Introduction

Have you heard of biophilia? Biophiliaas popularised by E.O. Wilson, is defined by the NRDC as “the innate human instinct to connect with nature and other living beings.” It supports improved cognitive function, physical health, and psychological wellbeing1.

With the rapid rise of urbanisation it’s estimated 70% of the world’s population will live in an urban area by 20502. With this comes an increase in air pollution, traffic congestion and noise pollution, all of which have been linked to increased mortality3 and reduced life expectancy4. Living in or close to a green space is linked to lower rates of high blood pressure and depression, a 7% reduction in the risk of heart disease, and better sleep5. It’s also linked to lowering stress levels, improving and restoring our attention, calming the mind, improving academic performance of school children, and for women, increasing longevity6.

A study published in Nature6 determined the minimum threshold of time spent in nature to maintain good health and mental wellbeing is 120 minutes a week, or 17 minutes and 14 seconds a day. However, other Australian research7 reveals the health benefits from nature experiences are dose dependent. This is one instance where “more is better” applies. The average American8 spends around 90% of their awake time indoors, (6% of that time in a vehicle)This poses the question, How much time are you spending in nature each day?

Rates of psychological distress9, depression and anxiety10 have risen significantly in recent years, especially due to the pandemic, highlighting the risk of developing mental mood disorders. For many, as an escape from lockdown, daily walks, exploring local bushland, and taking our children to local parks provided a sense of relief. A survey11 taken during the pandemic found increased use of urban green space during times of adversity serves to mitigate some of the negative effects of high stress, though they also noted the capacity and desire to do so varied greatly.

So, how much greenery do we need?

The WHO has determined a minimum of 9m2, but ideally 50m2, of green space per individual supported happier, healthier lifestyles. As cities become more densely populated and compact12, the inclusion of rooftop gardens, green walls, and parkland will impact the wellbeing of residents.

Green care: spending time in our own back yards

The back yard can be a sanctuary for health and wellbeing as urban gardeners dig in to get their hands dirty, tend and nurture their plants and their prize tomatoes. There’s something deeply satisfying about growing and eating your own food. The magic combination13 appears to be the physical activity itself increasing aerobic exercise strength and dexterity, combined with increased social interaction, increased exposure to sunlight and nature that makes gardening so enjoyable and relaxing.

It was Dr Benjamin Rush14 a 19th century psychiatrist who first reported on the benefits gardening provided his patients dealing with mental illness Florence Nightingale15 was a strong proponent for gardens around hospitals, while care homes and hospices also focus on providing garden outlooks for their patients and visitors. Therapeutic landscapes16 as proposed by Ulrich assist in reducing stress, pain, and increase recovery times in healthcare facilities, and in the wider urban environment.  Gardening17 can be offered as a form of therapy to improve both physical and mental health.

How can we implement more “green time,” and what does this do for us?

  • Green social prescriptions18 are becoming more widely used. Here, people are introduced to community-based nature activities for a variety of social, emotional, and practical support.
  • Green Walking19 initiatives have been trialled using nature-based therapy for inpatient psychiatric patients.
  • “Greendesking”20 has been used in workplaces and has been found to provide the same level of a “pick-me-up” as a cup of coffee! “Greendesking” simply involves getting outside for 20 minutes per day. It can also involve the simple act of looking out into nature for microbreaks during the day.
  • Simply looking outside! Research tells us “green booster breaks,”21 or taking micro-breaks to look outside into nature during the day, makes work feel more manageable, restores energy, and decreases stress.
  • Gardening can be a form a therapy, improving both physical and mental health. The magic combination of getting physical activity (and therefore developing strength and dexterity) and engaging in social interactions makes gardening not only delicious but also extremely beneficial22.
  • And even more methods are described in Lifestyle medicine prescriptions for personal and planetary health23.

A final thought: this isn’t just about us

We have the solutions and the opportunity to bring about a radical rethink of what health and wellbeing means and create a healthier, happier world, by starting small and sowing the seeds for effective and sustainable change. Our increased awareness of the power of green prescriptions and adopting a planetary health approach24 shows us, essentially, what’s good for us is good for the planet.

And now it’s time to grab my trainers and head out to the park for a walk.

    1. References

      1. Bringing the Outdoors In: The Benefits of Biophilia (2020). NRDC.  https://www.nrdc.org/experts/maria-mccain/bringing-outdoors-benefits-biophilia
      2. Callaghan, G. McCombe, A. Harrold, C. McMeel, G. Mills, N. Moore-Cherry & W.     Cullen (2021) The impact of green spaces on mental health in urban settings: a scoping review, Journal of Mental Health, 30:2, 179-193, DOI: 10.1080/09638237.2020.1755027
      3. Residential green spaces and mortality: a systematic review Mireia Gascona, Margarita Triguero-Mas David Martínez Payam Dadvand, MD, David Rojas-Rueda Antoni Plasènciaa , Mark J. Nieuwenhuijsen http://diposit.ub.edu/dspace/bitstream/2445/99572/1/gascon2015_2007.pdf
      4. Hamidi S, Ewing R, Tatalovich Z, Grace JB, Berrigan D. Associations between Urban Sprawl and Life Expectancy in the United States. Int J Environ Res Public Health. 2018;15(5):861. Published 2018 Apr 26. doi:10.3390/ijerph15050861
      5. Peter James, Jaime E. Hart, Rachel F. Banay, and Francine Laden 2016 Exposure to Greenness and Mortality in a Nationwide Prospective Cohort Study of Women, Environmental Health Perspectives 124:9 CID: https://doi.org/10.1289/ehp.1510363
      6. White, M.P., Alcock, I., Grellier, J. et al. Spending at least 120 minutes a week in nature is associated with good health and wellbeing. Sci Rep 9, 7730 (2019). https://doi.org/10.1038/s41598-019-44097-3
      7. Thomas Astell-Burt, Xiaoqi Feng, Does sleep grow on trees? A longitudinal study to investigate potential prevention of insufficient sleep with different types of urban green space, SSM – Population Health, Volume 10, 2020, 100497, ISSN 2352-8273, https://doi.org/10.1016/j.ssmph.2019.100497.
      8. Astell-Burt T, Feng X. Association of Urban Green Space with Mental Health and General Health Among Adults in Australia. JAMA Netw Open. 2019;2(7):e198209. doi:10.1001/jamanetworkopen.2019.8209
      9. McGinty EE, Presskreischer R, Han H, Barry CL. Psychological Distress and Loneliness Reported by US Adults in 2018 and April 2020. JAMA. 2020;324(1):93–94. doi:10.1001/jama.2020.9740
      10. Dawel Amy, Shou Yiyun, Smithson Michael, Cherbuin Nicolas, Banfield Michelle, Calear Alison L., Farrer Louise M., Gray Darren, Gulliver Amelia, Housen Tambri, McCallum Sonia M., Morse Alyssa R., Murray Kristen, Newman Eryn, Rodney Harris Rachael M., Batterham Philip J The Effect of COVID-19 on Mental Health and Wellbeing in a Representative Sample of Australian Adults Frontiers in Psychiatry,VOLUME11, 2020 https://www.frontiersin.org/article/10.3389/fpsyt.2020.579985, DOI10.3389/fpsyt.2020.579985, ISSN 1664-0640
      11. Berdejo-Espinola, V, Suárez-Castro, AF, Amano, T, Fielding, KS, Oh, RRY, Fuller, RA. Urban green space use during a time of stress: A case study during the COVID-19 pandemic in Brisbane, Australia. People Nat. 2021; 3: 597– 609. https://doi.org/10.1002/pan3.10218
      12. Russo A, Cirella GT. Modern Compact Cities: How Much Greenery Do We Need?. Int J Environ Res Public Health. 2018;15(10):2180. Published 2018 Oct 5. doi:10.3390/ijerph15102180
      13. Thompson R. Gardening for health: a regular dose of gardening. Clin Med (Lond). 2018;18(3):201-205. doi:10.7861/clinmedicine.18-3-201
      14. The History of Horticulture as Therapeutic Modality. Pedagogy Education. Retrieved from: https://pedagogyeducation.com/Main-Campus/News-Blogs/Campus-News/News.aspx?news=641
      15. The healing landscape: The influence of Florence Nightingale on hospital design https://www.fira-la.com/the-healing-landscape-the-influence-of-florence-nightingale-on-hospital-design/
      16. Clare Cooper Marcus, 15 – Therapeutic Landscapes, Editor(s): Ann Sloan Devlin, Environmental Psychology and Human Well-Being, Academic Press, 2018, Pages 387-413, ISBN 9780128114810, https://doi.org/10.1016/B978-0-12-811481-0.00015-9.
      17. Thompson R. Gardening for health: a regular dose of gardening. Clin Med (Lond). 2018;18(3):201-205. doi:10.7861/clinmedicine.18-3-201
      18. Green social prescribing https://sustainablehealthcare.org.uk/what-we-do/connecting-q-locally/green-social-prescribing-sustainable-healthcare
      19. The Green Walking Initiative; an example of nature-based therapy in health care https://www.youtube.com/watch?v=7ILxKneAHQA
      20. Beyond Blue to Green: The benefits of contact with nature for mental health and well-being. Deakin University. Retrieved from: https://www.deakin.edu.au/__data/assets/pdf_file/0004/310747/Beyond-Blue-To-Green-Literature-Review.pdf
      21. Lee, Kate & Williams, Kathryn & Sargent, Leisa & Williams, Nicholas & Johnson, Katherine. (2015). 40-second green roof views sustain attention: The role of micro-breaks in attention restoration. Journal of Environmental Psychology. 42. 10.1016/j.jenvp.2015.04.003.
      22. Thompson R. (2018). Gardening for health: a regular dose of gardening. Clinical medicine (London, England), 18(3), 201–205. https://doi.org/10.7861/clinmedicine.18-3-201
      23. Neha Pathak, Kathryn J. Pollard, Lifestyle medicine prescriptions for personal and planetary health, The Journal of Climate Change and Health, Volume 4, 2021, 100077, ISSN 2667-2782, https://doi.org/10.1016/j.joclim.2021.100077
      24. Robinson JM, Breed MF. Green Prescriptions and Their Co-Benefits: Integrative Strategies for Public and Environmental Health. Challenges. 2019; 10(1):9. https://doi.org/10.3390/challe1001000

      Additional resources:

      • Turner-Skoff, JB, Cavender, N. The benefits of trees for livable and sustainable communities. Plants, People, Planet. 2019; 1: 323– 335. https://doi.org/10.1002/ppp3.39
      • 7 million deaths from air pollution each year https://www.who.int/health-topics/air-pollution#tab=tab_1
      • The effects of urban trees on air quality 2002 https://www.nrs.fs.fed.us/units/urban/local-resources/downloads/Tree_Air_Qual.pdf
      • Astell-Burt T, Feng X. Association of Urban Green Space with Mental Health and General Health Among Adults in Australia. JAMA Netw Open. 2019;2(7):e198209. doi:10.1001/jamanetworkopen.2019.8209
      • Professor Roland Ennos University of Hull https://theconversation.com/can-trees-really-cool-our-cities-down-44099
      • Nieuwenhuis, M., Knight, C., Postmes, T., & Haslam, S. A. (2014, July 28). The Relative Benefits of Green Versus Lean Office Space: Three Field Experiments. Journal of Experimental Psychology: Applied. Advance online publication. http://dx.doi.org/10.1037/xap0000024
      • Ihab M.K. Elzeyadi, Ph.D., LEEDAP School of Architecture & Allied Arts – University of Oregon, Eugene, OR – USA Daylighting-Bias and Biophilia: Quantifying the Impact of Daylighting on Occupants Health
      • Mardie Townsend and Rona Weerasuryia Beyond Blue to Green: The benefits of contact with nature for mental health and wellbeing https://www.deakin.edu.au/__data/assets/pdf_file/0004/310747/Beyond-Blue-To-Green-Literature-Review.pdf
      • Li Q. Effect of forest bathing trips on human immune function. Environ Health Prev Med. 2010;15(1):9-17. doi:10.1007/s12199-008-0068-3
      • Faber Taylor A, Kuo FE. Children With Attention Deficits Concentrate Better After Walk in the Park. Journal of Attention Disorders. 2009;12(5):402-409. doi:10.1177/1087054708323000
      • Berman MG, Jonides J, Kaplan S. The Cognitive Benefits of Interacting with Nature. Psychological Science. 2008;19(12):1207-1212. doi:10.1111/j.1467-9280.2008.02225.x
      • Insufficient physical activity https://www.aihw.gov.au/reports/australias-health/insufficient-physical-activity
      • Kruize H, van der Vliet N, Staatsen B, et al. Urban Green Space: Creating a Triple Win for Environmental Sustainability, Health, and Health Equity through Behavior Change. Int J Environ Res Public Health. 2019;16(22):4403. Published 2019 Nov 11. doi:10.3390/ijerph16224403
      • Neha Pathak, Kathryn J. Pollard, Lifestyle medicine prescriptions for personal and planetary health, The Journal of Climate Change and Health, Volume 4, 2021, 100077, ISSN 2667-2782, https://doi.org/10.1016/j.joclim.2021.100077.
      • Improving access to greenspace A new review for 2020 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/904439/Improving_access_to_greenspace_2020_review.pdf Robinson JM, Breed MF. Green Prescriptions and Their Co-Benefits: Integrative Strategies for Public and Environmental Health. Challenges. 2019; 10(1):9. https://doi.org/10.3390/challe10010009
      • InVIVO A collaborative network for planetary health https://www.invivoplanet.com/
      • Peter James, Jaime E. Hart, Rachel F. Banay, and Francine Laden 2016 Exposure to Greenness and Mortality in a Nationwide Prospective Cohort Study of Women
      • Environmental Health Perspectives 124:9 CID: https://doi.org/10.1289/ehp.1510363

Dr Jenny Brockis is a Board Certified Lifestyle Medicine Physician, ASLM Fellow, founder of Brain Fit and workplace-based health consultant specialising in mental wellbeing, psychological safety, and burnout prevention. She is also the author of 4 books. www.drjennybrockis.com

This article has been written for the Australasian Society of Lifestyle Medicine (ASLM) by the documented original author. The views and opinions expressed in this article are solely those of the original author and do not necessarily represent the views and opinions of the ASLM or its Board.

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