Health and the natural environment: A review of evidence, policy, practice and opportunities for the future for Defra

The final report and research briefing for Becca’s fellowship with Defra have been published. An associated evidence statement was published earlier.

reportThe study focused on the interconnections between the natural environment and health, and the ways in which these are, or could be harnessed in policy and practice. The majority of the work was undertaken in 2015-2016 and informed the development of the 25 Year Plan to Improve the Environment.

The aims of the project were to: i) clarify what is known about the linkages between natural environments and health, to characterise how different social groups understand the health potential of the natural environment, and to examine the factors that may facilitate or prevent the realisation of those benefits; ii) evaluate how evidence of the value of natural environments to health is recognised, taken into account by, and incorporated into existing policy and practice; and iii) identify effective and promising opportunities to act on the value of natural environments to promote better health.

The key findings include:Summary

  1. There is evidence of positive associations (after controlling for confounding factors) between living in greener environments and a range of physical, mental and developmental outcomes and reduced health inequality. There is also a growing body of evidence demonstrating the effectiveness of the use natural environments as a setting for specific health interventions and that these interventions can be cost-effective
  2. There are gaps in the evidence base, these relate to mechanisms and causal linkages, and to variation in effect according to environment (location, type and quality), population or intervention. However, there is much ongoing multi-disciplinary work which may address these questions. There is a new emphasis on producing evidence suitable to inform future decision making.
  3. People value the natural environment for its role in helping achieve and maintain better health. In the UK the natural environment’s contribution to health is culturally important. Perceptions of the benefits of the natural environment differ according to socio-cultural group, geographical and political context, and through the life course, however this is less well understood.
  4. There is considerable interest, predominantly from 3rd sector and research organisations, but also from national and local government, in finding effective ways to harness the potential of the natural environment to promote health. This relates to a tangible recognition that the environment represents an underutilised resource. Examples of activity include local health projects making use of natural environments as a health promotion setting, to regional or national scale multi-sectoral efforts to coordinate programmes of interventions. However, existing activity is often disjointed, short term and opportunities to learn valuable lessons are missed. The multi-sectoral nature of the issues and activities means the potential of the natural environment to contribute to health is, arguably, ‘falling through the cracks’.
  5. The key constraints of activity are often structural, relating to the organisation and procedures of government (local and national) or institutions. Other barriers to activity relate to: the perception of the peripherality of the environment to health; reorganisations of institutions and the loss of networks and knowledge; difficulties in demonstrating impacts and outcomes of environment-health interventions; and the constrained budgets and (perceived) rigidity of the health and social care system.
  6. As current policy and practice display characteristics of ‘complex adaptive systems’, future activities should involve multiple partners, policy instruments and delivery methods at a variety of scales. Key strategies to increase recognition and activity regarding the health values of natural environments relate to: i) improving the evidence base and increasing evaluative activity; ii) identifying and facilitating key intervention and delivery options; and iii) focusing on the structures and systems in which decision making and delivery takes place.

Thanks to everybody who took the time to talk and provide information throughout! Heartfelt thanks go to the late Rachel Penny (Natural England) for all her help, support and guidance in the early stages of the project.

The report Health and the natural environment: A review of evidence, policy, practice and opportunities for the future and associated Research Briefing and Evidence Statement are published by Defra (Defra Project Code BE0109) and are available from the Department’s Science and Research Projects Database at


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