Doses of Nearby Nature Simultaneously Associated with Multiple Health Benefits
Abstract
:1. Background
2. Methods
2.1. Study Area and Survey Design
2.2. Health Response Variables
- Mental health (binary): A measure of depression was generated based on the depression component of the short version of the Depression, Anxiety and Stress Scale (DASS 21; [33]). Scores were converted to a binary measure, where 0 indicates no depression and 1 indicates mild or worse depression (see Section 1 in Supplementary Materials). Proposed mechanisms for the delivery of these benefits include improved cognition in individuals with depression [34], reduced rumination and reduced neural activity in an area of the brain linked to the risk of mental illness [12].
- Physical health (ordinal): Respondents scored their own general health on a five-point scale from very poor to very good [35]. This scale is related to morbidity and mortality rates and is a strong predictor of health status and outcomes [36]. Proposed mechanisms behind benefit delivery include temperature regulation and pollution filtration by vegetation (reviewed by [27,37]).
- Social health (linear): Perceptions of social cohesion were estimated based on three previously developed scales that measure trust, reciprocal exchange within communities and general community cohesion ([38,39,40], see Section 2 in Supplementary Materials). The average score across questions for each scale was calculated, highest (4) to the lowest (0). Average scores were then summed to provide a scale from highest (12) to lowest (0). Appealing green spaces promote a sense of connection to the outside world that generalizes to most people; this allows enhanced social and community interactions, leading to improved perceptions of cohesion and well-being [41].
- Physical behaviour (Poisson): This is a self-reported indication of the number of days respondents exercised for a minimum of 30 min during the survey week (the duration recommended by the UK government) [42]. Appealing green spaces promote use [10] and willingness to travel greater distances for use [43]. Further, green exercise can enhance health benefits relative to built-up or indoor environments [30].
- Nature orientation (linear): Respondents provided a measure of their affective, cognition and experiential relationship with the natural world (nature relatedness scale) [31]. Responses were aggregated according to [31], with a higher score indicating a stronger orientation towards nature. Engagement with the natural world increases feelings of connection, unity or being part of the natural world, which has been linked to psychological health [44]. Indeed, increased nature connection has been associated with improved mental health [45] and subjective well-being [46,47].
2.3. Nature Dose
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Variables | Mental Health | Physical Health | Social Health | Physical Behaviour | Nature Relatedness |
---|---|---|---|---|---|
Model (i) | R2 = 0.12 | # | R2 = 0.15 | R2 = 0.06 | R2 = 0.14 |
Intercept | 4.62 (0.90) *** | NA | 3.40 (0.62) *** | −0.76 (0.25) ** | 2.71 (0.09) *** |
Age | −0.23 (0.03) *** | −0.11 (0.03 ) *** | −0.05 (0.03) * | −0.03 (0.01) ** | 0.05 (0.01) *** |
Gender_female | −0.16 (0.15) | −0.26 (0.13) * | −0.01 (0.13) | −0.05 (0.04) | 0.10 (0.03) ** |
Children in home | −0.02 (0.07) | −0.05 (0.06) | 0.06 (0.06) | 0.06 (0.02) ** | 0.01 (0.01) |
Language at home | 0.27 (0.20) | 0.08 (0.17) | 0.26 (0.17) | −0.07 (0.06) | 0.05 (0.04) |
Work days per week | −0.08 (0.04) | 0.08 (0.03) * | −0.02 (0.04) | 0.02 (0.01) | −0.02 (0.01) * |
Income | −0.03 (0.04) | 0.13 (0.03) *** | 0.18 (0.03) *** | 0.02 (0.02) | −0.02 (0.01) ** |
Frequency of 30-min exercise | −0.02 (0.04) | 0.19 (0.03) *** | 0.11 (0.03) *** | NA | 0.04 (0.01) *** |
Social cohesion | −0.01 (0.04) | 0.20 (0.03) *** | NA | 0.05 (0.01) *** | 0.04 (0.01) *** |
Nature relatedness | −0.28 (0.26) | −0.12 (0.14) | 0.73 (0.14) *** | 0.26 (0.05) *** | NA |
Education (highest qual.) | |||||
A-level | 0.2 (0.20) | 0.41 (0.16) * | 0.18 (0.17) | −0.11 (0.06) | 0.02 (0.04) |
Undergraduate | −0.10 (0.25) | 0.47 (0.18) ** | 0.17 (0.18) | −0.04 (0.06) | 0.04 (0.04) |
Postgraduate | 0.01 (0.25) | 1.05 (0.21) *** | 0.38 (0.21) | −0.09 (0.07) | 0.08 (0.05) |
Self-assessment health | |||||
Poor | −1.01 (0.59) | NA | −0.05 (0.44) | −0.04 (0.18) | −0.06 (0.01) |
Average | −1.66 (0.56) ** | NA | 0.18 (0.40) | −0.04 (0.16) | −0.10 ( 0.10) |
Good | −2.55 (0.59) *** | NA | 0.81 (0.40) * | 0.29 (0.16) | −0.10 (0.10) |
Very good | −2.58 (0.57) *** | NA | 1.29 (0.41) ** | 0.44 (0.16) ** | −0.10 (0.10) |
Relative time outdoors | |||||
About the same | −0.83 (0.19) *** | −0.07 (0.16) | −0.16 (0.16) | 0.15 (0.06) *** | 0.02 (0.04) |
More time | −1.15 (0.22) *** | −0.05 (0.18) | −0.22 (0.18) | 0.28 (0.07) *** | 0.11 (0.04) ** |
Model (ii) | R2 = 0.13 | # | R2 = 0.17 | R2 = 0.06 | R2 = 0.17 |
Nature exposure frequency exposure | −0.2 (0.05) *** | 0.03 (0.05) | 0.23 (0.05) *** | 0.09 (0.02) *** | 0.07 (0.01) *** |
Model (iii) | R2 = 0.13 | # | R2 = 0.16 | R2 = 0.06 | R2 = 0.18 |
Nature exposure duration | −0.06 (0.03) * | 0.01 (0.02) | 0.07 (0.02) ** | 0.03 (0.01) *** | 0.04 (0.01) *** |
Model (iv) | R2 = 0.17 | # | R2 = 0.15 | R2 = 0.08 | R2 = 0.14 |
Nature exposure intensity | −0.04 (0.01) ** | 0.01 (0.01) | 0.01 (0.01) | 0.004 (0.003) | 0.004 (0.002) * |
Variable | Risk Factor | Odds Ratio (95% CI) | Average Population Fraction |
---|---|---|---|
Age | Higher risk < 46 years | 2.94 | 0.41 |
(1.96, 4.41) | |||
Self-assessment of physical health | Higher risk < average health | 3.64 | 0.07 |
(2.25, 5.90) | |||
Relative time outdoors | Higher risk < less time outdoors | 2.51 | 0.08 |
(1.76, 3.56) | |||
Frequency of exposure | Higher risk < once per week | 1.36 | 0.05 |
(1.02, 1.81) | |||
Duration of exposure | Higher risk < five hours per week | 2.12 | 0.27 |
(1.27, 3.54) | |||
Intensity of exposure | High risk < 15% vegetation cover | 2.09 | 0.05 |
(1.17, 3.72) |
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Cox, D.T.C.; Shanahan, D.F.; Hudson, H.L.; Fuller, R.A.; Anderson, K.; Hancock, S.; Gaston, K.J. Doses of Nearby Nature Simultaneously Associated with Multiple Health Benefits. Int. J. Environ. Res. Public Health 2017, 14, 172. https://doi.org/10.3390/ijerph14020172
Cox DTC, Shanahan DF, Hudson HL, Fuller RA, Anderson K, Hancock S, Gaston KJ. Doses of Nearby Nature Simultaneously Associated with Multiple Health Benefits. International Journal of Environmental Research and Public Health. 2017; 14(2):172. https://doi.org/10.3390/ijerph14020172
Chicago/Turabian StyleCox, Daniel T. C., Danielle F. Shanahan, Hannah L. Hudson, Richard A. Fuller, Karen Anderson, Steven Hancock, and Kevin J. Gaston. 2017. "Doses of Nearby Nature Simultaneously Associated with Multiple Health Benefits" International Journal of Environmental Research and Public Health 14, no. 2: 172. https://doi.org/10.3390/ijerph14020172