Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02215, USA.
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA 02215, USA.
Int J Environ Res Public Health. 2021 Apr 30;18(9):4790. doi: 10.3390/ijerph18094790.
There is extensive empirical literature on the association between exposure to nature and health. In this narrative review, we discuss the strength of evidence from recent (i.e., the last decade) experimental and observational studies on nature exposure and health, highlighting research on children and youth where possible. We found evidence for associations between nature exposure and improved cognitive function, brain activity, blood pressure, mental health, physical activity, and sleep. Results from experimental studies provide evidence of protective effects of exposure to natural environments on mental health outcomes and cognitive function. Cross-sectional observational studies provide evidence of positive associations between nature exposure and increased levels of physical activity and decreased risk of cardiovascular disease, and longitudinal observational studies are beginning to assess long-term effects of nature exposure on depression, anxiety, cognitive function, and chronic disease. Limitations of current knowledge include inconsistent measures of exposure to nature, the impacts of the type and quality of green space, and health effects of duration and frequency of exposure. Future directions include incorporation of more rigorous study designs, investigation of the underlying mechanisms of the association between green space and health, advancement of exposure assessment, and evaluation of sensitive periods in the early life-course.
关于接触自然与健康之间的关系，已有大量的实证文献。在这篇叙述性评论中，我们讨论了最近（即过去十年）关于自然暴露与健康的实验和观察研究的证据强度，重点介绍了可能涉及儿童和青少年的研究。我们发现了接触自然与改善认知功能、大脑活动、血压、心理健康、身体活动和睡眠之间的关联的证据。实验研究的结果提供了接触自然环境对心理健康结果和认知功能具有保护作用的证据。横断面观察性研究提供了自然暴露与身体活动水平增加和心血管疾病风险降低之间存在正相关关系的证据，而纵向观察性研究则开始评估自然暴露对抑郁、焦虑、认知功能和慢性疾病的长期影响。目前知识的局限性包括对自然暴露的测量不一致、绿色空间的类型和质量的影响，以及暴露持续时间和频率对健康的影响。未来的研究方向包括采用更严格的研究设计、研究绿色空间与健康之间关联的潜在机制、推进暴露评估以及评估生命早期的敏感时期。
