Over 30 years of research has shown that urban nature is a promising tool for enhancing the physical, psychological, and social well-being of the world's growing urban population. However, little is known about the type and amount of nature people require in order to receive different health benefits, preventing the development of recommendations for minimum levels of exposure and targeted city planning guidelines for public health outcomes. Dose–response modelling, when a dose of nature is modeled against a health response, could provide a key method for addressing this knowledge gap. In this overview, we explore how “nature dose” and health response have been conceptualized and examine the evidence for different shapes of dose–response curves. We highlight the crucial need to move beyond simplistic measures of nature dose to understand how urban nature can be manipulated to enhance human health.

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The Health Benefits of Urban Nature: How Much Do We Need?

Experiences of nature provide many mental-health benefits, particularly for people living in urban areas. The natural characteristics of city residents’ neighborhoods are likely to be crucial determinants of the daily nature dose that they receive; however, which characteristics are important remains unclear. One possibility is that the greatest benefits are provided by characteristics that are most visible during the day and so most likely to be experienced by people. We demonstrate that of five neighborhood nature characteristics tested, vegetation cover and afternoon bird abundances were positively associated with a lower prevalence of depression, anxiety, and stress. Furthermore, dose–response modeling shows a threshold response at which the population prevalence of mental-health issues is significantly lower beyond minimum limits of neighborhood vegetation cover (depression more than 20% cover, anxiety more than 30% cover, stress more than 20% cover). Our findings demonstrate quantifiable associations of mental health with the characteristics of nearby nature that people actually experience.

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Doses of neighborhood nature: The benefits for mental health of living with nature

Evidence that experiences of nature can benefit people has accumulated rapidly. Yet perhaps because of the domination of the visual sense in humans, most research has focused on the visual aspects of nature experiences. However, humans are multisensory, and it seems likely that many benefits are delivered through the non-visual senses and these are potentially avenues through which a physiological mechanism could occur. Here we review the evidence around these lesser studied sensory pathways—through sound, smell, taste, touch, and three non-sensory pathways. Natural sounds and smells underpin experiences of nature for many people, and this may well be rooted in evolutionary psychology. Tactile experiences of nature, particularly beyond animal petting, are understudied yet potentially fundamentally important. Tastes of nature, through growing and consuming natural foods, have been linked with a range of health and well-being benefits. Beyond the five senses, evidence is emerging for other non-visual pathways for nature experiences to be effective. These include ingestion or inhalation of phytoncides, negative air ions and microbes. We conclude that (i) these non-visual avenues are potentially important for delivering benefits from nature experiences; (ii) the evidence base is relatively weak and often based on correlational studies; and (iii) deeper exploration of these sensory and non-sensory avenues is needed.

https://www.mdpi.com/1660-4601/14/8/864/pdf

A Review of the Benefits of Nature Experiences: More Than Meets the Eye.

The COVID-19 pandemic and its global response have resulted in unprecedented and rapid changes to most people's day-to-day lives. To slow the spread of the virus, governments have implemented the practice of physical distancing ("social distancing"), which includes isolation within the home with limited time spent outdoors. During this extraordinary time, nature around the home may play a key role in mitigating against adverse mental health outcomes due to the pandemic and the measures taken to address it. To assess whether this is the case, we conducted an online questionnaire survey (n = 3,000) in Tokyo, Japan, to quantify the association between five mental health outcomes (depression, life satisfaction, subjective happiness, self-esteem, and loneliness) and two measures of nature experiences (frequency of greenspace use and green view through windows from home). Accounting for sociodemographic and lifestyle variables, we found that the frequency of greenspace use and the existence of green window views from within the home was associated with increased levels of self-esteem, life satisfaction, and subjective happiness and decreased levels of depression, anxiety, and loneliness. Our findings suggest that a regular dose of nature can contribute to the improvement of a wide range of mental health outcomes. With the recent escalation in the prevalence of mental health disorders, and the possible negative impacts of the COVID-19 pandemic on public mental health, our findings have major implications for policy, suggesting that urban nature has great potential to be used as a "nature-based solution" for improved public health.

https://esajournals.onlinelibrary.wiley.com/doi/pdf/10.1002/eap.2248

A room with a green view: the importance of nearby nature for mental health during the COVID-19 pandemic.

Although stress is an increasing global health problem in cities, urban green spaces can provide health benefits. There is, however, a lack of understanding of the link between physiological mechanisms and qualities of urban green spaces. Here, we compare the effects of visual stimuli (360 degree virtual photos of an urban environment, forest, and park) to the effects of congruent olfactory stimuli (nature and city odours) and auditory stimuli (bird songs and noise) on physiological stress recovery. Participants (N = 154) were pseudo-randomised into participating in one of the three environments and subsequently exposed to stress (operationalised by skin conductance levels). The park and forest, but not the urban area, provided significant stress reduction. High pleasantness ratings of the environment were linked to low physiological stress responses for olfactory and to some extent for auditory, but not for visual stimuli. This result indicates that olfactory stimuli may be better at facilitating stress reduction than visual stimuli. Currently, urban planners prioritise visual stimuli when planning open green spaces, but urban planners should also consider multisensory qualities.

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Reduction of physiological stress by urban green space in a multisensory virtual experiment

Bird sounds and their contributions to perceived attention restoration and stress recovery

Memory and place attachment as predictors of imagined restorative perceptions of favourite places

Associations with bird sounds: How do they relate to perceived restorative potential?

Acoustic experiences of nature represent a growing area in restorative environments research and are explored in this narrative literature review. First, the work surveyed indicates that nature is broadly characterized by the sounds of birdsong, wind, and water, and these sounds can enhance positive perceptions of natural environments presented through visual means. Second, isolated from other sensory modalities these sounds are often, although not always, positively affectively appraised and perceived as restorative. Third, after stress and/or fatigue nature sounds and soundscapes can lead to subjectively and objectively improved mood and cognitive performance, as well as reductions in arousal, although some inconsistencies in findings are observed. Fourth, theoretical frameworks of restorative environments would benefit from inclusion of acoustic environmental properties such as sound intensity or frequency. Fifth, findings regarding positive, learned semantic associations with nature have arisen as a result of recent work on sounds and restoration. This represents another important area of potential theoretical development for broader restorative environments research.

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Sound and Soundscape in Restorative Natural Environments: A Narrative Literature Review.

Top–down processing has been highlighted as a potential, but as yet understudied, aspect of restorative environmental experience. In an online study, N = 234 adults resident in Finland rated their favorite Finnish place on measures of perceived restorativeness, perceived restorative outcomes, and place attachment, and provided qualitative descriptions of the place and a positive memory associated with it. Thematic analysis of qualitative data revealed seven themes underpinning place memories: the environment itself, activities within it, cognitive responses, emotional responses, social context, self, and time. Mediated regression analyses showed positive and significant relationships between restorative perceptions and the presence of memories of self and time, as mediated via place attachment (place identity factor). These findings emphasize the contribution of the person to the perception of their restorative experiences in places, particularly in the form of personal memories that can enhance place identity.

Eleanor Ratcliffe

Papers

Bird sounds and their contributions to perceived attention restoration and stress recovery

Memory and place attachment as predictors of imagined restorative perceptions of favourite places

Associations with bird sounds: How do they relate to perceived restorative potential?

Sound and Soundscape in Restorative Natural Environments: A Narrative Literature Review.

Time- and Self-Related Memories Predict Restorative Perceptions of Favorite Places Via Place Identity: