Literature review mines additional disciplines and cultural knowledges to understand nature’s role in health historically and culturallyFor this review study, researchers from the United Kingdom and Canada, from the fields of landscape architecture and medicine, pooled their expertise to consider cultural and historical dimensions of nature-based approaches to human health. Their shared concern was that the dominant, medical-intervention model of healthcare in Western societies often ignores historical and multicultural contexts of health and place. Thus, the review drew upon additional disciplines and cultural knowledges to consider nature’s role in health and well-being more broadly than intervention-based scientific research. In doing so, they hoped to spark curiosity and reflection among medical workers, landscape designers, and other practitioners with respect to varied cultural and historical traditions of nature-based health interventions.
Their literature review first outlined the evidence for nature’s role in health and well-being, noting different interpretations of natural environments and nature engagement. Then, the review reflected on multicultural, historical, and current approaches associated with the researchers’ different areas of expertise: nature connectedness, landscape architecture, the environment-microbiome-health axis, and indigenous wellness knowledge. Therefore, this collaborative study spanned more academic literatures than most literature reviews on nature and health yet was more narrative than comprehensive or systematic.
This literature review identified many traditions of nature and place-based health interventions—past, present, and future. After opening with a more conventional review of the growth of nature-based health interventions in the present, the review also discussed non-western traditions, such as indigenous knowledges and traditional Asian medicines. Then, it traced some historical foundations of nature-based health to the ancient Greeks and older uses of gardens and public parks around the world—where people cultivated green spaces to grow medicinal plants, support religious and meditative practice, and provide urban residents with therapeutic refuges from industrial hazards. Next, the review traced 20<sup>th</sup> century developments in modern medicine in which technological innovation and the value of nature both played roles. Next, it situated current uses of nature-based interventions—including green prescriptions (UK), or nature prescriptions (US)—within a return to more holistic models of health and a global shift from reactive to preventative treatment. Finally, the authors forecasted future directions for nature-based health in which scientists recommend the amount, duration, and quality of nature engagement required for human health. Further, they call for future nature interventions to be based upon scientific knowledge of microbiomes (consortium of microbes in a given environment) and exposomes (chemical compounds in an environment); these burgeoning area of research could provide people with more personalized nature-based interventions based on a deeper understanding of their specific histories of exposure to natural environments.
Overall, this review points to many historical and cultural examples in which people engaged with nature in their immediate landscapes for health benefits. Its overarching argument is that the past 20 years have brought about a revival in nature-based interventions—a return to the historical use of nature-based features in Western hospital and healthy intervention design, such as hospital gardens, therapeutic landscapes, and nature prescriptions. At the same time, the authors call for practitioners and researchers to listen respectfully, engage, and learn from traditional approaches and from Indigenous Peoples who acknowledge intricate links between human health and the natural world.
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