Nature-based solutions are key for health, not just climate

Nature-based solutions, such as tree planting campaigns and rewilding efforts, are increasingly recognised as a key aspect of restoring the earth’s balance and mitigating the effects of climate change. Their major contribution happens in the form of carbon sequestration, that is, trees are very good at removing carbon from the atmosphere - an essential activity if we are to keep global warming levels below 1.5°C. Additionally, the presence of green space, including in urban areas, provides an array of environmental benefits such as better local temperature regulation, air pollution control and effective water drainage. But how else can nature-based solutions contribute to a more sustainable future? 

As NHS Forest delegates attended COP26 climate talks in November, we recognised the sole focus of these talks was on understanding the environmental impacts of nature-based solutions. Conversations failed, however, to strengthen the links between the natural environment and population health and wellbeing. We are calling for considerations on population health to be integrated as part of nature-based solutions as this can help maximise their impacts beyond climate change mitigation. This integration can happen at different levels such as through community stakeholders, local governments, anchor institutions and wider policies.  

The preventative healthcare benefits of greening neighbourhoods, particularly those in urban areas, cannot be overstated. A burgeoning collection of academic evidence now exists demonstrating that greener neighbourhoods can lower stress, extend life expectancy, prevent mental ill health, combat air pollution-related illnesses, and much more. On the flip side, neighbourhoods that are grey, polluted and lack access to safe and attractive green spaces are associated with higher risk of heart disease, obesity, cancers and mental illnesses. A good starting point to investigate the evidence of all this is the WHO review on urban green spaces and health - there are many more in-depth investigations on each of the above topics, as well. 

An emphasis on delivery benefits for people as well as nature leads to better-designed projects in the long term and prevents the risk of sole focus on a single environmental metric to the detriment of the true potential of a programme of nature-based solutions. For example, a sole focus on carbon sequestration by trees could lead to inaccessible monoculture woodlands being planted, which have little benefit to biodiversity, wellbeing or community health. However, a well-designed planting scheme of mixed-species native trees in an urban area in need of greening can provide multiple benefits: recreation opportunities, improvements in air quality, lower risk of flooding, increases in urban biodiversity, improvements in mental wellbeing and so on. And – it will also sequester carbon.

Southmead Hospital in Bristol benefits from rewilding, including meadow creation

Improving population level health though the greening of local areas also helps the NHS reduce its carbon footprint. Nature-based solutions have a knock-on effect on the sustainability of the healthcare system overall. Increased wellbeing, and better overall health, means fewer doctors’ visits, reduced demand for the manufacture, transport and distribution of medication, and lower prevalence of hospital stays and their associated carbon footprint. An improvement in mental and physical health in the most deprived communities, which are also typically those most in need of greening and the environmental and social benefits provided by green space development, also improves the sustainability of the health system. This demonstrates how, as an anchor institution, investment by the NHS into local green infrastructure and the restoration of urban nature has beneficial feedbacks in years to come as the health of the local population improves. 

As the NHS steps into its role as an anchor institution, the benefits of greening for population level public health should be at the forefront of decision makers’ minds. By discussing these issues, more weight is given to the power and potential of nature-based solutions for environmental issues and climate change; emphasising the co-benefits of these strategies for human and planetary health. Therefore, as the NHS focuses on its net zero commitments, at every stage of the carbon reduction and / or offsetting process, it should ask whether nature-based solutions co-designed and led by local communities and stakeholders can be part of the way it tackles climate change.  

Plans for nature-based solutions should not just focus on the headline sustainability metric of carbon, when there is so much more at stake. Fostering the long-term health of future generations takes many forms, and the fantastic potential of nature-based solutions is that many of them deliver on multiple benefits at once, and provide long-term benefits to nature, humans, health and the climate alike.