Engagement with nature is an important part of many people’s lives, and the health and wellbeing benefits of nature–based activities are becoming increasingly recognised across disciplines from city planning to medicine. Despite this, urbanisation, challenges of modern life and environmental degradation are leading to a reduction in both the quantity and the quality of nature experiences. Nature–based health interventions (NBIs) can facilitate behavioural change through a somewhat structured promotion of nature–based experiences and, in doing so, promote improved physical, mental and social health and wellbeing. We conducted a Delphi expert elicitation process with 19 experts from seven countries (all named authors on this paper) to identify the different forms that such interventions take, the potential health outcomes and the target beneficiaries. In total, 27 NBIs were identified, aiming to prevent illness, promote wellbeing and treat specific physical, mental or social health and wellbeing conditions. These interventions were broadly categorized into those that change the environment in which people live, work, learn, recreate or heal (for example, the provision of gardens in hospitals or parks in cities) and those that change behaviour (for example, engaging people through organized programmes or other activities). We also noted the range of factors (such as socioeconomic variation) that will inevitably influence the extent to which these interventions succeed. We conclude with a call for research to identify the drivers influencing the effectiveness of NBIs in enhancing health and wellbeing.

Exposure to nature provides a wide range of health benefits. A significant proportion of these are delivered close to home, because this offers an immediate and easily accessible opportunity for people to experience nature. However, there is limited information to guide recommendations on its management and appropriate use. We apply a nature dose-response framework to quantify the simultaneous association between exposure to nearby nature and multiple health benefits. We surveyed ca. 1000 respondents in Southern England, UK, to determine relationships between (a) nature dose type, that is the frequency and duration (time spent in private green space) and intensity (quantity of neighbourhood vegetation cover) of nature exposure and (b) health outcomes, including mental, physical and social health, physical behaviour and nature orientation. We then modelled dose-response relationships between dose type and self-reported depression. We demonstrate positive relationships between nature dose and mental and social health, increased physical activity and nature orientation. Dose-response analysis showed that lower levels of depression were associated with minimum thresholds of weekly nature dose. Nearby nature is associated with quantifiable health benefits, with potential for lowering the human and financial costs of ill health. Dose-response analysis has the potential to guide minimum and optimum recommendations on the management and use of nearby nature for preventative healthcare.

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.As people live more urbanised lifestyles there is potential to lose daily contact with nature,\ud diminishing access to the wide range of associated health benefits of interacting with nature.\ud Experiences of nature vary widely across populations, but this variation is poorly understood.\ud We surveyed 1,023 residents of an urban population in the UK to measure four distinctly\ud different nature interactions: indirect (viewing nature through a window at work and at home),\ud incidental (spending time outside at work), intentional (time spent in private gardens) and\ud intentional (time spent in public parks). Scaled-up to the whole study population, accumulation\ud curves of the total number of hours per week that people were exposed to each type of nature\ud interaction showed that 75% of nature interactions were experienced by half the population.\ud Moreover, 75% of the interactions of a type where people were actually present in nature were\ud experienced by just 32% of the population. The average hours each individual experienced\ud nature per week varied across interactions: indirect (46.0 ± 27.3 SD), incidental (6.4 ± 12.7 SD),\ud intentional-gardens (2.5 ± 2.9 SD) and intentional-parks (2.3 ± 2.7 SD). Experiencing nature\ud regularly appears to be the exception rather than the norm, with a person’s connection to nature\ud being positively associated with incidental and intentional experiences. This novel study\ud provides baseline information regarding how an urban population experiences different types of\ud nature. Deconstructing nature experience will pave the way for developing recommendations for\ud targeted health outcomes.DTCC, HLH & KJG were funded by NERC grant NE/J015237/1. D.F.S. is supported\ud through ARC Discovery Grant DP120102857 and the Centre of Excellence for\ud Environmental Decisions (CEED, Australia); R.A.F. holds an ARC Future Fellowship

Experiences of nature provide many mental-health benefits, particularly for people living in urban areas. The natural characteristics of city residents’ neighborhoods are likely to be crucial determinants of the daily nature dose that they receive; however, which characteristics are important remains unclear. One possibility is that the greatest benefits are provided by characteristics that are most visible during the day and so most likely to be experienced by people. We demonstrate that of five neighborhood nature characteristics tested, vegetation cover and afternoon bird abundances were positively associated with a lower prevalence of depression, anxiety, and stress. Furthermore, dose–response modeling shows a threshold response at which the population prevalence of mental-health issues is significantly lower beyond minimum limits of neighborhood vegetation cover (depression more than 20% cover, anxiety more than 30% cover, stress more than 20% cover). Our findings demonstrate quantifiable associations of mental health with the characteristics of nearby nature that people actually experience.

Interacting with nature is widely recognised as providing many health and well-being benefits. As people live increasingly urbanised lifestyles, the provision of food for garden birds may create a vital link for connecting people to nature and enabling them to access these benefits. However, it is not clear which factors determine the pleasure that people receive from watching birds at their feeders. These may be dependent on the species that are present, the abundance of individuals and the species richness of birds around the feeders. We quantitatively surveyed urban households from towns in southern England to determine the factors that influence the likeability of 14 common garden bird species, and to assess whether people prefer to see a greater abundance of individuals or increased species richness at their feeders. There was substantial variation in likeability across species, with songbirds being preferred over non-songbirds. Species likeability increased for people who fed birds regularly and who could name the species. We found a strong correlation between the number of species that a person could correctly identify and how connected to nature they felt when they watched garden birds. Species richness was preferred over a greater number of individuals of the same species. Although we do not show causation this study suggests that it is possible to increase the well-being benefits that people gain from watching birds at their feeders. This could be done first through a human to bird approach by encouraging regular interactions between people and their garden birds, such as through learning the species names and providing food. Second, it could be achieved through a bird to human approach by increasing garden songbird diversity because the pleasure that a person receives from watching an individual bird at a feeder is dependent not only on its species but also on the diversity of birds at the feeder.

The impacts of the changing climate on the biological world vary across latitudes, habitats and spatial scales. By contrast, the time of day at which these changes are occurring has received relatively little attention. As biologically significant organismal activities often occur at particular times of day, any asymmetry in the rate of change between the daytime and night‐time will skew the climatic pressures placed on them, and this could have profound impacts on the natural world. Here we determine global spatial variation in the difference in the mean annual rate at which near‐surface daytime maximum and night‐time minimum temperatures and mean daytime and mean night‐time cloud cover, specific humidity and precipitation have changed over land. For the years 1983–2017, we derived hourly climate data and assigned each hour as occurring during daylight or darkness. In regions that showed warming asymmetry of >0.5°C (equivalent to mean surface temperature warming during the 20th century) we investigated corresponding changes in cloud cover, specific humidity and precipitation. We then examined the proportional change in leaf area index (LAI) as one potential biological response to diel warming asymmetry. We demonstrate that where night‐time temperatures increased by >0.5°C more than daytime temperatures, cloud cover, specific humidity and precipitation increased. Conversely, where daytime temperatures increased by >0.5°C more than night‐time temperatures, cloud cover, specific humidity and precipitation decreased. Driven primarily by increased cloud cover resulting in a dampening of daytime temperatures, over twice the area of land has experienced night‐time warming by >0.25°C more than daytime warming, and has become wetter, with important consequences for plant phenology and species interactions. Conversely, greater daytime relative to night‐time warming is associated with hotter, drier conditions, increasing species vulnerability to heat stress and water budgets. This was demonstrated by a divergent response of LAI to warming asymmetry.