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The Influence of Urban Natural and Built Environments on Physiological and Psychological Measures of Stress—A Pilot Study

  • National University of Natural Medicine
  • Providence Research Network

Abstract and Figures

Environments shape health and well-being, yet little research has investigated how different real-world environmental settings influence the well-known determinant of health known as stress. Using a cross-over experimental design; this pilot study investigated the effect of four urban environments on physiological and psychological stress measures. Participants (N = 15) were exposed on separate days to one of the four settings for 20 min. These settings were designated as Very Natural; Mostly Natural; Mostly Built and Very Built. Visitation order to the four settings was individually randomized. Salivary cortisol and alpha-amylase; as well as self-report measures of stress; were collected before and after exposure to each setting. Gender was included as a variable in analysis; and additional data about environmental self-identity, pre-existing stress, and perceived restorativeness of settings were collected as measures of covariance. Differences between environmental settings showed greater benefit from exposure to natural settings relative to built settings; as measured by pre-to-post changes in salivary amylase and self-reported stress; differences were more significant for females than for males. Inclusion of covariates in a regression analysis demonstrated significant predictive value of perceived restorativeness on these stress measures, suggesting some potential level of mediation. These data suggest that exposure to natural environments may warrant further investigation as a health promotion method for reducing stress.
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Int. J. Environ. Res. Public Health
, 1250-1267; doi:10.3390/ijerph10041250
International Journal of
Environmental Resea rch and
Public H ealth
ISSN 1660-4601
The Influence of U rban Natural and Built E nvironments on
Physiological and Psychological Measures of Stress²
A Pilot Study
K urt Beil * and Douglas H anes
Helfgott Research Institute, National College of Natural Medicine, Portland, OR 97201, USA;
* Author to whom correspondence should be addressed; E-Mail:;
Tel.: +1-503-552-1804; Fax: +1-503-227-3750.
Received: 15 F ebruary 2013; in revised for
: 18 March 2013 / Accepted: 18 March 2013 /
Published: 26 March 2013
Abstract: Environments shape health and well-being, yet little research has investigated
how different real-world environmental settings influence the well-known determinant of
health known as stress. Using a cross-over experimental design; this pilot study investigated
the effect of four urban environments on physiological and psychological stress measures.
Participants (N = 15) were exposed on separate days to one of the four settings for 20 min.
These settings were designated as Very Natural; Mostly Natural; Mostly Built and Very
Built. Visitation order to the four settings was individually randomized. Salivary cortisol
and alpha-amylase; as well as self-report measures of stress; were collected before and
after exposure to each setting. Gender was included as a variable in analysis; and additional
data about environmental self-identity, pre-existing stress, and perceived restorativeness of
settings were collected as measures of covariance. Differences between environmental
settings showed greater benefit from exposure to natural settings relative to built settings;
as measured by pre-to-post changes in salivary amylase and self-reported stress;
differences were more significant for females than for males. Inclusion of covariates in a
regression analysis demonstrated significant predictive value of perceived restorativeness
on these stress measures, suggesting some potential level of mediation. These data suggest
that exposure to natural environments may warrant further investigation as a health
promotion method for reducing stress.
Int. J. Environ. Res. Public Health
Keywords: stress; cortisol; amylase; natural environment; built environment; green space;
biophilia; psychological restoration
1. I nt roduction
7KH³VHWWLQJV DSSURDFK´WR SXEOLF KHDOWK XVHV D holistic, multi-component model to describe how
environments shape health and well-being [1]. This systems-based approach, established by the 1986
WHO Ottawa Charter for Health Promotion, lays the groundwork for the inclusion of healthy,
supportive environments as part of the health promotion agenda [2]. The optimal design of physical
environmental features is one component of this approach that contributes WR D VHWWLQJ¶V FDSDFLW\ WR
influence health [3]. The tangible infrastructure and environmental features of a place affect numerous
health-determining processes. This is particularly true in urban settings, as initiatives such as the
:+2(XURSH¶V +HDOWK\ &LWLHV SURMHFW [4] DQG WKH &'&¶V +HDOWK\ 3ODFHV SURJUDP [5] have
demonstrated. The consideration and adoption of a health-promoting approach to urban design is
increasingly necessary as cities grow and the global population continues to surpass the 50% urban
threshold [6]. The importance of these perspectives is reflected in the difference in prevalence of
multiple physical and mental health conditions that exist between urban and rural areas [7±9].
One element of healthy supportive environments and urban design QRWHG IRUDQ ³XSVWUHDPKHDOWK
research has shown that residential proximity to these natural green spaces is associated with lower rates
of morbidity and mortality in some [13,14] but not all [15] cases. Evidence suggests that one mechanism
for contact with nature to positively influence health may be via their ability to facilitate stress
reduction [16,17]. Exposure to natural stimuli has been shown to reduce physiological and psychological
stress-related health measures in workplace environments [18±20], hospital settings [21±23]
and artificial simulations [24,25]. It is hypothesized that this reaction is the result of an evolutionary
adaptation known as biophiOLD WKH ³LQQDWH WHQGHQF\ WR IRFXV RQ OLIH DQG OLIH-OLNH SURFHVVHV´ [26].
7KLV ³SV\FKR-HYROXWLRQDU\ VWUHVV´ 3(6 theory [24] is widely regarded and many studies have
supported its premise that nature has the ability to increase health and well-being by reducing stress [27].
Stress is an epidemic public health concern that negatively impacts physical and mental health,
including cardiovascular, gastroenterological, immunological, neurological, endocrine and mental/
emotional health status [28,29]. The complex psychophysiological pathways of stress make
measurement via one single marker impossible. Most stress research utilizes a holistic approach of
collecting subjective psychological and objective physiological data to assess stress status.
Psychological stress is measured via subjective rating scales. Physiological stress is often measured by
salivary analysis due to the validity, reliability and ease of collection of salivary data. Salivary
collection also permits simultaneous measurement of the two principal SDWKZD\VRI WKH ERG\¶VVWUHVV
response: (1) the delayed-response, endocrine-mediated Hypothalamic-Pituitary-Adrenal (HPA)
pathway, measured by concentration of salivary cortisol (sCort), and (2) the immediate-response,
neuro-endocrine mediated Sympatho-Adreno-Medullary (SAM) pathway, measured by activity of
salivary alpha-amylase (sAA) [30]. These methods have been used to measure psychological and
Int. J. Environ. Res. Public Health
physiological stress response after short- and long-term exposures to different environmental
settings [16,31,32].
Few real-world experimental field studies have been conducted examining the relationship between
stress and
urban natural and built environmental settings. Of those that have, the vast majority utilize
an initiating stressor to elevate baseline stress and facilitate measurement of stress
de novo
stress status. The purpose of this study was two-fold: (1) To test a method for collecting
information from participants about the effects of environments on stress using a 4-arm cross-over
design, and (2) To detect the differences that natural and built urban settings have on physiological and
psychological measures of unprovoked,
de novo
stress. In addition, factors such as pre-existing stress,
perceived restorativeness of a setting, and gender have been suggested as influential determinants of
stress response to environments, and were therefore included in this pilot study.
2. Methods
2.1. Participants
Participants were recruited from the local community via printed and internet-based methods.
Anyone with a current or recent history of endocrine, neuro/psychiatric, salivary gland or acute/chronic
pain disorder, or that was using certain disqualifying medications, was excluded from participating.
To be eligible for enrollment, interested participants also agreed to do the following prior to each study
visit: Refrain from using alcohol, tobacco and recreational drugs for at least 24 h; get a good nights
sleep; avoid strenuous activity or caffeine for 12 h; and not consume any food or liquid (except water)
for one hour. Participants were given a $30 USD gift-card to a local hypermarket chain for each study
visit attended, and an additional $30 gift-card if all four visits were attended (Total = $150 USD).
A total of fifteen people (eight male, seven female) were enrolled and participated in the study.
All participants completed all four study visits except for one male participant who missed one visit
due to a scheduling error. Participants reported an average age of 42.3 years (range 20±61 years) and
homogenous ³Non-Hispanic White´ racial/ethnic background. Education and income levels of the
group reflected regional mean and distribution values, with a median annual income of $30,000 USD.
This study was approved by the Institutional Review Board of the National College of Natural
Medicine, Portland, OR USA (IRB#061912A).
2.2. Experi
ental Design
Interested participants contacted study personnel and were briefly screened for eligibility. Eligible
participants reported to the study lab to sign consent forms and complete questionnaires about their
health status and self-identity regarding the environment. They were asked to return for all scheduled
study visits, which occurred on four separate non-consecutive weekday mornings in August 2012.
The study used a four-arm cross-over design with identical visits as follows (see Figure 1): participants
arrived at the study lab by 9 a.m. and were asked to turn off their cell phones and not use any
electronic media or converse with other participants for the remainder of the visit. They were then
asked to complete a brief health check-in form, a measure of stress experienced in the last week, and a
Int. J. Environ. Res. Public Health
subjective measure of current stress level (Time1). Participants were then transported in groups of
three or four via passenger van to the environmental settings. Setting visitation order was individually
randomized so that no participants visited the four settings in the same order. Upon arrival at the
setting, participants provided a pre-exposure saliva sample and repeated the subjective stress scale
(Time2). They were then instructed to sit comfortably and observe their surroundings without
engaging in any activity for 20 min. After 20 min, post-exposure salivary and subjective stress data
were collected (Time3). Individual on-site subjective rating scales and a focus-group debriefing back
Figur e 1. Flow diagram for each visit (×4). (PSS²Perceived Stress Scale, Stress²
Subjective Stress Scale, PRS²Perceived Restorativeness Scale).
Environmental Settings
All settings were located within 15km of the study lab, and selected on the basis of: (1) proximity to
the study lab, (2) availability during the dates of the study visits, (3) presence of overhead covering to
minimize sun & rain exposure, and (4) sufficient level of safety, as perceived by the study authors.
following the method used by Matsuoka [35] as follows:
Int. J. Environ. Res. Public Health
9 Very Natural: Trees, shrubs, and other natural elements with minimal evidence of human
influence. Study setting was a 187-acre forested urban nature reserve
9 Mostly Natural: Presence of significant amounts of vegetation and some human influence such
as walkways and buildings. Study setting was a 8.76-acre tree-lined urban park
9 Mostly Built: Majority of viewable landscape is due to human influence, with some natural
elements such as trees. Study setting was a 0.92-acre urban plaza
9 Very Built: Entirety of viewable landscape is due to human influence, with minimal presence of
natural elements. Study settings was a 3.46-acre outdoor shopping mall
Figur e 2. Photos depicting each of the four environmental settings experienced by
participants. (a) Very Natural; (b) Mostly Natural; (c) Mostly Built; (d) Very Built.
Setting category labels were not shared with study participants at any time. Transportation to and
from each setting occurred via identical rented minivans and took no longer than 15 min one-way.
All settings were within 50 m of the roadway, thus minimizing the amount of walking required from
setting parking areas. Visitation to the settings occurred between 9:30 and 10:30 a.m. on weekday
mornings in order to minimize the presence of foot traffic and possible disruption.
Int. J. Environ. Res. Public Health
2.3. Measures
2.3.1. Outcome Measures
aliva (sCort and sAA)
Collection of saliva occurred before and after 20 min of environmental exposure at Time2 and
Time3 respectively. All saliva samples were collected using Saliva Oral Swabs® from Salimetrics,
LLC (State College, PA, USA). Participants placed inert polymer oral collection swabs under their
tongue for 2 min of passive retention before storing them in a provided swab storage tube. At the end
of each study visit, samples were centrifuged for 10 min at 1,500 g, separated, and stored at í80 °C
until assay. Salivary cortisol samples were analyzed in duplicate by ZRT labs (Beaverton, OR, USA)
using standard ELISA. Salivary alpha-amylase was analyzed by Salimetrics LLC using a Tecan Sunrise
plate reader to assess kinetic activity of 1:200 dilution at 37 °C with readings at 1 and 3 min.
ubjec tive
cale (
A one-item, 0±10 rating scale was used to collect participants' perceived levels of stress, in a
manner similar to that used by Nater
et al
. [36]. This instrument was administered at three times during
each study visit: (1) upon initial check-in (Time1); (2) upon arrival to the environmental settings at
(Time2), and (3) after 20 min of the exposure to each setting (Time3).
2.3.2. Exploratory Co-Variates (Pre-Exposure)
ental Identity (EID)
The EID scale is a validated, 28-item questionnaire that measures self-identification with the natural
environment and natural causes [37]. Previous research has demonstrated that EID is related to
affective connection to an environment and environmental behaviors [38], but tR WKH DXWKRUV¶
knowledge no studies have been conducted establishing a relationship between EID score and health
status or stress response to environmental settings.
Perce ived
cale (P
The PSS is a validated 10-item self-report questionnaire that measures an individuals response to
stressful events that have occurred during a given period of time [39], in this case during the seven
days prior to each study visit. To determine if pre-existing stress influenced study outcome measures,
the PSS was completed during visit check-in at Time1.
2.3.3. Exploratory Co-Variates (Post-Exposure)
Perce ived Restorativeness
cale (PR
The PRS is a validated 16-item scale that asks participants to rate their agreement with
opinion-based statements related to environmental features [40]. It was originally developed as an
Int. J. Environ. Res. Public Health
instrument to test the validity of .DSODQ¶V neuro-cognitive model of biophilia known as Attention
Restoration Theory (ART) [41], but has been used to adequately measure psychophysiological stress
demonstrate the relationship between subjective environmental assessment and psychophysiological
changes [42,43]. To account for participants subjective assessment of environmental settings, the PRS
was completed at the conclusion of each period of exposure at Time3.
tatistical Analysis
For each of the primary and secondary outcome measures, the following plan was followed: First,
the effect of Visit Order on the outcome was tested to exclude it as a significant factor. Second, it was
noticed that there was significant regression to the mean for almost all outcomes, so baseline values
were included as covariates in all main analyses. Third, between-setting outcomes were compared
using baseline values as a covariate. Where possible, mixed-model ANCOVAs were used with Setting
as a within-subjects factor. Both sCort and sAA measurements were log-transformed. For some
self-report outcomes, responses were distributed in a way that required non-parametric analysis, via
)ULHGPDQ¶VWHVW$VDIROORZ-up to the main analysis, tests were repeated with gender included in the
model to determine whether there were differences in outcomes between gender or interactions
between setting and gender effects. Correlations computed for some covariates and outcome measures
use all data points, including multiple measurements of individual subjects, and should therefore be
considered only as descriptive measures. This is likewise true of the regression of ǻStress on PRS
shown in Section 3.3.3.
3. R esults
Initial repeated-measures analyses for all outcome measures revealed no effect of either study visit
order (
, Visit 1±4) or interaction between visit order and environmental setting. As a result, study
visit order was excluded from subsequent analyses. Comparison of primary outcome measures
revealed no significant correlations between sCort and sAA stress biomarkers or between these
physiological measures of stress and the main psychometric stress measure (all R2 < 0.04).
The presence of gender effects in similar studies [44±46] led to the decision that all outcome measure
data would be analyzed by gender, subsequent to the main analyses for each measure.
alivary Measures
3.1.1. Cortisol (sCort)
All sCort data were subjected to a natural log transformation prior to analyses in order to normalize
outcome distributions. Analyses of logCort by setting demonstrated a mean Time3 decrease in logCort
relatLYH WR 7LPH EDVHOLQH ǻORJ&RUW) in all four settings, consistent with normal circadian rhythm
, logCort
reductions were largest after exposure to the Very Natural and Mostly Natural settings, and were larger
for the Mostly Built setting than the Very Built setting. However, while these results are consistent
with the PES model, ANOVA was not able to detect sWDWLVWLFDOO\ VLJQLILFDQFH ǻORJ&RUW GLIIHUHQFHV
Int. J. Environ. Res. Public Health
between settings (F3,38.4 = 0.675,
= 0.573). There were no gender differences detected for
measurements of sCort.
3.1.2. Amylase (sAA)
All sAA data was subjected to a natural log transformation prior to analysis in order to normalize
outcome distributions. Analysis of sAA by setting demonstrated a mean Time3 increase relative to
Time2 baseline in all four settings, though only the Very Built setting showed statistical significance
for the within-group change (
= 0.001; See Figure 3). The elevation in sAA indicates an activation of
the SAM pathway during exposure to the Very Built setting and suggests participants were highly
logTime3Amylase-logTime2Amylase) and logTime2Amylase (r = í0.369) was suggestive of a
regression to the mean and led to inclusion of logTime2Amylase as a covariate in subsequent analyses.
(F3, 38.3 = 1.69,
= 0.186). However, post hoc t-tests did show unadjusted significance in comparison
of the Mostly Built and Very Built settings (ݔҧ = 6.31
45.05 U/mL, respectively;
= 0.033),
suggesting some difference in activation of the SAM pathway between these two built urban settings.
Participant reporting during the debriefing revealed strong dislike and feelings of unease in the Very
Built setting, which likely contributed to the elevation of sAA.
Figure 3. &KDQJHVLQVDOLYDU\DP\ODVH¨Amylase) after 20 min exposure to environmental settings.
Inclusion of gender in the analysis revealed that females had a mean increase in logAmylase across
all four settings, while males had an overall mean decrease in logAmylase. However, ANCOVA
analysis did not reveal statistical significance for the effects of either Gender (F1,11.8 = 3.13,
= 0.103)
or the interaction between gender and setting (F3,36.0 = 0.391,
= 0.76).
ubjec tive
tress Measure
Analysis of subjective stress by setting demonstrated no between-settings difference for Time2
relative to Time1 baseline, ruling out any concern that the drive to each setting would influence
subjective stress response. Conversely, setting differences were detected for stress measured at Time3
Int. J. Environ. Res. Public Health
(Figure 4); only the Very Natural setting showed a statistically significant within-group change
= 0.01 Wilcoxon signed rank).
Figur e 4. &KDQJHVLQVXEMHFWLYHVWUHVV¨Stress) after 20 min exposure to environmental settings.
Comparison between settings via non-SDUDPHWULF )ULHGPDQ¶s test failed to reveal a statistically
significant difference in the change in self-reported Stress (
= 0.140). Large negative correlations
EHWZHHQǻ6WUHVVDQG7LPH6WUHVVUs = í0.346) suggested possible regression to the mean. Inclusions
of Time2 stress as a covariate was therefore used in subsequent analyses; this inclusion also yielded
residual distributions suitable for parametric analysis. Parametric repeated-measures ANCOVA
analysis revealed a near-statistically significant Setting main effect (F3,40.84 = 2.670,
= 0.060),
after adjustment for baseline values.
Post hoc
differences between the Very Natural and Mostly Built settings (ݔҧ = í1.00
+0.07, respectively;
= 0.008), suggesting that while these two settings did have different effects on stress status, these
may have been obscured by the four-way design of this study. It is interesting to note that comments
made during debriefing were mixed for the Mostly Built setting, with many participants enjoying the
physical setting but disliking the noise and activity of some non-study personnel. Over-all these
comments were more positive than the negative comments about the Very Built setting in which there was
Subsequent inclusion of Gender as a factor revealed no main effect of Gender on subjective stress;
however, a near-significant Setting × Gender interaction was reported (F3,37.7 = 2.764,
= 0.055). This
is primarily the result of responses to the Mostly Built setting, to which only females had a positive
ǻ6WUHVVresponse (See Table 1). With gender included in the model, post hoc pair-wise comparisons
= 0.003) and Very Built (
= 0.039) settings.
Int. J. Environ. Res. Public Health
Mean ǻ6WUHVV
95% Con fidenc e Interval
Lower Bound
Upper Boun d
Very natural
Mostly Natural
Mostly Built
Very Built
3.3. Co-Variate Measures
3.3.1. Environmental Identity Scale (EID)
Mean EID score for participants was 118.5 (SD = 10.1), in a possible range of 24±196 points; these
results are similar to other population means [37]. Correlations were detected between EID and both
ǻORJ&RUW U 
=  DQG ǻORJ$P\ODVH U 
= 0.033), indicating a potential
relationship between environmental identity and physiologic response. However, inclusion of EID in
ANCOVA analysis did not significantly influence the effect of Setting on these salivary measures
(F3,37.9 = 0.672,
= 0.575 & F3,37.1 = 1.672,
= 0.190, respectively). No correlation was detected
subjective experience during the study. Inclusion of EID as a covariate RIǻ6WUHVVGLGQRWVLJQLILFDQWO\
influence the effect of Setting on subjective stress.
3.3.2. Perceived Stress Scale (PSS)
No PSS differences were detected either by setting or visit date, indicating that all groups had
statistically equivalent stress levels prior to study arrival. The mean PSS score across all four study
visits was 11.94 (SD = 4.96) out of a possible 40 points. This is less than the 2009 US National PSS
mean of 15.84 [47], suggesting participants had lower levels of pre-existing stress at the beginning of
each visit than the population average. Regarding relationship with outcome measures, PSS score was
not associated with either sCort or sAA biomarker outcomes. A large correlation was detected between
PSS and both Time1 (r = 0.663) and Time2 (r = 0.439) subjective stress, suggesting participants¶OHYHO
of experienced stress in the previous week was related to their level of current stress during the study.
was not a factor in determining changes in stress level during the experiment. Inclusion of PSS as a
= 0.053).
Int. J. Environ. Res. Public Health
3.3.3. Perceived Restorativeness Scale (PRS)
Highly significant setting PRS differences were found (F3,40.97 = 12.526,
< 0.001) with
pair-wise comparisons demonstrating that the Very Natural setting was perceived as more restorative
than the other three settings (all
< 0.001; See Figure 5). Perceived restorativeness was not associated
with either sCort or sAA biomarker outcomes, but a significant correlation was detected between PRS
a relatiRQVKLS ZLWK VORSH Į í0.422 (R2 = 0.219) demonstrating a small but reliable effect on
subjective stress (See Figure 6). ,QFOXVLRQ RI 356 DV D FRYDULDWH LQ WKH SULRU DQDO\VLV RI ǻ6WUHVV E\
environmental setting showed a highly significant (
< 0.001) effecWRI356RQǻ6WUHVVEXWresulted in
a highly non-significant Setting effect (F3,41.77 = 0.140,
= 0.936), suggesting that PRS may be a
primary mediator of settings effect on subjective stress.
Figur e 5. 3DUWLFLSDQW¶VUDWLQJVRIWKH3HUFHLYHGRestorativeness of Environmental Settings.
Figur e 6. Simple linear regression between Perceived Restorativeness (PRS) score and
Int. J. Environ. Res. Public Health
4. D iscussion
Trends suggest that differences in environmental settings did influence SDUWLFLSDQWV¶ OHYHOV RI
measureable stress. Salivary alpha-amylase elevation after exposure to the Very Built setting,
independent of any significant change in subjective stress, identifies a physiological response that is
separate from a conscious psychological component. Reductions in subjective stress after exposure to
the Very Natural setting relative to the Mostly Built settings are consistent with the stress-moderating
implications of PES suggested by Ulrich [24].
Data from analysis of the outcome measures was unable to support the hypotheses that natural
urban settings produce more beneficial changes in measures of physiological and psychological stress
relative to built urban settings. This was not unexpected considering the small sample size and low
statistical power of the study.
The low level of baseline stress among participants at Time2 (ݔҧ = 2.39, SD = 1.71; Scale 0±10)
indicates a near-floor effect regarding baseline stress level. The likelihood of detecting measurable
changes in stress, particularly after exposure to a mild and passive activity, was minimal. Therefore,
the common use of an initiating, pre-exposure stressor may be warranted in future studies so that more
robust physiological and psychological stress changes can be measured.
However, the presence of a statistically significant subjective stress difference between the Very
Natural and Mostly Built settings in this pilot study, despite a near-floor effect and low statistical
power, does suggest a potential environmental contribution to the moderation of stress. This evidence
suggests that natural environments have stress-reducing capacity beyond the restorative, therapeutic
action that occurs after exposure to an acute stressor. Natural urban settings may therefore be useful for
helping to create the supportive, upstream health-promotive environments that are the foundation for a
more sustainable urban living experience [11,48]. Further studies will be needed to determine the
VWUHQJWK DQG RU ³GRVH´ RI VXFK DQ H[SRVXUH WKH GXUDWLon of such effects, the effect of single
repeated exposures, and the repercussions on physical and mental health status and disease conditions.
The gender differences in outcome measures support previous evidence suggesting women and men
respond to environmental settings differently [44±46]. A greater decrease in subjective stress for
women after Very Natural setting exposure, but greater increase after Mostly Built exposure (when
men had a decrease) suggests that women may be more influenced by environmental conditions than
men, in either direction of the stress scale. Comments made by female and male participants during
debriefing did not demonstrate any gender differences in setting experiences, suggesting a
subconscious component may be involved. Future studies in this area may want to continue including
gender as a variable for analysis.
Mean EID score consistent with other sample means indicates participants were representative of
other populations regarding environmental self-identity. Correlation of EID with salivary outcome
measures suggests that individuals with greater personal environmental identification may be more
physiologically sensitive to their surroundings. However, this sensitivity may be generalized to all
environments and not specific to the setting content as evidenced by negligible changes in ANCOVA
models. Lack of correlation between EID and subjective stress markers suggests that physiologic
sensitivity may occur due to sensori-perceptual level processing independent of conscious awareness.
Further exploration of these mechanisms is warranted. Future studies investigating how environmental
Int. J. Environ. Res. Public Health
setting differences influence healtK RXWFRPHV PD\ ZDQW WR LQFOXGH DQ LQGLYLGXDO¶V HQYLURQPHQWDO
self-identity in their analyses.
The mean PSS score below national average indicates a relatively relaxed sample population,
though this may reflect local or regional norms (data not available). Populations with different levels
of perceived baseline stress may experience different responses to setting exposures. Therefore,
the generalizability of study results is limited.
TKHPRGHUDWHO\VWURQJFRUUHODWLRQEHWZHHQ356DQGǻ6WUHVV suggests it is likely that restorativeness
categorization along a natural/built continuum [49]. As such, perceived restorativeness can differ for
two settings of comparable naturalness [50,51]. For these reasons, future studies hoping to measure
outcome differences between exposures to natural and built settings may want to include PRS or other
subjective environmental setting measures in covariate analyses.
It is unsurprising that there was little overlap between the salivary measures sCort and sAA. A lag
of up to 18 min have been reported between the immediate-timed response of sAA and the delay-timed
response of sCort after exposure to an acute stressor [52]. The limited number of salivary data
collection points in this study does not allow for a full temporal correlation comparison between
measures. In addition, the collection of Time3 saliva after only 20 min of setting exposure may not
have been sufficient to capture the full cortisol response, given a potential 18 min delay. Lack of
congruent findings between the physiological and psychological measures reflects stress response
complexity, and demonstrates how a holistic approach to environmental stress research is necessary.
As mentioned, this pilot study was limited in its statistical power by a small sample size due to
budgetary and logistical constraints. Future studies seeking to explore this area of research should
consider including more participants. In addition, the recruitment of participants from the local
geographic area of a mid-sized city in the Pacific Northwest of the United States limits the
generalizability of this study.
Conducting an experimental field study introduces the potential for exposure to non-extraneous
variables, preventing attribution of study findings to the dependant variable and making it impossible
to empirically assess the validity of PES. These variables fluctuate within and between settings, as well
as within and between setting visits. This variability includes both a normal range (e.g., background
traffic noise of ~60 dB at the Mostly Built setting) and unforeseen outlier events (e.g., infrastructure
construction noise of ~80 dB at the Very Natural setting). 3DUWLFLSDQWV¶ FRPPHQWV PDGH GXULQJ
debriefing shows these extraneous variables influenced conscious experience of setting exposures and
directly influenced subjective stress measures. It is likely that salivary measures were also influenced
by these variables [53]. A list of variables mentioned by participants includes: noise, presence of
non-study personnel, past memories of setting visits, physical discomfort, air temperature, and odors.
Future field studies seeking to validate environmentally-moderated stress measures should control for
these factors by capturing relevant data to incorporate into data analysis models. Attempts at such
exploratory data capture methods were made with the current study for the acoustic environment,
Int. J. Environ. Res. Public Health
but logistical issues prevented inclusion of useable data. Audio monitoring of setting decibel levels
was attempted, but the equipment used was only capable of recording isolated data at prescribed
time-points (
, at Time2 and Time3). This proved to be insufficient for representing the actual
experience of participants in settings with greatly fluctuating soundscapes.
The collection of only two salivary data points provides minimal data for analysis. Collection of
multiple salivary data points before and after exposure would permit incorporation of highly variable
individualized daily cortisol patterns known [54,55] into data analysis while also extending the
post-exposure window of extended or delayed cortisol effects, as mentioned above.
The PRS was validated XVLQJ .DSODQ¶V $57 PRGHO and the relationship between this type of
restoration and stress has not been firmly established in the research literature. A more appropriate
instrument might include assessments of the attractiveness and/or aesthetics of an environment, which
are constructs XVHG LQ8OULFK¶V 3(6 PRGHOSuch instruments have been used by Dijkstra
et al
., [56]
and Karmanov and Hamel [49]. Use of the latter instrument may be particularly appropriate, as it
includes a bipolar scale for rating WKH ³QDWXUDOQHVV´ RI D VHWWLQJ The individualized data of
SDUWLFLSDQWV¶VXEMHFWLYHUDWLQJfrom this instrument would be more informative than the categorizations
assigned by study personnel, and could be incorporated into co-variate analyses. It should be noted
that, to the authors knowledge, neither of these instruments have been validated.
5. Conclusions
The purpose of this pilot study was to test a within-subjects methodology for measuring urban
environments contribute to the accumulation of stress and how this information can be used to
positively affect health status in individuals and populations.
Though this study was not able to validate the hypothesis that natural urban environments have a
greater ability to positively affect unprovoked
de novo
levels of stress than built urban environments,
the presence of multiple extraneous variables cannot rule-out the possibility that such an effect occur.
Future studies looking to utilize an experimental field study design should control for these variables
(e.g., noise, past exposures, non-study personnel,
.). Consideration of environmental self-identity,
perceived restorativeness and pre-existing levels of stress should be included as co-variates, and data
should be analyzed by gender. Further studies are needed to determine what the effects on chronic or
repeat exposures to environments might be, and if measuring the effect of these repeat exposure visits
supports the epidemiological evidence.
This project was sponsored by NIH NCCAM Award 2R25AT002878-05A1. Thanks to the Helfgott
Research Institute of the National College of Natural Medicine, including Heather Zwickey, Mayen
Dada, Amy Goldfeder, Eric Jorgenson, Corey McAuliffe, Lindsay Rogers and Bethany Tennant.
Thanks also to Portland Parks and Recreation Department for use of Hoyt Arboretum-Stevens Pavilion
Picnic Shelter, and to ZRT Laboratory for providing cortisol analysis of saliva samples.
Int. J. Environ. Res. Public Health
Conflict of I nterest
The authors declare no conflict of interest.
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... Nature contact can include any human interaction with biophysical aspects of the natural environment including plants, animals and geological features (Hartig et al., 2014). Contact with nature, whether directly (through intentional time spent in nature) or indirectly (e.g. via indoor plants), has been associated with lower physiological and psychological stress (Beil & Hanes, 2013;Van Den Berg & Custers, 2011); less depression (Astell-Burt et al., 2014;Dallimer et al., 2012;Lachowycz & Jones, 2013;White et al., 2019); less anxiety (Maas et al., 2009); better perceived overall health (Maas et al., 2006) and well-being . Spending time in nature also reduces rumination Bratman, Hamilton, et al., 2015). ...
... This study adds to the body of literature that different types of nature engagement may be differentially associated with well-being. Specifically, it underscores the relevance of nearby nature for human well-being during times of challenge, adding to the body of research on nature as a source of stress reduction (Beil & Hanes, 2013;Ulrich et al., 1991;Van Den Berg & Custers, 2011) and on its restorative or micro-restorative benefits (Darcy et al., 2022;Soga et al., 2021;Wells, 2021). The health benefits of even small doses of nature such as birdwatching, gardening, day hiking or even watching nature out the window may positively contribute to wellbeing and should be promoted by nature-based organizations. ...
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Numerous studies have shown the positive association between nature engagement and well‐being. During the early phases of the SARS‐CoV‐2 pandemic, nature engagement changed dramatically as mental health and well‐being declined across the globe. This study examines how psychological connection to nature and engagement with nature in various forms is associated with well‐being during the SARS‐CoV‐2 pandemic. Specifically, we examine which types of nature engagement (i.e. with nearby nature, through nature excursions and media‐based) are more strongly associated with well‐being based on measures of loneliness, rumination, pandemic emotional impact and mental health. We employed a cross‐sectional online survey of adults (N = 3282) residing in the United States, 25% of whom report seldom spending time in nature. Our findings revealed that the psychological construct of connection to nature was associated with less loneliness and greater mental health. Overall, nature engagement was a consistent predictor of well‐being, but different types of activities predicted varying outcomes on our four dependent variables. Greater engagement with nearby nature during the pandemic was associated with less rumination, less pandemic emotional impact and better mental health while nature excursions (e.g. camping, backpacking) and media‐based nature engagement were associated with greater loneliness, more emotional impact from the pandemic and worse mental health. In addition, nature engagement via media was associated with greater rumination. Our findings suggest that promoting opportunities to increase engagement with and access to nearby nature is associated with better human well‐being, especially during challenging events, and should be part of a multi‐pronged approach for coping with the next public health crisis. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog.
... Many studies compared natural environments in urban contexts, such as blue spaces, green spaces, and forests. Although most studies found no differences across natural environments [21,[39][40][41], several reported mixed results. Some studies found that open grass space gave the best recovery effect. ...
... However, major theories about the impacts of exposure to nature on humans make no distinction between men and women [16,37]. Moreover, previous studies did not report gender differences in responses to nature [39,40,103,104]. There appears to be no reason to believe that there are gender differences regarding the benefits of nature. ...
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Previous studies may have overstated the restorative benefits of natural environments by comparing them to low-quality urban environments. Few studies have compared the stress recovery effects across various park settings. Moreover, it is unclear how depressive symptoms affect these benefits. Depressive symptoms may lessen or boost the restorative effects of viewing nature. A total of 125 participants engaged in the Trier Social Stress Test (TSST) to induce stress and were then randomly assigned to view one of five 10 min video presentations depicting greened streets, lawns, plazas, forests, or watersides. Depressive symptoms experienced over the last month were measured using the Patient Health Questionnaire (PHQ-9). The analysis revealed that, while greened streets had a physio-psychological stress-relieving effect, they were not as effective as the four park settings. The skin conductance level (SCL) declined significantly in the forest group’s first and second halves of the recovery period. However, the difference between the four park settings was insignificant at the end of recovery. Subjects viewing the four park conditions (vs. the greened street) reported that perceived stress remained stable as individual depressive symptoms increased; subjects with higher depressive symptoms reported lower perceived stress under lawn conditions. However, the SCL did not show the same trend. Our findings may support the hypothesis that natural interventions may be especially beneficial for people suffering from subclinical depressive symptoms. We also found gender differences in perceived stress and SCL reduction across all five settings, which may be due to the differences in women’s and men’s perceptions and use of restorative environments, or their responses to stressors.
... One hypothesized way to restore attention is outlined by Attention Restoration Theory (ART) which states that attention can be restored by spending time in nature (Kaplan, 1995). Previous studies have shown that exposure to natural environments can reduce self-reported stress (Beil and Hanes, 2013;Roe et al., 2013;, increase positive affect (Beute and De Kort, 2014;Bratman et al., 2015;Lee et al., 2015), induce relaxation (Anderson et al., 2017) and increase cognitive performance across a range of processes such as creativity (Atchley et al., 2012), sustained attention (Hartig et al., 2003), and working memory (Tennessen and Cimprich, 1995;Kuo and Sullivan, 2001;Ottosson and Grahn, 2005;Berman et al., 2008Berman et al., , 2012. ...
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Introduction Research suggests that spending time in natural environments is associated with cognitive and affective benefits, while increased use of technology and time spent in urban environments are associated with depletion of cognitive resources and an increasing prevalence of mental illness. Attention Restoration Theory suggests that exposure to natural environments can restore depleted attentional resources and thereby improve cognitive functioning and mood. Specifically, recent meta-analyses have revealed that the most improved cognitive abilities after nature exposure include selective attention, working memory, and cognitive flexibility. Methods While existing studies examined these cognitive abilities, few have examined the Operation Span (OSPAN), a complex measure of working memory capacity. Therefore, the current study ( N = 100) compared performance on the OSPAN and self-reported mood using the Positive and Negative Affect Schedule before and after a 30-min walk in a natural or urban environment. Results Results from the study showed that both groups exhibited an increase in positive affect and a decrease in negative affect, suggesting that going outside for a walk can boost mood regardless of environment type. Inconsistent with past work, there were no significant changes in OSPAN scores before and after the walk for either environment type. Discussion Future studies should analyze how the length of time spent in the environment, certain characteristics of the environment, and individual differences in connectedness to nature may impact attention restoration to gain insight on nature’s ability to improve our affect and cognition.
... Previous studies have confirmed that the urban landscape's natural settings, such as green spaces and vegetation, positively affect health [22,23]. The major limitation of our study was the lack of some spatial or ecological variables, such as environmental greenness, in the analytical model. ...
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The impact of urbanization on cataract incidence is still inconclusive. This study aimed to examine the association of urbanization and sunlight exposure with cataract incidence using a nationwide population-based database in Taiwan. The researchers used data retrieved from the Taiwan Longitudinal Health Insurance Database from 2001 to 2010 (LHID2010). The LHID2010 consists of medical claims data for reimbursement for 1 million individuals randomly selected from all enrollees (N = 23.25 million) in the Taiwan National Health Insurance (NHI) program in 2010. For adults aged over 40, we identified a total of 3080 people diagnosed with senile cataracts (ICD-9:360) and 393,241 people without senile cataracts in the LHID2010. In addition, sunlight exposure data between 2001 and 2011 were obtained from 28 meteorological stations of the Taiwan Central Weather Bureau. Logistic regression was performed to test the hypothesis. When controlled for the confounding factors, such as demographic factors, comorbidities, and sunlight exposure, the logistic regression results showed that those living in highly urbanized areas are more likely to suffer from senile cataracts (p < 0.001).
... The main benefits that people gained from visiting rivers and riparian forests, as discussed in Section 4.1, were associated with improvements to as well as the maintenance of physical and mental health. Based on these presumptions, it can be assumed that some of the importance of riparian areas should include the most concerning topic-health-as riverine forests are clearly an area people visit in order to enhance their wellness by exercising, relaxing, and unwinding in nature [30,31]. ...
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Riparian forests are ecotones that differ from the surrounding landscapes, delineating the transition from terrestrial ecosystems into aquatic ones. Riparian forest management has been recognized as a possible method for promoting several ecological functions. In order to develop a sustainable and resilient relationship between river riparian forests and society, it is necessary to analyze the sociocultural dimension of riparian zones. The aim of this study was to assess the social perceptions of riparian forests. A total of 734 respondents (61% woman), inhabitants from the region of Latvia, where there is a rather dense network of streams, were surveyed. Respondents represented various education levels, ages, and economic backgrounds. Riverine forests tend to be a less popular option for recreation compared with other types of forests. The most popular activities were walking and swimming. “Forest and water bodies” was not among the main topics that respondents were concerned about. Regarding rivers and riparian forests, the obstructed movement of fish to spawning grounds was recognized as the most important problem, but the least concerning was the reduction of water tourism and fishing opportunities. Dynamic river basin and river bank management could be a possible solution to restoring eligible locations for recreational activities, at least along some parts of rivers, and for improving the state of riparian ecosystems simultaneously.
... On the other hand, urban forests did not score as well on other restorative dimensions, such as fascination and coherence. This fact contrasts with results in the literature, which consider urban forests as the type with the highest value of restorativeness [42,43]. Moreover, there is a body of evidence [44,45] suggesting that the presence of very dense vegetation may compromise restoration by evoking feelings of insecurity. ...
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In this study, we used a survey to examine how urban residents in Ljubljana, Slovenia, value and use distinct urban public spaces. Specifically, we were interested to assess if urban public spaces in the city are used/perceived as restorative environments. To do this, we addressed the question: To what extent do restorative dimensions differ in nine selected urban public spaces, varying in size, design, amenities, number of visitors, and, most importantly, degree of naturalness? Results from survey allowed to determine to what extent the selected urban public spaces in Ljubljana differ in terms of their perceived degree of restoration. We hypothesized that urban public spaces with a higher degree of naturalness in the city have a higher restoration value than urban public spaces with a lower degree of naturalness. Surprisingly, the urban public space that was above average on most restorative dimensions was the Old Town. These results are somewhat at odds with the attentional restoration theory, which states that the combination of dimensions is most typical of natural environments. However, this could be an indicator of the effectiveness of the city’s current policies to improve the quality of life for its citizens.
... This innate preference is proposed to result from natural landscapes historically aiding human survival by providing means of food, shelter, and safety (Alvarsson et al., 2010). Natural environments have been found to reduce the physiological stress response by activating the parasympathetic nervous system to reduce cortisol levels, blood pressure, skin conductance, and heart rate (Beil & Hanes, 2013). This physiological response appears to be unconscious and has a restorative effect causing stress to decrease and mood to improve (Ulrich et al., 1991). ...
A body of environmental psychology research has demonstrated that the inclusion of natural elements within the built environment, known as biophilic design, can result in improvements in cognition and affect. The current study used two experimental within-subjects studies and virtual reality to examine the impact of window views of nature on affect and cognitive functioning. The first experiment compared the effect of office environments, with either no window or a window view of nature (i.e., trees, blue sky), on performance in commonly used cognitive tasks measuring tonic alertness (i.e. sustained attention), cognitive flexibility, and creativity. The second experiment extended the range of measures, assessing effects of the window with nature-views on phasic alertness, executive attention (i.e. working memory), and self-reported affect. The second study further introduced an additional condition that contained a window with shutters, which allowed for daylight infiltration, while blocking the view of nature. Paired samples t-test analysis revealed that the nature-view condition had a significant positive effect on creative fluency (i.e. quantity of output) but not on the quality of creative responses. Moreover, a Multivariate Analysis of Variance indicated that nature-views significantly enhanced positive affect and reduced negative affect. In contrast, no significant effect of the environment was observed for tonic and phasic alertness, and executive attention (i.e. working memory). These results indicate that affect, and specific cognitive processes, are restored by incorporating biophilic elements into architectural design.
... Many studies have been conducted to compare various natural environments in urban contexts, such as blue space, green space, and urban forests. Although several studies found no differences in perceived restoration [24], stress-relief [25][26][27], or emotional improvement [26] across different natural environments, other studies found mixed results. Three studies showed that open grass areas have the best restorative benefits. ...
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Previous research that compared the restorative effects of natural settings with poor-quality urban settings may have exaggerated the restorative benefits of greenspace. Few studies have been conducted to examine the restorative benefits of green streets and other types of park landscapes on attention and emotion. In addition, it is not clear how negative psychological symptoms (e.g., stress, depression) affect natural’s restorative benefits, especially as the current COVID-19 pandemic has added to people’s psychological burden. In this study, 125 participants were randomly assigned to view one of five videos (green street, lawn, plaza, forest, waterside) for a break after completing an emotion and attention fatigue induction task. Attention function and emotion were measured using the backward digit span test and the Self-Assessment Manikin scale. Stress and depressive symptoms experienced over the last month were measured using the Perceived Stress Scale(PSS-10) and the Patient Health Questionnaire(PHQ-9). Our results indicate that the four park settings showed significant attention function recovery and valence improvement compared to the green streets, while subjects’ arousal changed only over time. Hardscapes (plazas) could provide the same attentional and emotional restorative benefits as natural landscapes (forests, watersides, lawns). In addition, we also found that the mood-improving benefits of natural environments may decrease with increasing depressive symptoms, although chronic stress symptoms did not show the same trend.
Background: Numerous studies in developed countries have demonstrated that greenspace(GS) exposure is associated with improvements in the health of individuals with hypertension and diabetes. Currently, limited research examined associations between multiple GS exposures and chronic health conditions in developing countries. Methods: Geospatial data and spatial analysis were employed to objectively measure the total vegetative cover of the community (mean value of normalised difference vegetation index [NDVI] within specific buffer zone) and proximity to park-based GS (network distance from home to the entrance of park-based GS). Street view imagery and machine learning techniques were used to measure the subjective perceptions of the street GS quality. A multiple linear regression model was then applied to examine the associations between multiple GS exposures and the prevalence of hypertension and diabetes in the neighbourhoods located in Qingdao, China. Results: The model explains 29.8% and 28.2% of the prevalence of hypertension and diabetes, respectively. The results suggested that: 1) the total vegetative cover of the neighbourhood was inversely correlated with the prevalence of hypertension (β = -0.272, p = 0.013, 95% confidence interval (CI): [-1.332, -0.162]) and diabetes (β = -0.230, p = 0.037, 95% CI: [-0.720, -0.008]). 2) The street GS quality was negatively correlated with the prevalence of hypertension (β = -0.303, p = 0.007, 95% CI: [-2.981, -0.491]) and diabetes (β = -0.309, p = 0.006, 95% CI: [-1.839, -0.314]). 3) Proximity to park-based GS and the prevalence of hypertension and diabetes mellitus were not significantly correlated. Conclusions: This study used subjective and objective methods to comprehensively assess the greenspace exposure from overhead to eye level, from quantity, proximity to quality. The results demonstrated the beneficial relationships between street GS quality, total vegetative cover, and chronic health in a rapidly urbanising Chinese city. It further addressed that the street GS quality was more pronounced in potentially mitigating chronic health problems, and improving the quality of street GS might be an efficient and effective intervention pathway in chronic health issues in cities with high population densities.
One of the primary goals of smart cities is to improve the mental wellbeing of their inhabitants through the design of the surrounding environment. In this regard, urban spaces, as surrounding contexts embodying daily human activities, play a major role through their imposed personality perception. Unfortunately, one of the main adverse psychological effects of urban spaces design is the perceived psychological stress. Nonetheless, associations between urban design and human psychological health remain relatively unexplored. Accordingly, this study investigates the relationship between urban space personality and users’ stress perception, through adopting a theoretical method reviewing related theories and studies, correlating urban space’ stress-inducing attributes and stress components, and a practical method employing a study-developed questionnaire targeting the users of six urban spaces within the Faculty of Engineering, Ain Shams University. The investigation revealed contributions of each personality attribute in stress perception, with accounting the social component as the key role factor.
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Objectives Cultivating healthy workplaces is a critical aspect of comprehensive worksite health promotion. The influence of healthy workplace exposures on employee health outcomes warrants research attention. To date, it is unknown if nature contact in the workplace is related to employee stress and health. This study was designed to examine the effects of nature contact experienced at work on employee stress and health. Methods Office staff at a southeastern university ( n=503, 30% response rate) participated in the cross-sectional study. We used a 16-item workplace environment questionnaire, the Nature Contact Questionnaire, to comprehensively measure, for the first time, nature contact at work. The Perceived Stress Questionnaire and 13 established health and behavioral items assessed the dependent variables, general perceived stress, stress-related health behaviors, and stress-related health outcomes. Results There was a significant, negative association between nature contact and stress and nature contact and general health complaints. The results indicate that as workday nature contact increased, perceived stress and generalized health complaints decreased. Conclusions The findings suggest that nature contact is a healthy workplace exposure. Increasing nature contact at work may offer a simple population-based approach to enhance workplace health promotion efforts. Future researchers should test the efficacy of nature-contact workplace stress interventions.
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Green space has been associated with a wide range of health benefits, including stress reduction, but much pertinent evidence has relied on self-reported health indicators or experiments in artificially controlled environmental conditions. Little research has been reported using ecologically valid objective measures with participants in their everyday, residential settings. This paper describes the results of an exploratory study (n = 25) to establish whether salivary cortisol can act as a biomarker for variation in stress levels which may be associated with varying levels of exposure to green spaces, and whether recruitment and adherence to the required, unsupervised, salivary cortisol sampling protocol within the domestic setting could be achieved in a highly deprived urban population. Self-reported measures of stress and general wellbeing were also captured, allowing exploration of relationships between cortisol, wellbeing and exposure to green space close to home. Results indicate significant relationships between self-reported stress (P < 0.01), diurnal patterns of cortisol secretion (P < 0.05), and quantity of green space in the living environment. Regression analysis indicates percentage of green space in the living environment is a significant (P < 0.05) and independent predictor of the circadian cortisol cycle, in addition to self-reported physical activity (P < 0.02). Results also show that compliance with the study protocol was good. We conclude that salivary cortisol measurement offers considerable potential for exploring relationships between wellbeing and green space and discuss how this ecologically valid methodology can be developed to confirm and extend findings in deprived city areas to illuminate why provision of green space close to home might enhance health.
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Subjects viewed sixty color slides of either (1) nature with water, (2) nature dominated by vegetation, or (3) urban environments without water or vegetation. The information rates of the three slide samples were equivalent. Measurements were taken of the effects of the slide presentations on alpha amplitude, heart rate, and emotional states. Results revealed several significant differences as a function of environment, which together indicate that the two categories of nature views had more positive influences on psychophysiological states than the urban scenes. Alpha was significantly higher during the vegetation as opposed to urban slides; similarly, alpha was higher on the average when subjects viewed water rather than urban content. There was also a consistent pattern for nature, especially water, to have more positive influences on emotional states. A salient finding was that water, and to a lesser extent vegetation views, held attention and interest more effectively than the urban scenes. Implications of the findings for theory development in environmental aesthetics are discussed.
Psychological stress was assessed in 3 national surveys administered in 1983, 2006, and 2009. In all 3 surveys, stress was higher among women than men; and increased with decreasing age, education, and income. Unemployed persons reported high levels of stress, while the retired reported low levels. All associations were independent of one another and of race/ethnicity. Although minorities generally reported more stress than Whites, these differences lost significance when adjusted for the other demographics. Stress increased little in response to the 2008–2009 economic downturn, except among middle-aged, college-educated White men with full-time employment. These data suggest greater stress-related health risks among women, younger adults, those of lower socioeconomic status, and men potentially subject to substantial losses of income and wealth.
We studied the restorative potential of fragmented urban forests in Helsinki, Finland. Our aim was to explore how perceived restorativeness (PR) in urban forests changes when exposed to different levels of urbanity observed through the forest vegetation from the viewpoint of the forest interior. The level of PR was measured in forests that bordered either housing or a road. Three sampling points were selected within each forest, which included (1) an open view (at the edge), (2) a semi-closed view (at the edge zone), and (3) a closed view (in the forest interior) to the urban matrix. We hypothesized that the less urban matrix is observed through the forest vegetation from within the forest, the higher PR would be, and that PR is higher in forests bordering housing than in forests bordering roads. Results supported our hypotheses, as PR was higher inside forests with a closed view to the urban matrix compared to semi-closed and open views. PR was also higher in forests bordering housing than forests bordering a road, albeit not statistically significantly so. We conclude that in order to enhance the restorative potential of an urban forest, planners and managers should preserve sufficiently large forest patches with forest interior habitats, or promote the growth of dense and multilayered vegetation to restrict visibility to the urban matrix.
Natural environments have been found more restorative than built environments but studies have also highlighted mixed built and natural environments. The aims were to examine the perceived restorativeness of gardens, and evaluate the performance of the Perceived Restorativeness Scale, PRS, when applied to two examples from the same mixed built natural scene type rather than to a contrast between built and natural. The results show that the gardens are perceived restorative and the PRS also discriminated between the two gardens. This points to the PRS being a useful tool and emphasizes the shortcomings of broad scene type definitions. The results show that one scene type can include environments that are significantly different in perceived restorativeness. This underlines the need to collect data on a greater number of different scene types and examples within each type, as well as to have more controlled definitions of content and scene types to understand the relationship between the physical expression of a place and its potential of being restorative. The results show that the PRS is sensitive to place characteristics at subscale level, showing a high Being Away score for both gardens and a Scope score that differed substantially. The results show a high correlation between restorativeness and preference.
Research and teaching in environmental health have centered on the hazardous effects of various environmental exposures, such as toxic chemicals, radiation, and biological and physical agents. However, some kinds of environmental exposures may have positive health effects. According to E.O. Wilson’s “biophilia” hypothesis, humans are innately attracted to other living organisms. Later authors have expanded this concept to suggest that humans have an innate bond with nature more generally. This implies that certain kinds of contact with the natural world may benefit health. Evidence supporting this hypothesis is presented from four aspects of the natural world: animals, plants, landscapes, and wilderness. Finally, the implications of this hypothesis for a broader agenda for environmental health, encompassing not only toxic outcomes but also salutary ones, are discussed. This agenda implies research on a range of potentially healthful environmental exposures, collaboration among professionals in a range of disciplines from public health to landscape architecture to city planning, and interventions based on research outcomes.
It is argued that urban—rural health differences, which are found in many studies, may be at least partially associated with the availability of green space. Until recently there was only limited evidence from experimental research for this relationship, but recent large-scale epidemiological work found new evidence for the association between urban—rural health differences and availability of green space. It is argued that this would fit in with the theories of the classic urban sociologists Wirth and Milgram and the theories of environmental psychologists like Kaplan and Kaplan. The availability of new evidence and the fit into the classic theories would also justify renewed attention for green space in urban planning.