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      Mental Health Benefits of Long-Term Exposure to Residential Green and Blue Spaces: A Systematic Review

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          Abstract

          Many studies conducted during the last decade suggest the mental health benefits of green and blue spaces. We aimed to systematically review the available literature on the long-term mental health benefits of residential green and blue spaces by including studies that used standardized tools or objective measures of both the exposures and the outcomes of interest. We followed the PRISMA statement guidelines for reporting systematic reviews and meta-analysis. In total 28 studies were included in the systematic review. We found limited evidence for a causal relationship between surrounding greenness and mental health in adults, whereas the evidence was inadequate in children. The evidence was also inadequate for the other exposures evaluated (access to green spaces, quality of green spaces, and blue spaces) in both adults and children. The main limitation was the limited number of studies, together with the heterogeneity regarding exposure assessment. Given the increase in mental health problems and the current rapid urbanization worldwide, results of the present systematic review should be taken into account in future urban planning. However, further research is needed to provide more consistent evidence and more detailed information on the mechanisms and the characteristics of the green and blue spaces that promote better mental health. We provide recommendations for future studies in order to provide consistent and evidence-based recommendations for policy makers.

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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            Nature and health.

            Urbanization, resource exploitation, and lifestyle changes have diminished possibilities for human contact with nature in urbanized societies. Concern about the loss has helped motivate research on the health benefits of contact with nature. Reviewing that research here, we focus on nature as represented by aspects of the physical environment relevant to planning, design, and policy measures that serve broad segments of urbanized societies. We discuss difficulties in defining "nature" and reasons for the current expansion of the research field, and we assess available reviews. We then consider research on pathways between nature and health involving air quality, physical activity, social cohesion, and stress reduction. Finally, we discuss methodological issues and priorities for future research. The extant research does describe an array of benefits of contact with nature, and evidence regarding some benefits is strong; however, some findings indicate caution is needed in applying beliefs about those benefits, and substantial gaps in knowledge remain.
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              A systematic review of evidence for the added benefits to health of exposure to natural environments

              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.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                22 April 2015
                April 2015
                : 12
                : 4
                : 4354-4379
                Affiliations
                [1 ]ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona 08036, Spain; E-Mail: antoni.plasencia@ 123456isglobal.org
                [2 ]Parc de Recerca Biomèdica de Barcelona (PRBB), Centre for Research in Environmental Epidemiology (CREAL). Doctor Aiguader, 88, 08003 Barcelona, Catalonia, Spain; E-Mails: mtriguero@ 123456creal.cat (M.T.-M.); dmartinez@ 123456creal.cat (D.M.); pdadvand@ 123456creal.cat (P.D.); jforns@ 123456creal.cat (J.F.); mnieuwenhuijsen@ 123456creal.cat (M.J.N.)
                [3 ]CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona 08036, Spain
                [4 ]Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo 0403, Norway
                Author notes
                [* ]Author to whom correspondence should be addressed; E-Mail: mgascon@ 123456creal.cat ; Tel.: +34-932-147-331; Fax: +34-932-045-904.
                Article
                ijerph-12-04354
                10.3390/ijerph120404354
                4410252
                25913182
                © 2015 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/4.0/).

                Categories
                Review

                Public health

                green spaces, blue spaces, mental health

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