Health from the Outside In: Urban Design, Green Space and Human Health – reflections on a conference

On the 28th of April 2015 representatives of a range of disciplines, including researchers, council officials and action groups came together in Stoke-on-Trent (UK) to attend the PHENOTYPE Stakeholder Conference. Wilma Zijlema, PhD student at the University Medical Centre Groningen (NL) reflects on the event.


The conference was opened by Professor Michael Gunn, Vice Chancellor of the Staffordshire University, who ensured us that although Stoke-on-Trent may seem like an industrial and urban environment, the area also has a large amount of green space.

PHENOTYPE, funded by the EU since 2012, has made a lot of progress in investigating positive health effects of natural outdoor environments. The aim of the project is to investigate the relation between natural outdoor environments and better human health and well-being, and to provide a better understanding of the potential mechanisms that may explain this relationship. Large efforts have been made to collect data on the presence, quality and use of natural outdoor environments, and various long-term health outcomes. In addition, data have been collected for detailed exploration of the proposed mechanisms, including physical activity, social interactions, and stress reduction. A key feature of the PHENOTYPE project is that data are collected in four different countries, which have different types and uses of natural outdoor environments, resulting in insights into regional and cultural differences in relation to natural space. Detailed data collection was undertaken in Barcelona (Spain), Doetinchem (the Netherlands), Kaunas (Lithuania) and Stoke-on-Trent. Another important aspect of the PHENOTYPE project is the stakeholder involvement and the emphasis on implementation of the project results. Efforts are being made to exchange knowledge and ideas between researchers, policymakers and other stakeholders, in order to turn evidence into practice.

The first results show a large variation in the natural environments of the different study areas. These differences are important for studying the health effects of natural environments. For example, living near the beach in Spain may have different effects than living among agricultural land in the Netherlands. Also the frequency and duration of visits to, and satisfaction with the environment varied across the different cities. For example, study participants from Kaunas felt least safe in outdoor environments compared to the other study areas, and this may prevent people from spending time outdoors. The first epidemiological studies based on PHENOTYPE data showed that increased exposure to green space may be related to a decrease in unwanted pregnancy outcomes, may improve cardiovascular health, have potentially beneficial effects on child mental health, and is possibly related to a decrease in depressive symptoms. Furthermore, there are some results suggesting that the beneficial effects of natural environments may be larger for groups with lower socioeconomic status. Additional evidence for beneficial effects of natural outdoor environments is observed from experimental studies undertaken in the project. These studies evaluated psychological and physiological short term effects of exposure to natural environments. It turns out that spending time in natural environments may have therapeutic effects for patients suffering from heart disease and poor mental health. In addition, for healthy persons, taking a walk in natural environments may improve their mood and cognitive functioning. It became clear that a large amount of data have been collected, holding the promise of providing more evidence on the relation between exposure to natural outdoor environment and health and well-being.

Back in the train after a very interesting meeting, I remember the words of Professor Michael Gunn and I must agree with him: the numerous trees in Staffordshire are in full bloom. While looking back on a wonderful symposium and having beautiful green views from my train window, I felt happy, and even more curious about the beneficial effects of natural environments.