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Am J Public Health. 2015 Mar;105(3):470-7. doi: 10.2105/AJPH.2014.302324. Epub 2015 Jan 20.

Toward improved public health outcomes from urban nature.

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Danielle F. Shanahan and Richard A. Fuller are with the School of Biological Sciences, University of Queensland, St Lucia, Australia. Brenda B. Lin is with the Commonwealth Scientific and Industrial Research Organisation Land and Water Flagship, Aspendale, Victoria, Australia. Robert Bush, Julie H. Dean, and Elizabeth Barber are with the School of Population Health, University of Queensland, Brisbane, Queensland, Australia. Kevin J. Gaston is with the Environment and Sustainability Institute, University of Exeter, Penryn, Cornwall, United Kingdom.


There is mounting concern for the health of urban populations as cities expand at an unprecedented rate. Urban green spaces provide settings for a remarkable range of physical and mental health benefits, and pioneering health policy is recognizing nature as a cost-effective tool for planning healthy cities. Despite this, limited information on how specific elements of nature deliver health outcomes restricts its use for enhancing population health. We articulate a framework for identifying direct and indirect causal pathways through which nature delivers health benefits, and highlight current evidence. We see a need for a bold new research agenda founded on testing causality that transcends disciplinary boundaries between ecology and health. This will lead to cost-effective and tailored solutions that could enhance population health and reduce health inequalities.

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