Patrik Grahn

Landscape planning and stress

Stress and stress-related illnesses, as reflected in medical records, have in- creased dramatically among adults and children in Western societies. A growing part of the budget for medical service in Sweden is used for individuals suffering from different stress-related illnesses such as burnout syndrome, insomnia and fatigue, depression, feelings of panic, etc. In this paper, we present results from a study in which 953 ran- domly selected individuals in nine Swedish cities answered a questionnaire about their health and their use of different urban open green spaces in and close to the city. The results indicate that city landscape planning may affect the health of town-dwellers. Statistically significant relationships were found between the use of urban open green spaces and self-reported experiences of stress - regardless of the informants age, sex and socio-economic status. The results suggest that the more often a person visits urban open green spaces, the less often he or she will report stress-related illnesses. The same pattern is shown when time spent per week in urban open green spaces is measured. The distance to public urban open green spaces seems to be of decisive importance, as is access to a garden, in the form of a private garden or a green yard immediately adjacent to, for instance, an apartment building. People do not usually compensate for lack of green environments in their own residential area with more visits to public parks or urban forests. According to our results, laying out more green areas close to apartment houses, and making these areas more accessible, could make for more restorative environments. Out- door areas that provide environments free from demands and stress, and that are avail- able as part of everyday life, could have significant positive effects on the health of town-dwellers in Sweden. This may also apply to other Western societies.

Recreational values of the natural environment in relation to neighbourhood satisfaction, physical activity, obesity and wellbeing

Objectives: The aim of this population-based study was to investigate associations between recreational values of the close natural environment and neighbourhood satisfaction, physical activity, obesity and wellbeing. Methods: Data from a large public health survey distributed as a mailed questionnaire in suburban and rural areas of southern Sweden were used (N  =  24 819; 59% participation rate). Geocoded residential addresses and the geographical information system technique were used to assess objectively five recreational values of the close natural environment: serene, wild, lush, spacious and culture. Results: On average, a citizen of the Scania region, inner city areas excluded, only had access to 0.67 recreational values within 300 metres distance from their residence. The number of recreational values near the residence was strongly associated with neighbourhood satisfaction and physical activity. The effect on satisfaction was especially marked among tenants and the presence of recreational values was associated with low or normal body mass index in this group. A less marked positive association with vitality among women was observed. No evident effect on self-rated health was detectable. Conclusions: Immediate access to natural environments with high recreational values was rare in the study population and was distributed in an inequitable manner. Moreover, such access was associated with a positive assessment of neighbourhood satisfaction and time spent on physical activity, which can be expected to reduce obesity and increase vitality by having a buffering effect on stress.

A Comparison of Leisure Time Spent in a Garden with Leisure Time Spent Indoors: On Measures of Restoration in Residents in Geriatric Care

During the past 20 years, findings have indicated that nature plays an active role in helping people recover from stress and fatigue. Two of the most cited theories in this field are Rachel and Stephen Kaplans theory of recovery from Directed Attention Fatigue in nature and Roger Ulrichs theory of aesthetic and affective responses to natural environments and stress recovery. One aim of the present study is to test whether being outdoors in a green recreational environment causes people to be more focused, compared to being in a room indoors (in line with hypotheses suggested by the Kaplans). Another aim is to test whether people experience stress reduction, i.e. as evidenced by changes in blood pressure and heart rate, if they are placed in an environment with many green elements (in line with hypotheses suggested by Ulrich). The overall study design is that of an intervention study. Fifteen elderly persons living at a home for very elderly people participated. Their powers of concentration, blood pressure and heart rate were measured before and after an hour of rest in a garden or in an indoor setting. Seven elderly people were randomly chosen to have their first series of tests in a garden, while eight elderly people had their first series of tests indoors. The results indicate that powers of concentration increase for very elderly people after a visit to a garden outside the geriatric home in which they live, compared to that after resting indoors in their favourite room. The results did not show any effects on blood pressure or heart rate. It is suggested that having a one-hour rest outdoors in a garden setting plays a role in elderly peoples powers of concentration, and could thereby affect their performance of activities of daily living. One important factor in this study was that both the outdoor environment and the indoor environment at the home were highly valued by participants.

Green qualities in the neighbourhood and mental health - results from a longitudinal cohort study in Southern Sweden

BackgroundPoor mental health is a major issue worldwide and causality is complex. For diseases with multifactorial background synergistic effects of person- and place- factors can potentially be preventive. Nature is suggested as one such positive place-factor. In this cohort study we tested the effect of defined green qualities (Serene, Space, Wild, Culture, Lush) in the environment at baseline on mental health at follow-up. We also studied interaction effects on mental health of those place factors and varied person factors (financial stress, living conditions, and physical activity).MethodsData on person factors were extracted from a longitudinal (years 1999/2000 and 2005) population health survey (n = 24945). The participants were geocoded and linked to data on green qualities from landscape assessments, and stored in the Geographical Information System (GIS). Crude odds ratios (OR) and 95% confidence intervals (CI) were calculated, and multivariate logistic analyses were performed.ResultsMental health was not affected by access to the chosen green qualities, neither in terms of amount nor in terms of any specific quality. However, we found a reduced risk for poor mental health at follow-up among women, through a significant interaction effect between physical activity and access to the qualities Serene or Space. For men the tendencies were similar, though not significant. Regarding the other three green qualities, as well as amount of qualities, no statistically certain synergistic effects were found. Likewise, no significant synergies were detected between green qualities and the other person-factors. Only advanced exercise significantly reduced the risk for poor mental health among women, but not for men, compared to physical inactivity.ConclusionsThe results do not directly support the hypothesis of a preventive mental health effect by access to the green qualities. However, the additive effect of serene nature to physical activity contributed to better mental health at follow-up. This tendency was equal for both sexes, but statistically significant only for women.Objective landscape assessments may be important in detangling geographic determinants of health. This study stresses the importance of considering interaction effects when dealing with disorders of multifactorial background.

Inducing physiological stress recovery with sounds of nature in a virtual reality forest — Results from a pilot study

Experimental research on stress recovery in natural environments is limited, as is study of the effect of sounds of nature. After inducing stress by means of a virtual stress test, we explored physiological recovery in two different virtual natural environments (with and without exposure to sounds of nature) and in one control condition. Cardiovascular data and saliva cortisol were collected. Repeated ANOVA measurements indicated parasympathetic activation in the group subjected to sounds of nature in a virtual natural environment, suggesting enhanced stress recovery may occur in such surroundings. The group that recovered in virtual nature without sound and the control group displayed no particular autonomic activation or deactivation. The results demonstrate a potential mechanistic link between nature, the sounds of nature, and stress recovery, and suggest the potential importance of virtual reality as a tool in this research field.

The Role of Natural Settings in Crisis Rehabilitation: How Does the Level of Crisis Influence the Response to Experiences of Nature with Regard to Measures of Rehabilitation?

Abstract We compare people greatly affected by a crisis with those less affected to explore how level of crisis influences their response to experiencing nature. A questionnaire comprising a validated protocol to evaluate frequency of stress conditions, the level of crisis retention, reorientation and rehabilitation potential was answered by 547 individuals. The questionnaire also comprises items on everyday activities. Our findings may be interpreted as follows: experiencing nature has a more powerful influence on the rehabilitation potential of people greatly affected by a crisis; taking a walk also has an influence, although not of equal importance; the social factor has more influence on the rehabilitation potential of people affected by a crisis to a low/moderate degree. Individuals who have many experiences of nature are less affected by their crisis than are those who have few such experiences. We suggest that the rehabilitative effect of nature is tied to its function as an enriched environment. During stays in natural settings, an interaction takes place between sensory stimulation, emotions and logical thought—an interaction that leads to a new orientation and new ways of seeing ones self and ones resources. This seems to largely be a question of how we human beings take in and process information.

Solving problems in social–ecological systems : definition, practice and barriers of transdisciplinary research

Translating policies about sustainable development as a social process and sustainability outcomes into the real world of social–ecological systems involves several challenges. Hence, research policies advocate improved innovative problem-solving capacity. One approach is transdisciplinary research that integrates research disciplines, as well as researchers and practitioners. Drawing upon 14 experiences of problem-solving, we used group modeling to map perceived barriers and bridges for researchers’ and practitioners’ joint knowledge production and learning towards transdisciplinary research. The analysis indicated that the transdisciplinary research process is influenced by (1) the amount of traditional disciplinary formal and informal control, (2) adaptation of project applications to fill the transdisciplinary research agenda, (3) stakeholder participation, and (4) functional team building/development based on self-reflection and experienced leadership. Focusing on implementation of green infrastructure policy as a common denominator for the delivery of ecosystem services and human well-being, we discuss how to diagnose social–ecological systems, and use knowledge production and collaborative learning as treatments.

Perceived green qualities were associated with neighborhood satisfaction, physical activity, and general health : Results from a cross-sectional study in suburban and rural Scania, southern Sweden

In this study using cross-sectional survey data from suburban and rural Scania, Sweden (N=24,847), we assessed how the recently validated index score of area-aggregated perceived green neighborhood qualities (Scania Green Score; SGS), and the five distinct qualities within this index were associated with three self-reported indicators of well-being: neighborhood satisfaction, physical activity and general health. Effect sizes were compared with objective (GIS-based) assessments of the same five qualities. Area-aggregated SGS was positively associated with neighborhood satisfaction, physical activity and general health. The association with general health was mediated by physical activity and neighborhood satisfaction. Three perceived qualities had salutogenic potential: historical remains (culture), silence such that sounds of nature can be heard (serene) and species richness (lush). Spacious and wild were not appreciated. Some independent positive effects of the GIS-based index were noted, but could not be consistently attributed to specific qualities. Perceived qualities within green areas, not merely quantity, are related to aspects of well-being in suburban and rural areas.

Area-aggregated assessments of perceived environmental attributes may overcome single-source bias in studies of green environments and health: results from a cross-sectional survey in southern Sweden

BackgroundMost studies assessing health effects of neighborhood characteristics either use self-reports or objective assessments of the environment, the latter often based on Geographical Information Systems (GIS). While objective measures require detailed landscape data, self-assessments may yield confounded results. In this study we demonstrate how self-assessments of green neighborhood environments aggregated to narrow area units may serve as an appealing compromise between objective measures and individual self-assessments.MethodsThe study uses cross-sectional data (N = 24,847) from a public health survey conducted in the county of Scania, southern Sweden, in 2008 and validates the Scania Green Score (SGS), a new index comprising five self-reported green neighborhood qualities (Culture, Lush, Serene, Spacious and Wild). The same qualities were also assessed objectively using landscape data and GIS. A multilevel (ecometric) model was used to aggregate individual self-reports to assessments of perceived green environmental attributes for areas of 1,000 square meters. We assessed convergent and concurrent validity for self-assessments of the five items separately and for the sum score, individually and area-aggregated.ResultsCorrelations between the index scores based on self-assessments and the corresponding objective assessments were clearly present, indicating convergent validity, but the agreement was low. The correlation was even more evident for the area-aggregated SGS. All three scores (individual SGS, area-aggregated SGS and GIS index score) were associated with neighborhood satisfaction, indicating concurrent validity. However, while individual SGS was associated with vitality, this association was not present for aggregated SGS and the GIS-index score, suggesting confounding (single-source bias) when individual SGS was used.ConclusionsPerceived and objectively assessed qualities of the green neighborhood environment correlate but do not agree. An index score based on self-reports but aggregated to narrow area units can be a valid approach to assess perceived green neighborhood qualities in settings where objective assessments are not possible or feasible.

Measures of Restoration in Geriatric Care Residences: The Influence of Nature on Elderly People's Power of Concentration, Blood Pressure and Pulse Rate

Abstract In this paper, we have studied how elderly peoples frame of mind influences their response to experiencing nature, measured in terms of blood pressure, pulse rate, concentration and results from protocols. Two theories concerning the importance of psychological balance have been put forward earlier by Lawton and Kiiller, both of whom maintain that the surrounding everyday environment is one of the keys to a harmonious existence. We present findings supporting the theory that the positive experience of natural surroundings per se has a balancing and healing effect. We have found that the people most affected by their surroundings are those with the greatest psycho-physiological imbalance. When the balance tilts, the balancing effect of the green experience can restore the individual to a state of better harmony. Time spent in the outdoors is, thus, especially important for individuals who easily lose their equilibrium or find it difficult to make compensatory changes to restore harmony on their own. The research project is an intervention study in which fifteen elderly individuals living at a home for very old people participated. Their power of concentration, blood pressure and heart rate were measured before and after an hour of rest in a garden and in an indoor setting, respectively. Seven elderly people were randomly chosen to have their first series of tests in a garden, while eight elderly people had their first series of tests indoors. The results indicate that power of concentration increases for very old people after a visit in a garden outside the geriatric home in which they live, as compared to resting indoors in their favorite room. The results did not show any effects on blood pressure or heart rate. However, when we compared these results with the background variables, we found interesting correlations. Background variables included how often they took part in social activities, showed helpfulness toward other residents in group activities and tolerance/critique of other residents. After a factor analysis, the background variables formed three distinct factors, one of which showed significant correlation with blood pressure and heart rate: the factor psycho-physiological balance, with the variables “degree of tolerance,” “degree of helpfulness” and “frequency of hospital visits.” Elderly people with low psycho-physiological balance, that is, who had low tolerance of other residents, were not helpful in group activities and had a high frequency of hospital visits, were most affected by a stay in a garden, as could be measured in changes in heart rate and blood pressure. The results may be interpreted as showing that a garden can restore an elderly person with low psycho-physiological balance to a state of better harmony. The present study show, first, that an outdoor visit is important for recovery from stress and fatigue and, second, that the improvement is especially significant for the most susceptible. Thus, it is of particular importance that weak groups, such as elderly in great need of care, have access to an outdoor space. Such groups are likely to include many people who are in psycho-physiological imbalance.