Nature's contributions in coping with a pandemic in the 21st century: A narrative review of evidence during COVID-19

Benefits of green spaces on stress reduction have been shown in previous studies. Most existing studies to date have focused on the general population. However, there is a lack of understanding of physiological mechanisms underlying the beneficial effects of green space among special populations, such as pregnant women.To examine physiological and affective responses to green space on stress recovery among pregnant women, using simulated green space exposure through virtual reality (VR).We recruited 63 pregnant women between 8 and 14 weeks' gestational age for a laboratory experiment. Participants were randomly assigned to view one of three, 5-min, VR videos of an urban scene with different green space levels (i.e., non-green, moderate, and high) after a laboratory stressor, the Trier Social Stress Test. Physiological stress responses were measured via changes in blood pressure, heart rate, skin conductance level, salivary alpha-amylase, and salivary cortisol. Affective response was measured using the Positive and Negative Affect Scale.We found that visual exposure to a green space environment in VR was associated with both physiological and affective stress reduction among pregnant women, including lower systolic blood pressure [-4.6 mmHg, 95% confidence interval (CI): -8.8, -0.4], reduced salivary alpha-amylase concentration (-1.2 ng/ml, 95% CI: -2.2, -0.2), improved overall positive affect (score: 6.6, 95% CI: 0.3, 13.0) and decreased negative affect of anxiety (score: -2.6, 95% CI: -5.19, -0.04) compared to non-green space environment. Exposure to high green space environment in park-like setting had the strongest impacts on stress recovery.This study demonstrated that virtual green space exposure could effectively ease stress and improve mental health and well-being during pregnancy. Even a short immersion in VR-based green space environment may bring health benefits, which has significant implications for pregnant women when access to an actual nature may not be possible. 

Physiological and affective responses to green space virtual reality among pregnant women.

Exposure to natural environments offers an array of mental health benefits. Virtual reality provides simulated experiences of being in nature when outdoor access is limited. Previous studies on virtual nature have focused mainly on single "doses" of virtual nature. The effects of repeated exposure remain poorly understood. Motivated by this gap, we studied the influence of a daily virtual nature intervention on symptoms of anxiety, depression, and an underlying cause of poor mental health: rumination. Forty college students (58% non-Hispanic White, median age = 19) were recruited from two U.S. universities and randomly assigned to the intervention or control group. Over several weeks, anxious arousal (panic) and anxious apprehension (worry) decreased with virtual nature exposure. Participants identifying as women, past VR users, experienced with the outdoors, and engaged with the beauty in nature benefited particularly strongly from virtual nature. Virtual nature did not help symptoms of anhedonic depression or rumination. Further research is necessary to distinguish when and for whom virtual nature interventions impact mental health outcomes. 

/pdf/daily-exposure-to-virtual-nature-reduces-symptoms-of-anxiety-2z4zlg6l.pdf

Daily exposure to virtual nature reduces symptoms of anxiety in college students

Slower epigenetic aging is associated with exposure to green space (greenness); however, the longitudinal relationship has not been well studied, particularly in minority groups. We investigated the association between 20-year exposure to greenness [Normalized Difference Vegetation Index (NDVI)] and epigenetic aging in a large, biracial (Black/white), U.S. urban cohort. Using generalized estimating equations adjusted for individual and neighborhood socioeconomic characteristics, greater greenness was associated with slower epigenetic aging. Black participants had less surrounding greenness and an attenuated association between greenness and epigenetic aging [βNDVI5km: −0.80, 95% confidence interval (CI): −4.75, 3.13 versus βNDVI5km: −3.03, 95% CI: −5.63, −0.43 in white participants]. Participants in disadvantaged neighborhoods showed a stronger association between greenness and epigenetic aging (βNDVI5km: −3.36, 95% CI: −6.65, −0.08 versus βNDVI5km: −1.57, 95% CI: −4.12, 0.96 in less disadvantaged). In conclusion, we found a relationship between greenness and slower epigenetic aging, and different associations by social determinants of health such as race and neighborhood socioeconomic status.

https://www.science.org/doi/pdf/10.1126/sciadv.adf8140?download=true

Inequalities in urban greenness and epigenetic aging: Different associations by race and neighborhood socioeconomic status

Trait emotional intelligence reflects a set of self-perceptions and behavioral tendencies to empathize with others and manage one's own emotions. Trait emotional intelligence is a valuable characteristic since it can aid social interaction, bolster subjective wellbeing, and predict career success. Past research suggests that brief exposures to greenspace can enhance outcomes related to facets of trait emotional intelligence. The current study employed a retrospective life course analysis to examine whether residential greenness and other aspects of the residential environment predict trait emotional intelligence in early adulthood. Childhood exposure for 297 college students was based on up to three home addresses from birth to age 18, weighted by residency duration. Greenspace was calculated with normalized difference vegetation index (NDVI) values in 500 m and 1000 m buffers. Partially supporting our predictions, we found emotional intelligence in young adults growing up in lower-income areas was positively associated with cumulative neighborhood greenness around childhood homes. The opposite pattern was found for those who grew up in higher-income areas, with greater greenness500-m being associated with lower emotional intelligence scores. These are the first reported findings involving physical/natural environmental correlates of emotional intelligence and among the first to suggest an equigenic effect of greenspace on socio-emotional outcomes whereby exposure might help overturn inequalities rather than merely reduce them. If a causal link exists between nature exposure and emotional intelligence, then neighborhood greening might help children who begin life at a societal disadvantage through enhancing their ability to understand, use, and manage emotions.

Association between residential greenness during childhood and trait emotional intelligence during young adulthood: A retrospective life course analysis in the United States.

A growing literature shows that green space can have protective effects on human health. As a marginalized group, women often have worse life outcomes than men, including disparities in some health outcomes. Given their marginalization, women might have "more to gain" than men from living near green spaces. Yet, limited research has deliberately studied whether green space-health associations are stronger for women or men. We conducted a systematic review to synthesize empirical evidence on whether sex or gender modifies the protective associations between green space and seven physical health outcomes (cardiovascular disease, cancer, diabetes, general physical health, non-malignant respiratory disease, mortality, and obesity-related health outcomes). After searching five databases, we identified 62 articles (including 81 relevant analyses) examining whether such effect modification existed. We classified analyses based on whether green space-health were stronger for women, no sex/gender differences were detected, or such associations were stronger for men. Most analyses found that green space-physical health associations were stronger for women than for men when considering study results across all selected health outcomes. Also, women showed stronger protective associations with green space than men for obesity-related outcomes and mortality. Additionally, the protective green space-health associations were slightly stronger among women for green land cover (greenness, NDVI) than for public green space (parks), and women were also favored over men when green space was measured very close to one's home (0-500 m). Further, the green space-health associations were stronger for women than for men in Europe and North America, but not in other continents. As many government agencies and nongovernmental organizations worldwide work to advance gender equity, our review shows that green space could help reduce some gender-based health disparities. More robust empirical studies (e.g., experimental) are needed to contribute to this body of evidence. 

Do sex and gender modify the association between green space and physical health? A systematic review

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Do sex and gender modify the association between green space and physical health? A systematic review