Nature and ChildWellbeing - Theory and Data

Question 1

Where do most of the population live?

Answer 1

50% of the world population are city dwellers

Living in urban environments is related to adverse health effects

Question 2

What are the adverse health effects associated with living in urban environments?

Answer 2

50% higher risk of development anxiety

200% higher schizophrenia risk for children raised in urban environments

Question 3

What are the mechanisms about why an urban gradient is doing this?

Answer 3

Selective migration
Social stress processing
Increased to infections
Reduced exposure to nature/green space

Question 4

What is nature/green spaces?

Answer 4

Nature and green spaces - physical features and processes of nonhuman origins that people can perceive, including flora and fauna, still and running water, qualities of air and weather and the landscapes that comprise these and show the influence of geological processes

Question 5

What are the ways of measuring greenspace?

Answer 5

Contact/exposure to nature

Connectedness with nature

Question 6

How do you measure greenspace in terms of contact/exposure to nature?

Answer 6

Involves real or virtual interaction with nature / natural world - intentional or incidental
Indirect/passive exposure via images of nature, through windows, photographs etc
Frequency or duration of time spent in nature - people can make errors

Question 7

How do you measure greenspace in terms of connectedness with nature?

Answer 7

Subjective sense of emotional affinity to natural world
Reflects attitudes, beliefs and knowledge
Trait like individual differences but also fluctuates in short-term - exists on a continuum
Self-reports instruments - ‘I feel connected to all living things and the earth’

Question 8

What is normalised difference vegetation index?

Answer 8

Looks at the quantity (availability/density) and variability of green space in vicinity using satellite data

Take a satellite image and can calculate density of greenness in a particular area (density of greenness within 1k outside of your house)

NDVI uses differences in light absorption and reflection of landscapes covered by different amounts of vegetation to calculate a measure of greenness - lower values of NDVI indicate sparse vegetation and high values indicate dense vegetation

Question 9

Is contact with nature associated with MH and wellbeing in adults?

Answer 9

Greater exposure to green environments impact health - beneficial effect of contact with green environments on health and wellbeing:
lower risk of cardiovascular disease
obesity
diabetes 
asthma hospitalizations 
self-report health and wellbeing
stress, mood and mental health

Question 10

Market et al - UK crossectional study

Answer 10

Looked at NDVI data and presence of major depressive disorder diagnosis

Protective effect between amount of greenspace around someone and whether they had a diagnosis of major depressive disorder
Greater benefits in females, less than 60yrs old, low SES, high urbanity areas

Question 11

White et al - mental distress and life satisfaction

Answer 11

18 year panel survey comparing mental distress and life satisfaction of 10,000 people at different points in time when living in more and less green areas
Compared psychological health in different locations people have lived in to look at among of green space on MH and life satisfaction - controlled for stable characteristics

Greater green space predicted less mental distress and greater life satisfaction
small effect but meaningful

Question 12

Mass et al - green space and diagnosis of 24 disorders

Answer 12

Association between % of green space within 1 and 3 km from home and recorded diagnosis of 24 different disorder types e.g. cardiovascular, mental health

Greater green space within 1km from home predicted lower annual prevalence rate for 15/24 disorders
Association stronger for anxiety and depression
Strongest for participants less than 12 years of age - younger children spend more time at home, so around green more

Question 13

Is there a relationship between greenspace and risk for ADHD?

Answer 13

Donovan et al
49,000 children - longitudinal
ADHD diagnosis or prescription by age 18

Children who had always lived in a rural area after 2 years of age were less likely to develop ADHD, before age 2 it didn’t matter
but children living in rural areas may have lower rates of diagnosis due to poorer access to healthcare, so might just be less likely to be diagnosed

Minimum NDVI (smallest value of greenness across a Childs lifestime)
- increasing minimum NDVI (moving to area) in later childhood (2-18 years) but not during prenatal period was protective against ADHD
Minimum threshold of greenness below which adverse health consequences occur

Question 14

Is there a relationship between greenspace and risk for schizophrenia?

Answer 14

Engemann et al - 935,000 Danish people
Looked at quantity and SD (variation) of NDVI and whether they had a diagnosis of schizophrenia

Higher NDVI - less risk for children at aged 10
More risk with lowest levels
risk declined in dose response manner with higher doses of green space
children living in the lowest decile of greenspace had a 1.52 increase risk compared to children living in highest decile
Risk greatest at younger age
Risk decreased at higher values of mean green space at age 10
Protective effect of greenspace seen in early childhood years and when authors looked at greenspace closest to homes

Question 15

Is there a relationship between greenspace and risk for schizophrenia in terms of heterogeneity of greenspace?

Answer 15

Predict higher variation to be linked with MH
no clear relationship between variability in greenspace and schizophrenia 
alternative measures (land cover, blue space) may be more predictive

Question 16

How does nature contact play a role in brain and cognitive development?

Answer 16

attention restoration, creatively, risk raking etc

indirectly via noise and traffic related and air pollution reduction

Question 17

Cognitive development - Dadvand et al, does exposure to green space predict working memory and inattentiveness?

Answer 17

36 schools in barcelona
Measures of WM and attention assessed 4 times over 4 months
NDVI looked at buffer around home, walking/driving route to school

Results:
at baseline - didn’t differ with high and low levels of greenness
but both groups show an improvement in 12 months
children at schools with highest levels of greenness are showing a much greater improvement compared to lowest levels - gap is widening
make greater progress with higher levels of greenness

Question 18

Dadvand et al - is it mediated through air pollution?

Answer 18

Could it be explained by pollution reducing effects of greenness
indoor levels of elemental carbon (EC) highly correlated with school greenness
high levels of carbon - lower levels of school greenness
EC accounted for 20-65% of association between school greenness and 12 month progress in cognitive functions
Evidence that exposure to greenness at school has a beneficial impact on cog development and is mediated by reduction in air pollution

Question 19

Can we get the positive effects without actually being around it?

Answer 19

Yes
window views of nature from the office/home predict higher wellbeing and life satisfaction

children living in urban environments with views of nature perform better on cognitive tasks of memory, attention and concentration

viewing photos/videos of green/nature scenes reduces physiological indices of stress (heart rate, skin conductance)

green workspaces and the introduction of indoor plants associated with improved workplace satisfaction

Question 20

Are there individual differences in peoples interest in contact?

Answer 20

Yes - people’s interest in, fascination with and desire for nature contact

concern that many children are experiencing a loss of connection with nature - little research, not a real disorder

Question 21

What does a strong sense of nature connectedness do?

Answer 21

Predict greater environmental concerns/pro environmental behaviours
Predict greater happiness and wellbeing
Mediate relationship between nature exposure and wellbeing - not sure which direction

Question 22

What did the nature relatedness scale show? Nisbet and Zelenski

Answer 22

354 undergraduates
Nature connectedness realness correlated with:
positive affect
commitment to ecological issues
attitudes towards sustainability
psychological wellbeing

Question 23

Does nature connectedness associate with hedonic wellbeing and eudaemonic wellbeing?

Answer 23

Hedonic - Small effect size of r = 0.18

Eudaemonic - Small mean size of r = .24

Size of association between nature connection and EWB and nature connection and HWB was not significantly different

Question 24

How can the benefits of nature for WB be explained?

Answer 24

Biophilia hypothesis
Attention restoration
Stress reduction

Question 25

What is the biophilia hypothesis?

Answer 25

Wilson
argues that humans have an innate, biological driven need to connect with nature
wellbeing and survival of our ancestors depended upon connection with nature e.g. to find food, predict weather
biologically based preference that pesists in modern humans only recently begun with urban environments

However, problems with this theory are that it is difficult to test evolutionary concepts empirically

Question 26

What is the evidence for the biophilia hypothesis?

Answer 26

Humans have a preferences for nature scenes over built environments (e.g. Dopko et al., 2014)

Attraction/connectedness to nature observed across diverse cultures (e.g. Ulrich, 1993) and at a very young age (Kahn, 1997)

Question 27

What is the attention restoration hypothesis?

Answer 27

Kaplan and Kaplan
Distinguishes between 2 types of attention:
voluntary - effortful, focused, finite resource (can be depleted) and susceptible to fatigue neg outcomes
involuntary - effortless, less cognitively resource intensive

Urban living places increase demands on voluntary, directed attention leading to attention fatigue
nature encourages involuntary attention - time in natural environment places fewer demands on cognitive resources and provides opportunity to restore attentional capacities
spending time in nature provides an opportunity to get away, contains lots of stimuli than engages effortless attention

Question 28

What is the evidence for the attention restoration hypothesis?

Answer 28

Improvements in concentration, memory, attention, self reg

But, uncertainty regarding exactly which aspects of attention are effected

Question 29

Stevenson et al - attention restoration effects hypothesis

Answer 29

Meta-analysis investigating restoration effects of exposure to natural environments on cognitive demands - test the attention theory
49 outcomes that:
compare natural environments to control group
baseline and post exposure measure of cog performance

Exposure to nature across 49 outcomes led to improved performance for:
working memory
cognitive flexibility
attentional control

Larger effects seen for exposure to real environments relative to virtual exposures

Question 30

What is the attention theory?

Answer 30

Exposure to nature improves cognitive performance through restoration of limited attentional resources

Question 31

What is the stress reduction theory?

Answer 31

Urich et al
Focus on physiological processes and emotional effects of exposure to nature
exposure to natural environments that were evolutionary beneficial for survival automatically elicit a range of stress reducing responses - contact with nature can lower pulse rates, reduce stress hormones
positive effects can occur rapidly, for both indirect/direct/intentional exposure and may be most beneficial in those with high stress

Question 32

What is the evidence for the stress reduction theory?

Answer 32

Urich et al - asked ppts to watch a stressful film, while measuring physiological responses
change in pulse transit time correlates with systolic blood pressure (neg pulse transit time - higher blood press - more stressed)

Ppts were more stressed when seeing the film, then randomised into 3 different groups - watching scenes of nature, other groups watch urban scenes, look at blood pressure after watching films (recovery period)

Pulse transit time returned to baseline within 4-7 minutes after viewing nature scenes relative to urban scenes
after a stressor (film)m ppts who viewed a film of natural vs built environments showed more rapid and complete reduction in stress response

Question 33

Can we prescribe nature as a low cost, accessible health intervention?

Answer 33

This would be good for people with MH difficulties who don’t want to go to doctors for treatment etc

Question 34

Mygind et al - how does immersive nature-experience influence mental, physical and social health outcomes in children and adolescents?

Answer 34

Nature experiences (interventions include adventure camps, green breaks, forest schools): non competitive, intentional, sedentary or active, removed from everyday environment
90 studies: children with difficulties, low SES, overweight
compared treatment vs control on MH outcomes (self-esteem), physical outcomes (BMI, stress hormones) and social outcomes (relationships)

65.7% of MH outcomes showed sig improvements following nature experience, but not in control conditions
most convincing effects for self-esteem, self-efficacy, resilience, academic and cog performance
quality of evidence is still quite poor

Question 35

What dosage of nature is needed for health benefits? White et al

Answer 35

19,000 - asked people to categorise weekly contact with nature in 60 min blocks, explored association with health and WB controlled for residential greenspace

Good vs bad health:
increase between time spent in nature and good health
probability of reporting good health became sig greater with nature contact more than 120 mins compared to no nature
no additional benefits above 200-300 minutes per week
pattern of effect consistent in lots of groups

High vs low WB
better WB when more than 120 mins
120 mins contact per week may be a threshold below which no heath benefits occur
does not matter how exposure is achieved (short exposures or one long)
magnitude of association was similar to size of effect for achieving vs not achieving physical activity levels

Question 36

What are the limitations of research into interventions to help WB?

Answer 36

Threshold for benefits may differ in children/adolescents - research was for adults

Size of effect is small – explaining ~1% of variance

Observational, cross-sectional data - association may be explained by happier, healthier people spending more time in nature, might not actually be cause and effect

Unclear if benefits need to accumulate and how long they persist

Ignores quality all green space may not be equal in terms of effects

Question 37

What is ecotherapy?

Answer 37

Therapies that are more than just experience in nature, more specific for participants and more formal therapy as well
Improves mental WB - helps people who don’t usually exercise be more active - boots skills and confidence
people who have had it say they enjoy it, offers more choice than normal therapy

Question 38

What is ecotherapy often combined with?

Answer 38

Nature-based intervention in a natural setting, combined with formal therapy - CBT:
social and therapeutic horticulture
animal assisted interventions
care farming
nature arts and crafts
green exercise
environmental conservation
wilderness therapy

Question 39

What is the mind UK ecominds project?

Answer 39

Evaluation of impact of 130 ecotherapy projects for people living with MH problem

Question 40

Why are ecotherapy interventions important?

Answer 40

Lost cost, accessible, inclusive approach with benefits for individual, economy and society

Mechanisms by ecotherapy approaches may be improving WB - people becoming more active, connect with people in the community, take notice in world around them, effortless voluntary attention

Question 41

What are the benefits of ecotherapy?

Answer 41

Over 2/3 of ppts who took part showed sig improvements
Saves the gov money through lower welfare costs (over 35,000 one year)
Gave people skills so they could get back into employment
Helped 254 people find full-time employment
Over 80% said they were more involved in community activities
60% said they belonged more strongly
56% who opted to take on were men
62% said overall health was better
69% experiencing increases in MH

Question 42

What is care farming?

Answer 42

One of the most widely used ecotherapy for children
it is the therapeutic use of farm landscapes and farming practises (horticulture, woodland management) - e.g. going to a farm
used for a range of at risk groups - e.g. children at risk of exclusion, socially disadvantaged children

Sig improvements in self-esteem and mood and foster sense of social community

Question 43

What is wilderness theory?

Answer 43

Another type of ecotherapy
Barton et al - investigated impact of immersive wilderness expeditions (5-11 days) on adolscents self esteem and connectedness with nature
Intervention aimed to build connectedness, respect with others and nature, gain perspective, reduce stress
Measures taken pre and post intervention

Self-esteem sig increased from pre to post intervention, larger for females than males
nature connectedness sig increased from pre-post intervention, no interaction with gender
wilderness interventions may be an effective way of promoting mental well being, but no control group , not an at risk sample, no long term follow up

Question 44

What are the problems with ecotherapies?

Answer 44

They show pos effects of nature and green spaces and are low cost, effective and inclusive therapies but empirical evidence for beneficial effects in child samples are lacking

Question 45

What did Engemann et al, 2019 find? (reading)

Answer 45

Looked at green space presence assessed at the individual level from birth to age of 10

Higher levels of green space = lower risk of psychiatric disorders later in life, controlling for other factors only changed the risk slightly
Living at the lowest levels of green space was associated with 15-55% higher risk (apart from ID and schizophrenia)
risk was up to 55% higher if living in lowest levels of green space across disorders compared with those with high levels of green space

Getting natural environments into urban planning is a promising approach to improve mental health

Question 46

What did Mygind et al, 2019 find? (reading)

Answer 46

More exposure to nature - better MH
Correlational support for benefits on self-esteem, self-efficacy, resilience and academic/cog performance
Increased physical health (BMI decreased, psychological stress decreased, more physical activity)
Increased social health (more social support, less anxiety)