How nature contributes to mental and physical health

Abstract

Irrespective of where we come from in the world, it seems that the presence of living things makes us feel good. There are three levels of engagement with nature. The first is viewing nature, as through a window, or in a book, on television or in a painting. The second is being in the presence of usually nearby nature, which is incidental to some other activity, such as walking or cycling to work, or reading on a garden seat or talking to friends in a park. The third is active participation and involvement with nature, such as gardening or farming, trekking or running. There is now strong evidence that all these levels deliver mental health benefits. The evidence also suggests that green spaces and nearby nature should be seen as a fundamental health resource. Physical activity is now known to be a co-determinant of health. Yet there has been a dramatic fall in physical activity in recent decades, with severe health consequences. Exercising in the presence of nature (green exercise) thus has important public and environmental health consequences. Copyright © 2004 Whurr Publishers Ltd.

Full text

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How Nature Contributes to Mental and Physical Health
Jules Pretty
Spirituality and Health International vol 5 (2), 68-78 (2004)
Abstract
Irrespective of where we come from in the world, it seems that the presence of living things
makes us feel good. There are three levels of engagement with nature. The first is viewing
nature, as through a window, or in a book, on television or in a painting. The second is being
in the presence of usually nearby nature, which is incidental to some other activity, such as
walking or cycling to work, or reading on a garden seat to talking to friends in a park. The
third is active participation and involvement with nature, such as gardening or farming,
trekking or running. There is now strong evidence that all these levels deliver mental health
benefits. It also suggests that green spaces and nearby nature should be seen as a
fundamental health resource. Physical activity is now known to be a co-determinant of
health. Yet there has been a dramatic fall in physical activity in recent decades, with severe
health consequences. Combining exercise in the presence of nature (green exercise) thus has
important public and environmental health consequences.
Nature and Health
How does nature make us feel? Much, of course, will depend on what else is important in
our lives. Is it a good day or a bad day? Irrespective of where we come from in the world, it
seems that the presence of living things makes us feel good. They help us when we feel
stressed, and if there is green vegetation and blue sky, and water in the scene, then we like it
even more. This idea that the quality of nature in our home neighbourhood affects our
mental health is not a new one, but it has not greatly affected the planning of our urban and
rural environments, nor of public health priorities.
Since the advent of the industrial revolution, an increasing number of people have found
themselves living in wholly urban settings. Indeed, within the next decade, the number of
people in urban areas will exceed those in rural contexts for the first time in human history.
In 1960, the world population was some 3 billion; by 2010 there will be more than 3 billion
people dwelling in urban settlements. Some of this will be by choice – some offer the best
opportunities for employment. There are more services concentrated together, with better
access to schools, hospitals and sports clubs. But one thing is quite clear: an urban setting by
definition has less nature than a rural one. And less green nature means reduced mental
well-being – or at least less opportunity to recover from any mental stresses. This is
unfortunate. As our green environments have increasingly come under pressure from
development, so it seems we ourselves have suffered more. Is this all a simple coincidence,
or should we have a rethink?
There are many different ideas about what constitutes mental health. For a long time, it has
been taken to mean the absence of a recognisable illness. Yet this type of deficit model does
not explain how mental health and psychological well-being also positively influence us –
helping to shape how we think and feel, how we learn and communicate, how we form and
sustain relationships, and critically how we cope with shocks and stresses (HEA, 1997). Thus

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everyone has mental health needs, not just those with an illness. This is not widely accepted,
and mental ill-health is commonly assumed to be the fault of the sufferer, arising from some
lack of resolve or backbone. And for centuries, the policy response has been to lock up the
sufferers, to protect the rest of society from them.
Today, stress and mental ill-health is becoming more common, and the costs are high. The
WHO (2001) estimates that depression and depression-related illness will become the
greatest sources of ill-health by 2020. This is because many other activities, such as smoking,
over-eating and high alcohol consumption, are coping mechanisms for depression, and have
their own serious consequences. Stress is now a major problem for people living in modern
societies. In the late 1990s, some 24% of men and 29% of women in Britain reported having
suffered `a large amount of stress’ in the previous 12 months. Such self-reported general
health, including stress levels, has been shown to be a strong predictor of mortality
(Rainford et al., 2000), and mental ill-health in Britain costs some £77 billion per year for the
provision of care, lost outputs and costs to individuals.
Depression is known to be a risk factor for the outcomes of a range of chronic physical
illness, including asthma, arthritis, diabetes, strokes and heart disease (Hippisley-Fox et al.,
1998; Turner and Kelly, 2000; Ostir et al., 2001). On the other hand, emotional well-being is
known to be a strong predictor of physical health. In one study, elderly adults in the USA
who scored highest in a survey on emotional health were twice as likely to be alive at the
study’s end (Goodwin, 2000).
In most health care systems, the predominant focus for both treatment and expenditure has
come to be on people who have become ill. The same is also true for our environments – we
tend only to be come concerned when something important is harmed. Yet the best
approach, and the cheapest, is to focus efforts upstream, and try to create healthy
environments in which people can flourish rather than flounder. Thus we should be
concerned with not just preventing mental ill-health, but with creating positive mental
health for all.
It is increasingly well established that the natural and built features of the environment
affect behaviour, interpersonal relationships and actual mental states (Tuan, 1977; Freeman,
1984; Kellert and Wilson, 1993; Tall, 1996). The environment can, therefore, be therapeutic or
harmful. Though there are many reasons for preserving nature, from the value of its
economic services to the fundamentals of ethics, relatively little attention has been paid to
the potential personal health benefits (Pretty et al., 2003; 2004). What makes people care
about nature, and why are so many distressed about its loss? Why does nature still seem to
have a positive effect on people, despite the increasing urbanization of modern societies?
Nature seems to make positive contributions to our health, helps us recover from pre-
existing stresses or problems, has an immune effect by protecting us from future stresses,
and helps us to concentrate and think more clearly. I discern three levels of engagement
with nature, each with incremental benefits as we proceed from one to the next:
• The first is viewing nature, as through a window, or in a book, on television or in a
painting.
• The second is being in the presence of usually nearby nature, which is incidental to some
other activity, such as walking or cycling to work, or reading on a garden seat to talking
to friends in a park.

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• The third is active participation and involvement with nature, such as gardening or
farming, trekking, camping, running, horse-riding, hedge-laying or forestry.
The View from the Window
The evidence for the benefits of windows comes from both the workplace and home, and
from travelling to work (Tennessen and Cimprich, 1995; Leather et al., 1998; Kaplan, 2001).
Windows in the workplace buffer the stresses of work, and over long periods people with
windows have been shown to have fewer illnesses, feel less frustrated and more patient, and
express greater enthusiasm for work. People are better able to think with green views,
including university students. Those in offices without windows often compensate by
putting up more pictures of landscapes or by keeping indoor plants (Heerwagen and Orians,
1998). Those who cannot compensate, however, may respond by becoming more stressed
and aggressive. One study of Alzheimer patients in five homes found that those in the three
with gardens had significantly lower levels of aggression and violence than those in the two
with no gardens (Ulrich, 1993). Ulrich (1993) also reports on a Swedish psychiatric hospital
in which patients over a 15 year period had often complained about and damaged paintings
on the walls. Damage, though, was only ever done to abstract paintings, and there was no
recorded attack on any depicting nature and landscapes.
At home, the view is equally important. Kuo and colleagues have demonstrated that a little
bit of green in the barren urban environment of Chicago make a large difference to people’s
lives (Kuo et al., 1998; Taylor et al., 1998, 2001; Kuo and Sullivan, 2001). Green views from
home, plus nearby nature in which to play, have a positive effect on the cognitive
functioning of children and their capacity to think. Residents of two of the ten poorest
neighbourhoods in the USA positively responded to trees and grass near their blocks, and
the said the greener the better. Buildings with more vegetation also had 52% fewer property
and violent crimes than those with none, and these residents also reported lower levels of
fear and less generalised aggressive behaviour in the local neighbourhood. Interestingly,
there was a greater difference between non-green and moderately green buildings than
between moderately and very green, suggesting more of a benefit would accrue from a
light-greening of all urban spaces rather than a dark-greening of just a few. Indeed, well-
maintained vegetation may be a cue to care, as it suggests that local people care for their
environment and so are more vigilant (Kuo and Sullivan, 2001).
Another study of people exposed to different types of roadside corridors on a potential
commute to work found that those people on the urban drive dominated by human artefacts
were more stressed than those driving through the nature-dominated scenes of forests or
golf-courses. The nature drive also seemed to have a protective effect against future stresses
that might arise during the day (Parsons et al., 1998). However, there is a distinct tension
between these findings and what civic and park authorities tend to do. Green spaces are
often removed to keep down maintenance costs, and there is often a fear that well-vegetated
places offer more opportunities for criminals and drug-dealers to hide – echoing back to
centuries’ old fears of highwaymen in the forests.
This evidence also suggests that green spaces and nearby nature should be seen as a
fundamental health resource (Frumkin, 2001; Maller et al., 2002). Two classic studies from
the 1980s confirm this (Moore, 1981; Ulrich, 1984). The first found that prisoners in Michigan
whose cells faced farmland and trees had a 24% lower frequency of sick cell visits than those
in cells facing the prison yard. The second was a 10-year comparison of post-operative

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patients in Pennsylvania whose rooms looked out on trees or a brick wall, in which it was
found that patients with tree views stayed in hospital for significantly less time, needed less
strong or moderate medication and had fewer negative comments in the nurses’ notes.
A more recent study of hospital patients has shown the clear value of a picture and the
sounds of nature. One group of patients preparing for bronchoscopy (in which a fibre-optic
tube is inserted into the lungs) were given a large landscape picture to look at by their
bedside, and listened to the sounds of birdsong and a babbling brook prior to the operation.
This group had a 50% higher level of very good or excellent pain control than those who did
not have the picture or sounds. What such a simple intervention means is that less money
needs to be spent on painkilling drugs for patients (Diette et al., 2003). Another simple idea
has been to put an aquarium full of fish into the waiting room at a dental surgery. Those
exposed to this kind of nature are more relaxed than patients awaiting treatment in a room
without an aquarium (Katcher and Wilkins, 1993; Beck and Meyers, 1996).
Some of this evidence should not be a surprise. Frumkin (2001) points out that “hospitals have
traditionally had gardens as an adjunct to recuperation and healing,” and 95% of people living in
retirement communities say windows facing green landscapes are essential to well-being.
Ulrich (1984) states this aesthetic preference for nature may be universally expressed across
human cultures: “one of the most clear cut findings in the literature is the consistent tendency to
prefer natural scenes over built views, especially when the latter lack vegetation and water”.
Incidental Exposure to Nature
The second category of engagement with nature in incidental exposure whilst engaged in
some other activity. Again, the evidence ought to be compelling. Wells and Evans (2003)
found that those 8-10 year old children in five upstate New York communities exposed to
both indoor and outdoor vegetation were less stressed and more able to recover from
stressful events than those in greenless homes and backyards. This confirmed earlier work
on younger children in day facilities either surrounded by orchards, pasture and forests or
by tall buildings in the city. Those in the all-weather mode of operation with regular outdoor
exposure to nature had better attention capacity and motor coordination.
Wells (2000) also found that children in families moving to houses with more nearby nature
had higher levels of cognitive functioning – though it could have been that these types of
families were able to select these types of preferred homes. Cause and effect can be difficult
to disentangle. In New York City, children in poor neighbourhoods have access to some 17
square metres of park per person, whilst those in better-off districts have access to about 40
square metres of park.
Nearby natural settings or places can confer health benefits. Healing gardens are
acknowledged to be beneficial for patients of hospitals (Cooper-Marcus and Barnes, 1999;
Whitehouse et al., 2001). Such benefits appear to have been recognised as early as the Middle
Ages, with garden cloisters and vegetable gardens used as part of the healing process. In the
Victorian period, gardens were routinely located in hospitals for the benefit of patients, and
hospitals themselves located in pleasant surroundings. Some argue that modern health
systems, with a focus on treatment of diseases rather than patient comfort and care, have
abandoned useful principles regarding connections with nature and place (Lindheim and
Syme, 1983). Empirical studies have shown that patients regularly report positive changes in
mood when visiting gardens (Cooper-Marcus and Barnes, 1999).

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Whitehouse et al. (2001) found that a healing garden at a children’s hospital in California had
positive effects on users, with 54% reporting they were more relaxed and less stressed, 24%
refreshed and rejuvenated, 18% more positive and able to cope, and only 10% having no
difference in mood. Even very short visits were beneficial, as nearly half of all observed
visitors spent less than five minutes at a time in the garden. However, 28% of staff, 95% of
visiting families and 90% of patients had never been to the garden; 10% of staff and 65% of
visitors did not even know of its existence. Those who did go to the garden went “to escape
the stresses of the hospital and enjoy the relaxing and restorative elements of nature”.
Such principles are being applied in the Eden Alternative nursing homes in Texas, where
healing gardens, greenhouses, atriums and plants have been deployed. After conversion,
there were 57% fewer bedsores, an 18% reduction in patients restrained, a 60% reduction in
behavioural incidents, and a 48% reduction in staff absenteeism. The costs of such nature-
based treatments are expected to be much less than expenditure for drugs and surgery to
achieve the same outcomes (Eden Alternative, 2002).
Direct Participation with Nature
The third category of engagement with nature comprises direct participation in some
activity in green spaces, and includes gardening, trekking, walking, mountaineering,
running, camping, cycling. This differs from the second category as it implies a positive
decision to go to places where there is green nature, rather than be incidentally exposed to it
whilst doing something else. This category includes exposure to nearby nature, such as in
gardens or nature reserves, or in distant ecosystems, such as national parks and
wildernesses.
Hartig and colleagues have pioneered the idea that nature can restore deficits in attention
arising from overwork or over-concentration, making people both feel and think better
(Hartig et al., 1991, 2003). They found that sitting in a room with tree views promoted more
rapid blood pressure decline than sitting in a windowless room, and also that walking in a
nature reserve reduced blood pressure more than a walk along an urban and non-green
street. In both contexts, the green room and green walk, people recovered more rapidly from
attention-demanding tasks. They also found that the differential benefits of the nature walk
lasted for about 30 minutes, after which the difference converged, probably because the
physical benefits of the walk itself began to override any unpleasantness of the urban street.
It also again shows that short exposures to nature can be highly beneficial. Whilst this
various research does not tell us whether cumulative short exposures, such as looking out of
the window or short walks, equate to longer, less frequent exposures to nature, such as a
weekend away in the hills (Hartig et al., 2003). It also does not tell us whether there is an
enhanced or different effect of exposure to specific places because they have memories and
stories associated with them for certain people. In other words, some environments may be
green and beneficial, but anonymous, whereas others may be evoking pleasant memories as
well (Tuan, 1977; Gallagher, 1994).
Private and community gardens provide anther direct link to nature for many people, and
are particularly valuable in urban settings. In the UK, there are now some 300,000 occupied
allotments on 12,000 hectares of land – down from 120,000 hectares in the 1940s. These
allotments yield some 215,000 tonnes of fresh food each year. But more importantly, they

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provide an opportunity for regular contact with nature. There are now several hundred city
farms or community gardens in the UK (Pretty, 1998). They provide of food, especially
vegetables and fruit, for poorer urban groups, and a range of other natural products such as
wood, flowers and herbs. They also mean that derelict or vacant land is transformed into
desirable areas for local people to visit and enjoy, resulting in the creation of quiet tranquil
places for the community that can increase wildlife. They also provide the opportunity for
mental health patients to engage in work that builds self-esteem and confidence, and for
unemployed people to use their time productively in their own community.
A good example of what they tiny patches of nature can do is provided by the 1.6 ha Elder
Stubbs garden in Oxford (Pretty, 1998). It was started in 1989 on derelict allotments, and
links food production with developing the self-esteem and confidence of 24 mental health
patients working at the gardens. It grows vegetables, flowers, fruit and willow coppice.
Produce is sold to loyal buyers in the local community through regular deliveries by horse
and cart. Value is added by making baskets from the willow, and jams and chutneys. There
are positive links with the local community, and it shows what people with mental problems
can do. Local school children come to the site regularly to help with work, and vegetables
are sold to local people.
The American National Gardeners Association estimates that some 35 million people are
engaged in growing their own food in back gardens and allotments. Their contribution to
the informal economy is estimated to be about $12-14 billion per year. Private gardeners
cultivate mostly to produce better tasting and more nutritious food, but also to save money,
for exercise and for therapy. It makes them feel better. This is particularly true of community
gardens and farms that, by contrast, seek to enhance both food production and social
benefits. In New York, 87% of community gardeners invest their time in gardening so as to
improve the neighbourhood, 75% for fresh vegetable production, 62% for fun and self-
esteem, and 42% to save money (Weissman, 1995a, b). Many of the recently established
Community Supported Agriculture (CSA) farms, with direct links to their consumers, not
only provide weekly food boxes but also run horticultural therapy and educational sessions
(Pretty, 2002).
In a survey of 20 community gardens in New York State, it was reported that people
participated primarily to access fresh foods, to enjoy nature and for mental and physical
health benefits (Armstrong, 2000). In more than half the cases, the gardens had changed the
attitudes of residents about their neighbourhood, and in a third, had led to collective action
to address local issues.
The benefits of wilderness experiences date back to the testimony of 19th century writers
such as John Muir and Henry David Thoreau. Muir’s writing on the Sierra Nevada, and the
importance of such wild areas for well-being was instrumental in the establishment of the
world’s first national park at Yellowstone in 1872 (Muir, 1911, 1992; Thoreau, 1837-53, 1902;
Pretty, 2002).
A number of studies have shown that people both seek and derive a variety of values when
they visit wildernesses, in particular a desire for tranquility and natural beauty, escape from
the stresses of urban life, and the potential for dramatic `peak experiences’ (Scott, 1974) or
transcendent moments. Herzog and colleagues conclude that “the restorative potential of
natural settings is probably underappreciated”, as many people do not appreciate the full
benefits of such settings – particularly in the face of competition for multiple other leisure

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and entertainment opportunities of modern life (Rossman and Ulehla, 1977; Williams and
Harvey, 2001; Herzog et al., 2002).
Wilderness therapy has been widely used for its potential benefits for psychiatric patients,
emotionally disturbed children, bereaved people and patients with cancer and others
suffering various stresses and ailments (Frumkin, 2001). Positive effects on both physical
and mental health are found in many studies, but it was not clear the extent to which
benefits are also accruing from participation in organised programmes and trips, nor
whether people’s exposure to other forms of non-wilderness natures was having a distorting
effect.
Fredrickson and Anderson (1999) explored the effects of a wilderness experience on two
groups of women in two areas of Minnesota and Arizona. Participants stated that benefits
arose from both individual contact with nature, and from connections with their social
group sharing the experiences. Personal testimony showed that the experience left a lasting
impression on most participants, particularly as these experiences were so different to those
of their daily lives at home. Many spoke of renewed hope, a reawakening of emotions and a
new sense of identity. One said “It was so incredible being able to hear the birds…. Just the
crunching of animals all around us… The sounds of the forest, the snapping of twigs, hearing the tiny
sigh of the wind through the treetops at night.” Another noted that, “I noticed more, I felt more. I
felt more connected to myself and even to other people on the trip.” And another, “I can’t even fully
capture in words what happened to me when I was out there… It’s like the spirit is burning deep
inside me again, and I’m looking at my life a little differently.”
The study found that person-person interactions were just as important as person-place
connections: “the affective appeal of a particular place setting has as much to do with the social
interactions that occur there, as with the overall visual appeal of the landscape itself”. The
researchers concluded that these wildernesses contributed substantially to participants’
well-being.
Similar experiences have been noted in the forests of Australia, where so-called
`transcendent’ experiences were found to provoke a sense of harmony, freedom and well-
being that were sufficiently long-lasting to change long-term attitudes to the environment.
Several other studies have noted the value of natural and wildness experiences and their
therapeutic potential, and the additional role that physical hardship can play in triggering
more profound experiences (Mitchell, 1983; Kaplan, 1995; Fredrickson and Anderson, 1999;
Williams and Harvey, 2001; Herzog et al., 2002).
An important unanswered question for those concerned for sustainability is to what extent
do the benefits of such wildness experiences continue off-site? Do they provoke long-term
changes in thinking, which could lead to deep social and political transformations? It is also
true that people with a certain set of positive environmental values may be predisposed
towards the restorative potential of nature, and that these values help to shape
environmental attitudes (Kaiser et al., 1999; Kals et al. 1999; Schultz and Zelezny, 1999).
Combining Nature and Exercise
Physical activity is now known to be a co-determinant of health (CDC, 1996; DCMS, 2002). It
greatly reduces the risk of dying from coronary heart disease, and also reduces the risk of
developing diabetes, hypertension and colon cancer. It enhances mental health, fosters

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healthy muscles and bones, and helps maintain health and independence in older adults.
Appropriate exercise also induces physical fitness that has a substantial influence on
people’s sense of well-being (Pretty et al., 2004).
Compared with active people, those who are sedentary have an up to two fold increased
risk of dying, with levels of cardiovascular fitness strongly associated with overall mortality.
One study found that men reduced their risk of death by 33% if they walked 15 or more km
per week, by 25% if they climbed 55 or more flights of stairs a week, and by 53% with 3 or
more hours per week of moderate sports activity (Paffenbarger et al., 1994). There also
appears to be a protective effect in later life, with the effects of activity early in life persists
into the 70s and 80s.
In Europe, there has been a dramatic fall in physical activity over the past 50 years with on
average 2 MJ (500 kcal) less energy output per day in adults aged 20-60 years - equivalent to
the running of a marathon each week. Although similar trends have occurred across Europe
and North America, the UK compares badly with many countries. Jobs have become less
physical, people are more likely to take the lift than walk the stairs, and adults and children
are more likely to travel to work or school by car than to walk or bicycle. Some 63% of men
and 75% of women in the UK do not take enough physical activity to benefit their health. In
almost all activities (except swimming and yoga), female participation is lower than male. In
the group aged 16-24 years, 42% of men and 68% of women are inactive, and these
proportions rise steadily as people age. One of the major problems is that although 80% of
people in the UK correctly believe that regular exercise is good for their health, a majority
wrongly believe that they take enough exercise to stay fit.
As physical activity can positively affect mental well-being and self-esteem (Scully et al.,
1999), there may be a synergistic benefit in adopting physical activities whilst at the same
time being directly exposed to nature. We have called this `green exercise’ (Pretty et al.,
2003). The behaviour of many groups of people seems to suggest that they already
appreciate the benefits of protecting the environment, undertaking physical activity, and
combining the two. Despite the increased daily disconnections between a predominantly
urban population and nature, and the increase in sedentary lifestyles imposed or adopted by
the majority of the population, people still express their values in a variety of direct and
indirect ways, through membership of environmental and wildlife organisations; visits to
the countryside; and membership of gymnasiums and of sports and outdoor organisations.
Each year, some 551 million day visits are made to the UK countryside (433 m) and seaside
(118 m), and these visitors spend more (£14 billion) than the gross income earned by farms
for the food produced in the landscape. A substantial proportion of these day visits involves
significant physical exercise, including 110 million days on outdoor sport and leisure, 104
million days on hiking and walking, 77 million on pony trekking, mountaineering and
shooting, and 32 million on cycling (Pretty, 2002).
There is also evidence that membership of private and public gyms and health clubs has
increased in recent years, as urban people look to local opportunities to engage in physical
activity. In 2001, there were 4059 public and private health and fitness clubs, up from about
2200 in 1980. Some 5.4 million people are members of these clubs (though many do not take
regular advantage of their membership). The UK has a network of some 110,000 community
amateur sports clubs run by 1.5 million volunteers. Large numbers of people regularly
engage in physical activity in their communities – for example, 400,000 people play football
each weekend in 33,000 registered amateur football clubs. There are, however, concerns that

9
organised local sports are under threat from loss of playing fields for development, and the
number of sports clubs has declined by 40,000 since 1996.
Policies for Green Exercise
Green exercise has important public and environmental health consequences. At one level, a
fitter and emotionally more content population costs the economy less. Obesity already costs
more in public health terms, and will overtake smoking as Britain’s biggest killer in 10-15
years if current trends persist. If trends continue, other diet- and physical inactivity related
diseases will also increase. Increasing the support for and access to a wide range of green
exercise activities for all sectors of society will produce substantial public health benefits and
avoided costs.
Can green exercise be considered a good buy for public health, providing physical, social
and mental health benefits? Could some of the annual £10 billion of costs of obesity,
coronary heart disease and physical inactivity be avoided? Getting the policies right will
help, including support for gyms at GP surgeries, healthy walks projects, exercise on
prescription, healthy school environments, healthy travel to school projects, green views in
hospitals, support for city farms and community gardens, less anonymous food, more fruit
and vegetable consumption, and support for ecotourism, outdoor leisure activities, and
visits to the countryside.
A 10% increase in adult physical activity would benefit the UK by £500 million per year,
saving 6000 lives. The emotional benefits and mental well-being would be additional to
these benefits, and could indeed outweigh them. If these benefits are also achieved through
activities that provoke long-term changes in attitudes to nature and the environment across
society, then the possibilities for transformations and actions to support sustainability
outcomes will be all the more likely to occur.
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