Impact of the Forest Environment on Public Health: Forest Recreation, Forest Therapy, and Forest Bathing

Topic Information

Dear Colleagues,

With advances in technology and civilisation, people are gradually starting to feel more and more disconnected from the natural world, with very negative consequences for health. People are facing new technostresses, and these stresses are threatening their health. It is becoming more and more urgent to reverse this trend and seek solutions to facilitate contact with nature. Nature is as important for people's wellbeing and mental health as it is for society's ability to cope with global change, health risks and disasters. It has been reported that forest bathing/shinrin-yoku reduces mental and physical stress. People need nature in their lives, not only because of the need for health, but also because contact with nature makes them more creative and able to think innovatively. Forest ecosystems are an important place for recreation and leisure, the realisation of physical activity, and they contribute to building good social relations and shaping pro-environmental behaviour. In addition, forests increase people's resilience, protect them from noise and allow them to breathe cleaner air. There is a lot of scientific evidence indicating that nature can help people rebuild, regenerate their psycho-physical strength. By helping people maintain the adaptive resources needed to cope with the demands of life, nature can reduce the risk of chronic stress-related illnesses and promote a range of intermediate values, such as improved wellbeing and focused attention. This Topic aims to highlight the importance of forest ecosystems in promoting public health, as well as to promote awareness of the impact of the forest on human health.

Dr. Emilia Janeczko
Dr. Jitka Fialova
Prof. Dr. Qing Li
Prof. Dr. Chi-Ming Hsieh
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Healthcare healthcare	2.7	4.7	2013	22.4 Days	CHF 2700	Submit
International Journal of Environmental Research and Public Health ijerph	-	8.5	2004	29.5 Days	CHF 2500	Submit
Sustainability sustainability	3.3	7.7	2009	17.9 Days	CHF 2400	Submit

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Published Papers (6 papers)

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27 pages, 6807 KB  

Open AccessArticle

Unlocking the Restorative Power of Urban Green Spaces in Summer: The Interplay of Vegetation Structure, Activity Modality, and Human Well-Being

by Yifan Duan, Hua Bai, Le Yang and Shuhua Li

Sustainability 2026, 18(7), 3619; https://doi.org/10.3390/su18073619 - 7 Apr 2026

Viewed by 440

Abstract

Amidst global urbanization and rising psychological stress, urban green spaces are increasingly recognized as critical infrastructure for sustainable urban development and public health. However, the mechanisms by which summer vegetation structure mediates both physiological and psychological restoration, and the interplay between these two [...] Read more.

Amidst global urbanization and rising psychological stress, urban green spaces are increasingly recognized as critical infrastructure for sustainable urban development and public health. However, the mechanisms by which summer vegetation structure mediates both physiological and psychological restoration, and the interplay between these two dimensions, remain poorly understood. Understanding these mechanisms is essential for designing sustainable, health-promoting urban environments that can support growing urban populations in a warming climate. This study employed a controlled field experiment in Xi’an during summer to examine the effects of five vegetation structure types (Single-Layer Grassland, single-layer woodland, tree–shrub–grass composite woodland, tree–grass composite woodland, and a non-vegetated square) on university students’ physiological (heart rate variability) and psychological (perceived restorativeness and affective states) restoration. Following stress induction, 300 participants engaged with the green spaces through both quiet sitting and walking. The results revealed three key findings: (1) the tree–shrub–grass composite woodland consistently showed the most favorable trends other vegetation types across all psychological restoration dimensions, while also showing favorable trends in physiological recovery, underscoring the importance of structural complexity for restorative quality; (2) walking significantly enhanced physiological recovery compared to seated observation across all settings, confirming the role of physical activity as a critical activator of green space benefits; (3) correlation analysis identified a specific cross-system association: the R-R interval recovery value showed a weak but significant correlation with positive affect (PA) scores, suggesting that physiological calmness and positive emotional experience are linked, yet their weak coupling under short-term exposure indicates they may operate as parallel processes with distinct temporal dynamics. These findings indicate that the restorative potential of summer green spaces emerges from an integrated framework combining vegetation complexity and activity support. We propose that future sustainable landscape design should prioritize multi-layered vegetation structures as nature-based solutions that simultaneously enhance human well-being and urban resilience. These findings provide empirical evidence for integrating health-promoting green infrastructure into sustainable urban planning frameworks, supporting multiple Sustainable Development Goals (SDGs), including SDG 3 (Good Health and Well-being), SDG 11 (Sustainable Cities and Communities), and SDG 13 (Climate Action). Full article

(This article belongs to the Topic Impact of the Forest Environment on Public Health: Forest Recreation, Forest Therapy, and Forest Bathing)

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15 pages, 497 KB  

Open AccessArticle

Nature-Based Environment as a Workplace of Forest Therapy Specialist in Healthcare Context: Legal Perspective

by Gintarė Tamašauskaitė-Janickė and Daiva Petruševičienė

Healthcare 2026, 14(7), 933; https://doi.org/10.3390/healthcare14070933 - 3 Apr 2026

Viewed by 452

Abstract

Background/Objectives: This study examines the legislation governing forest therapy in healthcare, centered on nature-based environments as workplaces for professional forest therapy specialists within international, EU, and national legal frameworks from a labor law perspective. Methods: Using systematic legal analysis, comparative document analysis, and [...] Read more.

Background/Objectives: This study examines the legislation governing forest therapy in healthcare, centered on nature-based environments as workplaces for professional forest therapy specialists within international, EU, and national legal frameworks from a labor law perspective. Methods: Using systematic legal analysis, comparative document analysis, and analysis of the scientific literature, the study examines current relevant international, EU, and national (Lithuania, the Republic of Korea) regulations. Results: Based on a cross-sectoral legal norms analysis, the legal conception of forest therapy in healthcare systems and the general regulatory framework for the professional use of nature-based environments as workplaces were identified, along with their impact on the realization of the right to work, workplace requirements, and the provision of forest therapy services. Regulatory mechanisms and conditions governing the use of nature-based environments for forest therapy purposes, under schemes administered by public and private bodies, were identified and analyzed. The interaction between nature-based workplace factors and legal liability arising from professional, contractual, and service-based relationships was also defined and clarified. Conclusions: Fragmented legal regulation of nature-based environments as workplaces for forest therapy creates legal uncertainty, limits the realization of the right to work, and increases legal risks in employment, service provision, patient protection, and resource use. Strengthened interdisciplinary integration between health and forest policy is essential to ensure service quality, accessibility, and legal certainty. Therefore, future regulation should prioritize integrated and harmonized legal frameworks that recognize forest therapy within healthcare systems, ensure fair working conditions, and establish clear rules for the professional use of nature-based environments in therapeutic practices. Full article

(This article belongs to the Topic Impact of the Forest Environment on Public Health: Forest Recreation, Forest Therapy, and Forest Bathing)

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15 pages, 1131 KB  

Open AccessArticle

The Influence of Forest Landscape Spaces on Psychological and Visual Attention Responses: An Analysis Based on Different Seasons and Sexes

by Soyeon Kim

Int. J. Environ. Res. Public Health 2026, 23(4), 425; https://doi.org/10.3390/ijerph23040425 - 29 Mar 2026

Viewed by 325

Abstract

This study investigated seasonal and sex-based differences in psychological responses and area-of-interest (AOI)-based visual attention, as well as the associations between these variables, using images of the same forest-healing landscape captured in summer and autumn. A total of 40 adults (20 males and [...] Read more.

This study investigated seasonal and sex-based differences in psychological responses and area-of-interest (AOI)-based visual attention, as well as the associations between these variables, using images of the same forest-healing landscape captured in summer and autumn. A total of 40 adults (20 males and 20 females) participated in an eye-tracking experiment combined with psychological assessments, including the Perceived Restorativeness Scale (PRS-11) and semantic differential (SD) evaluations. Mixed-design ANOVA results indicated that perceived restorativeness remained stable across seasons, whereas emotional evaluations were significantly higher in autumn than in summer. Significant interaction effects between season and sex were observed in selected gaze metrics within the sky AOI, while the forest AOI showed a consistent main effect of sex across seasons. Spearman’s correlation analysis revealed a strong positive association between autumn PRS and SD scores, suggesting that aesthetic appreciation contributes to restorative perception. In addition, a significant negative correlation between forest and pond AOIs in autumn indicated a seasonal redistribution of visual attention. These findings highlight the importance of component-level landscape analysis and demonstrate that seasonal variation and user characteristics jointly influence perceptual and attentional responses in forest-healing environments. The results provide empirical implications for evidence-based forest landscape design and seasonal management strategies. Full article

(This article belongs to the Topic Impact of the Forest Environment on Public Health: Forest Recreation, Forest Therapy, and Forest Bathing)

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22 pages, 1231 KB  

Open AccessArticle

Visual Perspective and Psychological Restoration: Differential Pathways to Cognitive and Emotional Recovery in Mediated Nature Exposure

by Yuan Tang, Jiaqi Fu and Yuan Yao

Sustainability 2026, 18(5), 2565; https://doi.org/10.3390/su18052565 - 5 Mar 2026

Viewed by 826

Abstract

With the acceleration of urbanization, opportunities for direct contact with nature have diminished, making mediated nature exposure a sustainable approach to promoting public health. Existing studies predominantly present natural stimuli from a first-person horizontal perspective, leaving it unclear whether different viewing perspectives lead [...] Read more.

With the acceleration of urbanization, opportunities for direct contact with nature have diminished, making mediated nature exposure a sustainable approach to promoting public health. Existing studies predominantly present natural stimuli from a first-person horizontal perspective, leaving it unclear whether different viewing perspectives lead to divergent restorative outcomes. To examine how environment type and perspective jointly influence cognitive and emotional restoration, this study employed a 2 (environmental type: forest vs. city) × 2 (perspective: first-person perspective (1PP) vs. third-person perspective (3PP)) × 2 (time: pre-test vs. post-test) mixed experimental design grounded in Attention Restoration Theory (ART). Results showed that viewing forest videos, compared to city videos, significantly improved directed attention and emotional state. More importantly, a functional decoupling of perspectives was observed: the first-person perspective primarily facilitated the restoration of directed attention, while the third-person perspective was more effective in alleviating negative mood. These findings provide empirical evidence for the design of sustainable interventions, guiding both the development of tailored digital nature solutions and the planning of green infrastructure that integrates multiple perspectives. Thereby, nature exposure can be transformed into an equitable public health resource, contributing to the development of resilient, sustainable cities. Full article

(This article belongs to the Topic Impact of the Forest Environment on Public Health: Forest Recreation, Forest Therapy, and Forest Bathing)

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16 pages, 2686 KB  

Open AccessArticle

Effects of Forest Trail and Ground Walking on Mental and Physical Health Promotion in Middle-Aged Women Living in Urban Areas

by Eunheui Nam and Seongwoo Jeon

Healthcare 2025, 13(22), 2876; https://doi.org/10.3390/healthcare13222876 - 12 Nov 2025

Cited by 1 | Viewed by 810

Abstract

Background/Objectives: Recently, the importance of physical activity for health promotion has increased the demand for physical activities performed in natural environments. However, environmental characteristics that enhance the efficiency of physical activities and contribute to health promotion have not yet been established. This study [...] Read more.

Background/Objectives: Recently, the importance of physical activity for health promotion has increased the demand for physical activities performed in natural environments. However, environmental characteristics that enhance the efficiency of physical activities and contribute to health promotion have not yet been established. This study aimed to verify the mental and physical health of walking in different environments by measuring EEG and HR responses among middle-aged women living in urban areas during forest trail (GU) and school ground (NF) walking. Methods: In total, 30 middle-aged women participated in a 1.5 km walking, with HR measured during normal, NF, and GU walking. EEGs were recorded before and after walking 5 waves (Delta, Theta, Alpha, Beta, and Gamma). All data were collected under standardized conditions and analyzed using paired t-tests. Results: Alpha, beta, and gamma waves increased after GU walking (p < 0.001) but decreased after NF walking, suggesting that walking in natural environments promotes emotional stability, attentional recovery, and cognitive activation. Mean HR during GU was higher than during NF (p < 0.001), and NF walking corresponded to moderate-intensity exercise, whereas GU walking represented vigorous-intensity activity, likely influenced by its 5% slope and multi-sensory natural stimuli such as forest, sounds, and air quality. Conclusions: This study is not a clinical trial but a health experiment of physical activity, highlighting how walking in natural environments can contribute to improved health. The walking environment elicits distinct mental and physical responses, and forest walking has proven to be more effective in improving health. This result highlights the value of nature-based exercise spaces accessible in urban environments and can help with design and health policies. Full article

(This article belongs to the Topic Impact of the Forest Environment on Public Health: Forest Recreation, Forest Therapy, and Forest Bathing)

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12 pages, 260 KB  

Open AccessArticle

The Psychological Benefits of Forest Bathing in Individuals with Fibromyalgia and Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Pilot Study

by Mayte Serrat, Estíbaliz Royuela-Colomer, Sandra Alonso-Marsol, Sònia Ferrés, Ruben Nieto, Albert Feliu-Soler and Anna Muro

Healthcare 2025, 13(14), 1654; https://doi.org/10.3390/healthcare13141654 - 9 Jul 2025

Cited by 3 | Viewed by 2102

Abstract

Background/Objectives: The main objective of the present study is to assess the short-term effects of Forest Bathing (FB) conducted in a Mediterranean forest on individuals with fibromyalgia (FM) and/or chronic fatigue syndrome/myalgia encephalomyelitis (CFS/ME) on perceived pain, fatigue, state anxiety, positive and negative [...] Read more.

Background/Objectives: The main objective of the present study is to assess the short-term effects of Forest Bathing (FB) conducted in a Mediterranean forest on individuals with fibromyalgia (FM) and/or chronic fatigue syndrome/myalgia encephalomyelitis (CFS/ME) on perceived pain, fatigue, state anxiety, positive and negative affect, mood states, and state mindfulness. Methods: A total of 44 participants with FM and/or CSF/ME agreed to participate in this study. The FB session consisted of a 3 km silent walk, lasting three hours and guided by a specialized psychologist and a mountain guide to guarantee the safety of the activity. Paired-sample t-tests were used to analyze the pre–post changes in perceived pain, fatigue, state anxiety, positive and negative affect, mood states, and mindfulness. Results: All reported variables but self-reported pain showed statistically significant pre–post variations after the FB session. Particularly, large-to-very-large improvements in positive and negative affect, state anxiety, tension, depression, anger, and vigor were found. Small-to-moderate effect sizes for fatigue, friendliness, and state mindfulness were also reported. Conclusions: This study provides preliminary evidence of the short-term benefits of FB in individuals with FM and/or CFS/ME, especially on state anxiety and negative affect. Full article

(This article belongs to the Topic Impact of the Forest Environment on Public Health: Forest Recreation, Forest Therapy, and Forest Bathing)

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