematic review. International
journal of environmental research and public health. 2018 Dec;15(12):2668.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

Physical activity Microbiome Air pollution

Social contact Urban cooling

Stress reduction Water management

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Physical activity Microbiome Air pollution

Social contact Urban cooling

Stress reduction Water management

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
 Restoration is a physiological & psychological effect, driven by
the brain’s perception of nature.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

Experimental evidence: field

Park B, Tsunetsugu Y, Kasetani T, Kagawa T, Miyazaki Y. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing):
evidence from field experiments in 24 forests across Japan. Environmental Health and Preventive Medicine 2010; 15(1):18-26.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

 Experimental evidence: field

Park B, Tsunetsugu Y, Kasetani T, Kagawa T, Miyazaki Y. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing):
evidence from field experiments in 24 forests across Japan. Environmental Health and Preventive Medicine 2010; 15(1):18-26.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

 Forest trip City trip

Adrenaline
concentration

Fig. 9 Effect of a forest bathing trip on adrenaline and noradrenaline concentrations in urine. a Effect
of a forest bathing trip on urinary adrenaline concentration in male subjects (n = 12), b effect of a
city trip on urinary adrenaline concentration in male subjects (n = 11)

Li, Qing. "Effect of forest bathing trips on human immune function." Environmental health and preventive medicine 15, no. 1 (2010): 9-17.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

So. So what? Regular visits to nature in childhood are strongly
linked to visiting as an adult (and as a parent…)

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

Soga & Gaston Front Ecol Environ 2016; 14(2): 94–101, doi:10.1002/fee.1225

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

 Soga & Gaston Front Ecol Environ 2016; 14(2): 94–101, doi:10.1002/fee.1225

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
 By many measures, our children have never been
healthier

Sidebotham P, Fraser J, Fleming P, Ward-Platt M, Hain R. Patterns of child death in England and Wales. The Lancet. 2014 Sep 6;384(9946):904-14.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
emotional disorders. Rates for behavioural, hyperactivity and other
disorders have remained broadly stable.

Sadler et al. Mental Health of children and young people in England: trends and characteristics. 2018. NHS Digital
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
had visited daily.

What’s happening to contact with nature among Scots?

As shown in Figure 3.2, while the overall visit levels reported have been fairly consistent
since 2006, the frequency of visiting has increased in recent years, with the proportion of
adults indicating that they visit at least weekly up from 42% in the 2012 ScRS to 57% in the
2017/18 SPANS.

100%

80%
80% 83% 83% 82% 82%
79% 79% 79% 79%

60%

57%
40% 47% 48% 50%
44% 44% 46% 46%
42%
20%

0%
2006 2007 2008 2009 2010 2011 2012 2013/ 14 2017 / 18
(N=11,306) (N=11,133) (N=12,174) (N=12,200) (N=12,209) (N=12,356) (N=12,199) (N=12,104)* (N=12,502)*

Any visits Once a week or more

Figure 3.2 Visits taken to outdoors in last 12 months – ScRS 2006-2012; SPANS 2013/14
and 2017/18 (Base sizes shown on chart)
* Note SPANS survey periods cover Mar 13 to Feb 14 and May 17 to Apr 18 while the ScRS was
Source: TNS. on
undertaken 2014. Scotland’syear
a calendar People and Nature Survey 2013/14. Scottish Natural Heritage Commissioned Report No. 679.
basis.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Who doesn’t go?
0% 20% 40% 60% 80% 100%

Social grade AB (N=2,650) 92%

Children in household (N=2,595) 90%
Paid employment (N=5,210) 90%
No limiting illness/ disability (N=2,958) 88%
Good self-reported health (N=2,919) 88%
Age 54 and under (N=6,310) 87%
Own/ privately rent home (N=8,483) 86%
Have Internet access (N=8,986) 83%
Total population (N=12,502) 82%
No children in household (N=9,907) 79%
No Internet access (N=3,516) 79%
Not in paid employment (N=7,292) 74%
15% most deprived areas (N=2,176) 73%
Age 55+ (N=6,192) 73%
Council tenant (N=3,700) 71%
Social grade DE (N=3,918) 68%
Limiting illness/ disability (N=1,207) 63%
Poor self-reported health (N=383) 47%

Source: TNS. 2014. Scotland’s People and Nature Survey 2013/14. Scottish Natural Heritage Commissioned Report No. 679.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Figure 3.3 Percentage of adults taking any recreation visits to the outdoors in Scotland in the
 Among those who seldom or never visited the outdoors, the most frequently cited reasons
for not visiting were a lack of time (36% were ‘too busy’) and poor health (23%). Poor
(14%) and ‘no particular reason’ (11%) were the next most frequently mentioned
Forweather
those who don’t go, what are the barriers?
barriers (Figure 3-7 below).

Too busy (36%) Poor health (23%)

Bad/ poor weather (14%) No particular reason (11%)

Old age (8%) Not interested (5%)

Finances/ can’t afford to (4%) Young children (2%)

No car access (2%) Lack of places to go (1%)

Don’t like going alone (1%) Family ties/ commitments (1%)

Been abroad/ travelling (1%) Worried about safety (1%)

Source: TNS. 2014. Scotland’s People and Nature Survey 2013/14. Scottish Natural Heritage Commissioned Report No. 679.
Figure 3-7 Reasons for not visiting the outdoors in the last 12 months (Mar 13 to Feb 14)
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
% who do NOT agree that ‘spending time outdoors is an
important part of my life’
Do not agree

18

16

14

12

10

0
AB C1 C2 DE
Source: TNS. 2014. Scotland’s People and Nature Survey 2013/14. Scottish Natural Heritage Commissioned Report No. 679.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
We looked at school-age participants in the John Muir Award
Nearly 1 in 10 of the participants had never been to a wild
place before…but it was about 23% of the poorest kids and
about 4% of the others

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow.
 A social justice
perspective
matters.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow (c) Author's own image
While opportunity is an important driver for using natural spaces,
orientation is the more important influence.

Level of park use

Lin BB, Fuller RA, Bush R, Gaston KJ, Shanahan DF. Opportunity or orientation? Who uses urban parks and why. PLoS one. 2014 Jan
29;9(1):e87422.

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

Individuals, behaviours, environment etc. are quite obviously,
interlinked in a dynamic system. Contact with nature is one
part of people’s complex lives.

MRC/CSO Social
MRC/CSO and Public
Social and Health Sciences
Public Health Unit, University Unit,
Sciences of Glasgow
University of Glasgow
 Dogs
Time available
Novelty
Travel Experience
Other people

Access
Money

Homework Toilets Flora / Fauna

Chores
Fun?
Environment Maintenance
Identity
Agent based models are simulations of how individuals interact
with each other, and with their environment, allowing these
interactions to lead to change in both. They are a means of
modelling how individuals / groups / interactions environments
coalesce into a system.

(cc) image courtesy of Rog01@flickr.com

MRC/CSO Social
MRC/CSO and Public
Social and Health Sciences
Public Health Unit, University Unit,
Sciences of Glasgow
University of Glasgow
Source: author and team’s work in progress
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
 PHASE – a new network to connect ABM do’ers to ABM need’ers

•http://phasenetwork.org/

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
We know stories influence policy makers. Can stories, in
themselves, be an intervention?

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
 Evidence

Action
There is a lot happening

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

 Thank you.
RM is employed by the University of Glasgow and
leads the Neighbourhoods and Communities
research programme (MC_UU_12017/10) at the
MRC/CSO Social & Public Health Sciences Unit

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow

MRC/CSO Social and Public Health Sciences Unit, University of Glasgow