What evidence is there to support the impact of gardens on health outcomes? A systematic scoping review of the evidence

michelle Howarth, Alison Brettle, Michael Hardman, M Maden

Research output: Book/ReportBookpeer-review


According to the World Health Organisation Global Health Observatory (2017), non-communicable diseases (NCD’s) present a significant cause of death through cardiovascular disease, respiratory conditions and type 2 diabetes. The impact of NCDs on health and social care is estimated to outstrip service provision and the drive to promote health and well-being to tackle the key causes of NCD’s is at the vanguard of UK, European and global health care policy. There is a need for health and social care commissioners to examine and commission new treatment interventions that can offer multipurpose interventions for people in the community with LTC and co-morbid conditions. It is claimed that nature based activities, such as therapeutic horticulture or gardening activity, can improve health and wellbeing for a range of people with long-term conditions. Nature Based Activities have been defined as ‘an intervention with the aim to treat, hasten recovery, and/or rehabilitate patients with a disease or a condition of ill health, with the fundamental principle that the therapy involves plants, natural materials, and/or outdoor environment, without any therapeutic involvement of extra human mammals or other living creatures’ (Annerstedt & Währborg 2011). This includes, amongst other activities, gardens as a nature based activity that encourages individuals to engage with, observe or access.

This review has located and described research evidence that has reported on the impact of gardens on physical, mental, health and well being. A systematic approach was used to scope the evidence base across a range of data bases and external sources. The review reports on the following:
- How gardens can improve physical, mental, health and wellbeing outcomes
- A ‘map’ of the literature in relation to the benefits for particular conditions , types of garden, and health outcomes
- The gaps in the literature in relation to particular conditions, garden types and health outcomes
- Gardens as an intervention within the social prescribing movement
- Infographics and a logic models, which capture the data in a simple way. These can be used to inform the future development of the RHS therapeutic garden and for organisations interested in green care or nature-based activities

This report has provided an overview of the evidence for gardens as an intervention that could promote health and wellbeing in a range of populations. This has significance for public health and health care as there is a precedence to explore alternative methods of service provision. The findings from this review report on the impact of gardens and gardening on four key areas: Mental Health, Dementia, Wellbeing, Specific Conditions using Physiological Outcome Measures and Nutrition. The review evidence indicated that nature based activities such as gardens (in the range of formats) can help social inclusion, self-esteem and perceived wellbeing. Although the methodologies and interventions varied, the evidence base overwhelming supported the use of gardens as an activity that could promote wellbeing. Moreover, these activities were reflected in the Bragg et al (2016) Green Framework which suggests that gardens positively impact on people through everyday life such as home gardening, health promotion through nature based activates such as digging and community gardening through to and green care that uses more structured approaches for people with defined needs.
Original languageEnglish
Publication statusPublished - Sept 2017


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