Faced with the growing evidence that nature-based solutions (NbS) tend to meet the majority of 17 sustainable development goals (SDG), as well as the synergy between their total 169 targets (UN, 2030 AGENDA); suggestions will be made below to increase the attractiveness and branding competitiveness for tourist destinations related to: health, medical, wellness, SPA, resort, thermal, hot spring, natural. The correlations of nature and tourism with health are usually positive (due to direct beneficial assistance or prevention of harm), but sometimes negative (environmental imbalances and human actions). Some current geographic approaches: cultural ecosystem (environmental) services, WellVillage, SPA town, healthy city, urban green/blue space (UGBS), natural outdoor environment (NOE) and health and well-being – PHENOTYPE project, biophilia architecture. Since prehistoric times, beneficial effects on human health have been recognized through nature, as well as people's movements in search of places with such special characteristics. Named healing/sacred places, they gave rise to pilgrimages and the first forms of tourist organizations. In recent surveys on visitors' preferences for wellness and health destinations, attractiveness related to nature, environment and potentially therapeutic resources is at the top of the list compared to other items considered (Finland, Italy, Romania, Hungary, Poland). For the current Health Tourism Destination Index (Lee & Li, 2019) with 3 dimensions and 11 sub-dimensions, the natural environment dimension and sub-dimensions climate, air, water, and light; are highlights. (IUCN, 2016) Resolution 64 - Strengthening cross-sector partnerships to recognise the contributions of nature to health, well-being and quality of life (Nature is good medicine). (NCCAM-NIH, 2012) List of Total 259 therapies included as complementary alternative medicine - CAM, observed 50% direct nature related and 70% possible nature related (+indirect).In addition to the various traditional medicines, naturopathy, natural medicines and nature-based interventions direct nature related observed. Thus, increasing knowledge about occurrences of NTF - local natural therapeutic factors and their potentially bioactive properties - BAC (preventive, restorative or medicinal), become strategic in planning, development and sustainability of activities in these segments; whether public or private (Lazzerini, 2019; Ziemska et al., 2019). Main characteristics to be evaluated: physical, chemical, biological, toxicological, pharmacological, nutritional, traditional knowledge, sensory, thermodynamic, nanomolecular, ecogeophysical, energetic, vibrational, … Through an online literature review for “natural therapeutic factor” and similar terms (135 articles related to health tourism were selected) and systematization based on the Natural kind classification philosophy (Cleland et al., 2020) the NTF are described in 4 types of greater scope (environments, phenomena,

1. 10/04/2023
Wednesday
4:30 PM

2. THERMAL SPA DESTINATION BRANDING ENHANCEMENT
THROUGH NATURAL THERAPEUTIC FACTORS (NTF) KNOWLEDGE.
-A brief guide to diversification and innovation for survey or assessment.
“Sunt thermae medicinae optima pars”
“Thermal waters (SPA) are the best part of medicine”
Plinio il Vecchio (Roman naturalist, 23 B.C.)
Geol. Fabio Tadeu Lazzerini, postdoc
AUMENTAR LA MARCA DEL DESTINO SPA TERMAL A TRAVÉS DEL CONOCIMIENTO DE LOS
FACTORES TERAPÉUTICOS NATURALES (NTF).
-Una breve guía sobre diversificación e innovación para investigación o evaluación.

3. Membro Grupo Especialista
em Bem Estar e Saúde
Organização Mundial de Termalismo
Vice-Presidente
Caballero
Orden del Camino Santiago Compostela
Diretor Consultivo Asociación Latino-Americana de Thermalismo

4. .Thermal Health Tourism - similar terms: wellness, spa, health
resort, spa, medical hidrology, geomedicine, thermal medicine,
crenotherapy, balneotherapy, sanatorium, hot spring, climate
therapy, thalassotherapy.
.Key words: NTF, Vis medicatrix naturae, PSD, biophilia, CAM, TEK,
ART, NBI, nature therapy, naturopathy, healthy city, wellville, spa
town, forest bath, UGBS, therapeutic landscape, healing place,
salutogenesis, grounding, terrain kur, nature is good medicine,
sacred cultural space, natural homeopathic, pharmacopoeia,
orthomolecular, nanoparticles.
#congresotermatalia #formacionespecializada #fabiolazzerini @alath.thermal @termalismo @lazzerini.fabio

5. ECONOMY
+Natural capital, ecossistem services
Para toda a biosfera, o valor (a maior parte fora do mercado) é estimado na faixa de US $ 16-54
trilhões (10 12 ) por ano, com uma média de US $ 33 trilhões por ano.
O valor econômico ambiental Global é estimado em US$ 145 trilhões (Fenichel et al., 2016)
O produto nacional bruto global é de cerca de US $ 18 trilhões por ano.

6. Parque nacional New Forest/UK, custos evitados com a saúde pública ano 2022
estimado LIB$ 27 million, equivalente aos salários iniciais de 999 enfermeiros. Total de
horas passadas na natureza pela população local cerca de 8.5 million (Alden, 2023).
Na Republica da Letonia, a avaliação monetária relativa aos benefícios econômicos dos
espaços verdes e azuis é estimada em US$ 231.28 hab/ano (Lynch et al., 2020).
Nature’s non-material contributions to people, such as physical and psychological
experiences have a median value of (2017) International US$ 1117 / ha / yr.
Globalmente, estimou-se que os ecossistemas dentro de áreas protegidas fornecem
serviços no valor de 100 dólares por cada 1 dólar investido na gestão para manter a
provisão e aumentar a prestação de serviços ecossistémicos (Banco Mundial-GEF, 2010).
Assessment of the financial value of the health and well-being benefits of natural
environments, estimated the value of the perceived individual health and well-being
benefits at EU$ 208.00/yr - Kurjenrahka National Park/FIN (Vähäsarja, 2014).
About a method of the estimation of the recreational and health individual value of a
protected area, estimed at US$ 74.20/yr - Kampinoski National Park/ Warsaw/POL
(Mazurkiewicz & Pacelt, 2015).
Valuation of health benefits of green-blue areas for the purpose of ecosystem accounting: a pilot in
Flanders Region, Belgium; onde s maioria das contas de capital natural centra-se na estimativa e
avaliação da contribuição das UGBS para recreação e/ou turismo e valor imobiliário. Isso representa
12% do valor monetário total dos UGBS. Os benefícios monetários totais ascendem a EU$
464.00/hab/yr ou EU$ 3.00 billion/yr para Flandres (~ 1,3% do PIB) (Nocker et al., 2023).

7. Esta abordagem mostrou que os parques em todo o mundo têm um valor económico através da
saúde mental dos visitantes no valor de 6 trilhões de dólares por ano, incluindo 2,1 trilhões de
dólares provenientes de redução custos de saúde e maior produtividade no local de trabalho (Buckley
& Cooper, 2022).
The global medicine market is about 1.1 trillion US dollars. About 35 percent of medicines
have originated from natural products (Calixto, 2019).
The value of global ecosystem services was estimated to be about 4.5 times the value of
Gross World Product (GWP) in the year 2000 using this approach. For a current global
GDP of $75 trillion/yr this would be about $347 trillion/yr.
A conservative global estimate using quality-adjusted life years, a standard measure in
health economics, is US$6 trillion p.a. This is an order of magnitude greater than the
global value of protected area tourism, and two to three orders greater than global
aggregate protected area management agency budgets (Buckley et al., 2019).
Protected areas increase economic productivity, and reduce direct healthcare costs, by a
total of ~2.35 % of global GNP.
Aumento no valor imobiliário e patrimonial do capital natural quando associado com
benefícios ao bem estar e a saúde (Horlings, 2020).
A Systematic Review Exploring the Economic Valuation of Accessing and Using Green and
Blue Spaces to Improve Public Health; como resultados: o público está disposto a pagar
entre £ 5,72 e £ 15,64 por não adiar ou perder uma experiência ao ar livre e por caminhar
em ambientes locais sob melhores condições e acessíveis (Lynch et al., 2020).

8. BRANDING OF TOURIST DESTINATION AS AN IMPORTANT STRATEGIC RESOURCE OF
ECONOMIC DEVELOPMENT (Mikić et al., 2017).
To provide a brand destination which may offer something different of the best chance of success,
both the original and “tourist story” should be adapted for the tourists. In order to achieve really
successful branding of a tourist destination, the brand must become alive and relevant for all
visitors and tourists who wish to visit a destination.
Acknowledging that some places have modern hotels, conference facilities, unique culture, natural
attractions, interesting places of interest or some other forms of tourist attractions with which to
draw attention and increase value, the future success of attractions for tourists depends on the
creation of a unique identity and differentiation in relation to its competition.
Destination branding is about packaging and marketing a set of images to promote a particular
destination. There are however consequences that extend beyond marketing, for example, the
brand vision can become an instrument for transforming the place and social engineering local
cultures.
The term „destination brand“ is closely connected to the term „destination’s competitive identity“.
It is what makes a destination distinctive and memorable. It differentiates the destination from all
others. It is the foundation of the destination’s international competitiveness. A destination brand
represents the core essence and enduring characteristics of a destination.

10. The Process of Constructing a Health Tourism Destination Index
Chia-Wen Lee & Ching Li; 2019
A Theoretical Reflection on the Importance of Branding to Promote Thermal Destinations
Vera Antunes, Gisela Gonçalves and Cristina Estevão; Portugal (2022).
Main Topics:

11. Assessing Destination Competitiveness. An Application to the Hot Springs Tourism Sector
(Lee & King, 2005).

12. Characteristics of thermalism identified in the publications (Antunes et al., 2022).
TERMALISMO

13. FEMTEC topics 2023:
O desafio será conciliar as novas condições socioeconómicas e ambientais globais com as
especificidades únicas da tradição termal, definidas pelas características terapêuticas e
ambientais.
Além disso, como pode a crescente procura de saúde ser integrada com infra-estruturas
que permitam o desenvolvimento sustentável e o turismo?
Ambiente, Clima e Sustentabilidade nos “clusters balneológicos”

14. WelDest/FIN, 2015

16. .TEK-Traditional Ecological Knowledge,
.CAIM-Complementary Alternative Integrative Medicine,
.PIC-Práticas Integrativas Complementares,
.NbI-Nature Based Interventions,
.Naturotherapy.

17. TEK, CAIM, NATUROPATHY, NBI, PICs

18. 2019 = 259 total
50% direct nature related
70% posible nature related (+indirect)
https://cam.cochrane.org/operational-definition-complementary-medicine
CAM Therapies Included in the 2007 NHIS
List of therapies included as CAM – Altern Ther Health Med – PMC 2011
(National Centre for Complementary and Alternative Medicine (NCCAM) -
National Institutes of Health (NIH), 2012
+ de 50% das 100

19. The nature-health link: filling in the details. This Figure summarizes the state of the scientific literature on nature
and health, listing (1) the “active ingredients” in nature that have been identified as having impacts on health or
health antecedents; (2) physiological/psychological states, behaviors, and conditions tied to both nature and health;
and (3) specific health outcomes that have been tied to nature (controlling for socioeconomic variables) (Kuo, 2015).

20. Views, Concepts and Theories
Concerning the
Human-Environment Interaction

22. Hippocrates, 400 B.C.E

23. Plinio il Vecchio (Roman naturalist, 23 B.C.)

24. Iasolino, 1588

25. Sennert et al., 1665

26. 32 Total Global legislation resolutions; related to health resort and natural therapeutic
protected areas: ROM (2), POL (2), RUS (14), BUL (2), CZE (2), HUN (1), MOL (1), GER
(1), UKR (1), KBR (1), LATVIA (1), KOREA (1), GEORGIA (1), AUSTRIA (1), SINGAPORE (1).

30. Natural kind classification philosophy
For more than 2,000 years, the classification of natural objects and phenomena into
“kinds/species” has been a central quest of naturalistic philosophers (Locke, 1690;
Linnaeus, 1758; Thompson, 1910); as well as systematization and modern scientific
advancement (Cleland et al., 2020).
.Natural Factors - 4 Types of greater scope, where there are more than *100 (BAC-NTF)
Kinds:
I.ENVIRONMENTS
II. PHENOMENA
III. RESOURCES/MATERIALS
IV. LIVES
*See e-Book NTF Shades (PUB: nov, 2023).

31. BACS THERAPIES
I. ENVIRONMENTS
Healing Sacred Places
Nature Connecteness
Sea - Coast -Thalassotherapy
Therapeutic Landscapes
LAV-Landscape aesthetic value
Mountain
Caves - Speleotherapy
Forest Bathing Medicine
Green Spaces
Blue Spaces
Healthy Cities
SPA Towns, Wellvile, Healthy Villages Project, Estâncias, Health Resort Medicine
PNA-Protected Natural Area
Bioclimate, Climatotherapy, TCI-Tourism Climate Index
II. PHENOMENA
Cosmic and Sun Radiations, Heliotherapy
Grounding/Earthing
Ecogeophysical
Weather, Wind, Temperature, Humity
NAI-Negative Air Ions
Shumann Resonance, Flash
Geo-electromagnetism
Vibrational Energies
Radioactivity
5 Senses, PSD-Perceived Sensorial Dimension, Biophilia, ART-Attention Restoration Theory
III. RESOURCES/MATERIALS
Waters
Natural Remedies, Pharmacopea
Clays, Muds, Sappropel
Salts
Sands
Minerals, Crystals, Metals, Gemstones
Oils, Essentials
Chemical Inorganics and Organics Elements
Gases, Vapours
BVOCs, Phytoncides
Plants and Animals Extracts
Planktons, Algaes, Microbiota, Fungus
IV. LIVES

32. I. ENVIRONMENTS
1.Healing Sacred Places

34. 2.Nature Connecteness

35. Values in Nature

36. Continuum of environmental health research: from adverse to salutogenic. The green arrow
depicts the influence of salutary factors that pull individual well-being toward the salutogenic
outcomes, while the red arrow depicts the influence of environmental stressors that pull
individual well-being toward adverse outcomes (Silva et al., 2018).

37. Experience of nature and individual well-being: Grounding the benefits of natural environments
to individual wellbeing on exposure science and the concept of dose of nature (Silva et al., 2018).

38. Conceptual model outlining hypothesised pathways between natural environmental type and
quality and general health. Area socioeconomic and urban/rural status are considered both as
potential confounders and effect modifiers (Wheeler et al., 2015).

39. 4.Therapeutic Landscapes
LAV-Landscape aesthetic value
3.Sea - Coast

40. What is landscape? (Tudor, 2019)

42. Map of concepts where dotted lines represent dependencies between the concepts, e.g. perceived
disturbance is dependent on the visibility of the disturbing element, which is determined by the visual scale of
the landscapes (Ode et al., 2008).

43. Names, visualizations
and short descriptions of
the eight perceived
sensory dimensions
(PSD).
Stigsdotter et al., 2017

44. 5.Mountain
6.Forest Bathing Medicine
7.Caves - Speleotherapy

45. Concordância média sobre a capacidade dos fatores de qualidade de uso de UGS para
incentivar o uso de UGS (Zhang et al., 2021).
8.Green Spaces

46. 2021
9.Blue Spaces

47. 2020
10.Healthy Cities

48. The connection between the "11 Qualities Healthy Cities should strive for" (Hancock and Duhl, 1986)

49. 11. SPA Towns, Wellvile, Healthy Villages Project,
Estâncias, Health Resort Medicine

50. Tourism engaging with the public health agenda: Can we promote 'wellville' as a
destination of choice?
Article in Public health 126(12) · October 2012 with 143 Reads
DOI: 10.1016/j.puhe.2012.08.013 · Source: PubMed
Heather Hartwell
Ann Hemingway
Alan Fyall - University of Central Florida
Stacy Wall - Bournemouth University
... By embedding a health and well-being philosophy for tourist destinations, it is hoped that more individuals will
potentially engage in tourism and the economic benefits will follow. Health policy has acknowledged that disease
prevention is essential to ensure better population health and contributes to less spending on health care in the long
term (Hartwell, Hemingway, Fyall, Filimonau, & Wall, 2012;Wanless, 2002). As well-being has become an important
policy goal public health has begun to adopt strategies which focus on well-being across the life course through
considering the wider determinants of health and health behaviour . ...
... All of which are potentially impacted upon by tourism and public health policy and strategy at a local level coming
together. The health of the population is not exclusively an obligation of the health sector; indeed in the UK the recent
move of the public health function to local authorities is evidence of the contribution of the local policy context across
the wider determinants of health directly influenced by local authority strategy and local action (Hartwell et al. 2012).
This change is intended to help planners and politicians engage with their responsibility as laid out in the Health Act
1999 which is to come together to improve the health and well-being of local people. ...
... Regardless of these variances, where the two parties could find common ground is under the well-being effect of
tourism. Drawing on the work of Ritchie and Crouch (2003), Hartwell et al. (2012present a conceptual relationship
that demonstrates the fusion of public health and tourism using effective strategy and public policy formation.
Furthermore, the principles of sustainable tourism have been used to provide additional evidence on how integrating
public health principles into destination management, destination policy, local policy, activities and destination capital
can provide positive outcomes (Hartwell et al. 2012).

54. 12. PNA-Protected Natural Area
13. Bioclimate, Climatotherapy, TCI-Tourism Climate Index

55. 1.Cosmic and Sun Radiations, Heliotherapy
2. Grounding/Earthing
3. Ecogeophysical
4. Weather, Wind, Temperature, Humity,
5. NAI-Negative Air Ions
Shumann Resonance, Flash
Geo-electromagnetism
Vibrational Energies
II. PHENOMENA
Radioactivity

56. 6. Five Senses, PSD-Perceived Sensorial Dimension, Biophilia,
ART-Attention Restoration Theory

57. Four channels of human interactions with ecosystems: (a) knowing, thinking about
an ecosystem or just the concept of an ideal ecosystem; (b) perceiving, remote
interactions with ecosystem components; (c) interacting, physical, active, direct
multisensory interactions with ecosystem components; and (d ) living within,
everyday interactions with the ecosystem in which we live (Russell et al., 2013).

58. Fatores de influencia nas interações humanos-ambientes (Khaledi et al., 2022).

59. Kinds of connectedness (Ives et al., 2107)

60. Illustration of the optimal restorative forest environment combining the PSDs of serene, rich in species, nature and refuge
with the spatial dimensions of a both closed and open organic shaped space.

61. 3. Sight
4. Sound
5. Smell
6. Taste
6.1. Enjoyment of Flavours
6.2. More Natural Food
6.3. Growing Your Own Food
7. Touch
7.1. Animal Nature Touch
7.2. Non-Animal Nature Touch
8. Non-Sensory Pathways
8.1. Phytoncides
8.2. Negative Air Ions
8.3. Soil and Gut Microbes

62. The nature of spatial-
visual design vocabulary
(Liu & Nijhuis, 2022).
Earth Emotions (Albrecht, 2019)
BHI – Biophilic Healing Index
(Salingaros, 2019).

64. III. RESOURCES/MATERIALS

65. 8. Gases, Vapours
7. Inorganics, Organics Elements
6. Minerals, Crystals, Metals, Gemstones
5. Sands
4. Salts
3.Clays, Muds, Sappropel
2. Natural Remedies, Pharmacopea
1. Waters
10. Plants and Animals Extracts
11. Planktons, Algaes, Microbiota, Fungus

66. The bottom-up approach of basic physiological and ecological processes related to forest BVOC emissions. At
diferent levels, different types of measurements can be taken from leaf level cuvettes (Simpraga et al., 2019).
9. BVOCs, Phytoncides

67. Quilombo/SC
Machadinho/RS
Santana Livramento/RS
South Brazil – 3 Cases

68. 1a. VIN 1b. GUA 2. ALY 3a. PER 3b. ELD 4. ITA 5. IGU 6. SDL 7. MAC
km PNA to SPA<30km 9 0 0 2 22 0,5 10 12 15
2019%TOTAL NATURAL FOREST 47,1(mangrove 0,8) 20,2
75,6(mangr
ove 2,1) 83,5 15,7 33,7
7,6(grasslan
d 77,5) 20,1
2000%TREE COVER 50 to 100 0 to 25 0 to 100 25 to 50 50 to 100 25 to 100 75 to 100 50 to 100 25 to 75
2017%PFLORA 43,48 17 81,12 87,75 13,85 31,41 86,3 25,16
%dif 34 YEAR NATURAL FOREST DIF% 1,8 1,1 -5,3 -0,1 11,1 5,2 -5,7 -8,4
Q index 2 1 3 1 2 2 3 3 3
D index 6 3 9 6 7 6 8 7 9
2019% Wetland/Mangrove 2,1M 0,01W
2019% Other Non Vegetated Area 1,1 0,1 0,4 0,01 0,3 0,3 0,2 0,1
2019% Urban Infrastructure 4,9 6,4 10 0,1 0,7 11,2 0,2 0,5
2019% River, Lake and Ocean 1,2 0,2 0,5 0,5 41,1 27,5 0,9 6,6
1985-
2019 Water Area 0,2 0,1 -0,1 0 0,3 0,3 0,3 5,1
1985-
2019 Natural Forest Area 1,8 1,1 -5,8 -0,1 11,1 5,2 0,6 -8,4
PNA (Protected Natural Area) 2 PNA 1 PNA 1 PNA 4 PNA 7 PNA 10 PNA 4 PNA
Urban Nature SPA Town: IDH, Air quality, Urban
green, Lazzerini, 2013
1 Tourism
Region, 1
SPA Town
1 Tourism
Region, 1
SPA Center,
1 SPA Town
1 Tourism
Region, 1
SPA Center,
1 SPA Town
1 Tourism Region, 1 SPA
Center, 1 SPA Town
1 Tourism
Region, 1
SPA Center,
1 SPA Town 2 Tourism Region, 5 SPA Center
Green Space: % Vegetation 50 - 100 0 - 10 0 - 100 25 - 50 50 - 100 50 - 100 75 - 100 50 - 75
Blue Space: % Water, Waterscape feature, Flow
water 55 50 1 60 1 40 2 1
Land Cover Biome: Atlantic tropical rainforest, Wetland, Ripparian forest
Landscape Type: Low land, Plateaux, Wetland,
Waterfall rating system, Beach’s criteria (5
categories, 52 physical factors)
Coastal,
Mangrove,
Lake
Coastal
Urban Mountain
Coastal,
Mangrove,
Estuarine Karst Hill
Floodplain,
Plateau,Low
land Rollingplain, Plateau, Lowland
Landscape Form: Beach, Slope, Geomorphology hetereogeinity; Plain, valley, mid-forest and lakeside categories and 300 m.a.s.l. (HR Poland Norm) (Foz do Iguaçu
= 180)
Bioclimatic: Weather, Lat x Long, Environment,
(Cfa-Cw), 1500 hours sunshine/year and 183 rainy
days/year (HR Poland Norm) (Foz do Iguaçu =
2498 and 117)
Trop. Am -
Aw
Trop. Am -
Aw
STrop. Cs -
Cfb
STrop. Cfa -
Cfb
STrop. Am -
Af - Cf
STrop. Cf -
Cfa
STrop. Cf -
Cfa Cfa
TCI: (Impact score on tourist activities = Very good
to Excellent) 70 70 71,6 64,4 64,4 70,2 71,4 75,2 - 79,0
Ecogeophysical: Low nT, Local anomaly (Basalt fault soil, Waterfall electromagnetic), Flash, Rainstorm
Bio-microclimatic: Lake/Waterfall therapy, Beach
waterfornt, Dam border climate change, Blue flag,
Waterfall rating system, Beach’s criteria (5 cat.,
52 physical factors)
Beach,
Lake,
Wetland
HNBRa,
Beach
Hot Radon
Spring
Beach,
River
Cave,
Oceanic hill,
River
Dam
ripparian
Waterfall
ripparian Pampa Grassland

69. Quilombo/SC

70. Machadinho/RS

71. Santana do Livramento/RS

72. https://linktr.ee/Lazzerini.fabio
alath2014@gmail.com
Wzap: +55 19 982778608
Face, insta, youtube, linkedin, academia

74. Hablará sobre cómo “Aumentar la marca del destino Spa Termal a través del
conocimiento de los factores terapéuticos naturales (NFT). Breve guía sobre
diversificación e innovación para investigación o evaluación”. Lazzerini cuenta con más de
20 años de trayectoria en prospección mineral, turismo, spa termal, hidrogeología,
geología médica, SPA natural y NTF. Realización de consultorías, investigaciones y
publicaciones científicas en decenas de destinos de turismo de bienestar, salud y SPA
termales.
En su ponencia indicará en su ponencia que “desde la Prehistoria se han reconocido
efectos beneficiosos para la salud humana a través de la naturaleza, así como
movimientos populares en busca de lugares con características tan especiales.
Denominados lugares curativos/sagrados, dieron lugar a peregrinaciones y a las primeras
formas de organizaciones turísticas. En encuestas recientes sobre las preferencias de los
visitantes por destinos de bienestar y salud, los atractivos relacionados con la naturaleza,
el medio ambiente y los recursos potencialmente terapéuticos encabezan la lista en
comparación con otros elementos considerados (Finlandia, Italia, Rumania, Hungría,
Polonia). Para el actual Índice de Destinos de Turismo de Salud (Lee & Li, 2019) con 3
dimensiones y 11 subdimensiones, la dimensión del entorno natural y las
subdimensiones clima, aire, agua y luz; son aspectos destacados".

75. Faced with the growing evidence that nature-based solutions (NbS) tend to meet the majority of 17 sustainable
development goals (SDG), as well as the synergy between their total 169 targets (UN, 2030 AGENDA); suggestions will be
made below to increase the attractiveness and branding competitiveness for tourist destinations related to: health,
medical, wellness, SPA, resort, thermal, hot spring, natural.
The correlations of nature and tourism with health are usually positive (due to direct beneficial assistance or prevention of
harm), but sometimes negative (environmental imbalances and human actions). Some current geographic approaches:
cultural ecosystem (environmental) services, WellVillage, SPA town, healthy city, urban green/blue space (UGBS), natural
outdoor environment (NOE) and health and well-being – PHENOTYPE project, biophilia architecture.
Since prehistoric times, beneficial effects on human health have been recognized through nature, as well as people's
movements in search of places with such special characteristics. Named healing/sacred places, they gave rise to pilgrimages
and the first forms of tourist organizations. In recent surveys on visitors' preferences for wellness and health destinations,
attractiveness related to nature, environment and potentially therapeutic resources is at the top of the list compared to
other items considered (Finland, Italy, Romania, Hungary, Poland). For the current Health Tourism Destination Index (Lee &
Li, 2019) with 3 dimensions and 11 sub-dimensions, the natural environment dimension and sub-dimensions climate, air,
water, and light; are highlights.
(IUCN, 2016) Resolution 64 - Strengthening cross-sector partnerships to recognise the contributions of nature to health,
well-being and quality of life (Nature is good medicine). (NCCAM-NIH, 2012) List of Total 259 therapies included as
complementary alternative medicine - CAM, observed 50% direct nature related and 70% possible nature related
(+indirect).In addition to the various traditional medicines, naturopathy, natural medicines and nature-based interventions
direct nature related observed.
Thus, increasing knowledge about occurrences of NTF - local natural therapeutic factors and their potentially bioactive
properties - BAC (preventive, restorative or medicinal), become strategic in planning, development and sustainability of
activities in these segments; whether public or private (Lazzerini, 2019; Ziemska et al., 2019). Main characteristics to be
evaluated: physical, chemical, biological, toxicological, pharmacological, nutritional, traditional knowledge, sensory,
thermodynamic, nanomolecular, ecogeophysical, energetic, vibrational, …
Through an online literature review for “natural therapeutic factor” and similar terms (135 articles related to health tourism
were selected) and systematization based on the Natural kind classification philosophy (Cleland et al., 2020) the NTF are
described in 4 types of greater scope (environments, phenomena, resources/materials and lives) and having more than 100
subdivisions.
Details, presentation, indications, case studies and BACs; will be supplemented to interested participants. And at eBook in
production.