Health & Well-Being

Background Information

Research on outdoor recreation-associated health benefits has been increasing but typically focuses on specific risk factors (e.g. physical inactivity) rather than preventative measures and outcomes (e.g. healthy weight), and most of the previous research in this area has focused on physical health. Kaczynski and Henderson's (2007) review of 50 empirical studies examining associations between physical activity and park and recreation services found mixed results: 20 studies positive, 20 mixed, 9 no significant associations and one negative. Still, research asserts the positive association between proximity to parks and trails and physical activity across age groups (Boone-Heinonen, Casanova, Richardson, & Gordon-Larsen, 2010; Cohen et al., 2007; Frank, Kerr, Chapman, & Sallis, 2007; Roemmich, et al., 2006).

In terms of health outcomes (beyond specific risk factors), the limited research reveals no statistical association between indicators of recreation opportunity and healthy weight among youth (Potwarka, Kaczynski, & Flack, 2008) or between a neighborhood's access to open space and Body Mass Index (Witten, Hiscock, Pearce, & Blakely, 2008). However, Bell, Wilson, and Liu (2008) reported that greenness was generally associated with a reduction in body mass index in children. Healthy weight and BMI are two physical health outcomes. The 2014 report card on physical activity for U.S. children and youth indicates overall low physical activity indicators with grades of C- to F. The exception was a B- grade for 84.6% of children and youth (aged 6-17) living in neighborhoods with the presence of at least one park or playground. Disparities exist however by ethnicity, socioeconomic status, sidewalk and bike path accessibility, usage, perceived neighborhood safety and the parks availability of quality programming (Dentro, Beals, Crouter, Eisenmann, McKenzie, Pate,... & Katzmarzyk, 2014).

Physical health is just one aspect of health, however, and a growing body of research is beginning to explore connections between parks, green space, and other components of health (Hartig et al., 2014; Larson et al., 2016), including the contributions of ecosystem services to multiple aspects of health and well-being (Jennings et al., 2016). For example, Larson et al. (2016) used a holistic measure of subjective well-being that included physical, mental, and social components to demonstrate significant associations between parks and health outcomes in over 40 U.S. cities. In a recent literature review focused on parks and other green environments, Kuo (2010) summarizes rigorous, interdisciplinary and global evidence that persons living in greener neighborhoods have better social, psychological and physical health outcomes that those who do not, even when controlling for socioeconomic and other possibly competing variables. Of particular relevance to this project, contact with nature has been shown to reduce ADHD in children (Faber Taylor & Kuo, 2009). Kuo concludes that nearby spectacular scenery and/or physical activity alone are not necessary for achieving positive health effects. Healthy human functioning is sustained as well by the sensory experience stimulated by views of trees and vegetation and/or a walk in a green setting. Other research supports positive links between green space and psychological health (Beyer et al., 2014; Bratman et al., 2012; Cohen-Cline et al., 2015), cognitive functioning (Dadvand et al., 2015), and social development and interactions (Holtan et al., 2015; Zelenski et al., 2015), suggesting that benefits associated with green space and time in nature transcends extend well beyond physical activity promotion.

Studies involving self-reports tend to be in the positive direction regarding park access and health benefits. Local park and recreation users studied by Godbey et al. (1998) reported fewer visits to a physician for purposes other than check-ups than did non-park users, and active park users had better self-reported health and other indicators of good health than did passive users and non-park users. More recent literature reviews confirm these findings (Ho, Payne, Orsega-Smith, & Godbey, 2003; Maller, Townsend, Pryor, Brown, & St. Ledger, 2005). The majority of outdoor recreation and health research focuses on communities or neighborhoods. When examined at a larger geographic scale, research related to park proximity and health beyond is similarly inconsistent as found in Kaczynski and Henderson's (2007) review. The four published studies at the macro-level reveal stronger connections exist between state level outdoor recreation opportunities and physical activity than between outdoor recreation opportunities and obesity (Edwards et al., 2011; Rosenberger et al., 2005; Rosenberger et al., 2009; West et al., 2012). Larson, Jennings & Cloutier’s (2016) recent study on urban parks quality, quantity and accessibility as a predictor of five elements of human well-being provide insights in parks contribution to public health.

Much work has focused on urban parks, however Kline, Rosenberger, and White (2011) found that national forest lands significantly contribute to physical activity among the U.S. American public. Children with closer access to recreational facilities and programs have been shown to be more active (e.g. Cohen et al., 2007). However, studies reveal as many as half of park users are sedentary (Floyd, Spengler, Maddock, Gobster, & Suau, 2008; Shores & West, 2008).

Regardless of proximity or access, constraints to outdoor recreation intervene to prevent interest, participation and subsequent benefit attainment (Jackson & Scott, 1999). Initially, Crawford and Godbey (1987) identified three types of constraints: intrapersonal constraints (e.g., perceived lack of skill), interpersonal constraints (e.g., no one to go with), and structural constraints (e.g., lack of time/money). The latest evolution of constraints research differentiates structural constraints into four sub-categories: natural environment, social environment, territorial, and institutional (Walker & Virden, 2005). Structural constraints are of primary interest as they appear the most manageable. Understanding how and to what extend different populations enjoy the health benefits associated with green space is a central component of this project.

Our Objective #1: Demonstrate and expand the evidence for the role of park and outdoor recreation services in promoting physical activity and associated preventative health benefits, particularly among youth, as well as constraints to this activity.

A variety of methods have been and will continue to be used for understanding physical activity and outdoor activities, as well as constraints to outdoor activities. Surveys, interviews, direct observation and GIS examine not only the amount and type of physical activity by various age and ethnic groups, but also constraints to such activity and the key role of proximity. Expanding this systems-based approach to account for a broader array of socio-ecological forces and interactions is needed.

Auditing and assessment tools (e.g., SOPLAY-System for Observing Play and Leisure Activity in Youth; and NEWS-Neighborhood Environment Walkability Scale) are furthering the evidence and information, as is photo elicitation. Photo elicitation was used by Montanez et al. (2012) to explore children's perceptions of places to be physically active. Behavioral monitoring devices, such as pedometers and accelerometers are used to measure volume and intensity of activity associated with various types of outdoor facilities and amenities.

Concentration performance tests, clinical depression diagnostic tools, physiological measures using standard medical instrumentation and protocols (blood pressure, pulse, nerve and brain wave activity, blood cortisol and glucose levels, immune cells, etc.), experimental designs and large scale studies with statistical controls have been and are being employed in separate studies across the US and in other countries. The linkage between outdoor physical activity and longer-term well-being has yet to be established. Discovering evidence for such a linkage will require cross-sectional, longitudinal and experimental designs.

Determining the validity of the assumption that the amount of outdoor physical activity is declining across broad segments of the population will require establishing a baseline for comparison purposes. Meta-analyses of previous published research and identification of unpublished data are two methods for establishing a baseline. Subsequently, monitoring in multiple states for comparison purposes using a variety of behavioral (e.g., accelerometer) and direct observation procedures should be implemented; settings should also be varied (private residences, city streets, schoolyards, city, state and national parks, forests, and open space, etc.).

Expand Image Alt-Text

Measurements of Progress

Development, implementation and refinement of reliable and valid scales that measure different types of park, recreation, and nature-related health outcomes across diverse populations
Peer-reviewed publications and professional conference presentations that document the role of parks and outdoor recreation service in promoting associated preventative health benefits across diverse populations.

Short-term Outcomes

Increased understanding of the multifaceted health benefits of recreation in parks and other green environments.
Increased understanding of the mechanisms through which health benefits, particularly in relation to healthy human habitat, occur.
Increased understanding of how these benefits are experienced across diverse populations.

Long-term Impacts

Increased public awareness of active recreation opportunities and relationships to personal health.
Increased participation rates in active outdoor recreation, particularly among youth.
Infrastructure that supports healthy lifestyle choices, such as increased pedestrian and bicycle transportation coordinators to schools.
Improved health and quality of life across diverse populations.
Reduced strain on healthcare costs and the healthcare system via integration of nature-based health promotion strategies.
Inclusion of outdoor recreation in health education requirements.
Enhancement of school-based recreation programs to promote healthy lifestyle choices.

Relevant References

Bell, J. F., Wilson, J. S., & Liu, G. C. (2008). Neighborhood greenness and 2-year changes in body mass index of children and youth. American Journal of Preventative Medicine, 35(6), 547-553.

Beyer, K. M., Kaltenbach, A., Szabo, A., Bogar, S., Nieto, F. J., & Malecki, K. M. (2014). Exposure to neighborhood green space and mental health: evidence from the survey of the health of Wisconsin. International Journal of Environmental Research and Public Health, 11(3), 3453-3472.

Boone-Heinonen, J., Casanova, K., Richardson, A. S., & Gordon-Larsen, P. (2010). Where can they play? Outdoor spaces and physical activity among adolescents in US urbanized areas. Preventive Medicine, 51(3-4), 295-298.

Branas, C. C., Cheney, R. A., MacDonald, J. M., Tam, V. W., Jackson, T. D., & Ten Have, T. R. (2011). A difference-in-differences analysis of health, safety, and greening vacant urban space. American Journal of Epidemiology, 174, 1296-1306.

Bratman, G. N., Hamilton, J. P., & Daily, G. C. (2012). The impacts of nature experience on human cognitive function and mental health. Annals of the New York Academy of Sciences, 1249(1), 118-136.

Bruton, C. M., & Floyd, M. F. (2014). Disparities in built and natural features of urban parks: Comparisons by neighborhood level race/ethnicity and income. Journal of Urban Health, 91(5), 894-907.

Cohen, D. A., McKenzie, T. L., Sehgal, A., Williamson, S., Golinelli, D., & Lurie, N. (2007). Contribution of public parks to physical activity. American Journal of Public Health, 97(3), 509-514. doi:10.2105/AJPH.2005.072447

Cohen-Cline, H., Turkheimer, E., & Duncan, G. E. (2015). Access to green space, physical activity and mental health: a twin study. Journal of Epidemiology and Community Health, 69(6), 523-529.

Dadvand, P., Nieuwenhuijsen, M. J., Esnaola, M., Forns, J., Basagaña, X., Alvarez-Pedrerol, M., ... & Jerrett, M. (2015). Green spaces and cognitive development in primary schoolchildren. Proceedings of the National Academy of Sciences, 112(26), 7937-7942.

Diez Roux, A. V., Evenson, K. R., McGinn, A. P., Brown, D. G., Moore, L., Brines, S., & Jacobs, D. R., Jr. (2007). Availability of recreational resources and physical activity in adults. American Journal of Public Health, 97(3), 493-499.

Dentro, K. N., Beals, K., Crouter, S. E., Eisenmann, J. C., McKenzie, T. L., Pate, R. R., ... & Katzmarzyk, P. T. (2014). Results from the United States’ 2014 report card on physical activity for children and youth. J Phys Act Health, 11(Suppl 1), S105-12.

Edwards, M. B., Jilcott, S. B., Floyd, M. F., & Moore, J. B. (2011). County-level disparities in access to recreational resources and associations with adult obesity. Journal of Park and Recreation Administration, 29(2), 39-54.

Faber Taylor, A., & Kuo, F. E. (2009). Children with attention deficits concentrate better after walk in the park. Journal of Attention Disorders, 12, 402-409.

Faber Taylor, A., Kuo, F. E., & Sullivan, W. C. (2001). Coping with ADD: The surprising connection to green play settings. Environment and Behavior, 33(1), 54-77.

Floyd, M. F., Spengler, J. O., Maddock, J. E., Gobster, P. H., & Suau, L. J. (2008). Park-based physical activity in diverse communities of two U.S. cities. An observational study. American Journal of Preventive Medicine, 34(4), 299-305.

Godbey, G. (2009). Outdoor recreation, health, and wellness: Understanding and enhancing the relationship. Washington, D. C.: Resources for the Future.

Glover, T. D., Shinew, K. J., & Parry, D. C. (2005). Association, sociability, and civic culture: The democratic effect of community gardening. Leisure Sciences, 27(1), 75-92.

Goodwin, T. (2016). Educating for Ecological Literacy. American Biology Teacher, 78(4), 287-291

Hartig, T., Mang, M., & Evans, G. W. (1991). Restorative effects of natural environment. Environment and Behavior, 23, 3-26.

Hartig, T., Mitchell, R., De Vries, S., & Frumkin, H. (2014). Nature and health. Annual Review of Public Health, 35, 207-228.

Heerwagen, J. (2009). Biophilia, health, and well-being. In L. Campbell & A Wiesen (Eds.), Restorative commons: Creating health and well-being through urban landscapes (pp. 38-57). General Technical Report. Newtown Square, PA: U.S. Department of Agriculture, Forest Service, Northern Research Station.

Ho, C. H., Payne, L., Orsega-Smith, E., Godbey, G. (2003). Parks, recreation and public health. Parks & Recreation, 38(4), 18-27.

Jackson, E. L., & Scott, D. (1999). Constraints to leisure. In E. L. Jackson & T. L. Burton. (Eds.), Leisure studies: Prospects for the twenty-first century (pp. 299-322). State College, PA: Venture Publishing.

Jennings, V., Larson, L., & Yun, J. (2016). Advancing sustainability through urban green space: cultural ecosystem services, equity, and social determinants of health. International Journal of Environmental Research and Public Health, 13: 196. doi: 10.3390/ijerph13020196

Kaczynski, A. T., & Henderson, K. A. (2007). Environmental correlates of physical activity: A review of evidence about parks and recreation. Leisure Sciences, 29, 315-354.

Kesebir, P., & Diener, E. (2008). In pursuit of happiness: Empirical answers to philosophical questions. Perspectives on Psychological Science, 3(2), 117-125.

Kondo, M. C., South, E. C., & Branas, C. C. (2015). Nature-based strategies for improving urban health and safety. Journal of Urban Health, 92(5), 800-814.

Korpela, K. M., & Ylen, M. (2007). Perceived health is associated with visiting natural favourite places in the vicinity. Health & Place, 13(1), 138-151.

Kuo, F. E. (2010). Parks and other green environments: Essential components of a healthy human habitat. Research Series. Ashburn, VA: National Recreation and Park Association.

Kuo, F. E. (2001). Coping with poverty: Impacts of environment and attention in the inner city. Environment and Behavior, 33(l), 5-34.

Kuo, F E., & Sullivan, W. C. (2001). Aggression and violence in the inner city: effects of environment via mental fatigue. Environment and Behavior, 33(4), 543-571.

Larson, L. R., Jennings, V., & Cloutier, S. A. (2016). Public parks and wellbeing in urban areas of the United States. PloS ONE, 11(4), e0153211.

Maller, C. Townsend, M., Pryor, A., Brown, P., & St Leger, L. (2003). Healthy nature healthy people: Contact with nature as an upstream health promotion intervention for populations. Health Promotion International, 21(1), 45-54.

Mowen, A. J., & Confer, J. J. (2003). The relationship between perceptions, distance, and socio-demographic characteristics upon public use of an urban in-fill. Journal of Park and Recreation Administration, 21(3), 58-74.

Potwarka, L., Kaczynski, A., & Flack, A. (2008). Places to play: Association of park space and facilities with health weight status among children. Journal of Community Health, 33(5), 344-350.

Roemmich, J. N., Epstein, L. H., Raja, S., Yin, L., Robinson, J., & Winiewicz, D. (2006). Association of access to parks and recreational facilities with the physical activity of young children. Preventive Medicine, 43(6), 437-441. doi:10.1016/j.ypmed.2006.07.007

Rosenberger, R. S., Bergerson, T. R., & Kline, J. D. (2009). Macro-linkages between health and outdoor recreation: The role of parks and recreation providers. Journal of Park & Recreation Administration, 27(3), 8-20.

Rosenberger, R.S., Sneh, Y., Phipps, T. T., & Gurvitch, R. (2005). A spatial analysis of linkages between health care expenditures, physical inactivity, obesity and recreation supply. Journal of Leisure Research, 37(2), 216-235.

Sallis J. F, & Bauman, M. P. (1998). Environmental and policy interventions to promote physical activity. American Journal of Preventative Medicine, 15, 379-397.

Sallis J., Hovell M., Hofstetter C., Elder, J. P., Hackley, M., Caspersen, C. J., & Powell, K. E. (1990). Distance between homes and exercise facilities related to frequency of exercise among San Diego residents. Public Health Reports, 105(2), 179-186.

Shores, K. A., & West, S. T. (2008). Physical activity outcomes associated with African American park visitation in four community parks. Journal of Park and Recreation Administration, 26(3), 75-92.

Smith, L. M., Case, J. L., Smith, H. M., Harwell, L. C., & Summers, J. K. (2013). Relating ecoystem services to domains of human well-being: Foundation for a US index. Ecological Indicators, 28, 79-90.

Townsend, M. (2006). Feel blue? Touch green! Participation in forest/woodland management as a treatment for depression. Urban Forestry & Urban Greening, 5(3), 111-120.

Vaughan, K. B., Kaczynski, A. T., Stanis, S. A. W., Besenyi, G. M., Bergstrom, R., & Heinrich, K. M. (2013). Exploring the distribution of park availability, features, and quality across Kansas City, Missouri by income and race/ethnicity: an environmental justice investigation. Annals of Behavioral Medicine, 45(1), 28-38.

Wainger, L. A., & Price, E. W. (2004). Evaluating quality of life, economic vulnerabilities, and drivers of ecosystem change. Environmental Monitoring and Assessment, 94, 69-84.

Wells, N. M. & Evans, G. W. (2003). Nearby nature: A buffer of life stress among rural children. Environment & Behavior, 35(3), 311-330.

West, S. T., Shores, K. A., & Mudd, L. M. (2012). Association of available parkland, physical activity, and overweight in America's largest cities. Journal of Public Health Management and Practice, 18(5), 423-430.

Witten, K., Hiscock, R., Pearce, J., & Blakely, T. (2008). Neighbourhood access to open spaces and the physical activity of residents: a national study. Preventive Medicine, 47(3), 299-303. doi:10.1016/j.ypmed.2008.04.010

Google Sites

Report abuse