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      The relationship between greenspace and the mental wellbeing of adults: A systematic review

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          Abstract

          Introduction

          The view that interacting with nature enhances mental wellbeing is commonplace, despite a dearth of evidence or even agreed definitions of ‘nature’. The aim of this review was to systematically appraise the evidence for associations between greenspace and mental wellbeing, stratified by the different ways in which greenspace has been conceptualised in quantitative research.

          Methods

          We undertook a comprehensive database search and thorough screening of articles which included a measure of greenspace and validated mental wellbeing tool, to capture aspects of hedonic and/or eudaimonic wellbeing. Quality and risk of bias in research were assessed to create grades of evidence. We undertook detailed narrative synthesis of the 50 studies which met the review inclusion criteria, as methodological heterogeneity precluded meta-analysis.

          Results

          Results of a quality assessment and narrative synthesis suggest associations between different greenspace characteristics and mental wellbeing. We identified six ways in which greenspace was conceptualised and measured: (i) amount of local-area greenspace; (ii) greenspace type; (iii) visits to greenspace; (iv) views of greenspace; (v) greenspace accessibility; and (vi) self-reported connection to nature. There was adequate evidence for associations between the amount of local-area greenspace and life satisfaction (hedonic wellbeing), but not personal flourishing (eudaimonic wellbeing). Evidence for associations between mental wellbeing and visits to greenspace, accessibility, and types of greenspace was limited. There was inadequate evidence for associations with views of greenspace and connectedness to nature. Several studies reported variation in associations between greenspace and wellbeing by life course stage, gender, levels of physically activity or attitudes to nature.

          Conclusions

          Greenspace has positive associations with mental wellbeing (particularly hedonic wellbeing), but the evidence is not currently sufficient or specific enough to guide planning decisions. Further studies are needed, based on dynamic measures of greenspace, reflecting access and uses of greenspace, and measures of both eudaimonic and hedonic mental wellbeing.

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          Most cited references47

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          Green space, urbanity, and health: how strong is the relation?

          To investigate the strength of the relation between the amount of green space in people's living environment and their perceived general health. This relation is analysed for different age and socioeconomic groups. Furthermore, it is analysed separately for urban and more rural areas, because the strength of the relation was expected to vary with urbanity. The study includes 250 782 people registered with 104 general practices who filled in a self administered form on sociodemographic background and perceived general health. The percentage of green space (urban green space, agricultural space, natural green space) within a one kilometre and three kilometre radius around the postal code coordinates was calculated for each household. Multilevel logistic regression analyses were performed at three levels-that is, individual level, family level, and practice level-controlled for sociodemographic characteristics. The percentage of green space inside a one kilometre and a three kilometre radius had a significant relation to perceived general health. The relation was generally present at all degrees of urbanity. The overall relation is somewhat stronger for lower socioeconomic groups. Elderly, youth, and secondary educated people in large cities seem to benefit more from presence of green areas in their living environment than other groups in large cities. This research shows that the percentage of green space in people's living environment has a positive association with the perceived general health of residents. Green space seems to be more than just a luxury and consequently the development of green space should be allocated a more central position in spatial planning policy.
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            Happiness is greater in natural environments

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              Natural outdoor environments and mental and physical health: relationships and mechanisms.

              Evidence is growing for the beneficial impacts of natural outdoor environments on health. However, most of the evidence has focused on green spaces and little evidence is available on health benefits of blue spaces and about possible mediators and modifiers of such impacts. We investigated the association between natural outdoor environments (separately for green and blue spaces) and health (general and mental) and its possible mediators and modifiers.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                12 September 2018
                2018
                : 13
                : 9
                : e0203000
                Affiliations
                [1 ] Warwick Institute for Science of Cities, University of Warwick, Coventry, West Midlands, United Kingdom
                [2 ] ScHARR, University of Sheffield, Sheffield, South Yorkshire, United Kingdom
                [3 ] Centre for Interdisciplinary Methodologies, University of Warwick, Coventry, West Midlands, United Kingdom
                [4 ] Department of Computer Science, University of Warwick, Coventry, West Midlands, United Kingdom
                [5 ] Warwick Medical School, University of Warwick, Coventry, West Midlands, United Kingdom
                CUNY, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0003-2300-2976
                http://orcid.org/0000-0002-3160-3168
                Article
                PONE-D-18-11034
                10.1371/journal.pone.0203000
                6135392
                30208073
                8e6f00ef-43f8-40b8-8d09-d22de8f50df3
                © 2018 Houlden et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 12 April 2018
                : 12 August 2018
                Page count
                Figures: 1, Tables: 4, Pages: 35
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100000266, Engineering and Physical Sciences Research Council;
                Award ID: EP/L016400/1
                This work was supported by the Engineering and Physical Sciences Research Council, Recipient: VH (through studentship at Warwick Institute for Science of Cities), Grant number: EP/L016400/1, URL: https://epsrc.ukri.org/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Regression Analysis
                Linear Regression Analysis
                Physical Sciences
                Mathematics
                Statistics (Mathematics)
                Statistical Methods
                Regression Analysis
                Linear Regression Analysis
                Biology and Life Sciences
                Psychology
                Emotions
                Happiness
                Social Sciences
                Psychology
                Emotions
                Happiness
                Medicine and Health Sciences
                Health Care
                Quality of Life
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Research and Analysis Methods
                Database and Informatics Methods
                Database Searching
                Ecology and Environmental Sciences
                Terrestrial Environments
                Urban Environments
                Earth Sciences
                Geography
                Human Geography
                Land Use
                Social Sciences
                Human Geography
                Land Use
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

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                Uncategorized

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