White M P, Elliott L R, Taylor T, Wheeler B W, Spencer A, Bone A, Depledge M H, Fleming L E
European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge, Spa, Royal Cornwall Hospital Treliske, Cornwall, TR1 3HD, United Kingdom.
Health Economics Group, University of Exeter Medical School, South Cloisters, St Luke's Campus, Exeter EX1 2LU, United Kingdom.
Prev Med. 2016 Oct;91:383-388. doi: 10.1016/j.ypmed.2016.08.023. Epub 2016 Sep 9.
Building on evidence that natural environments (e.g. parks, woodlands, beaches) are key locations for physical activity, we estimated the total annual amount of adult recreational physical activity in England's natural environments, and assessed implications for population health.
A cross-sectional analysis of six waves (2009/10-2014/5) of the nationally representative, Monitor of Engagement with the Natural Environment survey (n=280,790). The survey uses a weekly quota sample, and population weights, to estimate nature visit frequency across England, and provides details on a single, randomly selected visit (n=112,422), including: a) duration; b) activity; and c) environment type.
Approximately 8.23 million (95% CIs: 7.93, 8.54) adults (19.5% of the population) made at least one 'active visit' (i.e. ≥30min, ≥3 METs) to natural environments in the previous week, resulting in 1.23 billion (1.14, 1.32) 'active visits' annually. An estimated 3.20 million (3.05, 3.35) of these also reported meeting recommended physical activity guidelines (i.e. ≥5×30min a week) fully, or in part, through such visits. Active visits by this group were associated with an estimated 109,164 (101,736, 116,592) Quality Adjusted Life Years (QALYs) annually. Assuming the social value of a QALY to be £20,000, the annual value of these visits was approximately £2.18 billion (£2.03, £2.33). Results for walking were replicated using WHO's Health Economic Assessment Tool.
Natural environments provide the context for a large proportion of England's recreational physical activity and highlight the need to protect and manage such environments for health purposes.
基于自然环境（如公园、林地、海滩）是体育活动关键场所的证据，我们估算了英格兰自然环境中成年人年度休闲体育活动的总量，并评估了其对人群健康的影响。
对具有全国代表性的自然环境参与监测调查的六个波次（2009/10 - 2014/5）进行横断面分析（n = 280,790）。该调查采用每周配额抽样和人口权重来估算英格兰各地的自然环境访问频率，并提供单次随机选择访问的详细信息（n = 112,422），包括：a）持续时间；b）活动；c）环境类型。
约823万（95%置信区间：793万，854万）成年人（占人口的19.5%）在前一周至少进行了一次“活跃访问”（即≥30分钟，≥3代谢当量）到自然环境，每年产生12.3亿次（11.4亿，13.2亿）“活跃访问”。其中估计有320万（305万，335万）人还报告通过此类访问完全或部分达到了推荐的体育活动指南（即每周≥5×30分钟）。该群体的活跃访问估计每年带来109,164（101,736，116,592）个质量调整生命年（QALY）。假设一个QALY的社会价值为20,000英镑，这些访问的年度价值约为21.8亿英镑（20.3亿，23.3亿）。使用世界卫生组织的健康经济评估工具对步行结果进行了重复分析。
自然环境为英格兰很大一部分休闲体育活动提供了背景，并凸显了为健康目的保护和管理此类环境的必要性。
