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Nature contact has associations with emotional ill-being and well-being. However, the mechanisms underlying these associations are not fully understood. We hypothesised that increased adaptive and decreased maladaptive emotion regulation strategies would be a pathway linking nature contact to ill-being and well-being. Using data from a survey of 600 U.S.-based adults administered online in 2022, we conducted structural equation modelling to test our hypotheses. We found that (1) frequency of nature contact was significantly associated with lesser emotional ill-being and greater emotional well-being, (2) effective emotion regulation was significantly associated with lesser emotional ill-being and greater emotional well-being, and (3) the associations of higher frequency of nature contact with these benefits were partly explained via emotion regulation. Moreover, we found a nonlinear relationship for the associations of duration of nature contact with some outcomes, with a rise in benefits up to certain amounts of time, and a levelling off after these points. These findings support and extend previous work that demonstrates that the associations of nature contact with emotional ill-being and well-being may be partly explained by changes in emotion regulation.

Whilst green space has been linked to healthier sleep outcomes, the roles of specific types of nature exposure, potential underlying mechanisms, and between-country variations in nature-sleep associations have received little attention. Drawing on cross-sectional survey data from an 18-country sample of adults (N = 16,077) the current study examined: 1) the relative associations between six different types of nature exposure (streetscape greenery, blue view from home, green space within 1 km, coast within 1 km, green space visits, blue space visits) and insufficient sleep (<6 h vs. 7-10 h per day); 2) whether these relationships were mediated by better mental wellbeing and/or physical activity; and 3) the consistency of these pathways among the different countries. After controlling for covariates, neighbourhood nature measures (green space, coast within 1 km) were not significantly associated with insufficient sleep; but nature visible from home (streetscape greenery, blue views) and recreational visits to green and blue spaces were each associated with less insufficient sleep. Significant nature-sleep associations were mediated, to varying degrees, by better mental wellbeing, but not self-reported physical activity. Country-level heterogeneity in the strength of nature-sleep associations was observed. Increasing nature visible from the home may represent a promising strategy for promoting healthier sleep duration at the population level, whilst nature-based interventions encouraging individuals to spend time in local green/blue spaces may be an appropriate target to assist individuals affected by insufficient sleep., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The world is undergoing massive atmospheric and ecological change, driving unprecedented challenges to human well-being. Olfaction is a key sensory system through which these impacts occur. The sense of smell influences quality of and satisfaction with life, emotion, emotion regulation, cognitive function, social interactions, dietary choices, stress, and depressive symptoms. Exposures via the olfactory pathway can also lead to (anti-)inflammatory outcomes. Increased understanding is needed regarding the ways in which odorants generated by nature (i.e., natural olfactory environments) affect human well-being. With perspectives from a range of health, social, and natural sciences, we provide an overview of this unique sensory system, four consensus statements regarding olfaction and the environment, and a conceptual framework that integrates the olfactory pathway into an understanding of the effects of natural environments on human well-being. We then discuss how this framework can contribute to better accounting of the impacts of policy and land-use decision-making on natural olfactory environments and, in turn, on planetary health.

Background: Emerging epidemiological evidence indicates nature exposure could be associated with greater health benefits among groups in lower versus higher socioeconomic positions. One possible mechanism underpinning this evidence is described by our framework: (susceptibility) adults in low socioeconomic positions face higher exposure to persistent psychosocial stressors in early life, inducing a pro-inflammatory phenotype as a lifelong susceptibility to stress; (differential susceptibility) susceptible adults are more sensitive to the health risks of adverse (stress-promoting) environments, but also to the health benefits of protective (stress-buffering) environments., Objective: Experimental investigation of a pro-inflammatory phenotype as a mechanism facilitating greater stress recovery from nature exposure., Methods: We determined differences in stress recovery (via heart rate variability) caused by exposure to a nature or office virtual reality environment (10 min) after an acute stressor among 64 healthy college-age males with varying levels of susceptibility (socioeconomic status, early life stress, and a pro-inflammatory state [inflammatory reactivity and glucocorticoid resistance to an in vitro bacterial challenge])., Results: Findings for inflammatory reactivity and glucocorticoid resistance were modest but consistently trended towards better recovery in the nature condition. Differences in recovery were not observed for socioeconomic status or early life stress., Discussion: Among healthy college-age males, we observed expected trends according to their differential susceptibility when assessed as inflammatory reactivity and glucocorticoid resistance, suggesting these biological correlates of susceptibility could be more proximal indicators than self-reported assessments of socioeconomic status and early life stress. If future research in more diverse populations aligns with these trends, this could support an alternative conceptualization of susceptibility as increased environmental sensitivity, reflecting heightened responses to adverse, but also protective environments. With this knowledge, future investigators could examine how individual differences in environmental sensitivity could provide an opportunity for those who are the most susceptible to experience the greatest health benefits from nature exposure., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Eisen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This article investigates relationships between public nature and health for unsheltered homeless populations. It examines perceptions of health benefits and harms for people living in public natural areas including local, state, and national forests and parks in the Seattle metropolitan area (USA). Interviews with environmental, social service, and law enforcement professionals who regularly interact with this vulnerable population were conducted and thematically analyzed to understand perceptions of physical and mental health outcomes. Results show professionals' perspectives on the health benefits and detriments of time spent in natural environments and the contextual factors perceived to influence health. Interviewees' observations about the variability of personal circumstances and biophysical, social, and weather conditions encourage the nuanced consideration of how contingent therapeutic landscapes provide deeply needed benefits, but for a population with a diminished capacity to adapt when conditions change. We conclude with insights for future research that directly assesses homeless populations' exposures and health outcomes of living in public natural areas., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Published by Elsevier Ltd.)

Climate change is exacerbating the need for urban greening and the associated environmental and human well-being benefits. Trees can help mitigate urban heat, but more detailed understanding of cooling effects of green infrastructure are needed to guide management decisions and deploy trees as effective and equitable climate adaptation infrastructure. We investigated how urban trees affect summer air temperature along sidewalks within a neighborhood of Tacoma, Washington, USA, and to what extent urban trees reduce risks of high summer temperatures (i.e., the levels regulated by state outdoor heat exposure rules intended to reduce heat-related illnesses). Air temperature varied by 2.57 °C, on average, across our study area, and the probability of daytime temperatures exceeding regulated high temperature thresholds was up to five times greater in locations with no canopy cover within 10 m compared to those with 100% cover. Air temperatures decreased linearly with increasing cover within 10 m, suggesting that every unit of added tree cover can help cool the air. Our findings highlight the value of trees in mitigating urban heat, especially given expected warming with climate change. Protecting existing urban trees and increasing tree cover (e.g., by planting street trees), are important actions to enhance climate change resilience of urban areas., (© 2024. The Author(s).)

Rates of living alone, especially in more urbanised areas, are increasing across many industrialised countries, with associated increases in feelings of loneliness and poorer mental health. Recent studies have suggested that access to nature (e.g. parks and green spaces) can reduce the stressors associated with loneliness, partly through providing opportunities to nurture personal relationships (relational restoration) and engage in normative community activities (collective restoration). Such associations might vary across different household compositions and socio-demographic or geographical characteristics, but these have not been thoroughly tested. Using data collected across 18 countries/territories in 2017-2018, we grouped urban respondents into those living alone (n = 2062) and those living with a partner (n = 6218). Using multigroup path modelling, we tested whether the associations between neighbourhood greenspace coverage (1-km-buffer from home) and mental health are sequentially mediated by: (a) visits to greenspace; and subsequently (b) relationship and/or community satisfaction, as operationalisations of relational and collective restoration, respectively. We also tested whether any indirect associations varied among subgroups of respondents living alone. Analyses showed that visiting green space was associated with greater mental well-being and marginally lower odds of using anxiety/depression medication use indirectly, mediated via both relationship and community satisfaction. These indirect associations were equally strong among respondents living alone and those living with a partner. Neighbourhood green space was, additionally, associated with more visits among respondents living with a partner, whereas among those living alone, this was sensitive to the green space metric. Within subgroups of people living alone, few overall differences were found. Some indirect pathways were, nevertheless, stronger in males, under 60-year-olds, those with no financial strain, and residents in warmer climates. In conclusion, supporting those living alone, as well as those living with a partner, to more frequently access their local greenspaces could help improve mental health via promoting relational and collective restoration., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

The role of neighbourhood nature in promoting good health is increasingly recognised in policy and practice, but consistent evidence for the underlying mechanisms is lacking. Heterogeneity in exposure methods, outcome measures, and population characteristics, little exploration of recreational use or the role of different types of green or blue space, and multiple separate mediation models in previous studies have limited our ability to synthesise findings and draw clear conclusions. We examined multiple pathways linking different types of neighbourhood nature with general health using a harmonised international sample of adults. Using cross-sectional survey data from 18 countries (n = 15,917), we developed a multigroup path model to test theorised pathways, controlling for sociodemographic variables. We tested the possibility that neighbourhood nature (e.g. greenspace, inland bluespace, and coastal bluespace) would be associated with general health through lower air pollution exposure, greater physical activity attainment, more social contact, and higher subjective well-being. However, our central prediction was that associations between different types of neighbourhood nature and general health would largely be serially mediated by recent visit frequency to corresponding environment types, and, subsequently, physical activity, social contact, and subjective well-being associated with these frequencies. Several subsidiary analyses assessed the robustness of the results to alternative model specifications as well as effect modification by sociodemographics. Consistent with this prediction, there was statistical support for eight of nine potential serial mediation pathways via visit frequency which held for a range of alternative model specifications. Effect modification by financial strain, sex, age, and urbanicity altered some associations but did not necessarily support the idea that nature reduced health inequalities. The results demonstrate that across countries, theorised nature-health linkages operate primarily through recreational contact with natural environments. This provides arguments for greater efforts to support use of local green/blue spaces for health promotion and disease prevention., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Lewis R Elliott reports financial support was provided by EU Framework Programme for Research and Innovation Societal Challenges. Mathew P White reports financial support was provided by EU Framework Programme for Research and Innovation Societal Challenges. Benedict W Wheeler reports financial support was provided by EU Framework Programme for Research and Innovation Societal Challenges. James Grellier reports financial support was provided by EU Framework Programme for Research and Innovation Societal Challenges. Marta Cirach reports financial support was provided by EU Framework Programme for Research and Innovation Societal Challenges. Matilda van den Bosch reports financial support was provided by EU Framework Programme for Research and Innovation Societal Challenges. Mark Nieuwenhuijsen reports financial support was provided by EU Framework Programme for Research and Innovation Societal Challenges. Lora E Fleming reports financial support was provided by EU Framework Programme for Research and Innovation Societal Challenges. Co-author Mark Niewenhuijsen is co-Editor-in-Chief of Environment International.]., (Copyright © 2023. Published by Elsevier Ltd.)

Many researchers suggest that the COVID-19 pandemic may have more negative effects on women than men. Accordingly, we hypothesized that women would experience greater COVID-19 related distress and more psychopathological symptoms than men during the first COVID-19 lockdown in Italy. Moreover, we expected emotion regulation strategies (cognitive reappraisal and expressive suppression, as protective and risk factors respectively) to interact with gender in shaping psychological health. We administered an online questionnaire to 1519 participants during the first national COVID-19 lockdown in Italy. As predicted, women reported greater COVID-19 related distress and more psychopathological symptoms than men. Furthermore, women who made greater use of reappraisal reported lower levels of distress and fewer psychopathological symptoms. Suppression was associated with more psychopathological symptoms, but there were no interaction effects with gender. Our findings have implications for policymakers wishing to sustain women's health during stressful situations such as the COVID-19 outbreak and beyond.

People who make habitual use of an emotion regulation strategy such as cognitive reappraisal may be more sensitive to the emotion cues coming from a surrounding natural environment and, thus, get more benefits from virtual nature exposure such as enhanced subjective vitality. However, no previous study investigated the moderating role of cognitive reappraisal in the relationship between exposure to different types of natural environments (a national park, a lacustrine environment, and an arctic environment vs. an urban environment) and subjective vitality. We designed a between-subject design (four conditions, one per type of environment) with a sample of 187 university students (M age  = 21.17, SD = 2.55). Participants were exposed to four 360° panoramic photos of the environment for one minute each with a virtual reality head-mounted display. The results of a multicategorical moderation analysis attested that there were two significant interactions, respectively between lacustrine and arctic environments and cognitive reappraisal. More specifically, for participants with low levels of habitual use of cognitive reappraisal, the effects of virtual nature (vs. urban) exposure on subjective vitality were not significant, while for participants with high levels, the effects were significant and positive. Findings show how the potential of virtual nature may be boosted with training aimed at increasing the general use of cognitive reappraisal, supports enhancing the applications of virtual nature, and demonstrates the need to take individual differences into account when determining the benefits of these applications., (© 2023. The Author(s).)

The effects of 'nature' on mental health and subjective well-being have yet to be consistently integrated into ecosystem service models and frameworks. To address this gap, we used data on subjective mental well-being from an 18-country survey to test a conceptual model integrating mental health with ecosystem services, initially proposed by Bratman et al. We analysed a range of individual and contextual factors in the context of 14,998 recreational visits to blue spaces, outdoor environments which prominently feature water. Consistent with the conceptual model, subjective mental well-being outcomes were dependent upon on a complex interplay of environmental type and quality, visit characteristics, and individual factors. These results have implications for public health and environmental management, as they may help identify the bluespace locations, environmental features, and key activities, that are most likely to impact well-being, but also potentially affect recreational demand on fragile aquatic ecosystems., (© 2023. The Author(s).)

Exposure to natural environments offers an array of mental health benefits. Virtual reality provides simulated experiences of being in nature when outdoor access is limited. Previous studies on virtual nature have focused mainly on single "doses" of virtual nature. The effects of repeated exposure remain poorly understood. Motivated by this gap, we studied the influence of a daily virtual nature intervention on symptoms of anxiety, depression, and an underlying cause of poor mental health: rumination. Forty college students (58% non-Hispanic White, median age = 19) were recruited from two U.S. universities and randomly assigned to the intervention or control group. Over several weeks, anxious arousal (panic) and anxious apprehension (worry) decreased with virtual nature exposure. Participants identifying as women, past VR users, experienced with the outdoors, and engaged with the beauty in nature benefited particularly strongly from virtual nature. Virtual nature did not help symptoms of anhedonic depression or rumination. Further research is necessary to distinguish when and for whom virtual nature interventions impact mental health outcomes., (© 2023. The Author(s).)

Purpose: The purpose of this study was to develop and evaluate the reliability and validity of self-efficacy and intentions measures for time spent in nature (TSN). TSN is related to improvement in psychological well-being and health, yet most American adults spend very little time in such settings. Theory-based interventions have been effective in increasing physical activity, a related behavior, and may be one mechanism to increase TSN. Self-efficacy and intentions have been shown to be strong predictors of health behaviors and are used across several theories. However, scales to measure these factors have not yet been developed and are needed to facilitate effective interventions., Methods: TSN self-efficacy and intentions scales were developed using a sequential nine-step procedure: identification of the domain and item generation; content validity; pre-testing of questions; sampling and survey administration; item reduction; extraction of factors; tests of dimensionality; tests of reliability; and tests of validity. The 14-member multidisciplinary, researcher and practitioner investigative team generated 50 unique items for self-efficacy and 24 unique items for intentions. After subjecting items to content validity and pre-testing, item sets were reduced to 21 assessing self-efficacy and nine assessing intentions. A nationwide sample of 2109 adult participants (49.7% female, Mean Age = 58.1; 59.8% White, 18.4% Hispanic, 13.3% Black) answered these items via an on-line survey., Results: Using split-half measures, principal components analysis indicated a one-factor solution for both scales. The factor structure was upheld in confirmatory factor analyses and had high internal consistency (α = .93 self-efficacy; .91 intentions). The scales were moderately correlated with each other (r = .56, p < .001) and were strongly related to TSN with large effect sizes (eta 2  > .20)., Conclusions: The study resulted in reliable and valid self-efficacy (14 items) and intentions (8 items) scales that can be used to develop future theory-based interventions to increase TSN and thereby improve population health., (© 2022. The Author(s).)

Trait emotional intelligence reflects a set of self-perceptions and behavioral tendencies to empathize with others and manage one's own emotions. Trait emotional intelligence is a valuable characteristic since it can aid social interaction, bolster subjective wellbeing, and predict career success. Past research suggests that brief exposures to greenspace can enhance outcomes related to facets of trait emotional intelligence. The current study employed a retrospective life course analysis to examine whether residential greenness and other aspects of the residential environment predict trait emotional intelligence in early adulthood. Childhood exposure for 297 college students was based on up to three home addresses from birth to age 18, weighted by residency duration. Greenspace was calculated with normalized difference vegetation index (NDVI) values in 500 m and 1000 m buffers. Partially supporting our predictions, we found emotional intelligence in young adults growing up in lower-income areas was positively associated with cumulative neighborhood greenness around childhood homes. The opposite pattern was found for those who grew up in higher-income areas, with greater greenness 500-m being associated with lower emotional intelligence scores. These are the first reported findings involving physical/natural environmental correlates of emotional intelligence and among the first to suggest an equigenic effect of greenspace on socio-emotional outcomes whereby exposure might help overturn inequalities rather than merely reduce them. If a causal link exists between nature exposure and emotional intelligence, then neighborhood greening might help children who begin life at a societal disadvantage through enhancing their ability to understand, use, and manage emotions., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Extreme, prolonged wildfire smoke (WFS) events are becoming increasingly frequent phenomena across the Western United States. Rural communities, dependent on contributions of nature to people's quality of life, are particularly hard hit. While prior research has explored the physical health impacts of WFS exposure, little work has been done to assess WFS impacts on mental health and wellbeing, or potential adaptation solutions., Methods: Using qualitative methods, we explore the mental health and wellbeing impacts experienced by community members in a rural Washington State community that has been particularly hard hit by WFS in recent years, as well as individual, family, and community adaptation solutions. We conducted focus groups with residents and key informant interviews with local health and social service providers., Results: Participants identified a variety of negative mental health and wellbeing impacts of WFS events, including heightened anxiety, depression, isolation, and a lack of motivation, as well as physical health impacts (e.g., respiratory issues and lack of exercise). Both positive and negative economic and social impacts, as well as temporary or permanent relocation impacts, were also described. The impacts were not equitably distributed; differential experiences based on income level, outdoor occupations, age (child or elderly), preexisting health conditions, housing status, and social isolation were described as making some residents more vulnerable to WFS-induced physical and mental health and wellbeing challenges than others. Proposed solutions included stress reduction (e.g., meditation and relaxation lessons), increased distribution of air filters, development of community clean air spaces, enhancing community response capacity, hosting social gatherings, increasing education, expanding and coordination risk communications, and identifying opportunities for volunteering. Findings were incorporated into a pamphlet for community distribution. We present a template version herein for adaptation and use in other communities., Conclusions: Wildfire smoke events present significant mental health and wellbeing impacts for rural communities. Community-led solutions that promote stress reduction, physical protection, and community cohesion have the opportunity to bolster resilience amid this growing public health crisis., (© 2022. The Author(s).)

Context: Daily outdoor play is encouraged by the American Academy of Pediatrics. Existing evidence is unclear on the independent effect of nature exposures on child health., Objective: We systematically evaluated evidence regarding the relationship between nature contact and children's health., Data Sources: The database search was conducted by using PubMed, Cumulative Index to Nursing and Allied Health Literature, PsychInfo, ERIC, Scopus, and Web of Science in February 2021., Study Selection: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In all searches, the first element included nature terms; the second included child health outcome terms., Data Extraction: Of the 10 940 studies identified, 296 were included. Study quality and risk of bias were assessed., Results: The strongest evidence for type of nature exposure was residential green space studies ( n = 147, 50%). The strongest evidence for the beneficial health effects of nature was for physical activity ( n = 108, 32%) and cognitive, behavioral, or mental health ( n = 85, 25%). Physical activity was objectively measured in 55% of studies, and 41% of the cognitive, behavioral, or mental health studies were experimental in design., Limitations: Types of nature exposures and health outcomes and behaviors were heterogenous. Risk of selection bias was moderate to high for all studies. Most studies were cross-sectional ( n = 204, 69%), limiting our ability to assess causality., Conclusions: Current literature supports a positive relationship between nature contact and children's health, especially for physical activity and mental health, both public health priorities. The evidence supports pediatricians in advocating for equitable nature contact for children in places where they live, play, and learn., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2021 by the American Academy of Pediatrics.)

Objectives: To evaluate feasibility and acceptability of a group-based nature recreation intervention (nature hiking) and control condition (urban hiking) for military Veterans with post-traumatic stress disorder (PTSD)., Design and Setting: A pilot randomised controlled trial conducted in the US Pacific Northwest., Participants: Veterans with PTSD due to any cause., Interventions: Twenty-six participants were randomised to a 12-week intervention involving either six nature hikes (n=13) or six urban hikes (n=13)., Primary and Secondary Outcome Measures: Feasibility was assessed based on recruitment, retention and attendance. Questionnaires and postintervention qualitative interviews were conducted to explore intervention acceptability. Questionnaires assessing acceptability and outcomes planned for the future trial (eg, PTSD symptoms) were collected at baseline, 6 weeks, 12 weeks (immediately after the final hike) and 24 weeks follow-up., Results: Of 415 people assessed for eligibility/interest, 97 were interested and passed preliminary eligibility screening, and 26 were randomised. Mean completion of all questionnaires was 91% among those in the nature hiking group and 68% in those in the urban hiking group. Over the course of the intervention, participants in the nature and urban groups attended an average of 56% and 58%, respectively, of scheduled hikes. Acceptability of both urban and nature hikes was high; over 70% reported a positive rating (ie, good/excellent) for the study communication, as well as hike locations, distance and pace. Median PTSD symptom scores (PTSD Checklist-5) improved more at 12 weeks and 24 weeks among those in the nature versus urban hiking group., Conclusions: This pilot study largely confirmed the feasibility and acceptability of nature hiking as a potential treatment for Veterans with PTSD. Adaptations will be needed to improve recruitment and increase hike attendance for a future randomised controlled trial to effectively test and isolate the ways in which nature contact, physical activity and social support conferred by the group impact outcomes., Trial Registration Number: NCT03997344., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Nature underpins human well-being in critical ways, especially in health. Nature provides pollination of nutritious crops, purification of drinking water, protection from floods, and climate security, among other well-studied health benefits. A crucial, yet challenging, research frontier is clarifying how nature promotes physical activity for its many mental and physical health benefits, particularly in densely populated cities with scarce and dwindling access to nature. Here we frame this frontier by conceptually developing a spatial decision-support tool that shows where, how, and for whom urban nature promotes physical activity, to inform urban greening efforts and broader health assessments. We synthesize what is known, present a model framework, and detail the model steps and data needs that can yield generalizable spatial models and an effective tool for assessing the urban nature-physical activity relationship. Current knowledge supports an initial model that can distinguish broad trends and enrich urban planning, spatial policy, and public health decisions. New, iterative research and application will reveal the importance of different types of urban nature, the different subpopulations who will benefit from it, and nature's potential contribution to creating more equitable, green, livable cities with active inhabitants., Competing Interests: The authors declare no competing interest., (Copyright © 2021 the Author(s). Published by PNAS.)

Living near, recreating in, and feeling psychologically connected to, the natural world are all associated with better mental health, but many exposure-related questions remain. Using data from an 18-country survey (n = 16,307) we explored associations between multiple measures of mental health (positive well-being, mental distress, depression/anxiety medication use) and: (a) exposures (residential/recreational visits) to different natural settings (green/inland-blue/coastal-blue spaces); and (b) nature connectedness, across season and country. People who lived in greener/coastal neighbourhoods reported higher positive well-being, but this association largely disappeared when recreational visits were controlled for. Frequency of recreational visits to green, inland-blue, and coastal-blue spaces in the last 4 weeks were all positively associated with positive well-being and negatively associated with mental distress. Associations with green space visits were relatively consistent across seasons and countries but associations with blue space visits showed greater heterogeneity. Nature connectedness was also positively associated with positive well-being and negatively associated with mental distress and was, along with green space visits, associated with a lower likelihood of using medication for depression. By contrast inland-blue space visits were associated with a greater likelihood of using anxiety medication. Results highlight the benefits of multi-exposure, multi-response, multi-country studies in exploring complexity in nature-health associations.

Mounting evidence shows that nature contact is associated with affective benefits. However, the psychological mechanisms responsible for these effects are not well understood. In this study, we examined whether more time spent in nature was associated with higher levels of positive affect in general, and lower levels of negative affect and rumination in general. We also conducted a cross-sectional mediation analysis to examine whether rumination mediated the association of nature contact with affect. Participants ( N = 617) reported their average time spent in nature each week, as well as their general levels of positive and negative affect, and the degree to which they typically engaged in rumination in daily life. We then used structural equation modeling to test our hypotheses. Our results support the hypothesis that nature contact is associated with general levels of affect, and that rumination mediates this association for negative affect, and marginally mediates this association for positive affect., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Bratman, Young, Mehta, Lee Babineaux, Daily and Gross.)

Evolutionary psychology theories propose that contact with green, natural environments may benefit physical health, but little comparable evidence exists for brown, natural environments, such as the desert. In this study, we examined the association between "brownness" and "greenness" with fasting glucose among young residents of El Paso, Texas. We defined brownness as the surface not covered by vegetation or impervious land within Euclidian buffers around participants' homes. Fasting glucose along with demographic and behavioral data were obtained from the Nurse Engagement and Wellness Study ( n = 517). We found that residential proximity to brownness was not associated with fasting glucose when modeled independently. In contrast, we found that residential greenness was associated with decreased levels of fasting glucose, despite the relatively low levels of greenness within the predominantly desert environment of El Paso. A difference between the top and bottom greenness exposure quartiles within a 250 m buffer was associated with a 3.5 mg/dL decrease in fasting glucose levels (95% confidence interval: -6.2, -0.8). Our results suggest that within the understudied context of the desert, green vegetation may be health promoting to a degree that is similar to other, non-desert locations in the world that have higher baselines levels of green.

Background: University students are increasingly recognized as a vulnerable population, suffering from higher levels of anxiety, depression, substance abuse, and disordered eating compared to the general population. Therefore, when the nature of their educational experience radically changes-such as sheltering in place during the COVID-19 pandemic-the burden on the mental health of this vulnerable population is amplified. The objectives of this study are to 1) identify the array of psychological impacts COVID-19 has on students, 2) develop profiles to characterize students' anticipated levels of psychological impact during the pandemic, and 3) evaluate potential sociodemographic, lifestyle-related, and awareness of people infected with COVID-19 risk factors that could make students more likely to experience these impacts., Methods: Cross-sectional data were collected through web-based questionnaires from seven U.S. universities. Representative and convenience sampling was used to invite students to complete the questionnaires in mid-March to early-May 2020, when most coronavirus-related sheltering in place orders were in effect. We received 2,534 completed responses, of which 61% were from women, 79% from non-Hispanic Whites, and 20% from graduate students., Results: Exploratory factor analysis on close-ended responses resulted in two latent constructs, which we used to identify profiles of students with latent profile analysis, including high (45% of sample), moderate (40%), and low (14%) levels of psychological impact. Bivariate associations showed students who were women, were non-Hispanic Asian, in fair/poor health, of below-average relative family income, or who knew someone infected with COVID-19 experienced higher levels of psychological impact. Students who were non-Hispanic White, above-average social class, spent at least two hours outside, or less than eight hours on electronic screens were likely to experience lower levels of psychological impact. Multivariate modeling (mixed-effects logistic regression) showed that being a woman, having fair/poor general health status, being 18 to 24 years old, spending 8 or more hours on screens daily, and knowing someone infected predicted higher levels of psychological impact when risk factors were considered simultaneously., Conclusion: Inadequate efforts to recognize and address college students' mental health challenges, especially during a pandemic, could have long-term consequences on their health and education., Competing Interests: The authors have declared that no competing interests exist.

Nature interactions have been demonstrated to produce reliable affective benefits. While adults demonstrate strong preferences for natural environments over urban ones, it is not clear whether these affective benefits result from exposure to nature stimuli per se, or result from viewing a highly preferred stimulus. In one set of studies (Study 1 and 2), state affect before and after image viewing was examined as a function of both preference level (high, low, very high, or very low aesthetic value) and environment type (nature or urban). When aesthetic value was matched, no differences in affect change were found between environments. However, affect change was predicted by individual participants' ratings for the images. The largest affective benefits occurred after viewing very high aesthetic nature images, but Study 2 lacked an equivalently preferred urban image set. In a second set of studies (Study 3 and 4), new sets of very highly preferred images in categories other than nature scenes (urban scenes and animals) were employed. As before, individual differences in preference for the images (but not image category) was predictive of changes in affect. In Study 5, the nature and urban images from Study 1 were rated on beauty to assess whether the stimuli's preference ratings were capturing anything other than simple aesthetics. Results showed that beauty/aesthetics and preference ('liking') were nearly identical. Lastly, a replication of Study 2 (Study 6) was conducted to test whether priming preference accounted for these benefits, but this was not the case. Together, these results suggest that nature improves affective state because it is such a highly preferred environment., Competing Interests: The authors declare no conflicts of interest., (© 2020 Elsevier Ltd. All rights reserved.)

Exposure to natural environments is associated with a lower risk of common mental health disorders (CMDs), such as depression and anxiety, but we know little about nature-related motivations, practices and experiences of those already experiencing CMDs. We used data from an 18-country survey to explore these issues (n = 18,838), taking self-reported doctor-prescribed medication for depression and/or anxiety as an indicator of a CMD (n = 2698, 14%). Intrinsic motivation for visiting nature was high for all, though slightly lower for those with CMDs. Most individuals with a CMD reported visiting nature ≥ once a week. Although perceived social pressure to visit nature was associated with higher visit likelihood, it was also associated with lower intrinsic motivation, lower visit happiness and higher visit anxiety. Individuals with CMDs seem to be using nature for self-management, but 'green prescription' programmes need to be sensitive, and avoid undermining intrinsic motivation and nature-based experiences.

A growing body of empirical evidence is revealing the value of nature experience for mental health. With rapid urbanization and declines in human contact with nature globally, crucial decisions must be made about how to preserve and enhance opportunities for nature experience. Here, we first provide points of consensus across the natural, social, and health sciences on the impacts of nature experience on cognitive functioning, emotional well-being, and other dimensions of mental health. We then show how ecosystem service assessments can be expanded to include mental health, and provide a heuristic, conceptual model for doing so.

Unprecedented rates of urbanization are changing our understanding of the ways in which children build connections to the natural world, including the importance of educational settings in affecting this relationship. In addition to influencing human-nature connection, greenspace around school grounds has been associated with benefits to students' cognitive function. Questions remain regarding the size of this benefit relative to other factors, and which features of greenspace are responsible for these effects. We conducted a large-scale correlative study subsampling elementary schools ( n = 495) in ecologically, socially and economically diverse California. After controlling for common educational determinants (e.g., socio-economic status, race/ethnicity, student teacher ratio, and gender ratio) we found a significant, positive association between test scores and tree and shrub cover within 750 and 1000 m of urban schools. Tree and shrub cover was not associated with test scores in rural schools or five buffers closer to urban schools (10, 50, 100, 300, and 500 m). Two other greenspace variables (NDVI and agricultural area) were not associated with test performance at any of the analyzed buffer distances for rural or urban schools. Minority representation had the largest effect size on standardized test scores (8.1% difference in scores with 2SD difference in variable), followed by tree and shrub cover around urban schools, which had a large effect size (2.9-3.0% at 750 and 1000 m) with variance from minority representation and socioeconomic status (effect size 2.4%) included. Within our urban sample, average tree-cover schools performed 4.2% (3.9-4.4, and 95% CI) better in terms of standardized test scores than low tree-cover urban schools. Our findings support the conclusion that neighborhood-scale (750-1000 m) urban tree and shrub cover is associated with school performance, and indicate that this element of greenspace may be an important factor to consider when studying the cognitive impacts of the learning environment. These results support the design of experimental tests of tree planting interventions for educational benefits.

Background: At a time of increasing disconnectedness from nature, scientific interest in the potential health benefits of nature contact has grown. Research in recent decades has yielded substantial evidence, but large gaps remain in our understanding., Objectives: We propose a research agenda on nature contact and health, identifying principal domains of research and key questions that, if answered, would provide the basis for evidence-based public health interventions., Discussion: We identify research questions in seven domains: a ) mechanistic biomedical studies; b ) exposure science; c ) epidemiology of health benefits; d ) diversity and equity considerations; e ) technological nature; f ) economic and policy studies; and g ) implementation science., Conclusions: Nature contact may offer a range of human health benefits. Although much evidence is already available, much remains unknown. A robust research effort, guided by a focus on key unanswered questions, has the potential to yield high-impact, consequential public health insights. https://doi.org/10.1289/EHP1663.

Urbanization has many benefits, but it also is associated with increased levels of mental illness, including depression. It has been suggested that decreased nature experience may help to explain the link between urbanization and mental illness. This suggestion is supported by a growing body of correlational and experimental evidence, which raises a further question: what mechanism(s) link decreased nature experience to the development of mental illness? One such mechanism might be the impact of nature exposure on rumination, a maladaptive pattern of self-referential thought that is associated with heightened risk for depression and other mental illnesses. We show in healthy participants that a brief nature experience, a 90-min walk in a natural setting, decreases both self-reported rumination and neural activity in the subgenual prefrontal cortex (sgPFC), whereas a 90-min walk in an urban setting has no such effects on self-reported rumination or neural activity. In other studies, the sgPFC has been associated with a self-focused behavioral withdrawal linked to rumination in both depressed and healthy individuals. This study reveals a pathway by which nature experience may improve mental well-being and suggests that accessible natural areas within urban contexts may be a critical resource for mental health in our rapidly urbanizing world.

Scholars spanning a variety of disciplines have studied the ways in which contact with natural environments may impact human well-being. We review the effects of such nature experience on human cognitive function and mental health, synthesizing work from environmental psychology, urban planning, the medical literature, and landscape aesthetics. We provide an overview of the prevailing explanatory theories of these effects, the ways in which exposure to nature has been considered, and the role that individuals' preferences for nature may play in the impact of the environment on psychological functioning. Drawing from the highly productive but disparate programs of research in this area, we conclude by proposing a system of categorization for different types of nature experience. We also outline key questions for future work, including further inquiry into which elements of the natural environment may have impacts on cognitive function and mental health; what the most effective type, duration, and frequency of contact may be; and what the possible neural mechanisms are that could be responsible for the documented effects., (© 2012 New York Academy of Sciences.)