Environmental quality for nature-based interventions for health

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Aesthetic quality

The visual aspects of a green/blue space influence how people interact with it, and how they gain benefits from it. There are often common elements that are seen as positive (e.g. the quality of light, views and the variety of colours and natural shapes). However, people can also have different responses to the way a green or blue space looks.

Introduction

Nature-based activities for health (such as conservation and gardening programmes) in green and blue spaces (green = with vegetation; blue = by water) improve the health and wellbeing of participants. These activities also improve the ‘quality’ of the environment for both nature and people. Currently, most health-based commissioning and evaluation of these activities do not consider how environmental quality has been improved or how environmental quality supports participant health benefits. We talked with conservation and community organisations who run nature-based activities for health, conservation volunteering and/or who look after green and blue spaces in Humber and North Yorkshire and in Greater Manchester. Through interviews and a workshop, partners in this project explained how the quality of green and blue spaces is important for staff, volunteers and participants. For most organisations improving green and blue spaces for people and nature was a core aim. They identified seven connected aspects of the quality of these spaces that influence how their activities are designed and run and that are important for participants to receive health benefits. Here we share an overview of these aspects - click on each text bubble to see a more detailed summary. The ‘resources and ideas’ button opens a web page of links to useful information and tools related to environmental quality, and you can add to this page if there’s anything you’d like to share. Please feel free to share this resource with anyone who may find it useful.

Accessibility

Various qualities of green and blue spaces and organised nature-based activities for health can make them more or less accessible for people with different needs and life experiences. Barriers to access can be both physical and psychological. Some barriers can be addressed through physical changes in the space (such as changes to paths, signage, layout or how a space is managed), or by improving transport or equipment such as clothing. Other barriers might need to be tackled through the support, training and information provided to staff, volunteers and participants.

Acoustic quality

The presence of bird song and absence of traffic noise were raised as important aspects contributing to the tranquillity of a green or blue space. The impact of the soundscape may not be immediately obvious, but can contribute to staff and participant experiences and might be more important for people with particular needs (such as autistic people). It may be possible to make changes at a site level using vegetation to reduce the impact of unwanted noise. However, perceptions of what is negative ‘noise’ and what are positive ‘sounds’ may differ across people and settings, with some enjoying a noisier space. Perceptions can also be altered by facilitators and the activities that people engage with in the space.

Aesthetic quality

The visual aspects of a green/blue space influence how people interact with it, and how they gain benefits from it. There are often common elements that are seen as positive (e.g. the quality of light, views and the variety of colours and natural shapes). However, people can also have different responses to the way a green or blue space looks.

Biodiversity

Green and blue spaces with high levels of biodiversity and opportunities to interact with wildlife have positive impacts on health and wellbeing. Activities to maintain and improve biodiversity can also provide opportunities to improve people’s connection with nature, health and social connections. However, there can also be fear of certain species and spaces with higher levels of biodiversity can be perceived as unsafe, unkempt and hard to access. Changes to improve accessibility, aesthetics and maintenance might conflict with management actions intended to enrich biodiversity. There may also be differences between the perception of what a wildlife friendly and biodiverse space should look like, and the relative value of different types of spaces for biodiversity.

Built environment

Facilities such as toilets, parking, public transport, paths and seating can be really important in allowing participants with various health and social care needs to access a green/blue space and take part in activities. They can dictate the choice of space and the type and timing of activities. These aspects need to be balanced with the other aspects of environmental quality. More subtle features such as natural or built barriers to create separated areas can have both positive and negative impacts on a sense of seclusion and safety. Information boards and signage can influence how people access and feel welcome in a space. Knowledge about the biodiversity or built heritage of a space, or gaining a sense of ownership and contribution to a space might alter and deepen people’s relationship with a place.

Safety

Safety is a key aspect in determining whether people feel able to enter a green/blue space independently or take part in group activities for health and wellbeing. Practical actions to improve safety and perceptions of safety may vary depending on the space and needs of different people (e.g. women, young people). In addition to practical safety concerns, people from different communities, life experiences and of different ages can vary in their sense of how welcome they feel to enter a green or blue space.

Tidiness/Maintenance

Expectations for levels of tidiness and maintenance can vary among people and types of green and blue spaces. Tidiness and the sense that a space is being cared for can influence perceptions of safety and tie in with a wider sense that a local community matters and is valued. In some circumstances this might conflict with managing a space for biodiversity and perceptions of ‘wildness’ that are valued for nature-based activities.

Acknowledgements

This resource was produced as part of the Embedding environmental quality into Nature-Based Interventions for health York Environmental Sustainability Institute Knowledge Exchange Fellows project, and funding from Salford University. By Laura J Harrison, Catherine Cowie, Patricia Darcy, Rachel Dexter, Anthony Hurd, Jo Featherstone, Sarah Knight, Peter Coventry & Piran CL White. 2024. HEY Smile Foundation, University of York and Salford University. Please reference this resource as: Cowie, C.E., Harrison, L.J., Darcy, P., Dexter, R., Hurd, A., Featherstone, J., Knight, S., Coventry, P. and White, P.C.L. (2025) An infographic about environmental quality in the context of nature-based interventions for health. Available at: https://view.genially.com/67732b829b883c786f384af4/interactive-content-environmental-quality-for-nature-based-interventions-for-health With thanks to Blossom, East Riding of Yorkshire Council, Faraway CIC, Friends of Bottesford Beck, Friends of Western Library Garden, Groundwork Greater Manchester, Groundwork Yorkshire, Green Futures, Humber Conservation Volunteers, Humber Nature Partnership, Humber Wild, Natural England, North York Moors National Park Authority, Orb Community Arts, Rewilding Youth, Solidarity Hull CIC, Sow The City, TCV and Yorkshire Ambulance Service Trust. Graphic design by Lucy Haldenby at the HEY Smile Foundation.