Anna Jorgensen

Nature-based solutions (NbS), including green social prescribing (GSP), are sustainable ways to address health and wellbeing, especially since the COVID-19 pandemic exacerbated the strain on healthcare. NbS require national and local cross-sector coordination across complex, interrelated systems, but little is known about the specific challenges this poses for community-led NbS. We carried out a traditional literature review to establish the context and knowledge base for this study and interviewed 26 stakeholders. These came from environment, health and social care sectors at national and local levels, with local-level stakeholders from Bradford and Walsall: English cities significantly affected by the pandemic, with high levels of deprivation and health inequality. The interviews explored experiences of implementing NbS, both pre- and post-pandemic and the resulting renewed interest in the salutogenic effects of engaging with natural environments. We coded the interview transcriptions using NVivo to identify the challenges existing in the systems within which these stakeholders operate to create and manage NbS. By synthesizing what is known about the challenges from existing literature with findings from the interviews, we developed eight categories of challenges (perception and knowledge, political, financial, access to natural spaces, engagement, institutional and organisational, coordination, GSP referral and services) faced by multiple sectors in implementing community-led NbS in England. Furthermore, this study highlights the new challenges related to the pandemic. Identifying these challenges helps stakeholders in existing complex systems recognise what is needed to support and mainstream NbS in England.

Schoolyards in North America and Europe are increasingly using green fences as one measure to protect vulnerable populations from localised air pollution. This paper assesses the possibilities and limits for mobilising this format of site-specific green infrastructure in cities in low- and middle-income countries beset by air pollution and multiple other socio-environmental challenges, and particularly questions the definition of green fences as a green infrastructure for air quality (GI4AQ). We applied several qualitative and action research methods to the question of green fence implementation in Buenos Aires, Argentina—a Latin American city with weak air-quality policies, limited green infrastructure, and little experience with nature-based solutions. Firstly, we conducted a literature review of the role that urban vegetation and ecosystem services may play in AQ policy and the implementation barriers to such approaches globally and in the city. Secondly, we planned, designed, constructed, maintained, and evaluated a pilot green fence in a school playground. Thirdly, we carried out supplementary interviews with stakeholders and expert informants and compiled project members’ narratives to respectively characterise the barriers that the project encountered and delineate its attributes based on the associated actions that we took to overcome such barriers to implementation and complete the pilot. Our findings identify multiple barriers across seven known categories (institutional, engagement, political, socio-cultural, built environment and natural landscape, knowledge base and financial) and highlight examples not previously considered in the extant international literature. Furthermore, learning from this experience, the paper proposes an expanded model of green infrastructure for air quality plus multi-dimensional co-benefits (GI4AQ+) to increase implementation chances by attending to local needs and priorities.

The COVID-19 pandemic has brought about unprecedented changes to human lifestyles across the world. The virus and associated social restriction measures have been linked to an increase in mental health conditions. A considerable body of evidence shows that spending time in and engaging with nature can improve human health and wellbeing. Our study explores nature’s role in supporting health during the COVID-19 pandemic. We created web-based questionnaires with validated health instruments and conducted spatial analyses in a geographic information system (GIS). We collected data (n = 1184) on people’s patterns of nature exposure, associated health and wellbeing responses, and potential socioecological drivers such as relative deprivation, access to greenspaces, and land-cover greenness. The majority of responses came from England, UK (n = 993). We applied a range of statistical analyses including bootstrap-resampled correlations and binomial regression models, adjusting for several potential confounding factors. We found that respondents significantly changed their patterns of visiting nature as a result of the COVID-19 pandemic. People spent more time in nature and visited nature more often during the pandemic. People generally visited nature for a health and wellbeing benefit and felt that nature helped them cope during the pandemic. Greater land-cover greenness within a 250 m radius around a respondent’s postcode was important in predicting higher levels of mental wellbeing. There were significantly more food-growing allotments within 100 and 250 m around respondents with high mental wellbeing scores. The need for a mutually-advantageous relationship between humans and the wider biotic community has never been more important. We must conserve, restore and design nature-centric environments to maintain resilient societies and promote planetary health.

Prescribing nature-based health interventions (green prescribing)—such as therapeutic horticulture or conservation activities—is an emerging transdisciplinary strategy focussed on reducing noncommunicable diseases. However, little is known about the practice of, and socioecological constraints/opportunities associated with, green prescribing in the UK. Furthermore, the distribution of green prescribing has yet to be comprehensively mapped. In this study, we conducted a socioecological exploration of green prescribing. We deployed online questionnaires to collect data from general practitioners (GPs) and nature-based organisations (NBOs) around the UK and conducted spatial analyses. Our results indicate that GPs and NBOs perceive and express some common and distinct constraints to green prescribing. This highlights the need to promote cross-disciplinary communication pathways. Greenspace presence and abundance within close proximity (100 and 250 m) to GP surgeries (but not greenness—as a proxy for vegetation cover) and NBO presence within 5 km were associated with higher levels of green prescribing provision. Lower levels of deprivation were associated with higher frequency of NBOs. This suggests that the availability of greenspaces and NBOs could be important for green prescribing provision, but there could be greater opportunities in less deprived areas. Important foci for future research should be to establish transdisciplinary collaborative pathways, efficient infrastructure management and a common vocabulary in green prescribing—with the overall aim of reducing inequalities and enhancing planetary health.

Humans are spending less time in biodiverse environments, and according to the Old Friends and Biodiversity hypotheses, this has led to fewer interactions with diverse immunoregulatory micro‐organisms or ‘old friends’. Non‐communicable diseases such as asthma and inflammatory bowel disease are on the rise, and the development and progression of these ‘modern’ diseases may be attributed in part, to the breakdown of this evolutionary relationship between humans and environmental microbiota. There is a growing interest in the environment–microbiome–health axis as a mechanism to explain some of the health benefits linked to spending time in nature. This may provide a platform for proposing a new, holistic and transdisciplinary approach to public and environmental health. The field of landscape research—which combines social and natural sciences—responds to emerging socioecological issues and can make a significant contribution towards this approach. This paper explores innovative, landscape research‐based approaches to understanding the complex relationships between the environment, the microbiome and human health. Transdisciplinarity will play an important role moving forward. This forms a major discussion point in this paper, along with future research directions, key research questions and novel concepts supported by recent technological advancements. The development of a new field of study—Microbioscape Research as a crossover between microbiome science and landscape research—is also discussed. A free plain language summary can be found within the Supporting Information of this article.

The multiple benefits of ‘nature’ for human health and well‐being have been documented at an increasing rate over the past 30 years. A growing body of research also demonstrates the positive well‐being benefits of nature‐connectedness. There is, however, a lack of evidence about how people's subjective nature experience relates to deliberately designed and managed urban green infrastructure (GI) with definable ‘objective’ characteristics such as vegetation type, structure and density. Our study addresses this gap. Site users (n = 1411) were invited to walk through woodland, shrub and herbaceous planting at three distinctive levels of planting structure at 31 sites throughout England, whilst participating in a self‐guided questionnaire survey assessing reactions to aesthetics, perceived plant and invertebrate biodiversity, restorative effect, nature‐connectedness and socio‐demographic characteristics. There was a significant positive relationship between perceived naturalness and planting structure. Perceived naturalness was also positively related to the perceived plant and invertebrate biodiversity value, participants’ aesthetic appreciation and the self‐reported restorative effect of the planting. A negative relationship was recorded between perceived naturalness and perceived tidiness and care. Our findings showed that participants perceived ‘naturalness’ as biodiverse, attractive and restorative, but not necessarily tidy. Perceived naturalness was also related to participants’ educational qualifications, gender and nature‐connectedness, with women and more nature‐connected participants perceiving significantly greater levels of naturalness in the planting. These findings are highly significant for policymakers and built environment professionals throughout the world aiming to design, manage and fund urban GI to achieve positive human health and biodiversity outcomes. This applies particularly under austerity approaches to managing urban green spaces where local authorities have experienced cuts in funding and must prioritise and justify GI maintenance practices and regimes. Aplain language summaryis available for this article.