Plant for Life: The Green Health Agenda ` For more information, Please see websites below: ` Organic Edible Schoolyards & Gardening with Children http://scribd.com/doc/239851214 ` Double Food Production from your School Garden with Organic Tech http://scribd.com/doc/239851079 ` Free School Gardening Art Posters http://scribd.com/doc/239851159` ` Increase Food Production with Companion Planting in your School Garden http://scribd.com/doc/239851159 ` Healthy Foods Dramatically Improves Student Academic Success http://scribd.com/doc/239851348 ` City Chickens for your Organic School Garden http://scribd.com/doc/239850440 ` Simple Square Foot Gardening for Schools - Teacher Guide http://scribd.com/doc/239851110

1. PLANT FOR LIFE
Briefing Report 11: January 2006
Ross Cameron and Sarah Swan
University of Reading
The Green Health Agenda
The psychological and physical health benefits associated with the natural
environment appears to be gaining political momentum. In their recent report
‘Ecosystems and human well-being’, The World Health Organisation acknowledges
that natural ecosystems not only provide humans with physical and nutritional
requirements, but they impact on our psychological health as well (Corvalan, et al.
2005).
“People and communities obtain many non-material benefits from ecosystems.
Ecosystems provide sites and opportunities for tourism, recreation, aesthetic
appreciation, inspiration and education. Such services can improve mental health,
enhance a subjective sense of culture or place; and also enrich objective knowledge of
natural and social sciences. Health benefits of these services may be materially less
tangible than those captured by conventional health indicators or standard economic
evaluation measures, but they are highly valued by people in all societies
nevertheless.”
On the domestic agenda too, Green Space has entered the health of the nation
debate. The Forestry Commission has just released their scoping study on the
economic benefits to be associated with access to green space in terms of improved
health for UK citizens (Crabtree et al., 2005). This report highlights the growing
concern in government with the health status of the population and its increasing
sedentary lifestyle. 23% of males and 26% of females in the UK are classified as

2. sedentary. The cost of physical inactivity in England is estimated at £8.2bn per year
with an additional £2.5bn as the contribution of inactivity to obesity. The Public
Health White Paper from the Department of Health has, as three of its six overarching
priorities, ‘reducing obesity’, ‘increasing exercise’ and ‘improving mental health’.
The report states that Green Space can contribute to the delivery of all of these
objectives.
Green Space is seen as a major resource for physical activity, especially
walking, running and cycling (the extent to which urban and rural Green Space
contribute is not made clear). Regular physical activity is highly efficacious in the
prevention of illness and as a therapeutic intervention for existing illness. Physical
activity is beneficial (preventative and therapeutic) for cardiovascular disease,
musculo-skeletal diseases, stroke and cancer. The report outlines that access to, and
use of,Green Space has benefits for psychological health but these are more difficult
to quantify with the evidence available.
Crabtree et al. (2005) identified there were still a number of gap areas for
determining the benefits of access to green space. These were:
1. The value of psychological benefits from Green Space (from physical
activity and less active use).
2. Relative risk information for different age groups and the time profile of
risks when exercise is continued or discontinued.
3. Information on the benefits from increased physical activity to people who
are intermediate in activity between the totally sedentary and those taking
frequent physical activity
4. Improved evaluation of activity programmes with measures of health
outcomes, drop out rates, added benefits and programme costs.
The reports main findings are summarised –
1. A permanent reduction of 1% unit in the UK sedentary population (from 23%
to 22%) is estimated to deliver a social benefit of up to £1.44bn per year. This

3. does not include psychological benefits from Green Space. The evidence on
this aspect is limited but benefits may be substantial.
2. Accessible, attractive Green Space is associated with autonomous physical
activity. There is evidence that people are more likely to engage in frequent
physical activity (with a lower rate of obesity) in locations that have high
quality Green Space and a well cared-for environment.
3. Green Space is most valuable as a physical activity resource where it is used
regularly by high volumes of people (mainly in an urban context). It needs to
be accessible, attractive, and of sufficient size to facilitate activity (or connect
to other areas). Sports fields generally deter undedicated use. Remote Green
Space is generally less valuable as a health resource, when assessed in terms
of its ability to facilitate high volume and frequent physically active use.
4. Passive use of Green Space (e.g. visual), low-level physical use (e.g.
picnicking and social activities) and intermittent or irregular use i.e. not on a
weekly or daily basis, is unlikely to give significant physical benefits.
However, this use is associated with psychological and quality of life benefits.
There is a lack of evidence as to the size of the benefits using validated health
and quality of life scales.
5. There is a general lack of information on the long-term benefits of
programmes that encourage Green Space-based physical activity. Data
collection in organised programmes is weak and needs to concentrate on
additional benefits, long-term behavioural change (drop out rates) and
programme costs including costs to participants. There is a need to incorporate
a standardised assessment of physical activity and brief health and quality of
life information on people entering them. This would provide ongoing
baseline data for more extensive follow up studies, and for community studies
assessing awareness and willingness to use programmes.

4. 6. The evidence available on activity programmes that use existing Green Space
indicates the potential for cost-effective health benefits at low cost if running
costs are low. Capital expenditure for woodland or other Green Space-based
physical exercise projects is minimal by comparison with gyms and leisure
complexes. Much depends on generating added interest by attracting relatively
sedentary people into the programmes.
7. The key attribute for classifying Green Space in relation to health is its
functionality in relation to physical activity. A dichotomous classification
would split Green Space into:
· That which facilitates physical activity (through scale, attraction and
accessibility or through connectedness, including networks of paths);
and
· That which does not.
The report also concluded that with the current evidence base it is not possible
to provide a more detailed classification based on the characteristics of Green
Space that encourage autonomous use for physical activity. Similarly, it is not
possible to classify Green Space according to the psychological benefits it
delivers. As the evidence base is extended it should be possible to create a
more detailed classification of Green Space in relation to health benefits.
Although there is scientific evidence to suggest that well-managed Green
Space can encourage physical activity and may improve mental well-being, it is rarely
prescribed by medical professionals. A recent paper by Pretty et al. (2003), states that
“Intuition, experience and some evidence support the notion that nature contact
should be seen as a positive health intervention, yet health professionals have not
widely adopted horticulture, wilderness, nature or animal therapy”.
The Pretty et al. (2003) report also goes on to re-emphasise the possible
problems associated without providing access to Green Space.

5. “If nature is important to humans, then deprivation is likely to create problems.
Kellert (1993) suggests that a degraded relationship to nature increases the likelihood
of diminished material, social and psychological existence. Thus increasing
disconnections between people and nature will have an impact on individuals, on their
communities and cultures, and ultimately on how they treat and care for nature. These
disconnections are now a common part of many lifestyles in modern industrialised
societies – with increasing numbers of people living in urban areas, and fewer people
having daily or routine contact with nature. Wilson (1993) asks what will happen to
the human psyche when such a defining part of the human evolutionary experience is
diminished or erased? There is a well-established literature that shows that the
physical and social features of the environment affect behaviour, interpersonal
relationships and actual mental states (Newman, 1980; Freeman, 1984, 1998), as well
as shape relations with nature (Pretty and Ward, 2001). The design of the built and
natural environment thus matters for mental health (Kaplan et al., 1998; Freeman,
1984; Halpern, 1995). People seem to prefer natural environments to other settings,
and the benefits go beyond just enjoyment. Kaplan et al. (1998) indicate that such
natural settings need not be remote wildlands, and emphasise the value of ‘the
everyday, often unspectacular natural environment that is, or ideally would be,
nearby’ – parks and open spaces, street trees, vacant lots and backyard gardens, as
well as fields and forests. Equally, a dysfunctional built environment can often be a
source of stress, and a malign influence over social networks and support
mechanisms. Despite this, we seem not to care. Halpern (1995) asserts almost no
reference is made by planners to the psychological literature.”
What does gardening mean to people ?
A number of recent reports focus on gardening specifically, as a green activity
and highlight the advantages (and some drawbacks) of this activity for different user
groups. Unruh (2004) provides a paper which compares the meaning of gardens and
gardening in daily life for people with serious health problems. Twenty-seven women
and 15 men were interviewed about the meaning of gardens and gardening in their
daily life. Eighteen participants were diagnosed with cancer. The majority of the

6. participants were aged 45 to 65 years. Approximately 2/3 of the gardens were located
in small towns or rural areas of Nova Scotia, Canada. The interview questions were
semi-structured and used as conversational prompts to explore interest in gardening;
relationships between gardening, health and well-being; and frustrations with
gardening. Comparisons were drawn between the meaning of gardening for people
with cancer and people without cancer. The study revealed important benefits of
gardening on physical, emotional, social, and spiritual well-being, and highlighted a
key role of gardening as a coping strategy for living with stressful life experiences.
Milligan et al, (2004) also explored the role gardening played in peoples lives
in terms of emotional well-being. In particular, they examined how communal
gardening activity on allotments contributed to the maintenance of health and well
being amongst older people. Drawing on research in northern England, they examined
firstly the importance of the wider landscape and the domestic garden in the lives of
older people, then focused on gardening activity on allotments.
Milligan et al, (2004) concluded that older people can gain a sense of
achievement, satisfaction and aesthetic pleasure from their gardening activity.
However, while older people continue to enjoy the pursuit of gardening, the physical
shortcomings attached to the aging process means they may increasingly require
support to do so. Communal gardening on allotment sites, they maintain, creates
inclusive spaces in which older people benefit from gardening activity in a mutually
supportive environment that combats social isolation and contributes to the
development of their social networks.
Similar studies evaluating the role of community gardens in the USA
produced similar conclusions. Approximately one-third of the participants developed
new friendships through community gardens (Patel, 1991). Patel concluded that
gardening promotes a community atmosphere and gives people an opportunity to
meet others, share concerns, and solve a few problems together. In his study, almost a
third helped others and 14% shared their produce. What stood out in his responses
was that through gardening, participants felt good about themselves and their ability
to cope with the world around them. Behaviour as a social group was modified by the

7. presence of plants and participation in gardening activities; and gardening served as a
way to break down some of the social barriers existing between neighbours.
Community garden activities have also been shown to help empower individuals in
the UK. The ‘taste of a better future’ project aimed to empower ethnic minority
women to grow their own organic food in land close to their homes (Rycroft, 2000).
The author reports that
“ All of the women said their lives had changed for the better; the project had made
them happier and helped them to fight boredom”.
Many of the participants claimed they saw the vegetable garden as a place of natural
beauty and helped provide a connection to their country of origin.
Milligan et al., (2004) suggest communal gardening sites offer a practical and
cost-effective way to help develop a 'therapeutic landscape'. Another study (Brown et
al. 2004) examined the effects of indoor gardening on socialization, activities of daily
living (ADLs), and perceptions of loneliness in elderly nursing home residents. A
total of 66 residents from two nursing homes participated in this two-phase study. In
the first phase, one experimental group participated once a week for 5 weeks in
gardening activities while a control group received a 20-minute visit. While no
significant differences were found between groups in socialization or perceptions of
loneliness, there were significant pre-test and post-test differences within groups on
loneliness and guidance, reassurance of worth, social integration, and reliable alliance.
The results also demonstrated gardening interventions had a significant effect on three
ADLs (transfer, eating, and toileting). The second phase examined differences in the
effects of a 5-week versus a 2-week intervention program. Although no significant
within-group differences were noted in socialization, loneliness, or ADLs, the 5-week
program was more effective in increasing socialization and physical functioning.
Continuing with the theme of older people, another study by Infantino (2005)
discusses gardening as a strategy for health promotion in older women. According to
this paper preliminary research has identified gardening as an activity that may be
‘cognitively protective’ (helps keep the brain functioning in terms of learning and
reasoning skills). Clarification of gardening as a concept is a first step toward the

8. development of theory that will enable nurses to develop interventions related to
gardening. The study aimed to describe the phenomenon of gardening. Using a
phenomenological methodology, interviews with five older women were analysed.
Four themes emerged: "Gardening is challenge and work," "Gardening is connection,"
"Gardening is continuous learning," and "Gardening is sensory and aesthetic
experience." The author states the phenomenon of gardening is analogous to the
relationship between a spider and its web, linking internal and external environments
and providing support over a lifetime. It appears that the gardening experience, as an
evolving lifelong process, sustains older women in their cognitive and spiritual
development.
In contrast to some of the aforementioned findings, research by Bloedel et al.
(2000) did not show a relationship between gardening activities and a sense of
control, when a study was conducted on an elderly individual. Sense of control is
important to elderly and disable people in providing value to their lives (for example,
a degree of independence and control over their activities helps maintain a positive
attitude for people in residential care). The authors acknowledge though that the
population sample was too small to make any ‘hardline’ conclusions.
A recent paper by Söderback et al. (2004) highlights the role of horticultural
therapy in Sweden and patients rehabilitation following brain damage. Forty-six
patients with brain damage participated in group horticultural therapy. The
horticulture therapy included imagining nature, viewing nature, visiting a hospital
healing garden and, most important, actual gardening. It was expected to influence
healing, alleviate stress, increase well-being and promote participation in social life
and re-employment for people with mental or physical illness. The results obtained
suggests horticulture therapy does mediate emotional, cognitive and/or sensory motor
functional improvement, increased social participation, health, well-being and life
satisfaction. However, the authors felt the degree of effectiveness, especially of the
interacting and acting forms, requires further investigation.
Gardening based injuries

9. A survey carried out by Powell et al. (1998) aimed to estimate the frequency
of injuries associated with five commonly performed moderately intense activities:
walking for exercise, gardening and yard work, weightlifting, aerobic dance, and
outdoor bicycling. National estimates were derived from weighted responses of over
5,000 individuals contacted between April 28 and September 18, 1994, via random-digit
dialling of U.S. residential telephone numbers. Self-reported participation in
these five activities in the late spring and summer of 1994 was common, ranging from
an estimated 14.5 of the population for aerobics (nearly 30 million people) to 73.0%
for walking (about 138 million people). The estimated number of people injured in the
30 d before their interview ranged from 330,000 for outdoor bicycle riding to 2.1
million for gardening or yard work. During walking and gardening, men and women
were equally likely to be injured, but younger people (18-44 yr) were more likely to
be injured than older people (45+ yr). Injury rates were low, yet large numbers of
people were injured because participation rates were high. Most injuries were minor,
but injuries may reduce participation in these otherwise beneficial activities. The
authors conclude that additional studies are needed to confirm the magnitude of the
problem, to identify modifiable risk factors, and to recommend methods to reduce the
frequency of such injuries.
Emotional responses to flowers and evolutionary behaviour
A recent study published by Haviland-Jones et al. (2005) in the Journal
Evolutionary Psychology aimed at understanding human response to flowers. The
authors claim that for more than 5000 years, people have cultivated flowers although
there is no known reward for this ‘costly’ behaviour. They carried out three different
studies in an attempt to show that flowers are a powerful positive emotion ‘inducer’.
In Study 1, flowers, upon presentation to women, always elicited the Duchenne or
true smile. Women who received flowers reported more positive moods 3 days later.
In Study 2, a flower given to men or women in an elevator elicited more positive
social behaviour than other stimuli (e.g. a gift of a pen). In Study 3, flowers presented
to elderly participants (55+ age) elicited positive mood reports and improved episodic
memory, but did not increase social contact between recipients. The authors conclude
that flowers have immediate and long-term effects on emotional reactions, mood,

10. social behaviours and even memory for both males and females. There is little
existing theory in any discipline that explains these findings. They suggest that
cultivated flowers are rewarding because they have evolved to rapidly induce positive
emotion in humans, just as other plants have evolved to induce varying behavioural
responses in a wide variety of species leading to the dispersal or propagation of the
plants.
Indirect support for Wilson’s, Biophilia theory (Wilson, 1984), comes from a
paper by Öhman et al. (2001). These authors showed that images of potential threats
(in this case photographs of snakes and spiders) were selected more rapidly from a
matrix of images, than more benign images such as flowers or mushrooms. The
authors conclude the brain works in a different way when determining threat signals
from non-threatening images. This intrinsic and early response to images of natural
threats, may provide addition evidence for Wilson’s theory that we retain emotional
responses relating to our evolutionary past.
References
Bloedel, D., Baumgarten, S. Bores, N. and Fanetti, K. (2000). Gardening and the
elderly: A study involving the effects on purpose of life and activity involvement.
Journal of Undergraduate Research, University of Wisconsin. 3:281-286.
Brown, V.M., Allen, A.C., Dwozan, M., Mercer, I., Warren, K. (2004). Indoor
gardening older adults: effects on socialization, activities of daily living, and
loneliness. Journal of Gerontological Nursing. 30:34-42
Corvalan, C., Hales, S. and McMichael, A. (2005). Ecosystems and human well-being
– Health synthesis. World Health Organization. WHO Press, Geneva, Switzerland.
pp53.
http://www.who.int/globalchange/ecosystems/ecosys.pdf
Crabtree, R., Willis, K. and Osman, L. (2005). Economic benefits of accessible green
spaces for physical and mental health: Scoping study. Final Report for the Forestry
Commission. pp56.
http://www.forestry.gov.uk/pdf/FChealth10-2final.pdf/$FILE/FChealth10-2final.pdf
Freeman, H. (ed). (1984). Mental Health and the Environment. Churchill Livingstone,
London.

11. Freeman, H. (1998). Healthy environments. In Encyclopaedia of Mental Health,
Volume 2. Academic Press.
Halpern, D. (1995). Mental Health and the built environment. More than bricks and
mortar? Taylor and Francis, London.
Haviland-Jones, J., Hale Rosario, H., Wilson, P. and McGuire, T.R. (2005). An
environmental approach to positive emotion: Flowers. Evolutionary Psychology. 3:
104-132
Infantino, M. (2005).Gardening: a strategy for health promotion in older women.
Journal of New York State Nurses Association. 35:10-7.
Kaplan, R., Kaplan, S. and Ryan, R.L. (1998). With people in mind. Design and the
management of everyday nature. Island Press, Washington DC.
Kellert, S. (1993). The biological basis for human values of nature. In Kellert, S.R.
and Wilson E.O. (eds). The Biophilia Hypothesis. Island Press, Washington DC.
Milligan, C., Gatrell, A., Bingley, A. (2004)."Cultivating health": Therapeutic
landscapes and older people in northern England. Social Science and Medicine.
58:1781-93.
Newman 1980. Community of Interest. Anchor, New York.
Öhman, A. Flykt, A. and Esteves, F. (2001). Emotion drives attention: Detecting the
snake in the grass. Journal of Environmental Psychology 130: 466-478.
Pretty, J., Griffin, M., Sellens, M. and Pretty C. (2003). Green exercise:
Complementary roles of nature, exercise and diet in physical and emotional well-being
and implications for public health policy. Occasional Paper 2003-1, University
of Essex. pp38.
http://www2.essex.ac.uk/ces/ResearchProgrammes/CESOccasionalPapers/GreenExer
cise.pdf
Patel, I.C. (1991). Gardening's socioeconomic impacts. Journal of Extension 29.
http://www.joe.org/joe/1991winter/a1.html
Powell, K.E., Heath, G.W., Kresnow, M.J., Sacks, J.J., Branche, C.M. (1998).
Injury rates from walking, gardening, weightlifting, outdoor bicycling, and aerobics.
Medicine & Science in Sports & Exercise.30:1246-1249.
Pretty, J.N. and Ward, H. (2001). Social capital and the environment. World
Development 29: 209-227.
Rycroft, V. (2000). Women’s Environmental Network. Taste of a better future: A
participatory evaluation. pp 17.
http://72.14.207.104/search?q=cache:xpURbmoWlnMJ:www.wen.org.uk/local_food/r

12. eports/Evaluation.pdf+taste+of+a+better+future+and+2000&hl=en&gl=uk&ct=clnk&
cd=1
Söderback, I., Söderström, M. and Schälander, E. (2004). Horticultural therapy: the
'healing garden' and gardening in rehabilitation measures at Danderyd hospital
rehabilitation clinic, Sweden. Pediatric rehabilitation.7: 245-260.
Unruh, A.M. (2004). The meaning of gardens and gardening in daily life: A
comparison between gardeners with serious health problems and healthy participants.
Acta Horticulturae 639: 67-73.
Wilson, E.O. (1984). Biophilia, The human bond with other species. Harvard
University Press.
Wilson, E.O. (1993). Biophilia and the conservation ethic. In Kellert S R and Wilson
E O (eds). The Biophilia Hypothesis. Island Press, Washington DC.