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Park Access and Mental Health Among Parents and Children During the COVID-19 Pandemic

2022 / Children, Healthcare providers

Table 2. Parent and child physical activity and mental health outcomes Background Time spent outdoors and in nature has been associated with numerous benefits to health and well-being. We examined relationships between park access and mental health for children and parents during the COVID-19 pandemic. We also explored associations between park access and co-participation of parent and child in time outdoors, and child and parent physical activity. Methods We used data from 1,000 respondents to a nationally representative U.S. survey of parent–child dyads during October–November 2020. Park access was defined as an affirmative response to: “do you have a park that you can safely walk to within 10 min of your home?” Child mental health was operationalized as the Strengths and Difficulties Questionnaire (SDQ) total difficulties score. The Patient Health Questionnaire-4 (PHQ-4) total score assessed parent mental health and the International Physical Activity Questionnaire (IPAQ) assessed parent physical activity. Child physical activity and co-participation in outdoor activity were reported as number of days in the prior week. Linear regression was used to examine relationships between park access and health outcomes in models adjusted for child and parent characteristics and COVID-19 impact. Results Our sample included 500 parents of children ages 6–10 years, and 500 parent–child dyads of children ages 11–17 years. Park access was associated with a lower SDQ total score among children (β: -1.26, 95% CI: -2.25, -0.27) and a lower PHQ-4 total score among parents (β: -0.89, 95% CI: -1.39, -0.40). In models stratified by child age, these associations were observed for SDQ scores among adolescents ages 11–17 and for PHQ-4 scores among parents of children ages 6–10 years. Park access was also associated with 0.50 more days/week of co-participation in outdoor time (95% CI: 0.16, 0.84), and higher levels of parent physical activity (β: 1009 MET-min/week, 95% CI: 301, 1717), but not child physical activity (β: 0.31 days/week, 95% CI: -0.03, 0.66). Conclusions Park access was associated with better mental health among children and parents, and more parent physical activity and parent–child co-participation in outdoor activity during the COVID-19 pandemic. Access to nearby parks may be an important resource to promote health and well-being, for both individuals and families.

Stress Recovery from Virtual Exposure to a Brown (Desert) Environment Versus a Green Environment

2022 / Virtual nature

Fig. 1. Experimental procedure. Note: Mean arterial pressure, pulse, and cortisol measures were collected 6 times during the experiment (i.e. Stage T0∼T5). Serum samples were collected at T0 and T5. TSST: Trier Social Stressor Test. The beneficial association between nature contact and human health is often explained with psycho-evolutionary frameworks such as stress reduction theory and the savanna hypothesis. However, evidence is limited on how natural environments that are not green affect stress. One example is the desert, which does not offer affordances for nourishment or safety in an evolutionary sense. In this study, we determine the effect of a virtual reality (VR) exposure to a desert vs. green environment among 95 healthy adult male residents of El Paso, Texas. The procedure consisted of an acute stressor followed by random assignment to a 10 min VR experience (desert, green space, or office [control condition]) and a 40 min resting period. Participants in the desert condition showed significant reductions in salivary cortisol compared to participants in the office. Participants in the desert condition showed decreases in mean arterial pressure compared to participants in the control condition. Collectively, these findings suggest that factors beyond those proposed by psycho-evolutionary frameworks such as lived experiences and familiarity with landscapes may play a role in the health benefits of nature exposure.

The Relationship Between Natural Environments and Subjective Well-Being as Measured by Sentiment Expressed on Twitter

2022 / Health and well-being, Social media

Fig. 1. (A) The spatial distribution of tweets in the sample. (B) Land cover in Seattle. (C) Tree canopy coverage in Seattle. (D) Parks in Seattle. Land-cover and tree-canopy data were taken from the 2016 National Land Cover Database (NLCD) (Dewitz, 2019). Polygons representing urban parks within Seattle were downloaded from Seattle GeoData portal (Seattle Parks, 2012). There is growing evidence that time spent in nature can affect well-being. Nonetheless, assessing this relationship can be difficult. We used 1,971,045 geolocated tweets sent by 81,140 users from Seattle, Washington, USA to advance our understanding of the relationship between subjective well-being and natural environments. Specifically, we quantified the relationships between sentiment (negative/neutral/positive) expressed in geolocated tweets and their surrounding environments, focusing on three environmental indicators: land-cover type, tree-canopy density, and urban parks. We allowed the relationships to vary according to the broader type of environment (i.e., land-use zoning). We estimated three random-intercept partial proportional odds models corresponding to the three environmental indicators while controlling for multiple covariates. Our results suggested that for a given land-use type, tweets sent from some natural land-cover types were less likely to be negative compared to tweets sent from the urban built land-cover type. For tweets sent in industrial zones, an increase in tree-canopy cover was associated with a lower probability of having negative sentiments and with a higher probability of having positive sentiments; but for tweets sent in commercial/mixed zones, the association was reversed. Also, urban parks were generally associated with a lower probability of having negative sentiments, but tweets sent from large natural parks in residential zones were less likely to be positive. Our results suggest that the relationship between subjective well-being and natural environments depends on where people are situated in the built environment and may be more complex than previously thought. The more nuanced understanding provided by analyzing geolocated social media has potential to inform urban planning and land management.

What Can We Do When the Smoke Rolls In? An Exploratory Qualitative Analysis of the Impacts of Rural Wildfire Smoke on Mental Health and Well-Being, and Opportunities for Adaptation

2022 / Health and well-being, Wildfires

Figure 1. Suggested content, distribution location, medium, and messenger for a wildfire smoke and wellbeing toolkit Background Extreme, prolonged wildfire smoke (WFS) events are becoming increasingly frequent phenomena across the Western United States. Rural communities, dependent on contributions of nature to people’s quality of life, are particularly hard hit. While prior research has explored the physical health impacts of WFS exposure, little work has been done to assess WFS impacts on mental health and wellbeing, or potential adaptation solutions. Methods Using qualitative methods, we explore the mental health and wellbeing impacts experienced by community members in a rural Washington State community that has been particularly hard hit by WFS in recent years, as well as individual, family, and community adaptation solutions. We conducted focus groups with residents and key informant interviews with local health and social service providers. Results Participants identified a variety of negative mental health and wellbeing impacts of WFS events, including heightened anxiety, depression, isolation, and a lack of motivation, as well as physical health impacts (e.g., respiratory issues and lack of exercise). Both positive and negative economic and social impacts, as well as temporary or permanent relocation impacts, were also described. The impacts were not equitably distributed; differential experiences based on income level, outdoor occupations, age (child or elderly), preexisting health conditions, housing status, and social isolation were described as making some residents more vulnerable to WFS-induced physical and mental health and wellbeing challenges than others. Proposed solutions included stress reduction (e.g., meditation and relaxation lessons), increased distribution of air filters, development of community clean air spaces, enhancing community response capacity, hosting social gatherings, increasing education, expanding and coordination risk communications, and identifying opportunities for volunteering. Findings were incorporated into a pamphlet for community distribution. We present a template version herein for adaptation and use in other communities. Conclusions Wildfire smoke events present significant mental health and wellbeing impacts for rural communities. Community-led solutions that promote stress reduction, physical protection, and community cohesion have the opportunity to bolster resilience amid this growing public health crisis.

What Next? Expanding Our View of City Planning and Global Health, and Implementing and Monitoring Evidence-Informed Policy

2022 / Built environment + Urban design

Figure 1. The pathways through which urban and transport planning decisions affect health This Series on urban design, transport, and health aimed to facilitate development of a global system of health-related policy and spatial indicators to assess achievements and deficiencies in urban and transport policies and features. This final paper in the Series summarises key findings, considers what to do next, and outlines urgent key actions. Our study of 25 cities in 19 countries found that, despite many well intentioned policies, few cities had measurable standards and policy targets to achieve healthy and sustainable cities. Available standards and targets were often insufficient to promote health and wellbeing, and health-supportive urban design and transport features were often inadequate or inequitably distributed. City planning decisions affect human and planetary health and amplify city vulnerabilities, as the COVID-19 pandemic has highlighted. Hence, we offer an expanded framework of pathways through which city planning affects health, incorporating 11 integrated urban system policies and 11 integrated urban and transport interventions addressing current and emerging issues. Our call to action recommends widespread uptake and further development of our methods and open-source tools to create upstream policy and spatial indicators to benchmark and track progress; unmask spatial inequities; inform interventions and investments; and accelerate transitions to net zero, healthy, and sustainable cities.

Advancing Sustainable Development and Protected Area Management with Social Media-Based Tourism Data

2021 / Healthcare providers, Tourism, Underserved populations

Figure 1. The Bahamian archipelago, including the network of marine protected areas (orange boundaries), geotagged Flickr photos (purple points), and Andros, the largest island in The Bahamas. Politically considered a single island, Andros is in fact comprised of three major landmasses, North Andros (which contains the districts of North Andros and Central Andros), Mangrove Cay, and South Andros. Sustainable tourism involves increasingly attracting visitors while preserving the natural capital of a destination for future generations. To foster tourism while protecting sensitive environments, coastal managers, tourism operators, and other decision-makers benefit from information about where tourists go and which aspects of the natural and built environment draw them to particular locations. Yet this information is often lacking at management-relevant scales and in remote places. We tested and applied methods using social media as data on tourism in The Bahamas. We found that visitation, as measured by numbers of geolocated photographs, is well correlated with counts of visitors from entrance surveys for islands and parks. Using this relationship, we predicted nearly 4 K visitor-days to the network of Bahamian marine protected areas annually, with visitation varying more than 20-fold between the most and least visited parks. Next, to understand spatial patterns of tourism for sustainable development, we combined social media-based data with entrance surveys for Andros, the largest island in The Bahamas. We estimated that tourists spend 125 K visitor-nights and more than US$45 M in the most highly visited district, five times that of the least visited district. We also found that tourists prefer accessible, natural landscapes—such as reefs near lodges—that can be reached by air, roads, and ferries. The results of our study are being used to inform development and conservation decisions, such as where to invest in infrastructure for visitor access and accommodation, siting new marine protected areas, and management of established protected areas. Our work provides an important example of how to leverage social media as a source of data to inform strategies that encourage tourism, while conserving the environments that draw visitors to a destination in the first place.

Affective Benefits of Nature Contact

2021 / Health and well-being

Figure 1. Nature contact and the process model of emotion regulation. We describe the ways in which these five family of strategies may be influenced by natural environmental factors, which in turn leads to affective benefits. Figure icon made by eucalyp from www.flaticon.com Mounting evidence demonstrates that nature exposure can have affective benefits. These include behavioral and psychophysiological responses consistent with (a) decreases in stress and negative affect; and (b) increases in subjective well-being and positive affect. What is less clear, however, is what mechanisms are responsible for these effects. In this article, we examine the evidence for affective impacts of nature exposure, consider underlying mechanisms (with a focus on affect regulation), and discuss what might moderate these effects at the individual and population level. We end by pointing to future research directions and practical applications. This includes investigations into the range of effects and duration of their impact, harnessing knowledge about temporal dynamics for insights into causal mechanisms, broadening the discussions around moderators and effect modifications to include diverse perspectives on the relationship between nature exposure and psychological well-being, and integrating findings into existing frameworks from public health.

Affective Benefits of Nature Contact: The Role of Rumination

2021 / Health and well-being

Figure 1. Structural equation mediation model of the relationships between time in nature, rumination and positive and negative affect. Ovals denote latent variables (i.e., all but “Weekly time in nature”). Standardized coefficients are presented. *indicates path with significant relationship (α = 0.05). †Indicates path with marginally significant relationship (α = 0.10). For the “ab” paths, significance was tested with bootstrapped 95% confidence intervals. The “ab” paths indicate the indirect effect of time in nature on affect. The “c” paths indicate the total effect of time in nature on affect. The “c”’ paths indicate the direct effect of time in nature on affect. Mounting evidence shows that nature contact is associated with affective benefits. However, the psychological mechanisms responsible for these effects are not well understood. In this study, we examined whether more time spent in nature was associated with higher levels of positive affect in general, and lower levels of negative affect and rumination in general. We also conducted a cross-sectional mediation analysis to examine whether rumination mediated the association of nature contact with affect. Participants (N = 617) reported their average time spent in nature each week, as well as their general levels of positive and negative affect, and the degree to which they typically engaged in rumination in daily life. We then used structural equation modeling to test our hypotheses. Our results support the hypothesis that nature contact is associated with general levels of affect, and that rumination mediates this association for negative affect, and marginally mediates this association for positive affect.

An Ecosystem Service Perspective on Urban Nature, Physical Activity, and Health

2021 / Green spaces, Health and well-being

Figure 1. Conceptual model of the relationships among urban nature (as part of the urban system), PA (quantity and quality), and health, alignedwith an ecosystem service approach. Numbers correspond with The Current State of Knowledge points 1 and 2. Nature underpins human well-being in critical ways, especially in health. Nature provides pollination of nutritious crops, purification of drinking water, protection from floods, and climate security, among other well-studied health benefits. A crucial, yet challenging, research frontier is clarifying how nature promotes physical activity for its many mental and physical health benefits, particularly in densely populated cities with scarce and dwindling access to nature. Here we frame this frontier by conceptually developing a spatial decision-support tool that shows where, how, and for whom urban nature promotes physical activity, to inform urban greening efforts and broader health assessments. We synthesize what is known, present a model framework, and detail the model steps and data needs that can yield generalizable spatial models and an effective tool for assessing the urban nature–physical activity relationship. Current knowledge supports an initial model that can distinguish broad trends and enrich urban planning, spatial policy, and public health decisions. New, iterative research and application will reveal the importance of different types of urban nature, the different subpopulations who will benefit from it, and nature’s potential contribution to creating more equitable, green, livable cities with active inhabitants.

Associations Between Green/Blue Spaces and Mental Health Across 18 Countries

2021 / Blue spaces, Green spaces, Health and well-being

Figure 1. Relationships between: (1) Green space visits in last 4 weeks, (2) Inland-blue space visits in last 4 weeks, (3) Coastal-blue space visits in last 4 weeks, and (4) nature connectedness (1–7); and positive well-being (0–100; a,e,l,m), risk of mental distress (0–1; b,f,j,n), use of depression medication (0–1; c,g,k,o), and use of anxiety medication (0–1; d,h,l,p), averaged across 18 countries (n = 16,302). Living near, recreating in, and feeling psychologically connected to, the natural world are all associated with better mental health, but many exposure-related questions remain. Using data from an 18-country survey (n = 16,307) we explored associations between multiple measures of mental health (positive well-being, mental distress, depression/anxiety medication use) and: (a) exposures (residential/recreational visits) to different natural settings (green/inland-blue/coastal-blue spaces); and (b) nature connectedness, across season and country. People who lived in greener/coastal neighbourhoods reported higher positive well-being, but this association largely disappeared when recreational visits were controlled for. Frequency of recreational visits to green, inland-blue, and coastal-blue spaces in the last 4 weeks were all positively associated with positive well-being and negatively associated with mental distress. Associations with green space visits were relatively consistent across seasons and countries but associations with blue space visits showed greater heterogeneity. Nature connectedness was also positively associated with positive well-being and negatively associated with mental distress and was, along with green space visits, associated with a lower likelihood of using medication for depression. By contrast inland-blue space visits were associated with a greater likelihood of using anxiety medication. Results highlight the benefits of multi-exposure, multi-response, multi-country studies in exploring complexity in nature-health associations.

Associations of Residential Brownness and Greenness with Fasting Glucose in Young Healthy Adults Living in the Desert

2021 / Children, Health and well-being, Underserved populations

Figure 1. Aerial image showing examples of brownness, greenness, and grayness in a residential area of El Paso, Texas, in June, 2019. Image source: GoogleEarth®, © 2020 Google; © 2020 INEGI. Evolutionary psychology theories propose that contact with green, natural environments may benefit physical health, but little comparable evidence exists for brown, natural environments, such as the desert. In this study, we examined the association between “brownness” and “greenness” with fasting glucose among young residents of El Paso, Texas. We defined brownness as the surface not covered by vegetation or impervious land within Euclidian buffers around participants’ homes. Fasting glucose along with demographic and behavioral data were obtained from the Nurse Engagement and Wellness Study (n = 517). We found that residential proximity to brownness was not associated with fasting glucose when modeled independently. In contrast, we found that residential greenness was associated with decreased levels of fasting glucose, despite the relatively low levels of greenness within the predominantly desert environment of El Paso. A difference between the top and bottom greenness exposure quartiles within a 250 m buffer was associated with a 3.5 mg/dL decrease in fasting glucose levels (95% confidence interval: −6.2, −0.8). Our results suggest that within the understudied context of the desert, green vegetation may be health promoting to a degree that is similar to other, non-desert locations in the world that have higher baselines levels of green.

Casting a Wide Net and Making the Most of the Catch

2021 / Blue spaces, College students, Development, Underserved populations

Usha Varanasi describes lessons learned and the people and principles that influenced six decades of professional endeavours from graduate schools to ascending, often unexpectedly, the science and management ladder in National Oceanic and Atmospheric Administration (NOAA) Fisheries, which manages US living marine resources. For this woman chemist from India, the twists of fate and love of adventure presented amazing opportunities as well as challenges. Her research on cetacean biosonar as well as on the impact of fossil fuel pollution on seafood safety and the health of marine organisms taught her the value of multidisciplinary approaches and unusual alliances. Transitioning into management, and eventually as the director of Northwest Fisheries Science Center, Usha learned the value of transparency and empathy while communicating our results to impacted communities, and the resolve to support the science regardless of the consequences. Her advice to young professionals is that the journey should be as fulfilling as reaching the goalpost.

Climate Adaptation Actions for Urban Forests and Human Health

2021 / Climate, Urban

Urban areas can be particularly vulnerable to climate change due to extensive impervious cover, increased pollution, greater human population densities, and a concentration of built structures that intensify impacts from urban heat, drought, and extreme weather. Urban residents are at risk from a variety of climate stressors, which can cause both physical and mental harm. Urban forests and tree cover provide a critical role in helping cities address climate change by supporting greenhouse gas mitigation, reducing the impacts of extreme heat and altered climate that impair human health, and helping communities to adaptively respond through engagement with nature. At the same time, urban forests are vulnerable to changes in climate and in need of robust strategies to adapt to those changes. As climate change impacts increase, efforts to “green” cities and adapt urban forests to changing conditions take on greater importance to support human health and well-being. Urban forest managers and allied professionals are looking for information to reduce climate risks to urban forests and secure their benefits for people and ecosystems. This report, Climate Adaptation Actions for Urban Forests and Human Health, synthesizes adaptation actions to address climate change in urban forest management and promote human health and well-being through nature-based solutions. It compiles and organizes information from a wide range of peer-reviewed research and evidence-based reports on climate change adaptation, urban forest management, carbon sequestration and storage, and human health response to urban nature. This report includes the Urban Forest Climate and Health Adaptation Menu, which presents information and ideas for optimizing the climate and human health outcomes of urban forestry projects and provides professionals who are working at the intersection of climate, public health, and urban forestry with resources to support climate adaptation planning and activities. Notably, it does not provide specific recommendations or guidance for any particular place; rather, it offers a range of action opportunities at different scales that can be incorporated into either comprehensive or specific climate adaptation initiatives. The Menu can be used with an existing, tested adaptation process to help managers consider climate risks and explore the benefits and drawbacks of potential adaptation actions within the context of a particular situation or project. It also can be useful for generating productive discussions about community needs and values to guide planning, education and outreach, research, or changes in policy or infrastructure within communities.

COVID-19, the Built Environment, and Health

2021 / Built environment + Urban design, COVID

Figure 1. Milan’s lazaretto, built just outside the city’s walls in the late 15th and early 16th centuries to house plague victims. Having outlived its usefulness, it was demolished about 400 y later. This part of Milan, Porta Venezia, is now a vibrant neighborhood of galleries and ethnic restaurants—or it was until COVID-19 struck. Source: Wikimedia Background Since the dawn of cities, the built environment has both affected infectious disease transmission and evolved in response to infectious diseases. COVID-19 illustrates both dynamics. The pandemic presented an opportunity to implement health promotion and disease prevention strategies in numerous elements of the built environment. Objectives This commentary aims to identify features of the built environment that affect the risk of COVID-19 as well as to identify elements of the pandemic response with implications for the built environment (and, therefore, for long-term public health). Discussion Built environment risk factors for COVID-19 transmission include crowding, poverty, and racism (as they manifest in housing and neighborhood features), poor indoor air circulation, and ambient air pollution. Potential long-term implications of COVID-19 for the built environment include changes in building design, increased teleworking, reconfigured streets, changing modes of travel, provision of parks and greenspace, and population shifts out of urban centers. Although it is too early to predict with confidence which of these responses may persist, identifying and monitoring them can help health professionals, architects, urban planners, and decision makers, as well as members of the public, optimize healthy built environments during and after recovery from the pandemic.

Effects of the COVID-19 Pandemic on Park Visitation Measured by Social Media

2021 / COVID, Green spaces, Public land, Social media

Figure 1. Time series of weekly PUD from 2019–2020, in four US cities. Major COVID-related policies are denoted as vertical lines. The COVID-19 pandemic and the resulting economic recession have negatively affected many people’s physical, social, and psychological health. Parks and green-spaces may have ameliorated the negative effects of the pandemic by creating opportunities for outdoor recreation and nature exposure, while other public activities and gatherings were restricted due to risk of disease transmissions. Using park visitation estimates derived from 140K Instagram images shared in four US metropolitan areas, this study investigates trends in park use over the span of the COVID-19 pandemic. We find that while COVID-related stay-at-home orders are associated with shifts in park visitation, the cities that we analysed do not follow uniform trends. Our analyses suggest that future research may be able to explain variability in park visitation based on local factors such as park location and the socio-demographics of visitors. However, the research community does not currently have access to the volume and resolution of data that is necessary to study the issue. There is an urgent need for the CSCW community and social computing researchers to address this data gap if we are to understand the impacts of the pandemic, plan for urban resiliency, and ensure equitable access to parks and other shared resources.

Nature and Children’s Health: A Systematic Review

2021 / Children, Healthcare providers

The American Academy of Pediatrics has long recognized the importance of play and has encouraged outdoor play to promote children’s health and social-emotional development. Outdoor play environments vary widely, from urban parking lots to grass sports fields to wilderness. There is increasing evidence that outdoor play environments containing natural elements may offer health benefits that come specifically from engaging in the natural world. Recent studies have demonstrated that a broad range of outcomes are related to access to, and contact with nature, including increased physical activity, reduced obesity, decreased stress, and improved mental health. However, nature contact is not regularly experienced by all children because of urbanization, sedentary indoor lifestyles, and disparities in access to green space. Neighborhoods with more socioeconomically disadvantaged residents and families of color tend to have fewer nearby residential parks, and financial and transportation limitations that prevent access to parks and wilderness outside of city limits. This inequity extends to school grounds in low-income neighborhoods, which are less likely to have school gardens compared with schools in high-income neighborhoods. Furthermore, there is evidence that contact with nature and green space may disproportionately benefit disadvantaged populations by attenuating the toxic effects of poverty: the so-called “equigenic” effect. For these reasons, promoting nature contact and ensuring equitable access to green spaces could play a role in improving health outcomes and behaviors, and reducing health disparities. Pediatricians are uniquely positioned to offer guidance about evidence-informed interventions to promote child health during clinical interactions, and through community advocacy. Our goal was to conduct a systematic review to aggregate and evaluate the evidence regarding the effects of nature contact on children’s health, and to make it available to pediatric health care providers. Therefore, we explore the full breadth of quantitative evidence with a systematic literature search and consensus-based review process to make the evidence accessible on which to base clinical recommendations, health-promoting programs, and policies and to guide future research. Related News As Outdoor Preschools Gain Traction, States Work to Unlock Funding (January 27, 2023) Nature is Nurture: Outdoors are Key to Children’s Health, Buffer to Pandemic Stress (November 5, 2021) Children with access to nature are mentally and physically healthier (September 30, 2021) Science backs nature as key to children’s health (September 29, 2021)

Nature at Work: The Effects of Day-to-Day Nature Contact on Workers’ Stress and Psychological Well-Being

2021 / Health and well-being, Workers

Interior shot of the Spheres. Image source: AshlynG/Flickr, CC BY-ND 2.0 (G A, 2018). Objectives Chronic stress and burnout are key health issues for office workers that may contribute to a myriad of poor health outcomes. The presence of natural elements may improve psychological well-being in workers but the number of existing studies is relatively low, and more longitudinal research is specifically needed to assess how characteristics of workers’ day-to-day environments may impact mental health outcomes like affect, depression and stress. This report outlines a multi-study investigation of workers at Amazon, a multinational e-commerce company based in Seattle, Washington, USA, and the mental health benefits associated with exposure to nature. Methods In Study 1, participants (n = 153) responded to a cross-sectional survey that assessed the association of self-reported visitation to an indoor company greenspace with psychological well-being including symptoms of depression, anxiety, positive and negative affect, and stress. In Study 2, a subset of participants from Study 1 (n = 33) completed multiple surveys in a 2-week period that assessed the association of the naturalness of their current environments with their state levels of psychological well-being. Results We found contact with more natural outdoor environments was significantly associated with reduced state anxiety, after adjusting for activity type, location, and participants’ trait levels of nature relatedness. Conclusions Findings demonstrate that nature contact in everyday life is significantly associated with decreased levels of state anxiety. More research is needed to investigate the role of nature contact as a potential intervention in the workplace for improved mental health.

Nature Versus Urban Hiking for Veterans with Post-Traumatic Stress Disorder: A Pilot Randomized Trial Conducted in the Pacific Northwest USA

2021 / PTSD, Veterans

Figure 1. Conceptual model Objectives To evaluate feasibility and acceptability of a group-based nature recreation intervention (nature hiking) and control condition (urban hiking) for military Veterans with post-traumatic stress disorder (PTSD). Design and setting A pilot randomised controlled trial conducted in the US Pacific Northwest. Participants Veterans with PTSD due to any cause. Interventions Twenty-six participants were randomised to a 12-week intervention involving either six nature hikes (n=13) or six urban hikes (n=13). Primary and Secondary Outcome Measures Feasibility was assessed based on recruitment, retention and attendance. Questionnaires and post-intervention qualitative interviews were conducted to explore intervention acceptability. Questionnaires assessing acceptability and outcomes planned for the future trial (eg, PTSD symptoms) were collected at baseline, 6 weeks, 12 weeks (immediately after the final hike) and 24 weeks follow-up. Results Of 415 people assessed for eligibility/interest, 97 were interested and passed preliminary eligibility screening, and 26 were randomised. Mean completion of all questionnaires was 91% among those in the nature hiking group and 68% in those in the urban hiking group. Over the course of the intervention, participants in the nature and urban groups attended an average of 56% and 58%, respectively, of scheduled hikes. Acceptability of both urban and nature hikes was high; over 70% reported a positive rating (ie, good/excellent) for the study communication, as well as hike locations, distance and pace. Median PTSD symptom scores (PTSD Checklist-5) improved more at 12 weeks and 24 weeks among those in the nature versus urban hiking group. Conclusions This pilot study largely confirmed the feasibility and acceptability of nature hiking as a potential treatment for Veterans with PTSD. Adaptations will be needed to improve recruitment and increase hike attendance for a future randomised controlled trial to effectively test and isolate the ways in which nature contact, physical activity and social support conferred by the group impact outcomes. Trial Registration Number NCT03997344

No Walk in the Park: the Viability and Fairness of Social Media Analysis for Parks and Recreational Policy Making

2021 / Public land, Recreation, Social media

Figure 1. Social Vulnerability Index classes by census tract in Seattle (WA). The yellow regions depict the selected parks. Recent years have seen an increase in the use of social media for various decision-making purposes in the context of urban computing and smart cities, including management of public parks. However, as such decision-making tasks are becoming more autonomous, a critical concern that arises is the extent to which such analysis are fair and inclusive. In this article, we examine the biases that exist in social media analysis pipelines that focus on researching recreational visits to urban parks. More precisely, we demonstrate the potential biases that exist in different data sources for estimating the number and demographics of visitors through a comparison of image content shared on Instagram and Flickr from 10 urban parks in Seattle, Washington. We draw a comparison against a traditional intercept survey of park visitors and a multi-modal city-wide survey of residents. We evaluate the viability of using more complex AI facial recognition algorithms and its capabilities for removing some of the presented biases. We evaluate the AI algorithm through the lens of algorithmic fairness and its impact on sensitive demographic groups. We show that despite the promising results, there are new sets of concerns regarding equity that arise when we use AI algorithms.

Planetary Health: Safeguarding the Environment and Human Health in the Anthropocene

2021 / Planetary Health

We live in unprecedented times – the Anthropocene – defined by far-reaching human impacts on the natural systems that underpin civilisation. Planetary Health explores the many environmental changes that threaten to undermine progress in human health, and explains how these changes affect health outcomes, from pandemics to infectious diseases to mental health, from chronic diseases to injuries. It shows how people can adapt to those changes that are now unavoidable, through actions that both improve health and safeguard the environment. But humanity must do more than just adapt: we need transformative changes across many sectors – energy, housing, transport, food, and health care. The book discusses specific policies, technologies, and interventions to achieve the change required, and explains how these can be implemented. It presents the evidence, builds hope in our common future, and aims to motivate action by everyone, from the general public to policymakers to health practitioners.

Psychological Impacts from COVID-19 Among University Students

2021 / College students, COVID

Figure 1. COVID-19 psychological impact profiles derived from z-scores of eight items reduced to two factors using data from college students across the United States (n = 2,534). Background University students are increasingly recognized as a vulnerable population, suffering from higher levels of anxiety, depression, substance abuse, and disordered eating compared to the general population. Therefore, when the nature of their educational experience radically changes—such as sheltering in place during the COVID-19 pandemic—the burden on the mental health of this vulnerable population is amplified. The objectives of this study are to 1) identify the array of psychological impacts COVID-19 has on students, 2) develop profiles to characterize students’ anticipated levels of psychological impact during the pandemic, and 3) evaluate potential sociodemographic, lifestyle-related, and awareness of people infected with COVID-19 risk factors that could make students more likely to experience these impacts. Methods Cross-sectional data were collected through web-based questionnaires from seven U.S. universities. Representative and convenience sampling was used to invite students to complete the questionnaires in mid-March to early-May 2020, when most coronavirus-related sheltering in place orders were in effect. We received 2,534 completed responses, of which 61% were from women, 79% from non-Hispanic Whites, and 20% from graduate students. Results Exploratory factor analysis on close-ended responses resulted in two latent constructs, which we used to identify profiles of students with latent profile analysis, including high (45% of sample), moderate (40%), and low (14%) levels of psychological impact. Bivariate associations showed students who were women, were non-Hispanic Asian, in fair/poor health, of below-average relative family income, or who knew someone infected with COVID-19 experienced higher levels of psychological impact. Students who were non-Hispanic White, above-average social class, spent at least two hours outside, or less than eight hours on electronic screens were likely to experience lower levels of psychological impact. Multivariate modeling (mixed-effects logistic regression) showed that being a woman, having fair/poor general health status, being 18 to 24 years old, spending 8 or more hours on screens daily, and knowing someone infected predicted higher levels of psychological impact when risk factors were considered simultaneously. Conclusion Inadequate efforts to recognize and address college students’ mental health challenges, especially during a pandemic, could have long-term consequences on their health and education.

Taking the Long View for Oceans and Human Health Connection through Community-Driven Science

2021 / Blue spaces, Community science, Health and well-being, Indigenous communities, Reciprocal healing

Figure 1. Olympic Region Harmful Algal Bloom (ORHAB) partners and sampling sites. The most proactive approach to resolving current health and climate crises will require a long view, focused on establishing and fostering partnerships to identify and eliminate root causes of the disconnect between humans and nature. We describe the lessons learned through a unique scientific partnership that addresses a specific crisis, harmful algal blooms (HABs), along the northeast Pacific Ocean coast, that blends current-day technology with observational knowledge of Indigenous communities. This integrative scientific strategy resulted in creative solutions for forecasting and managing HAB risk in the Pacific Northwest as a part of the US Ocean and Human Health (OHH) program. Specific OHH projects focused on: Understanding genetic responses of Tribal members to toxins in the marine environment Knowledge sharing by elders during youth camps Establishing an early warning program to alert resource managers of HABs are explicit examples of proactive strategies used to address environmental problems. The research and monitoring projects with Tribal communities taught the collaborating non-Indigenous scientists the value of reciprocity, highlighting both the benefits from and protection of oceans that promote our well-being. Effective global oceans and human health initiatives require a collective action that gives equal respect to all voices to promote forward thinking solutions for ocean health.

The COVID-19 Pandemic and Global Environmental Change: Emerging Research Needs

2021 / COVID

Figure 1. COVID-19 and Environment, Climate and Health. The figure shows the different stages of the pandemic development and, at each stage, the environmental factors that either contribute to or are impacted by that particular stage. The HERA consortium has made proposals for multidisciplinary research to achieve transformational change supporting and merging different agendas such as zero pollution, climate change resilience and mitigation, farm to fork, circular economy, EU chemical strategy for sustainability. These proposals can be found online. The outbreak of COVID-19 raised numerous questions on the interactions between the occurrence of new infections, the environment, climate and health. The European Union requested the H2020 HERA project which aims at setting priorities in research on environment, climate and health, to identify relevant research needs regarding Covid-19. The emergence and spread of SARS-CoV-2 appears to be related to urbanization, habitat destruction, live animal trade, intensive livestock farming and global travel. The contribution of climate and air pollution requires additional studies. Importantly, the severity of COVID-19 depends on the interactions between the viral infection, ageing and chronic diseases such as metabolic, respiratory and cardiovascular diseases and obesity which are themselves influenced by environmental stressors. The mechanisms of these interactions deserve additional scrutiny. Both the pandemic and the social response to the disease have elicited an array of behavioural and societal changes that may remain long after the pandemic and that may have long term health effects including on mental health. Recovery plans are currently being discussed or implemented and the environmental and health impacts of those plans are not clearly foreseen. Clearly, COVID-19 will have a long-lasting impact on the environmental health field and will open new research perspectives and policy needs.

The Planetary Wellbeing Initiative: Pursuing the Sustainable Development Goals in Higher Education

2021 / Health and well-being, Planetary Health

We live in a time of pressing planetary challenges, many of which threaten catastrophic change to the natural environment and require massive and novel coordinated scientific and societal efforts on an unprecedented scale. Universities and other academic institutions have the opportunity and responsibility to assume a leading role in an era when the destiny of the planet is precisely in the hands of human beings. Drawing on the Planetary Health project promoted by the Rockefeller Foundation and The Lancet, Pompeu Fabra University launched in 2018 the Planetary Wellbeing Initiative, a long-term institutional strategy also animated by the United Nations Sustainable Development Goals (SDGs). Planetary Wellbeing might be defined as the highest attainable standard of wellbeing for human and non-human beings and their social and natural systems. Developing the potential of these new concepts involves a substantial theoretical and empirical effort in many different fields, all of them interrelated by the crosscutting challenges of global complexity, interdisciplinarity, and urgency. Close collaboration of science, humanities, and culture is more desperately needed now than ever before in the history of humankind.

Time Spent in Nature is Associated with Increased Pro-Environmental Attitudes and Behaviors

2021 / Children, Development

Urbanization, screen dependency, and the changing nature of childhood and parenting have led to increased time indoors, creating physical and emotional distancing from nature and time spent in natural environments. Substantial evidence from observational and intervention studies indicates that overall time spent in nature leads to increased perceived value for connectedness to nature and, subsequently, greater pro-environmental attitudes and behaviors (PEAB). This narrative review of the recent literature evaluates associations between time spent in nature with values ascribed to nature and nature connectedness, as well as PEAB. We discuss the influence of nature exposure and education in childhood on subsequent development of PEAB in adulthood. We analyze theoretical frameworks applied to this research as well as metrics employed, populations studied, and individual and societal values before presenting limitations of this research. We conclude with suggestions for future research directions based on current knowledge, underscoring the importance of promoting time spent in nature and PEAB in the face of growing challenges to planetary health. Research indicates that overall time spent in nature, regardless of the quality of environmental conditions, leads to increased perceived values ascribed to nature, which is associated with PEAB; however, this literature is predominantly cross-sectional. Furthermore, personal and social factors may influence PEAB. Thus, more longitudinal studies that consider these factors are needed to assess the duration and frequency of time spent in nature in childhood and its impact on PEAB throughout the life course. Identifying contexts which cultivate PEAB and reverse alienation from nature beginning in childhood may better sensitize adults to the urgency of environmental issues such as climate change, which adversely impact individual and environmental health.

When Screen Time Isn’t Screen Time: Tensions and Needs Between Tweens and Their Parents During Nature-Based Exploration

2021 / Children, Parents, Virtual nature

Figure 1: Screens of the NatureCollection app 1: Onboarding “What are your interests?” 2: Homepage 3: My Collections 4: Classification 5: Challenges We investigated the experiences of 15 parents and their tween children (ages 8-12, n=23) during nature explorations using the NatureCollections app, a mobile application that connects children with nature. Drawing on parent interviews and in-app audio recordings from a 2-week deployment study, we found that tweens’ experiences with the NatureCollections app were influenced by tensions surrounding how parents and tweens negotiate technology use more broadly. Despite these tensions, the app succeeded in engaging tweens in outdoor nature explorations, and parents valued the shared family experiences around nature. Parents desired the app to support family bonding and inform them about how their tween used the app. This work shows how applications intended to support enriching youth experiences are experienced in the context of screen time tensions between parents and tween during a transitional period of child development. We offer recommendations for designing digital experiences to support family needs and reduce screen time tensions.

“Being on the Walk put it Somewhere in my Body”: The Meaning of Place in Health for Indigenous Women

2020 / Health and well-being, Indigenous communities

Relationship to place is integral to Indigenous health. A qualitative, secondary phenomenological analysis of in-depth interviews with four non-Choctaw Indigenous women participating in an outdoor, experiential tribally-specific Choctaw health leadership study uncovered culturally grounded narratives using thematic analysis as an analytic approach. Results revealed that physically being in historical trauma sites of other Indigenous groups involved a multi-faceted process that facilitated embodied stress by connecting participants with their own historical and contemporary traumas. Participants also experienced embodied resilience through connectedness to place and collective resistance. Implications point to the role of place in developing collective resistance and resilience through culturally and methodologically innovative approaches.

“Otter this World”: Can a Mobile Application Promote Children’s Connectedness to Nature?

2020 / Children, Virtual nature

Can a mobile application encourage children to spend more time outdoors and promote their connectedness to nature? In this paper, we present results from a three-week experimental deployment study of NatureCollections, a mobile application that allows users to build, curate, and share nature photo collections. Twenty-eight children (aged 9-12) and their parents participated in the study; 15 used the NatureCollections app, and 13 used a basic Photo app. We found that the NatureCollections app significantly increased the time children spent outdoors compared to the Photo app. Children in both groups said they felt happy and excited about spending time in nature. However, children in the NatureCollections group reported that time spent outside with the app increased their curiosity about the types of species and plants they saw and photographed. Children in the NatureCollections group also engaged in nature-based conversations with their parents, and even sought to look up information online about the plants and animals they observed. In contrast, children in the basic Photo app group did not display this level of curiosity about what they saw in nature, and the photos they took were driven largely by the aesthetic qualities of nature elements. Our results suggest that NatureCollections promotes and supports children’s connectedness to nature.

Affective Reactions to Losses and Gains in Biodiversity: Testing a Prospect Theory Approach

2020 / Biodiversity

Figure 1. Prospect theory predictions applied to reports of biodiversity change in the current studies. Recent reports have presented evidence of dramatic biodiversity declines. Despite the threat posed by such losses we know little about people’s reactions to such information, or rarer ‘bright spot’ stories of localised recovery. We explored these issues through the lens of prospect theory, testing three aspects: a) reference dependence, b) loss aversion, and c) diminishing sensitivity. Study 1 (n = 393) presented US participants with a hypothetical ecological survey reporting changes in bird species at a key site between 1996 and 2016 using a 2 (Baseline species richness: Low/high) x 2 (Change direction: Loss/gain) x 4 (Change magnitude: 5/10/15/20 species) between-participants design. Study 2 (n = 570) used the same design but focused on marine species richness among a UK sample. Responses were measured using a version of the Scale of Positive and Negative Experience. Both studies found evidence of reference dependence, but not loss aversion. In fact both studies found that reactions to biodiversity gains were stronger than equivalent losses; gains ‘loomed larger’ than losses. There was little evidence of diminishing sensitivity; scope insensitivity was the predominant pattern for losses and gains across both studies. Although those high in nature relatedness reacted more strongly to losses and gains, relatedness did not moderate any effects. Results suggest that communicators should not be surprised if reports of biodiversity declines do not have the impact they hoped, and that weaving in ‘bright spot’ stories may help people engage with the broader issues.

Closing the Gap Through Rewilding, Interacting, and Overcoming

2020 / Health and well-being, Nature school

The Research Handbook on Childhoodnature provides a compilation of research in Childhoodnature and brings together existing research themes and seminal authors in the field alongside new cutting-edge research authored by world-class researchers drawing on cross-cultural and international research data. The underlying objectives of the handbook are two-fold: Opening up spaces for Childhoodnature researchers; Consolidating Childhoodnature research into one collection that informs education. The use of the new concept ‘Childhoodnature’ reflects the editors’ and authors’ underpinning belief, and the latest innovative concepts in the field, that as children are nature this should be redefined in this integrating concept. The handbook will, therefore, critique and reject an anthropocentric view of nature. As such it will disrupt existing ways of considering children and nature and reject the view that humans are superior to nature. The chapter “Closing the gap through rewilding, interacting, and overcoming” (pages 391-394) is co-authored by Peter Kahn, a Nature and Health researcher.

Focusing Attention on Reciprocity Between Nature and Humans can be the Key to Reinvigorating Planetary Health

2020 / Reciprocal healing

In industrialized and urbanized societies, medical science focuses primarily on trauma and diseases, and most environmental work attempts to remediate natural and anthropogenic degradation. This essay raises the importance of shifting individual and societal attention to preventive and precautionary measures to maintain human and ecological health. It points to the growing body of research that nature (wilderness to green and blue space) is necessary for people’s physical, mental, and emotional health. Such evidence should persuade the public and policymakers to proactively conserve ecosystems, reducing the need to rescue depleted species or repair and restore their degraded habitats. This paper also describes the creative tension between the need for evidence-based research to demonstrate the health benefits of nature, which can lead to public health policies that make nature exposure widely accessible, and the need to ensure that nature is not viewed merely as a ‘‘service provider’’ from which humans can continue to extract health benefits. The author suggests that a drastic change is needed in the prevailing attitude of dominance over nature. This essay concludes with a plea for focused attention on reciprocal healing of both nature and humans, which can occur only if our interaction with nature—be it wilderness, an urban park, or a garden—is sustained and respectful. The author suggests that the nature-and-health paradigm may be the game-changing strategy needed to sustain grassroots awareness for halting and hopefully reversing the trajectory of decline in planetary health.

NatureCollections: Can A Mobile Application Trigger Children’s Interest In Nature?

2020 / Children, Virtual nature

Figure 1. a. Student taking a close-up shot of a flower b. One student pointing nature element to her peers a c. Students walking and scanning their surroundings. In this study, we investigate whether and how a mobile application called NatureCollections supports children’s triggered situational interest in nature. Developed from an interest-centered design framework, NatureCollections allows children to build and curate their own customized photo collections of nature. We conducted a comparison study at an urban community garden with 57 sixth graders across 4 science classrooms. Students in two classrooms (n = 15 and 16) used the NatureCollections app, and students in another two classrooms (n = 13 and 13) used a basic Camera app. We found that NatureCollections succeeded in focusing students’ attention–an important aspect of interest development– through sensory engagement with the natural characteristics in their surroundings. Students who used NatureCollections moved slower in space while scanning their surroundings for specific elements (e.g., flowers, birds) to photograph. In contrast, students who used the basic Camera app were more drawn to aesthetic aspects (e.g., color, shape) and tended to explore their surroundings through the device screen. NatureCollections supported other dimensions of interest development, including personal relevance, social interactions, and positive experiences for continued engagement. Our findings further showed that the NatureCollections app facilitated students’ scientific discourse with their peers.

Next-Generation Visitation Models using Social Media to Estimate Recreation on Public Lands

2020 / Public land, Recreation, Social media

Figure 1. Locations of geotagged social media posts made by visitors to public lands in WWA and NNM. Points represent the latitude and longitude where a Flickr photograph (purple) or tweet (green) was created. For Instagram, points represent places to which images were assigned by users (blue). Larger points represent a greater number of Instagram images from the location. Study sites are contained within the management units (shaded grey). Figure created using R48 version 3.5.3. Outdoor and nature-based recreation provides countless social benefits, yet public land managers often lack information on the spatial and temporal extent of recreation activities. Social media is a promising source of data to fill information gaps because the amount of recreational use is positively correlated with social media activity. However, despite the implication that these correlations could be employed to accurately estimate visitation, there are no known transferable models parameterized for use with multiple social media data sources. This study tackles these issues by examining the relative value of multiple sources of social media in models that estimate visitation at unmonitored sites and times across multiple destinations. Using a novel dataset of over 30,000 social media posts and 286,000 observed visits from two regions in the United States, we compare multiple competing statistical models for estimating visitation. We find social media data substantially improve visitor estimates at unmonitored sites, even when a model is parameterized with data from another region. Visitation estimates are further improved when models are parameterized with on-site counts. These findings indicate that while social media do not fully substitute for on-site data, they are a powerful component of recreation research and visitor management.

Ode’imin Giizis: Proposing and Piloting Gardening as an Indigenous Childhood Health Intervention

2020 / Gardens, Indigenous communities

Figure 1. Gardening by the moons as digitally interpreted by RICH Postdoctoral Fellow, Dr. LaPensee, who worked with local tribal members. The Research for Indigenous Community Health Center and the American Indian Housing Organization sought to reduce obesity among Indigenous children and families in a Northern Midwestern urban community who are at risk for homelessness by piloting a gardening health intervention. This community-based participatory research, mixed-methods study examined the feasibility of gardening as an obesity intervention among a school-aged Indigenous population at risk for homelessness through using focus groups, key informant interviews, and valid health measures. The program was found highly feasible and fulfilled a critical need among Indigenous youth and their families, who reportedly suffered from food insecurity and access. This intervention increased healthy food awareness and perceptions, cultural resources, and ancestral food knowledge skills through activities, mentorship, and multigenerational engagement. This study augments the literature on the feasibility of using tribal ecological knowledge and the environment in designing culturally appropriate health interventions.

Planetary Health: Protecting Nature to Protect Ourselves

2020 / Health and well-being

Human health depends on the health of the planet. Earth’s natural systems—the air, the water, the biodiversity, the climate—are our life support systems. Yet climate change, biodiversity loss, scarcity of land and freshwater, pollution and other threats are degrading these systems. The emerging field of planetary health aims to understand how these changes threaten our health and how to protect ourselves and the rest of the biosphere. Planetary Health: Protecting Nature to Protect Ourselves provides a readable introduction to this new paradigm. With an interdisciplinary approach, the book addresses a wide range of health impacts felt in the Anthropocene, including food and nutrition, infectious disease, non-communicable disease, dislocation and conflict, and mental health. It also presents strategies to combat environmental changes and its ill-effects, such as controlling toxic exposures, investing in clean energy, improving urban design, and more. Chapters are authored by widely recognized experts. The result is a comprehensive and optimistic overview of a growing field that is being adopted by researchers and universities around the world. Students of public health will gain a solid grounding in the new challenges their profession must confront, while those in the environmental sciences, agriculture, the design professions, and other fields will become familiar with the human consequences of planetary changes. Understanding how our changing environment affects our health is increasingly critical to a variety of disciplines and professions. Planetary Health is the definitive guide to this vital field.