Nature is a powerful tool that can be harnessed by social prescribers to improve people's health and wellbeing, according to a series of new evidence reviews led by a UCL researcher.
Researchers worked with the National Academy for Social Prescribing (NASP) to prepare four Evidence Information Notes, commissioned by Natural England, relating to the links between time spent in nature and mental and physical health for adults and children, and an NHS England-commissioned review and briefing on the role of nature-based social prescribing and how it can be used to support those who may be experiencing health inequalities.
Together, the reviews have extracted evidence from hundreds of high-quality studies, examining the experiences of thousands of people to understand how nature has affected them. The result is a large body of evidence, detailing the many ways in which spending time in nature, and connecting with it, is beneficial for our health and wellbeing.
Professor Helen Chatterjee (UCL Genetics, Evolution & Environment), lead author of the review and co-author of all four Evidence Information Notes, said: "These reviews draw on a wide range of evidence to show that spending time in nature is good for our mental and physical health, and that green social prescribing supports social connections and reduces isolation and loneliness.
"One recent study showed that spending 120 minutes per week benefits your health and wellbeing. Another study showed that adults and communities exposed to local green spaces show reduced risk of type 2 diabetes and obesity, and increased likelihood of physical activity. Gardening has been shown to be particularly beneficial to both physical and mental health."
How can time spent in nature affect our health?
The studies demonstrate that there is now a large body of research evidence reporting the benefits of the natural environment on mental health. Benefits associated with exposure to nature include increased wellbeing, including subjective wellbeing, happiness, resilience, and reduced social isolation. Exposure to nature can also lead to a decrease in symptoms associated with PTSD and ADHD (when offered alongside therapeutic and mindfulness activities).
Living or working close to nature can lead to many physical and mental health benefits, such as lower levels of heart or respiratory problems, lower blood pressure, lower levels of stress and physical symptoms of stress, lowered risk of diabetes and obesity, COVID-19 and slower cognitive decline.
According to the review, there is "strong and consistent" evidence that shows how green space around the home is associated with lower rates of all-cause mortality (death for any reason).
The researchers found strong evidence for nature's benefits for children specifically. Spending time in nature is associated with better health, increasing children's physical activity, wellbeing, and cognitive performance.
Both contact with and connection with nature can play a role in improving health and wellbeing outcomes. While time in nature is associated with our general health, 'nature connection' - how we think and feel about nature - appears to be associated with improvements in our wellbeing too, but more research is needed in this area.
What are the barriers to nature connection?
There are inequalities in which groups of children have the opportunities to be outside in nature. And the time that children spend playing outside in nature without adult supervision continues to decline.
During the Covid-19 pandemic, connection to nature was highlighted in the media and the role of nature was discussed widely. However, access to nature, and therefore opportunities for connection to nature, are not distributed equally due to a lack of suitable, good quality local provision and more complex societal barriers. Furthermore, there have been fluctuations and differences in accessing nature during the pandemic.
What role does Green Social Prescribing play?
Nature-base social prescriptions, or 'Green Social Prescribing' can benefit long term health and wellbeing, particularly life satisfaction and happiness. Such interventions can connect people to the wider community, increase feeling of connection to nature and help to increase social connectedness; in turn, this can increase feelings of happiness and wellbeing.
The study authors say there is a clear need for more research to tell us about the impact of different referral pathways to green social prescribing, and research is currently ongoing.
Meanwhile, where there have been studies that have estimated the economic value associated with 'green' interventions for mental health, they have typically shown them to be cost effective and to result in savings to society.
Natural England, NHS England and NASP are partners in the cross-Government 'Preventing and tackling mental ill health through green social prescribing' project, which defines Green Social Prescribing as the practice of a social prescribing link worker connecting and supporting people to engage in nature-based activities to improve their mental health. Seven 'test and learn' sites have been set up, and a full evaluation of the project will be published in 2023.
Jim Burt, Interim Joint Chief Executive at NASP, said: "We have heard the calls for more evidence for social prescribing so are delighted to be able to publish this collection of evidence. The extensive, high-quality research outlined in these reports shows that nature can be of real benefit to both our mental and physical health."
Marian Spain, Chief Executive of Natural England, said: "Spending time outdoors in our incredible nature rich places - no matter how big or small or whether in town or country - has been shown to improve people's lives. That's why it's vital that we continue to invest in nature recovery and make places for everybody to enjoy and reap the benefits for their physical and mental health. The huge body of evidence being published reinforces the importance of Natural England's work to support communities in creating better and more accessible greenspaces that are vital to our nation's wellbeing."
James Sanderson, Director of Community Health and Personalised Care at NHS England, said: "With partners, we have been promoting the wide range of physical and mental ill-health benefits of nature based activities, particularly with examples across the country through our Green Social Prescribing Test and Learn sites to tackle and prevent mental ill-health. To now see this evidenced in this report, it provides the health and care system with the foundation to encourage a wider rollout reaching into areas who may experience health inequalities and support people and what matters to them."
