Dr Carly WoodUniversity of Essex

Nature, Health and WellbeingWhat does the research show?

Outline

• Theories linking nature & health – a snapshot

• Green Exercise or Ecotherapy– What do the

terms mean?

• Green Exercise Research Grants

• Ecotherapy: Ecominds Project

• Implications and Conclusions

Our relationship with nature has changed....

Theory Linking Nature and Health• “an innate sensitivity to and need for other

living things – as we have co-existed for thousands of generations”

• Hardwired into our genetic makeup• Evolved with affiliation for nature, urban

settings not part of our genetic history• Closeness to nature ↑ WB & likelihood of

understanding & caring for nature • Important resource for human health

Wilson (1984)

Nature Contributes to Healthy Communities

Nature

Reduces property crimeViolent crime Levels of aggression

Provides a sense of belonging

Enhances social cohesionReduces social isolationImproves social networkingEncourages intergenerational links

Reduces stressPerceivedObjective – e.g. CortisolRestores mental fatigue

Improves mental health and wellbeingSelf-esteemMood

Reduces health inequalities

Facilitates activityImproves physical healthLowers BPIncreases HRVReduces obesity

Physical ActivityKnown to have positive effects on physical and

mental health

Green ExerciseTo what extent does physical activity in

the presence of green space affect mental and physical well-being?

Exposure to Nature

Known to have positive effects on mental health

“Green Exercise”Green Exercise

‘Ecotherapy’ or ‘Green Care’?• Umbrella terms for a range of nature-based interventions for

vulnerable groups.• Initiatives – facilitated, specific intervention, for particular

participants, rather than simply ‘an experience in nature’ for general public.

• ‘Green Care’ approaches – ‘therapeutic’ in nature although some (minority) of initiatives also include formal

therapy as an integral part of the programme.• Recently term ‘Ecotherapy’ used more generically/

interchangeably with GC

Green Exercise Research Grants

• ESRC Early Career Fellowship (2009-2012)

• British Heart Foundation Studentship (2010-2014)

• Series of studies exploring the links between nature and stress in terms of:- Stress recovery- Response to stress

Heart Rate Variability

• Marker of cardiovascular function which is altered by stress

• High HRV reflects a healthy CV system able to adapt to stimuli from the brain and receptors around the body

• Reduced HRV is a risk for cardiovascular disease

Study 1

Can viewing scenes of nature prior to stress 1. ↓physiological stress response &/or

2. ↑ physiological recovery from a stressor?

On arrival

• Participant reads information sheet and signs informed consent• Participant fitted with ECG, finger blood pressure cuff, and respiration strap

Baseline

• Participants rested in a semi-supine position for 15 minutes• Physiological measures recorded for the final 5 minutes of the rest period

Viewing

• Participants viewed scenes of either a nature or built environment for 10 minutes

• During Visit 2 participants viewed the set of slides not viewed during Visit 1

Stressor

• Five minute forward digi-span stressor• Buzzer was sounded twice irrespective of incorrect or correct answers given• Physiological measures recorded throughout

Recovery

• Physiological measures recorded immediately post-stressor for five minutes

Views

Results – response

n = 23

Mean heart rate Mean systolic blood pressure

* *

Mean (± SD) heart rate variability

Results – recovery

Study 2- Can a walk in nature affect night time HRV?

Randomly assigned to walking a 1.8km route around either a built or a natural environment. On the second visit they

undertook the other walk.

Pace was similar on both walks.

Participants wore an RR interval sensor overnight (eMotion sensor, Mega Electronics Ltd) to allow HRV to

be examined during sleep.

Three 10 minutes segments were selected by a reviewer blinded to type of walk. These segments were 1-2 hours

after the participant noted in a diary they had fallen asleep (approx phase 4 of sleep).

Results

Walk0

5

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BuiltNature

RM

SS

D m

s2

Summary: Green Exercise Grants

• Research provides ecologically valid evidence that nature reduces physiological stress and enhances recovery from stress;

• Physiological effects of Green Exercise may last for more than 12 hours

• Green Exercise may therefore enhance essential recovery and restoration during night time sleep and improve overall health.

Ecotherapy: Ecominds wellbeing evaluation

• First study of different types of ecotherapy in the UK

• Longitudinal & acute effect study

• Recognised outcome measures

3 key themes:i) wellbeing, ii) social inclusion, iii) connection to nature

All projects study In-depth study

Within group study

Between groups study

Changes after an

Ecominds session

Changes over the Ecominds programme

Ecominds evaluationFigure 3. Overview of the University of Essex Ecominds evaluation

Results All projects study - Significant changes

Bragg et al., (2013)

Change in mean positivity, nature connection and health scores from beginning to the end of the

Ecominds programme

* *

*

* indicates a significant increase in mean score

Results ‘In Depth’ study

Significant increase in participant wellbeing over the course of the programme

Significant increase in participant self-esteem over the course of the

programme

Results ‘In Depth’ study

Increased social inclusion

Increased connection to nature

Summary: Ecotherapy Interventions• Encourages PA which impacts on health• ↑ Self-esteem, mood, WB• ↑ Connection to nature - (giving back to nature through shaping & restoring NE’s)• ↑ Self-perceived health • ↑ Environmentally friendly behaviour • Facilitate social contact , ↓ social exclusion• Build resilience & capacity to cope with life stresses• Provide sense of place • Are multifaceted, promoting good health & WB

Implications of Research• Nature can improve public health and wellbeing

• Build resilience for those at risk of developing mental ill-health• Preventative measure for the vulnerable• And for us all....

• Treatment option for those with existing mental health problems• Another tool in the tool box for mental healthcare

Implications continued.• An enjoyable option to help people feel better• Efficient – multiple outcomes simultaneously

• wider than clinical outcomes• Cost-effective

• Leaving the diagnosis at the gate• Helps reduce social isolation

Conclusion• NE is an important resource for human health – need to

actively protect it to ensure access for all• Nature↓ public health costs by promoting healthier

communities• Need to engage commissioners of health & social care

services to fund & support Ecotherapy initiatives• Promote it to GP’s, call upon NICE to consider the evidence

& recommend Ecotherapy interventions as treatment options for mental ill-health

• Need to think of Natural Health Service to complement NHS?

“DQ has done more for me than I could have imagined, it has released my spirit and I feel completely

different”

Thank you for listeningcjwood@essex.ac.ukwww.greenexercise.org