This document summarizes a European Union funded research project that aims to investigate the health benefits of natural outdoor environments. The project will: 1) Examine the underlying mechanisms by which nature impacts health, including stress reduction, physical activity, and pollution exposure. 2) Study the effects on different population groups across multiple European regions. 3) Inform land use planning and green space management based on evidence of nature's preventive and therapeutic health impacts.

1. Positive health effects of the natural outdoor environment
in typical populations of different regions in Europe
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2. FP7 Theme ENV.2011.1.2.3-2; Positive effects of natural environment
for human health and well-being. Grant Agreement 282996
1st January 2012 – 31st December 2015
EC contribution: € 3.499.403
Beneficiaries:
– Fundació Centre de Recerca en Epidemiologia Ambiental – Spain (C)
– Rijksinstituut voor Volksgezondheid en Milieu – Netherlands
– Staffordshire University – United Kingdom
– Vytauto Didziojo Universitetas – Lithuania
– Université de Geneve – Switzerland
– Vereniging voor Christelijk Hoger Onderwijs, Wetenschappelijk
Onderzoek en Patientenzorg – Netherlands
– Veiligheids- en Gezondheidsregio Gelderland Midden – Netherlands
– University of California, Berkeley Campus – United States
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3. Objective:
To investigate the interconnections between exposure to natural
outdoor environments, in both rural and urban settings, and better
human health and well-being and particularly:
• Identify the underlying mechanisms at work;
• Examine the effects for different population groups;
• Examine the effects of different characteristics of the natural outdoor
environment;
• Cover both preventive as well as therapeutic effects of contact with
the natural environment;
• Address the implications for land-use planning and green space
management, specifically focusing on the integration of human
health needs, and translating the research outcomes into
recommendations for policy makers and guidelines for professional
practitioners.
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4. Project Structure
Land use planning
and natural environment
Management (WP5)
Natural environment:
Quantitative and quality characteristics (amount, type)
Different levels of urbanity (WP2)
Epidemiological studies Mechanism assessment
(WP3) Therapeutic studies
(WP2)
(WP4)
General health/well being Stress reduction/
Mental health/neural development Mental health
Restorative function
Cardiovascular, respiratory and High stress
Physical activity
cancer morbidity and mortality Social interaction Cardiovascular
Birth outcomes Environmental pollutants
Obesity
Inclusive subgroups Inclusive subgroups
Large studies Small studies (n=4*20-40)
Medium size studies (n=4*1000)
Implications, including health impact assessment and application(WP5)
Policy involvement and Dissemination, including stakeholders (WP 6)
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5. WP1 – Management - Technical and financial management of the project
WP 2 - Mechanisms
• To examine underlying mechanisms of positive health impact through the quantitive
relation of factors including stress, physical activity, social interaction and pollution,
with the natural environment.
• 1000 subjects to be recruited in all participating countries.
• Case-study of 100 subjects working with Calfit.
WP3 - Epidemiological Studies
• To evaluate the relationship between natural environment indicators and various
health outcomes in different regions of Europe. Analysis of large routine databases
containing health outcome data, cohort study data and natural environment
indicators.
• 17 Studies, n>24M
• Outcomes covered: respitory health, BMI, neural development, birth weigth/gestation,
all cause and specific mortality, asthma, serum cholesterol, (health) quality of life,
psychological factors, cancer, general health.
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6. WP4 - Therapeutic Studies
• To measure stress reduction and restorative function of different
environments, as well as behaviour and social interaction to further explore
mechanisms implicated in the health-natural environment relations.
• 20-40 subjects to be recruited in Netherlands, Lithuania, UK and Spain
WP5 - Implications, Health Impact Assessment and Planning
• To integrate human health needs into land use planning and green space
management in rural and urban areas.
• Considering: Qualitative characteristics of natural environements; Facilities,
maintenance and services; Accessibility Guidelines to natural environments.
WP6 - Policy involvement and dissemination
• To establish a framework for dissemination, engagement and stakeholder
dialogue. In particular focussed on natural environment and related DG-
Environment programmes.
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7. Geographical Expertise
North Western Eastern
Europe
INPUT FROM DIFFERENT Europe
-United kingdom EUROPEAN REGIONS -Lithuania
-Netherlands Natural outdoor
*Natural outdoor Environment
Standardized and comparable *Mechanisms
Environment
European data base *Health outcomes
*Mechanisms
Natural outdoor Environment *Stakeholders
*Health outcomes
-green and blue
*stakeholders
-Quantity and Quality
Mechanisms
-Stress reduction/
Restorative function
-Physical activity
-Social interaction
-Environmental pollutants
Health outcomes
-General health/well being
-Mental health/neural development
-Cardiovascular, respiratory and
cancer morbidity and mortality
Southern -Birth outcomes
Europe -Obesity
Susceptible group Central Europe
-Spain
Pregnancy -Switserland
Natural outdoor
Age -Policy and
Environment
Socio-economic status guidelines
*Mechanisms
Ethnic minorities -Stakeholders
*Health outcomes
*Stakeholders
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8. Use of novel application for measurements of spatial, physical a.o. factors
Figure 3. Calfit Phone Showing (a) Basic Interface, (b) Calorie Counts by 30
second Epoch, and (c) Google Maps Display of Activity Levels in Different
Locations
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9. www.phenotype.eu
Mark Nieuwenhuijsen mnieuwenhuijsen@creal.cat
Coordinator
Diana van Gent dvangent@creal.cat
Project Manager and contact
CREAL - Centre de Recerca en Epidemiologia Ambiental
Parc Recerca Biomèdica de Barcelona
Doctor Aiguader, 88
08003 Barcelona
Tel +34 932 14 7354
Fax +34 932 14 7301
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