Introduction
How does nature make us feel? Much, of course, depends on
what else is important in our lives. Is it a good or a bad day?
Irrespective of where we come from, it seems that the
presence of living things makes us feel good. They help us
when we feel stressed, and if there is green vegetation, blue
sky and water in the scene, then we like it even more. This idea
that the quality of nature affects our mental health is not a new
one, but it has not greatly affected the planning of our urban
and rural environments, nor the setting of public health
priorities.
In the UK, more than 80% of people live in urban areas (Defra,
2004), though the greater growth is now in rural areas. Urban
settings by definition have less nature than rural ones. And less
green nature means reduced mental well-being, or at least less
opportunity to recover from mental stress. As natural green
environments have increasingly come under pressure from
economic development, so it seems our own wellbeing has
suffered as a consequence.
Today, stress and mental ill-health are becoming more
common, and the associated public health costs are growing.
The World Health Organisation estimates that depression and
depression-related illness will become the greatest source of
ill-health by 2020. This is partly because some other
behaviours, such as smoking, over-eating and high alcohol
consumption, are likely to be coping mechanisms for mental
ill-health and stress, and have their own serious
consequences. In addition, many urgent physical health
challenges, including obesity and coronary heart disease, are
also connected to sedentary lifestyles. Yet it is known that
physically active people have a lower risk of dying from
coronary heart disease, type II diabetes, hypertension and
colon cancer. In the UK, there is evidence for a dramatic fall in
physical activity over the past 50 years.
A Countryside for Health and Wellbeing:
The Physical and Mental Health Benefits of Green Exercise
Executive summary
www.countrysiderecreation.org.uk
Purpose of research
There is substantial evidence that links the natural
environment with good physical health and psychological
wellbeing. The `Biophilia Hypothesis' states that the desire for
contact with nature is partly innate. As both physical activity
and nature can positively affect wellbeing, we have
undertaken research to explore the synergy in adopting
physical activities whilst being directly exposed to nature. We
have called this `green exercise'.
Evidence
The evidence indicates that nature can make positive
contributions to our health, help us recover from pre-existing
stresses or problems, have an `immunising' effect by
protecting us from future stresses, and help us to concentrate
and think more clearly. We have discerned three levels of
engagement with nature
i. viewing nature ­ as through a window, or in a painting;
ii. being in the presence of nearby nature ­ which may be
incidental to some other activity, such as walking or
cycling to work, reading on a garden seat or talking to
friends in a park; and
iii. active participation and involvement with nature ­ such
as gardening, farming, trekking, camping, cross-country
running or horse-riding.
Most evidence, though, comes from the USA, Scandinavia
and Japan. There there have been few UK studies on the
effect of nature on health, and very little research has
investigated the separate effects of social capital on
wellbeing.
Methodology
In this report, we have reviewed on existing green exercise
studies in the UK on the effects of the view from the window
(University of Essex), on Walking for Health Initiatives, and
Green Gyms (conservation activities for health).
We have also undertaken research on the effects of active
participation in the countryside. To do this, we conducted a
quantitative analysis of the effects of ten countryside activities
in England, Scotland, Northern Ireland and Wales on the
health of 263 people. The range of projects incorporated both
group activities (such as the health walks) and activities
which people undertook on their own. This enabled us to
examine whether the health benefits of green exercise were
affected by a variation in social capital context. The projects
are shown in the box.
The data from people taking part in the ten green exercise
case studies was obtained in the field by means of a
composite questionnaire, which was administered both
before and after the activity. The questionnaire was
designed to fit all scenarios including different levels of
activity and engagement and contained questions relating
to basic data, physical health, mental health and physical
activity. It also included an opportunity to gather qualitative
narratives. Components of the questionnaire consisted of
standardised and widely used formats (Euroqol EQ-5D,
Rosenberg Self­Esteem Scale, Profile of Mood States test),
together with additional questions particular to this research.
Results of the research
The ten case studies represented a variety of activities that
took place in diverse contexts with varying durations and
intensities. The amount of activity varied from 100 to 650
calories per hour and from 330 to 3,500 calories per visit.
As a result of green exercise, there was a significant
improvement in self-esteem in 9 out of the 10 case studies,
excluding Arnside and Silverdale (where participants had an
arduous and long day) (Figure 1). The largest change was
detected amongst the Close House participants, followed
closely by the fishing group. The smallest increases in self
esteem were found in both the walking project groups and the
Green Gym. [Note a decrease in score equals an increase in
self-esteem].
1 Arnside & Silverdale AONB, Lancashire, England conservation
work
2 Glentress Forest Recreation, Borders, Scotland mountain
biking and walking;
3 Re-Union Canal Boats, Edinburgh, Scotland ­ canal
boating;
4 Close House Initiative, Herefordshire, England woodland
activities;
5 Walking the Way to Health Initiative (WHI), Ballymena,
County Antrim, Northern Ireland - walking;
6 Horse riding club, Lagan Valley, County Antrim,
Northern Ireland ­ horse riding;
7 Afan Forest Centre, Port Talbot, West Glamorgan,
Wales ­ mountain biking and walking;
8 Torfaen Green Gym, Pontypool, Gwent, Wales conservation
work;
9 Walking Out Project, Lincoln, England - walking;
10 Layer Pit fishing club, Essex, England - fishing
Figure 1: Change in self esteem after participating in the activity
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15
16
17
18
19
20
IndexofSelf-Esteem
Arnside & Silverdale
Glentress Forest
Re-Union Canal
Close House
Ballymena WHI
Lagan Valley
Afan Forest
Torfaen Green Gym
Walking Out Project
Fishing
We found that self-esteem was significantly correlated with an
individuaľs body weight. The heavier the body weight
reported, the poorer the self esteem score. We also found that
self-esteem was not affected by the intensity of the green
exercise activities, though it did appear to rise over very long
visits. This is an encouraging finding as it implies that all
intensities and durations of activity generate significant
mental health benefits.
We also gathered data on the six mood measures assessed
using the POMS method. Mood is measured according to six
characteristic themes: anger-hostility, confusionbewilderment,
depression-dejection, fatigue-inertia, tensionanxiety,
and vigour-activity. The majority of these showed
significant positive changes in most of the projects (see
Figures 2 and 3).
An estimation of participants' physical fitness level was
calculated. Some 70% of individuals reported participating in
light activities daily, with the overall majority (97%)
participating at least once a week. Only 20% engaged in
vigorous activities daily. The average weekly duration for
moderate activities was 404 minutes, which is equivalent to 58
minutes per day.
This data shows that the participants studied were a very
healthy, active group, who currently meet the Chief Medical
Officer's physical activity recommendations of 30 minutes of
moderate activity, five times a week. It re-emphasises the
difficulty in accessing those people who do not currently
engage in regular activity. If this active group of individuals can
derive numerous health benefits from participating in varying
types and intensities of activity, the possible gains for a more
inactive group may be substantial.
The full report presents detailed findings on each of the ten
case studies, but from the range of initiatives examined for
this research it can be noted that the synergistic effects of
green exercise generate many positive physical and mental
health benefits regardless of the level of intensity, duration or
type of green activity.
Research implications
We conclude therefore that green exercise has important
implications for public and environmental health. A fitter and
emotionally more content population would clearly cost the
economy less, as well as reducing individual human suffering.
Thus increasing support for and access to a wide range of
green exercise activities for all sectors of society should
produce substantial economic and public health benefits.
If green exercise can have such a positive effect on health,
why then do not more people regularly take exercise and visit
green space? First, it is clear from participation rates that
many people in the UK already do engage in forms of green
exercise. Each year, some 1.5 billion day visits are made to
the UK countryside and seaside, and 2.5 billion day visits are
made to urban parks. The Walking the Way to Health Initiative
has already encouraged 900,000 people to walk more. Thus,
there is already a health dividend being experienced. On the
other hand, health data indicates that a substantial proportion
of the population is obese and too sedentary. It is clear that
barriers to participation (eg lack of time, feeling too tired from
work, no motivation to take exercise) are affecting different
groups of people in different ways. Many of these, however,
have been overcome in the best projects, and factors that
make up best practice in green-exercise land-based and
group-based projects ­ which include attention to good
partnerships, opportunities for feedback, clearly-marked
routes, good information, facilities, successful market
research, good staff, a programme of events with clear dates
and locations, personality of group leaders, and advertising to
local people.
Figure 2: Change in depression - dejection mood measure after
participation in the activity
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40
41
42
43
Indexofmood
Arnside & Silverdale
Glentress Forest
Re-Union Canal
Close House
Ballymena WHI
Lagan Valley
Afan Forest
Torfaen Green Gym
Walking Out Project
Fishing
Figure 3: Change in tension - anxiety mood measure after
participation in the activity
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30
32
34
36
38
40
42
44
Indexofmood
Arnside & Silverdale
Glentress Forest
Re-Union Canal
Close House
Ballymena WHI
Lagan Valley
Afan Forest
Torfaen Green Gym
Walking Out Project
Fishing
Figure 4: How often participants have taken part in various levels
of activity in the last 6 months
0
10
20
30
40
50
60
70
80
Daily 2-3 times a
week
Once a
week
Once a
fortnight
Once a
month
Never
%ofparticipants
Light Activities
Moderate Activities
Vigorous Activites
Light activities: Activities like routine
use of stairs, walking for pleasure etc
Moderate activities: Activities like
gardening, housework, walking for
exercise, bowling etc.
Vigorous activities: Activities like
playing sports, e.g. racket sports,
running, swimming and cycling etc.
Recommendations
We conclude with sectoral policy recommendations,
addressing
i) Access and recreation providers (including local
authorities), who need to address maintenance of paths,
sustainable transport, promotion of facilities and provision
of information.
ii) Agricultural managers and policy makers, who need to
increase countryside access and encourage the farming
industry to promote the opportunity to indicate that land
management can involve opportunities for public health
provision.
iii) Schools should ensure that all primary age school children
experience visits to a range of types of countryside, and
where possible establish their own
on-site gardens; they should also emphasise the public
health value of physical activity for all children.
iv) Health sector ­ which needs to consider the contribution
that green exercise makes to public wellbeing and saving
money for the NHS. The forthcoming Physical Activity Plan
should emphasise the value of nature and green space for
formal and informal use, and also stress the therapeutic
value of the outdoors (both rural and urban) for delivering
mental wellbeing.
v) Planners and developers ­ who should take account of the
vital role that local green space (or nearby nature) plays for
all people, and regard outdoor recreational activities as
part of economic regeneration strategies in both rural and
urban economically depressed areas.
vi) Social services ­ who should acknowledge that green
exercise has clear mental health benefits for those people
who engage collectively with existing groups or new
groups, and so countryside and local authority agencies
should ensure their provision of services at recreation and
leisure locations is focused on encouraging families and
other groups. Crime/social service agencies should also
consider the therapeutic value of green exercise.
vii) Environmental managers ­ local and national Biodiversity
Action Plans should be rewritten to include a component
on biodiversity activities that contribute to public health.
viii) Sports and leisure industry ­ gyms and fitness centres
should improve the green aspects of their facilities, and the
formal sports sector should emphasise the health value of
participation, as some sports (eg football, cricket) draw
from a wider range of social groups than most countryside
recreation.
ix) Partnerships - green exercise has implications for many
sectors, suggesting the need for cross-disciplinary and
sectoral strategies and action, and so countryside
agencies should market the countryside as a health
resource, and the private sector, particularly the food
manufacture and retail industry, should be engaged in
partnerships for provision of both healthy food and healthy
places where the food is raised and grown.
Authors: Jules Pretty1, Murray Griffin1, Jo Peacock1, Rachel Hine1, Martin Sellens1 and Nigel South2
1Department of Biological Sciences University of Essex, Colchester and
2Department of Health and Human Sciences, University of Essex, Colchester
The research was commissioned and funded jointly by members of the Countryside Recreation Network (CRN). These members
are British Waterways, Countryside Agency, Department for Food, Environment and Rural Affairs, Department for Culture, Media
and Sport, English Nature, Environment Agency, Environment and Heritage Service, Forestry Commission, Hampshire County
Council and Sport England.
For further information please contact
Countryside Recreation Network, Sheffield Hallam University, Unit 7, Sheffield Science Park, Howard Street, Sheffield S1 2LX.
Telephone 0114 225 4494.
www.countrysiderecreation.org.uk