The Natural Health Service

Why is the NHS suddenly interested in the natural environment? Why is Natural England (an environment organisation) working with the Department of Health to help patients with diabetes and high blood pressure? The health benefits we feel when going for a walk in the fresh air and seeing nature around us are almost taken for granted. But can nature cure, heal or even prevent illness?

Over the last 500 years hospitals have used healing gardens for treating patients with TB and many other conditions. Parks were built by the Victorians to save lives and provide the lungs of the city and rich people who lived in London always had a second home in the country to recuperate at weekends. The mountains were valued as much for their healing properties as for their beauty.

However it is only recently that we have the evidence to show that the natural environment affects the brain and body and even alters our behaviour.

The theory linking humans with our natural environment is called the biophilia hypothesis and was proposed in the 1980s by EO Wilson from Harvard University. This evolutionary theory is defined as:

 ‘the innately emotional affiliation of human beings to other living organisms. Innate means hereditary and hence part of human nature’.

In simpler terms this means that even today, surrounded by such abundance of food and successful technology, we are still attracted to nature as part of a basic survival mechanism that was laid down in our genes when we were hunter gatherers on the plains of Africa.

So is this yearning like our appendix; a redundant item to be ignored or removed, or do we really function less well and even become ill when removed from contact with nature?

Evidence is at hand to suggest that healthy natural environment around us is as important as drinking pure water and breathing clean air.

There are two mechanisms that have been proposed to demonstrate this theory.

The first was developed by Roger Ulrich.  In his experiment, contact with nature or even pictures of nature reduced blood pressure, pulse rate and muscle tension within 3 minutes. Ulrich’s work started when he studied how patients in a surgical ward recovered from gall bladder surgery and found that those who looked out onto trees needed less painkillers and complained less to nurses than those who looked onto the brick wall - these patients also stayed in hospital for longer. Stress reduction as a response to nature is a reflex caused by the oldest part of the brain called the limbic system and may have survived for over one million years of our evolution. Even our brain waves change to comfort mode when looking at greenery.

The second mechanism, proposed by two psychologists in the US, demonstrated that contact with nature allowed people to restore their levels of concentration far quicker than any other environment.  Many studies have shown that being in a natural environment boosts levels of concentration better than when indoors or in an urban area. Even older people resting after lunch in the garden compared to their bedroom showed significant improvement in concentration levels after just one hour.

Studies in a large public housing complex in Chicago showed some dramatic findings. Three miles of tower blocks housed some of the poorest people in Chicago and although each tower block was surrounded by planted trees when they were built these had since died and around some blocks even the grass had been concreted over.

People living in the blocks where there was no grass or trees showed significantly higher levels of aggression and violence to partners. There was less interaction with neighbours and girls showed less concentration on school work.

Other work in the same area showed that those living in relative poverty were able to cope better and plan how to deal with problems more effectively when they lived in the blocks surrounded by more trees and grass. It is worth noting that each person was allocated their flat randomly when the next flat became vacant.

In other work, urban areas with less green space were shown to shorten lives due to older people taking less exercise (even when accounting for the fact that green areas often had richer people).

So the NHS is now interested in green space helping to tackle health inequalities since those who are stressed, ill or in poverty benefit more from contact with the natural environment. Human interventions have so far proved incapable of reversing the inequalities that have developed over the past few years.

But the other great benefit of nature is for our inactive children and obese adults. Green space sustains regular physical activity. A small study showed that depression and self esteem improved with so called green exercise that took place outdoors.

The health problems of diabetes, cancer, depression and dementia that we face today are very different to the infectious diseases of just 50 years ago. Medicine, having been so successful with antibiotics and vaccinations, is struggling to prevent these new long term conditions. The natural environment may be an ally that has just been dangerously neglected for the last 50 years and we are paying the price. It’s perhaps time to realise that drugs, surgery and new technology aimed at treating disease are no longer the best way to improve the nation’s health. While we have an unhealthy natural environment which causes people to shut themselves away indoors then we will have inequalities, obesity and inactivity and all the subsequent problems.

References

EO Wilson p32 in ‘The Biophilia Hypothesis’ Stephen R Kellert and Edward O Wilson, Ed (1993) Island Press Washington DC.

Ulrich R, Simons RF, Losito E, Fiorito E, Miles MA and Zelson M (1991) Stress Recovery during Exposure to Natural and Urban Environments. J Env Psychology 11, pp201-230

Ulrich RS (1984). View through a window may influence recovery from surgery. Science 224,420-421.

Nakamura R and Fujii E (1990) Studies of the characteristics of EEG when observing potted plants. Pelargonium Hortorum and Begonia Evansiana. Technical Bulletin of the Faculty of Horticulture of Chiba University. 43: 177-183. (In Japanese)

Kaplan R and Kaplan S (1995) The experience of nature: A psychological perspective. Ann Arbor, MI: Ulrich’s. in Kaplan S. The restorative effects of nature: Toward an integrative framework. Journal of Environmental Psychology,15,169-182.

Kuo FE and Sullivan WC (2001) Aggression and Violence in the inner city: Effects of Environment via Mental Fatigue. Environment and Behaviour 33 No4 July 2001 543-571.

Taylor AF, Kuo FE and Sullivan WC (2001) Views of nature and self-discipline: evidence from inner city children JEVP 21 Suppl.

Kuo F (2001) Coping with Poverty: Impacts of environment and attention in the inner city. Environment and Behavior, Vol 33(1), January 2001.

Pretty J, Peacock J, Sellens M and Griffin M (2005) The Mental and Physical Health Outcomes of Green Exercise. International Journal of Environmental Health Research. October 2005;15(5):319-337.