Figure 1.2.4: Examples of pathways and mediators between natural landscapes and health


Ecosystem Services Examples:


• Cooling of cities • Storm-water runoff • Reduced air pollution


Physical activity Natural environment


Examples: • Type (e.g., urban park) • Quality (e.g., species diversity) • Amount (e.g. tree canopy near home)


Contact with nature as such


Examples: • Frequency of contact • Duration of contact • Activity affordable ( e.g. for viewing, for walking)


Examples: • Increased walking for recreation • Increased outdoor play


Social contacts


Examples: • Increased interaction with neighbours


• Increased sense of community Stress


Effect modifiers 1. Examples: Distance, weather, societal context Effect modifiers 2. Examples Gender, age, SES, context


Source: Adapted from Hartig et al. 2014


underpins all ecosystem services, guaranteeing supply of environmental goods and services, such as nutrients and food, clean air and freshwater.


Biodiverse landscapes provide health and well-being Biodiversity at the large scale, the richness of species on a community and landscape level, provides health and well- being through several pathways. A recent meta-analysis revealed that disease prevalence (among animals, humans and plants) is often higher in less diverse systems (Civitello et al. 2015). A biodiverse natural environment also offers several other psychological and physiological health benefits (Hartig et al. 2014) (Figure 1.2.4). In addition, many pharmaceuticals are derived from micro-organisms, and modern medicine continues to rely on biodiversity which contains raw materials for developing new drugs (David et al. 2015).


Biodiversity loss impacts health Biodiversity is negatively impacted by intensive crop agriculture and livestock systems (Machovina et al. 2015), urbanisation, over- exploitation such as over-fishing, pollution, invasive species and climate change. Although the region experiences an increase in forested areas, forest degradation may also contribute to biodiversity loss (UNECE and FAO 2015; FOREST EUROPE 2015). Declining biodiversity can increase the likelihood of the local transmission of infectious diseases and alter exposure across the region (Keesing et al. 2010; LoGiudice et al. 2003). Loss of pollinating species can reduce crop yields, potentially increasing under-nutrition (Eilers et al. 2011; IPBES 2016). It also reduces provision of healthy foods such as fruits, vegetables and nuts, thereby indirectly contributing to reliance on less healthy food and a subsequent increase in NCDs. Recognizing the biodiversity-health link provides grounds for integrating health and environmental indicators into assessments.


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Examples: • Reduction of stressor exposures • Acquisition of coping resources • Affective, cognitive, physiological • Restoration • Reduced neurophysiological vulnerability


Health and well-being


Examples: • Performance (e.g., academic occupational) • Subjective well-being (e.g. happiness)


• Persistent physiological changes (e.g., high cortisol levels) • Morbidity (e.g., CHD, depression) • Mortality (e.g., CVD, all cause) • Longevity


Chapter 1: Regional Context and Priorities


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