WHITE COATS, GREEN PLANTS: CLINICAL EPIDEMIOLOGY MEETS HORTICULTURE

‘Gardening without Borders’: Reflections on the Results of a Survey of Practitioners of an ‘Unstructured’ Profession

For several years, the social and therapeutic horticulture (STH) movement has been considering its own gradual professionalisation, as a way of raising its profile and ensuring standards of training and practice. A survey of 119 STH practitioners showed that the vast majority of respondents wanted a national body and the registration of projects and/or practitioners; over half wanted a protected job title; and there was a wish for more research-based evidence. The implications of this survey for the STH movement are discussed and issues of potential interest for occupational therapists are highlighted.

Green qualities in the neighbourhood and mental health - results from a longitudinal cohort study in Southern Sweden

BACKGROUND

Poor mental health is a major issue worldwide and causality is complex. For diseases with multifactorial background synergistic effects of person- and place- factors can potentially be preventive. Nature is suggested as one such positive place-factor. In this cohort study we tested the effect of defined green qualities (Serene, Space, Wild, Culture, Lush) in the environment at baseline on mental health at follow-up. We also studied interaction effects on mental health of those place factors and varied person factors (financial stress, living conditions, and physical activity).

METHODS

Data on person factors were extracted from a longitudinal (years 1999/2000 and 2005) population health survey (n = 24945). The participants were geocoded and linked to data on green qualities from landscape assessments, and stored in the Geographical Information System (GIS). Crude odds ratios (OR) and 95% confidence intervals (CI) were calculated, and multivariate logistic analyses were performed.

RESULTS

Mental health was not affected by access to the chosen green qualities, neither in terms of amount nor in terms of any specific quality. However, we found a reduced risk for poor mental health at follow-up among women, through a significant interaction effect between physical activity and access to the qualities Serene or Space. For men the tendencies were similar, though not significant. Regarding the other three green qualities, as well as amount of qualities, no statistically certain synergistic effects were found. Likewise, no significant synergies were detected between green qualities and the other person-factors. Only advanced exercise significantly reduced the risk for poor mental health among women, but not for men, compared to physical inactivity.

CONCLUSIONS

The results do not directly support the hypothesis of a preventive mental health effect by access to the green qualities. However, the additive effect of serene nature to physical activity contributed to better mental health at follow-up. This tendency was equal for both sexes, but statistically significant only for women.Objective landscape assessments may be important in detangling geographic determinants of health. This study stresses the importance of considering interaction effects when dealing with disorders of multifactorial background.

Cultivating healthy places and communities: evidenced-based nature contact recommendations

Cultivating healthful places is an important public health focus. This paper presents evidence-based recommendations related to nature contact. A multidisciplinary review was conducted in several fields of study and findings were organized into public health recommendations: (1) cultivate grounds for viewing, (2) maintain healing gardens, (3) incorporate wooded parks and green space in communities, (4) advocate for preservation of pristine wilderness, (5) welcome animals indoors, (6) provide a plethora of indoor potted plants within view, (7) light rooms with bright natural light, (8) provide a clear view of nature outside, (9) allow outside air and sounds in, (10) display nature photography and realistic nature art, (11) watch nature on TV or videos, and (12) listen to recorded sounds of nature. The findings should inform public health promoters in the design of healthy places and communities. Future research needs are highlighted.

Nature-assisted therapy: Systematic review of controlled and observational studies

Background: Nature’s potentially positive effect on human health may serve as an important public health intervention. While several scientific studies have been performed on the subject, no systematic review of existing evidence has until date been established. Methods: This article is a systematic evaluation of available scientific evidence for nature-assisted therapy (NAT). With the design of a systematic review relevant data sources were scrutinised to retrieve studies meeting predefined inclusion criteria. The methodological quality of studies and abstracted data were assessed for intervention studies on NAT for a defined disease. The final inclusion of a study was decided by the authors together. Results: The included studies were heterogeneous for participant characteristics, intervention type, and methodological quality. Three meta-analyses, six studies of high evidence grade (four reporting significant improvement), and 29 studies of low to moderate evidence grade (26 reporting health improvements) were included. For the studies with high evidence grade, the results were generally positive, though somewhat ambiguous. Among the studies of moderate to low evidence grade, health improvements were reported in 26 cases out of 29. Conclusions: This review gives at hand that a rather small but reliable evidence base supports the effectiveness and appropriateness of NAT as a relevant resource for public health. Significant improvements were found for varied outcomes in diverse diagnoses, spanning from obesity to schizophrenia. Recommendations for specific areas of future research of the subject are provided.