In March we published a review of the linkages between natural environments and health outcomes with Defra. You can download a copy of the full Evidence Statement on the links between natural environments and human health or a set of summary slides.

We found that we now have a relatively robust body of evidence which has demonstrated that spending time in greener environments is associated with better health outcomes. This has resulted in an increasing interest in using natural environment as a setting for health promotion and care. However there is uncertainty as to how, when and where natural environments could be best used to improve health outcomes. We concluded that there is relatively little synthesized evidence of the impacts of nature based health interventions.

As a result, and funded by Defra, the project team have now started work to identify ‘What Works’ in nature based health interventions. The results will inform Defra’s approach to supporting nature based health interventions.

We are focusing on identifying ‘what works’ in relation to three specific groups:

1. Urban people’s use of urban greenspaces
2. Hard to reach groups
3. Children and young people’s natural environment based physical activity

Characterising natural environment based health interventions

The plurality of natural environment based health interventions makes systematic characterisation difficult, however most interventions can be described using the following typology:

1. Nature of action: Natural environment interventions – where new spaces are created or, existing spaces are linked, modified or improved. ‘Built’ environment interventions – where ‘man made’ elements are created, modified etc. to improve the health potential of a natural environment. Social Interventions – where efforts are made through social activities (e.g. not through physical changes to a space) to improve the health potential of a natural environment. Organisational actions – where organisations (at all levels and types) might shift their practices, policies and strategies to make use of, or take account of the potential of the natural environment to improve health outcomes.
2. Type of exposure to the natural environment: Remote exposure – where natural elements of the environment are present or visible but that the individual is not ‘in’ the natural environment. Incidental exposure – where activities take place in natural environments but the activity is not specifically focused on the natural environment. Intentional use – where the natural environment is more than just a setting but is fundamental to the activity.
3. Type of health promotion: Population level health promotion – where actions are taken which create the conditions in which a population’s health might be improved. A population can be at a national scale or more local (for this definition it is used to refer to a spatial population, and does not refer to demographic populations or populations who share a certain characteristic such as a specific health issue). Targeted prevention – where activities are specifically designed to address a specific health outcome or engage a specific community (e.g. according to a health condition or demographics – older people, children etc.). Therapeutic – where activities are provided to specifically improve health status following, to prevent or manage a health problem such as a heart attack, mental health breakdown or injury. Examples might include therapeutic gardening, or park based exercise for physical strength.
4. Stage: ‘upstream’ or ‘downstream’ interventions.

We are now populating this typology and undertaking an initial assessment of any evidence of effectiveness. We are searching for evidence of effective approaches to nature based health interventions and hope to address a number of questions, including;

1. how are effective interventions designed, implemented and delivered;
2. how interventions are funded and supported;
3. what makes an intervention scalable and sustainable?

If you have any good examples of nature based health interventions relating to the three topics above please do get in touch! We are particularly interested in finding intervention evaluations and especially so any which tell us about the process of designing, implementing and delivering the intervention.