EnviroAtlas www.epa.gov Linking ecosystem services and human health: The Eco-Health Relationship Browser Laura E. Jackson1, Jessica L. Daniel2, Betsy McCorkle2, Alexandra Sears2, Kathleen F. Bush3 'ORD/US EPA, Research Triangle Park, NC, USA; 2Student Services Contractor, ORD/US EPA, Research Triangle Park, NC, USA; 3ASPH/EPA Environmental Health Fellow, ORD/US EPA, Research Triangle Park, NC, USA Introduction Ecosystems provide many nature-based goods and services that are beneficial to society. There is a large body of research linking these ecosystem services to improvements in human health. The ecosystem services that are most relevant to human health can be broadly categorized as: air filtration; biodiversity conservation; climate stabilization; habitat maintenance; natural hazard mitigation; food, fuel and fiber production; water filtration; water regulation; and the provision of aesthetic environments and recreational opportunities. A review article summarizing this work was recently published in IJPH (doi: 10.1007/s0003 8-013-0482-1). Results: The Eco-Health Browser Objectives (1) Identify literature focused on the relationship between ecosystem services and human health. (2) Design an interactive, web-based tool highlighting the weight of evidence. (3) Make the information accessible to a wide audience. Stage 1: Google Scholar search terms Health terms Environment Terms Health Natural Environment Mental Health Green space Wellbeing Ecosystem Services Well-being Open space Social Nature Physical Park (s) Urban forest Greenness Wetlands Stage 2: PubMed & Science Direct search terms a) Health + Green space; Greenness; Urban forest; Natural environment b) Mental Health + Ecosystem service; Greenness; Urban forest c) Wellbeing/Well-being + Greenness; Urban forest d) Physical + Parks; Green space Stage 3: Targeted journals Searched "health" and "green" within: Landscape and Urban Planning; Urban Forestry & Urban Greening; Health & Place; American Journal of Preventive Medicine; Environment and Behavior; Journal of Environmental Psychology; Journal of Epidemiology and Community Health Stage 4: Targeted keywords Category 1 + Category 2 + Category 3 a) Ecosystem + Topic (T) + Human health b) Ecosystem + Service (S1) + Human health c) Ecosystem + Service (S2) + Human health The four stages of the systematic review Screening Articles for the Browser A four stage systematic review focused on ecosystem services and human health was conducted (see left) The literature search was limited to peer- reviewed journal articles published from 1 January 1990 to 31 December 2012 Gathered articles were then screened for inclusion in the Browser Preference was given to articles that were published after 2000, with objectively measured variables, and quantitative results Article Exclusion Inappropriate article type (e.g., book, abstract) No reported consideration of ecosystem services/natural stimuli/nature as the exposure variable No mention of a health outcome Lack of adherence to Browser structure (e.g., review papers) Stage 1: Stage 2: Stage 3: Stage 4: 2012 Update: Google PubMed & Targeted Targeted Repeat stages Scholar Science Direct journals keywords 3 and 4 n = 196 n = 17 n = 11 n = 46 n = 74 Total articles from systematic review n = 344 Met inclusion criteria for systematic review n = 225 Excluded based on selection criteria for the Browser Total articles included in Eco-Health Relationship Browser n = 169 Search results from the systematic review and screening for The Browser Results: Systematic Review Number of relevant articles returned from the systematic review from 1990 to 2012 7990 1994 1996 1998 2°00 2°02 2°04 2°0e 2°08 2°10 2°12 Year 344 potentially relevant articles were collected for further review Results suggest an increase in attention to the subject area, as the annual publication of articles increased substantially from 0 to 75 from 1990 to 2012 (see left) Journals publishing the most articles identified in review of ecosystem services and human health 1990-2012 Several journals published multiple articles; between 4 and 17 articles were found in 12 journals (see right) The majority of articles focused on either buffering or health-promotional services #'///////' The Eco-Health Relationship Browser www. epa. gov/ enviroatlas/enviroatlas-eco- health-relationship-browser There are four ecosystems in the Browser: Forests Urban Ecosystems Wetlands Agro-Ecosystems Health Outcomes There are over 30 health outcomes in the Eco-Health Browser that relate to various ecosystem services. These include the following: Ecosystem Services Health promotional services Aesthetics and Engagement with Nature Recreation and Physical Activity Buffering Services Clean Air Clean Water Heat Hazard Mitigation Water Hazard Mitigation Anxiety Stress Cognitive function Low birth weight ADHD Healing Confusion Fatigue Self-esteem Social relations Mental Health Birth Outcomes Browser Pop-Up Box Pop-up appears when user hovers over "+". Article summaries capture the state of the science on the selected link. Includes citations, sample sizes, and study locations. Summaries allow reader to distinguish between speculative and more well-established results. Discussion: Mechanisms for Observed Health Outcomes Prevailing Mechanistic Theories Engagement with Nature Stress Reduction Ulrich 1993 Attention Restoration Kaplan and Kaplan 1989 Nature Appreciation Bratman et al. 2012 Social Interaction Maas et al, 2008; Barton and Pretty 2010 Decreased Cortisol and blood pressure (Hartig et al. 2003; Lee et al. 2011; Park et al. 2008; Thompson Coon et al. 2011) Improved attention and cognitive function (Hartig 2008; Kuo and Taylor 2004; Pretty et al. 2005; Taylor and Kuo 2009 Improved mood and mental health (Barton and Pretty 2010; van den Berg et al. 2010) Increased social cohesion (Coley et al. 1997;Kuo et al. 1998; Seeland et al. 2009) An Example of Integrating Mechanistic Theories into the Browser Attention Restoration Potential Mechanisms Stress Reduction Ulrich 1983 ¦ Directed attention ¦ Concentration tasks in children with ADHD ¦ Attentional functioning ¦ Academic achievement ¦ ADHD symptoms ¦ Feelings of confusion Acknowledgements and Disclaimer This work was supported by US EPA Contracts EP-10-D-000808, EP-1 l-D-000186, and EP-11-D- 000529; and Cooperative Agreement Number X3-83388101 between the US Enviromnental Protection Agency and the Association of the Schools of Public Health. Findings and conclusions do not necessarily represent the official views of EPA or ASPH. We would like to recognize the contribution of several individuals who reviewed the Browser during the beta-testing stage of development. U.S. Environmental Protection Agency Office of Research and Development SEPA ------- |