Publications

    Dallimer M, Irvine KN, Skinner AMJ, Davies ZG, Rouquette JR, Maltby LL, Warren PH, Armsworth PR, Gaston KJ. Biodiversity and the Feel-Good Factor: Understanding Associations between Self-Reported Human Well-being and Species Richness. BioScience [Internet]. 2012;62 (1) :47-55. Publisher's VersionAbstract

    Over half of the world’s human population lives in cities, and for many, urban greenspaces are the only places where they encounter biodiversity. This is of particular concern because there is growing evidence that human well-being is enhanced by exposure to nature. However, the specific qualities of greenspaces that offer the greatest benefits remain poorly understood. One possibility is that humans respond positively to increased levels of biodiversity. Here, we demonstrate the lack of a consistent relationship between actual plant, butterfly, and bird species richness and the psychological well-being of urban greenspace visitors. Instead, well-being shows a positive relationship with the richness that the greenspace users perceived to be present. One plausible explanation for this discrepancy, which we investigate, is that people generally have poor biodiversity- identification skills. The apparent importance of perceived species richness and the mismatch between reality and perception pose a serious chal- lenge for aligning conservation and human well-being agendas. 

    Dadvand P, Nieuwenhuijsen MJ, Esnaola M, Forns J, Basagana X, Alvarez-Pedrerol M, Rivas I, Lopez-Vicente M, Pascual MDC, Su J, et al. Green Space and Cognitives Development in Primary Schoolchildren. PNAS [Internet]. 2015;112 (26) :7937-7942. Publisher's VersionAbstract

    Exposure to green space has been associated with better physical and mental health. Although this exposure could also influence cognitive development in children, available epidemiological evidence on such an impact is scarce. This study aimed to assess the association between exposure to green space and measures of cognitive development in primary schoolchildren. This study was based on 2,593 schoolchildren in the second to fourth grades (710 y) of 36 primary schools in Barcelona, Spain (20122013). Cognitive development was assessed as 12-mo change in developmental trajectory of working memory, superior working memory, and in- attentiveness by using four repeated (every 3 mo) computerized cognitive tests for each outcome. We assessed exposure to green space by characterizing outdoor surrounding greenness at home and school and during commuting by using high-resolution (5 m × 5 m) satellite data on greenness (normalized difference vegetation index). Multilevel modeling was used to estimate the associations between green spaces and cognitive development. We observed an enhanced 12-mo progress in working memory and superior working memory and a greater 12-mo reduction in inattentiveness associated with greenness within and surrounding school bound- aries and with total surrounding greenness index (including green- ness surrounding home, commuting route, and school). Adding a traffic-related air pollutant (elemental carbon) to models explained 2065% of our estimated associations between school greenness and 12-mo cognitive development. Our study showed a beneficial association between exposure to green space and cognitive devel- opment among schoolchildren that was partly mediated by reduc- tion in exposure to air pollution. 

    Davies J, Campbell D, Campbell M, Douglas J, Hueneke H, LaFlamme M, Pearson D, Preuss K, Walker J, Walsh F. Attention to Four Key Principles Can Promote Health Outcomes from Desert Aboriginal Land Management. The Rangeland Journal [Internet]. 2011;33 :417-431. Publisher's VersionAbstract

    We identify four principles that can promote the prospects of health outcomes for desert Aboriginal people from livelihoods engaged with land management. The principles were derived inductively using a grounded theory approach, drawing on primary research that used qualitative and participatory methods, and from relevant literature and theoretical frameworks. International and Australian literature offers evidence that supports desert Aboriginal peoples view that their health depends on their relationship with their land. Engagement with land management can lead desert Aboriginal people to feel that their own actions are consistent with their own sense of the right and proper way for them to behave towards land, family and community. This increased sense of controlimpacts positively on health by moderating the impact of sustained stress from health risk factors in the environment and lifestyle. The four principles focus on underlying characteristics of Aboriginal land management that are important to promoting this increased sense of control: (1) Aboriginal land management governance recognises and respects Aboriginal custom and tradition, and is adaptive; (2) learning is embraced as a life-long process; (3) relationships are recognised as very important; and (4) partnerships give priority to doing things that all parties agree are important. These principles are presented as hypotheses that warrant further development and testing. While they do not account specifically for the impact of lifestyle and environmental factors on health, we expect that the increased sense of control that desert Aboriginal people are likely to develop when involved in Aboriginal land management that applies these principles will moderate the impact of such factors on their health. The principles offer a starting point for further development of criteria and standards for good practice in Aboriginal land management, potentially including an environmental certification scheme that integrates social and environmental outcomes. 

    Hough RL. Biodiversity and Human Health: Evidence for Causality. Biodivers Conserv [Internet]. 2014;23 :267-288. Publisher's VersionAbstract

    The Millennium Ecosystem Assessment and other commentators have warned about the impacts that biodiversity decline will have on human health. There is no doubting that the natural world provides mankind with the majority of the resources required to sustain life and health. Many species provide food, fuel, medicines; with the potential for many more (as of yet) undiscovered uses for various species. Despite this, there have been very few attempts to actually investigate relationships between biodiversity (i.e. number of species, rather than the ability of specific species to provide health benefits) and human health. This paper reviews the available evidence and demonstrates that while the links between biodiversity and health seem intuitive, they are very difficult to prove. Socio- economics has a huge influence on health status and the exploitation of natural resources (leading to eventual biodiversity loss) tends to have a positive economic effects. More direct effects of biodiversity on health include the diversity of the internal microbiome, the effect of natural diversity on our mental health and well-being (although this has large social aspects with many people feeling fearful in very diverse environments). Still to be elucidated are the tipping points where the level of global biodiversity loss is such that human health can no longer be sustained. 

    Pullin AS, Bangpan M, Dalrymple S, Dickson K, Haddaway NR, Healey JR, Hauari H, Hockley N, Jones JPG, Knight T, et al. Human Well-being Impacts of Terrestrial Protected Areas. Environmental Evidence [Internet]. 2013;2 (19). Publisher's VersionAbstract

     

    Background: Establishing Protected Areas (PAs) is among the most common conservation interventions. Protecting areas from the threats posed by human activity will by definition inhibit some human actions. However, adverse impacts could be balanced by maintaining ecosystem services or introducing new livelihood options. Consequently there is an ongoing debate on whether the net impact of PAs on human well-being at local or regional scales is positive or negative. We report here on a systematic review of evidence for impacts on human well-being arising from the establishment and maintenance of terrestrial PAs.

    Methods: Following an a priori protocol, systematic searches were conducted for evidence of impacts of PAs post 1992. After article title screening, the review was divided into two separate processes; a qualitative synthesis of explanations and meaning of impact and a review of quantitative evidence of impact. Abstracts and full texts were assessed using inclusion criteria and conceptual models of potential impacts. Relevant studies were critically appraised and data extracted and sorted according to type of impact reported. No quantitative synthesis was possible with the evidence available. Two narrative syntheses were produced and their outputs compared in a metasynthesis.

    Results: The qualitative evidence review mapped 306 articles and synthesized 34 that were scored as high quality. The quantitative evidence review critically appraised 79 studies and included 14 of low/medium susceptibility to bias. The meta-synthesis reveals that a range of factors can lead to reports of positive and negative impacts of PA establishment, and therefore might enable hypothesis generation regarding cause and effect relationships, but resulting hypotheses cannot be tested with the current available evidence.

    Conclusions: The evidence base provides a range of possible pathways of impact, both positive and negative, of PAs on human well-being but provides very little support for decision making on how to maximize positive impacts. The nature of the research reported to date forms a diverse and fragmented body of evidence unsuitable for the purpose of informing policy formation on how to achieve win-win outcomes for biodiversity and human well-being. To better assess the impacts of PAs on human well-being we make recommendations for improving research study design and reporting. 

    Karjalainen E, Sarjala T, Raitio H. Promoting Human Health through Forests: Overview and Major Challenges. Environ Health Prev Med [Internet]. 2010;15 :1-8. Publisher's VersionAbstract

    This review aims to contribute to the ongoing discussion about human health, global change, and biodiversity by concentrating on the relationships between forests and human health. This review gives a short overview of the most important health benefits that forests provide to humans, and the risks that forests may pose to human health. Furthermore, it discusses the future chal- lenges for the research on the links between forests and human health, and for delivering health through forests in practice. Forests provide enormous possibilities to improve human health conditions. The results of a vast amount of research show that forest visits promote both physical and mental health by reducing stress. Forests represent rich natural pharmacies by virtue of being enormous sources of plant and microbial material with known or potential medicinal or nutritional value. Forest food offers a safety net for the most vulnerable population groups in develop- ing countries, and healthy forest ecosystems may also help in regulation of infectious diseases. Utilizing forests effectively in health promotion could reduce public health care budgets and create new sources of income. Main challenges to delivering health through forests are due to ecosystem and biodiversity degradation, deforestation, and climate change. In addition, major implementation of research results into practice is still lacking. Inadequate implementation is partly caused by insufficient evidence base and partly due to the lack of policy-makers’ and practitioners’ awareness of the potential of forests for improving human health. This calls for strong cooperation among researchers, policy-makers, and practitioners as well as between different sectors, especially between health and environmental professionals. 

    Sandifer PA, Sutton-Grier AE, Ward BP. Exploring Connections among Nature, Biodiversity, Ecosystem Services, and Human Health and Well-being: Opportunities to Enhance Health and Biodiversity Conservation. Ecosystem Services [Internet]. 2015;12 :1-15. Publisher's VersionAbstract

    We are at a key juncture in history where biodiversity loss is occurring daily and accelerating in the face of population growth, climate change, and rampant development. Simultaneously, we are just beginning to appreciate the wealth of human health benefits that stem from experiencing nature and biodiversity. Here we assessed the state of knowledge on relationships between human health and nature and biodiversity, and prepared a comprehensive listing of reported health effects. We found strong evidence linking biodiversity with production of ecosystem services and between nature exposure and human health, but many of these studies were limited in rigor and often only correlative. Much less information is available to link biodiversity and health. However, some robust studies indicate that exposure to microbial biodiversity can improve health, specifically in reducing certain allergic and respiratory diseases. Overall, much more research is needed on mechanisms of causation. Also needed are a re- envisioning of land-use planning that places human well-being at the center and a new coalition of ecologists, health and social scientists and planners to conduct research and develop policies that promote human interaction with nature and biodiversity. Improvements in these areas should enhance human health and ecosystem, community, as well as human resilience. 

    Lowe D, Ebi KL, Forsberg B. Factors increasing vulnerability to health effects before, during and after floods. International Journal of Environmental Research and Public Health [Internet]. 2013;10 (12) :7015-7067. Publisher's VersionAbstract

    Identifying the risk factors for morbidity and mortality effects pre-, during and post-flood may aid the appropriate targeting of flood-related adverse health prevention strategies. We conducted a systematic PubMed search to identify studies examining risk factors for health effects of precipitation-related floods, among Organisation for Economic Co-Operation and Development (OECD) member countries. Research identifying flood-related morbidity and mortality risk factors is limited and primarily examines demographic characteristics such as age and gender. During floods, females, elderly and children appear to be at greater risk of psychological and physical health effects, while males between 10 to 29 years may be at greater risk of mortality. Post-flood, those over 65 years and males are at increased risk of physical health effects, while females appear at greater risk of psychological health effects. Other risk factors include previous flood experiences, greater flood depth or flood trauma, existing illnesses, medication interruption, and low education or socio-economic status. Tailoring messages to high-risk groups may increase their effectiveness. Target populations differ for morbidity and mortality effects, and differ pre-, during, and post-flood. Additional research is required to identify the risk factors associated with pre- and post-flood mortality and post-flood morbidity, preferably using prospective cohort studies. 2013 by the authors; licensee MDPI, Basel, Switzerland.

    Alderman K, Turner LR, Tong S. Floods and human health: a systematic review. Environ Int [Internet]. 2012;47 :37-47. Publisher's VersionAbstract

    Floods are the most common type of disaster globally, responsible for almost 53,000 deaths in the last decade alone (23:1 low- versus high-income countries). This review assessed recent epidemiological evidence on the impacts of floods on human health. Published articles (2004-2011) on the quantitative relationship between floods and health were systematically reviewed. 35 relevant epidemiological studies were identified. Health outcomes were categorized into short- and long-term and were found to depend on the flood characteristics and people's vulnerability. It was found that long-term health effects are currently not well understood. Mortality rates were found to increase by up to 50% in the first year post-flood. After floods, it was found there is an increased risk of disease outbreaks such as hepatitis E, gastrointestinal disease and leptospirosis, particularly in areas with poor hygiene and displaced populations. Psychological distress in survivors (prevalence 8.6% to 53% two years post-flood) can also exacerbate their physical illness. There is a need for effective policies to reduce and prevent flood-related morbidity and mortality. Such steps are contingent upon the improved understanding of potential health impacts of floods. Global trends in urbanization, burden of disease, malnutrition and maternal and child health must be better reflected in flood preparedness and mitigation programs.

    Sheffield PE, Landrigan PJ. Global climate change and children's health: threats and strategies for prevention. Environ Health Perspect [Internet]. 2011;119 (3) :291-8. Publisher's VersionAbstract

    BACKGROUND: Global climate change will have multiple effects on human health. Vulnerable populations-children, the elderly, and the poor-will be disproportionately affected. OBJECTIVE: We reviewed projected impacts of climate change on children's health, the pathways involved in these effects, and prevention strategies. DATA SOURCES: We assessed primary studies, review articles, and organizational reports. DATA SYNTHESIS: Climate change is increasing the global burden of disease and in the year 2000 was responsible for > 150,000 deaths worldwide. Of this disease burden, 88% fell upon children. Documented health effects include changing ranges of vector-borne diseases such as malaria and dengue; increased diarrheal and respiratory disease; increased morbidity and mortality from extreme weather; changed exposures to toxic chemicals; worsened poverty; food and physical insecurity; and threats to human habitation. Heat-related health effects for which research is emerging include diminished school performance, increased rates of pregnancy complications, and renal effects. Stark variation in these outcomes is evident by geographic region and socioeconomic status, and these impacts will exacerbate health disparities. Prevention strategies to reduce health impacts of climate change include reduction of greenhouse gas emissions and adaptation through multiple public health interventions. CONCLUSIONS: Further quantification of the effects of climate change on children's health is needed globally and also at regional and local levels through enhanced monitoring of children's environmental health and by tracking selected indicators. Climate change preparedness strategies need to be incorporated into public health programs.

    Irvine KN, Warber SL. Greening healthcare: practicing as if the natural environment really mattered. Altern Ther Health Med [Internet]. 2002;8 (5) :76-83. Publisher's VersionAbstract

    OBJECTIVE: The natural world's role in human well-being is an essential, yet often forgotten, aspect of healthcare. Of particular importance are the benefits one can derive through interaction with natural environments. While health is an obvious goal of allopathic medicine, many healthcare settings are neither nurturing nor healing. Reincorporating the natural world into the design of settings in which medicine is practiced is one way to complement conventional healing modalities and move healthcare toward being more "green." This article discusses the breadth of existing knowledge available on the positive aspects of interaction with nature and provides a comprehensive theoretical perspective for future research. DATA SOURCES: Computerized searches were conducted using MEDLINE, PsycINFO, the Social and Scientific Science Indices, Dissertation Abstracts, Lexus-Nexus, the University of Michigan library, and the Internet. Searches were conducted from June 2001 through March 2002. STUDY SELECTION: Keywords used included health, well-being stress, attention, nature, garden, landscape, restorative, and healing. The literature, published between 1960 and 2001, came from various disciplines, including medicine, public health, nursing psychology, natural resources, history, and landscape architecture. Four components of well-being were used as a framework for literature selection: physical psychological-emotional social, and spiritual. DATA EXTRACTION: Articles were qualitatively reviewed to extract theories, hypotheses, and experimental evidence. DATA SYNTHESIS: Interaction with nature positively affects multiple dimensions of human health. Physiological effects of stress on the autonomic nervous system are lessened. Psychologically, deficits in attention can be restored or minimized, and people report feeling greater satisfaction with a variety of aspects of life. The presence of the natural world promotes social health by encouraging positive social interaction and lessening the frequency of aggressive behavior. Spiritual well-being is enhanced through the experience of greater interconnectedness, which occurs when interacting with the natural world. CONCLUSIONS: The literature reviewed provides evidence to support the intuitive belief that interaction with the natural world is a vital part of biopsychosocial-spiritual well-being. Incorporating the natural world into healthcare could provide health benefits and improve the design of healthcare facilities. Applied more broadly to society, this knowledge may change the way we approach public health, guard and manage natural resources, and design environments for human use.

    Hosking J, Campbell-Lendrum D. How well does climate change and human health research match the demands of policymakers? A scoping review. Environ Health Perspect [Internet]. 2012;120 (8) :1076-82. Publisher's VersionAbstract

    BACKGROUND: In 2008, the World Health Organization (WHO) Member States passed a World Health Assembly resolution that identified the following five priority areas for research and pilot projects on climate change and human health: health vulnerability, health protection, health impacts of mitigation and adaptation policies, decision-support and other tools, and costs of health protection from climate change. OBJECTIVES: To assess the extent to which recently published research corresponds to these priorities, we undertook a scoping review of original research on climate change and human health. Scoping reviews address topics that are too broad for a systematic review and commonly aim to identify research gaps in existing literature. We also assessed recent publication trends for climate change and health research. METHODS: We searched for original quantitative research published from 2008 onward. We included disease burden studies that were specific to climate change and health and included intervention studies that focused on climate change and measured health outcomes. We used MEDLINE, Embase, and Web of Science databases and extracted data on research priority areas, geographic regions, health fields, and equity (systematic differences between advantaged and disadvantaged social groups). DISCUSSION: We identified 40 eligible studies. Compared with other health topics, the number of climate change publications has grown rapidly, with a larger proportion of reviews or editorials. Recent original research addressed four of the five priority areas identified by the WHO Member States, but we found no eligible studies of health adaptation interventions, and most of the studies focused on high-income countries. CONCLUSIONS: Climate change and health is a rapidly growing area of research, but quantitative studies remain rare. Among recently published studies, we found gaps in adaptation research and a deficit of studies in most developing regions. Funders and researchers should monitor and respond to research gaps to help ensure that the needs of policymakers are met.

    Völker S, Kistemann T. The impact of blue space on human health and well-being - Salutogenetic health effects of inland surface waters: a review. Int J Hyg Environ Health [Internet]. 2011;214 (6) :449-60. Publisher's VersionAbstract

    Water is one of the most important physical, aesthetic landscape elements and possesses importance e.g. in environmental psychology, landscape design, and tourism research, but the relationship between water and health in current literature is only investigated in the field of environmental toxicology and microbiology, not explicitly in the research field of blue space and human well-being. Due to the lack of a systematic review of blue space and well-being in the various fields of research, the aim of this review is to provide a systematic, qualitative meta-analysis of existing studies that are relevant to this issue. Benefits for health and well-being clearly related to blue space can be identified with regard to perception and preference, landscape design, emotions, and restoration and recreation. Additionally, direct health benefits have already been stated. The studies included in the review are mostly experimental studies or cross-sectional surveys, focusing on students as the subject group. There is a need for more qualitative and multi-faceted, interdisciplinary studies, using triangulation as a method to achieve a resilient image of reality. A broader study design considering all age groups would contribute to identifying benefits for the whole of society. The inattentiveness to blue space makes it difficult to measure long-term effects of blue space on well-being. There is still little respect for water and health in planning issues, although salutogenetic health benefits can be identified. To close the gap regarding missing systematic concepts, a concept for assessing salutogenetic health effects in blue space is provided. Blue space is considered therein as a multi-dimensional term including four dimensions of appropriation, as well as at least five ontological dimensions of substantiality. The aim of the concept is to support researchers and practitioners analysing health effects in blue space.

    Calogiuri G, Chroni S. The impact of the natural environment on the promotion of active living: an integrative systematic review. BMC Public Health. 2014;14 :873.Abstract

    BACKGROUND: An understanding of how the living environment influences physical activity (PA) is of great importance for health promotion. Researchers have reported increased PA when there is a greater availability of nature within people's living environment. However, little has been said about underlying motivational processes. The aim of this study was to review the existing literature on the relationship between the natural environment (NE) and PA, integrating it into a conceptual model that depicts the motivational process underlying this relationship. METHODS: Through a systematic literature search in line with PRISMA guidelines, peer-reviewed articles were sought using PubMed (search updated to October 2013) and scrutiny of reference lists. In addition, we contacted experts within our network. We reviewed papers in which the research question(s) concerned: 1) Effects of PA in NE on individuals' feelings and beliefs; 2) Relationships between PA and availability of NEs; and 3) Motivational processes underlying visits to NEs in association with PA. Analysis and integration of the 90 selected studies were performed using the theory of planned behaviour (TPB). RESULTS: People's experiences in using the NE can enhance attitudes toward PA and perceived behavioural control via positive psychological states and stress-relieving effects, which lead to firmer intentions to engage in PA. Individual and environmental barriers, as expressions of social support and actual behavioural control, impact the process via subjective norm and perceived behavioural control. Instrumental beliefs such as a desire to enjoy nature and the expected health benefits also influence the process via attitudes. Different patterns have been identified for neighbourhood-based PA and outdoor recreations that take place in a NE. CONCLUSIONS: The availability of a NE and attractive views of nature within an individual's living environment are important contributors to PA, yet attention should focus on personal characteristics and environmental barriers. Policy and infrastructural interventions should aim to guarantee access and maintenance of the NE, as well as information and programming of social activities. Social campaigns via media and health institutions should highlight how nature can be a source of motivation for maintaining a PA routine, reducing stress and achieving aesthetic and health goals.

    Keniger LE, Gaston KJ, Irvine KN, Fuller RA. What are the benefits of interacting with nature?. International Journal of Environmental Research and Public Health [Internet]. 2013;10 (3) :913-935. Publisher's VersionAbstract

    There is mounting empirical evidence that interacting with nature delivers measurable benefits to people. Reviews of this topic have generally focused on a specific type of benefit, been limited to a single discipline, or covered the benefits delivered from a particular type of interaction. Here we construct novel typologies of the settings, interactions and potential benefits of people-nature experiences, and use these to organise an assessment of the benefits of interacting with nature. We discover that evidence for the benefits of interacting with nature is geographically biased towards high latitudes and Western societies, potentially contributing to a focus on certain types of settings and benefits. Social scientists have been the most active researchers in this field. Contributions from ecologists are few in number, perhaps hindering the identification of key ecological features of the natural environment that deliver human benefits. Although many types of benefits have been studied, benefits to physical health, cognitive performance and psychological well-being have received much more attention than the social or spiritual benefits of interacting with nature, despite the potential for important consequences arising from the latter. The evidence for most benefits is correlational, and although there are several experimental studies, little as yet is known about the mechanisms that are important for delivering these benefits. For example, we do not know which characteristics of natural settings (e.g., biodiversity, level of disturbance, proximity, accessibility) are most important for triggering a beneficial interaction, and how these characteristics vary in importance among cultures, geographic regions and socio-economic groups. These are key directions for future research if we are to design landscapes that promote high quality interactions between people and nature in a rapidly urbanising world.

    Capaldi CA, Dopko RL, Zelenski JM. The relationship between nature connectedness and happiness: a meta-analysis. Front Psychol [Internet]. 2014;5 :976. Publisher's VersionAbstract

    Research suggests that contact with nature can be beneficial, for example leading to improvements in mood, cognition, and health. A distinct but related idea is the personality construct of subjective nature connectedness, a stable individual difference in cognitive, affective, and experiential connection with the natural environment. Subjective nature connectedness is a strong predictor of pro-environmental attitudes and behaviors that may also be positively associated with subjective well-being. This meta-analysis was conducted to examine the relationship between nature connectedness and happiness. Based on 30 samples (n = 8523), a fixed-effect meta-analysis found a small but significant effect size (r = 0.19). Those who are more connected to nature tended to experience more positive affect, vitality, and life satisfaction compared to those less connected to nature. Publication status, year, average age, and percentage of females in the sample were not significant moderators. Vitality had the strongest relationship with nature connectedness (r = 0.24), followed by positive affect (r = 0.22) and life satisfaction (r = 0.17). In terms of specific nature connectedness measures, associations were the strongest between happiness and inclusion of nature in self (r = 0.27), compared to nature relatedness (r = 0.18) and connectedness to nature (r = 0.18). This research highlights the importance of considering personality when examining the psychological benefits of nature. The results suggest that closer human-nature relationships do not have to come at the expense of happiness. Rather, this meta-analysis shows that being connected to nature and feeling happy are, in fact, connected.

    Bowler DE, Buyung-Ali LM, Knight TM, Pullin AS. A systematic review of evidence for the added benefits to health of exposure to natural environments. BMC Public Health [Internet]. 2010;10 :456. Publisher's VersionAbstract

    BACKGROUND: There is increasing interest in the potential role of the natural environment in human health and well-being. However, the evidence-base for specific and direct health or well-being benefits of activity within natural compared to more synthetic environments has not been systematically assessed. METHODS: We conducted a systematic review to collate and synthesise the findings of studies that compare measurements of health or well-being in natural and synthetic environments. Effect sizes of the differences between environments were calculated and meta-analysis used to synthesise data from studies measuring similar outcomes. RESULTS: Twenty-five studies met the review inclusion criteria. Most of these studies were crossover or controlled trials that investigated the effects of short-term exposure to each environment during a walk or run. This included 'natural' environments, such as public parks and green university campuses, and synthetic environments, such as indoor and outdoor built environments. The most common outcome measures were scores of different self-reported emotions. Based on these data, a meta-analysis provided some evidence of a positive benefit of a walk or run in a natural environment in comparison to a synthetic environment. There was also some support for greater attention after exposure to a natural environment but not after adjusting effect sizes for pretest differences. Meta-analysis of data on blood pressure and cortisol concentrations found less evidence of a consistent difference between environments across studies. CONCLUSIONS: Overall, the studies are suggestive that natural environments may have direct and positive impacts on well-being, but support the need for investment in further research on this question to understand the general significance for public health.

    Dzhambov AM, Dimitrova DD. Urban green spaces' effectiveness as a psychological buffer for the negative health impact of noise pollution: a systematic review. Noise Health [Internet]. 2014;16 (70) :157-65. Publisher's VersionAbstract

    Noise pollution is one of the four major pollutions in the world. Little evidence exists about the actual preventive benefits of psychological noise attenuation by urban green spaces, especially from the perspective of environmental medicine and, to the best of our knowledge, there is not a systematic analysis on this topic. The aim of this review was to systematically evaluate whether there is conclusive scientific evidence for the effectiveness of urban green spaces as a psychological buffer for the negative impact of noise pollution on human health and to promote an evidence-based approach toward this still growing environmental hazard. MEDLINE and EMBASE databases were searched for experimental and epidemiological studies published before June 04, 2013 in English and Spanish. Data was independently extracted in two step process by the authors. Due to the heterogeneity of the included studies qualitative assessment was performed. We found moderate evidence that the presence of vegetation can generally reduce the negative perception of noise (supported with an electroencephalogram test in one of the experimental studies; consistent with the data from two epidemiological studies; one experiment found no effect and one was inconclusive about the positive effect). This review fills a gap in the literature and could help researchers further clarify the proper implementation of urban green spaces as a psychological buffer in areas with population exposed to chronic noise pollution.

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