Economic values of metro nature health benefits: A life course approach

https://doi.org/10.1016/j.ufug.2015.06.009Get rights and content

Highlights

  • Human health and wellness outcomes are associated with experiences of metro nature elements.

  • Life course theory is a foundational tenet of human health promotion and disease prevention.

  • An annual economic valuation was derived from six benefit categories that span the human life course.

  • Benefits generated estimated values of between $2.7 and $6.8 billion USD annually (2012).

Abstract

The presence of metro nature enables daily environmental interactions, and a substantial body of evidence now demonstrates that nature contact generates extensive psychosocial, cognitive, and physical health and well-being benefits. Estimates of the economic values of such benefits have lagged similar valuation efforts for environmental services (such as improved air and water quality). In this article, using a life course approach, we estimate the potential annual value of six metro nature benefits, and cautiously extrapolate to a national scale, based on best available data and research. This is done by applying established economic values associated with epidemiology and public health to metro nature benefits estimates reported in prior peer-reviewed literature. The six situations of benefits valuation potential focused on: birth weight, attention deficit hyperactivity disorder (ADHD), school performance, crime, cardiovascular disease, and Alzheimer's disease. This benefits set demonstrates the importance of nature contact in urban areas over the course of the human lifespan. We estimate that the potential cost savings, avoided costs, and increased income range between $2.7 and $6.8 billion annually (2012 USD). Yet these values represent only a subset of benefits described in the current literature concerning urban nature experiences and health and well-being outcomes, pointing to the need for increased research concerning further valuations. We also point out challenges encountered in developing these estimates and limitations of their use. There is an urgent need to improve, expand, and integrate research methods and valuation strategies that link urban natural resources, public health, and economics. The resulting contributions to policy and programs can greatly improve urban quality of life.

Introduction

Environmental health disciplines have traditionally focused on recognition, impacts, and control of chemical and toxic exposure. Negative externalities associated with human contact with pesticides and herbicides, solvents, or pollutants situated in the environment have long been a major public health and societal concern. More recently environmental health practices have been expanded to include nature exposure as a contributor to human well-being and positive public health, in addition to concerns of risk reduction (Frumkin, 2005). A substantial body of evidence now demonstrates that equitably distributed, well-managed metro nature elements can be sources of environmental interactions that generate extensive physiological, social, and mental wellness benefits (Keniger et al., 2013, Russell et al., 2013, Hartig et al., 2014).

The term ‘metro nature’ is a broadly inclusive term which refers to collective opportunities for human nature experiences that promote wellness and improve urban livability (Wolf, 2008, Wolf and Robbins, 2015). It includes endemic ecosystems, such as remnant urban forest parcels, greenbelts, conserved open spaces, and riparian corridors that may be patch or relic expressions of native ecological associations. It also includes culturally constructed nature such as parks, streetscapes, community gardens, pocket parks, and recreational paths, as well as structural elements integrated within any built form to serve specific functions or supplement utilities, such as green roofs, green walls, or green infrastructure facilities.

Acknowledging potential contributions of metro nature for human health and wellness has important economic implications. The U.S. National Health Expenditure tally for 2012 was $2.9 trillion, representing 17.9% of the United States (U.S.) gross domestic product (World Bank, 2014), and health spending is projected to grow at an average rate of 5.7% from 2013 to 2023 (CMS, 2014). Considering both rapidly increasing costs and diminished quality of life associated with illness, there is an expanding interest in disease prevention and health promotion practices (Fielding et al., 2013, Office of Disease Prevention and Health Promotion, 2014).

Community health strategies are becoming more common (CDCP, 2009), in addition to individual health care, in addressing situations and contexts that can influence population health across a geographic area, such as a neighborhood or county (Kindig et al., 2008, Dannenberg et al., 2011). Also, disease prevention and health promotion initiatives must address human beings at all stages of the life cycle, as the implications of disease can extend beyond the time of any single diagnosis and treatment (Koplan and Fleming, 2000). Life course is defined here as a sequence of age categories that humans are normally expected to pass through as they progress from birth to death. Included in the culturally defined conceptions of the life course are estimates of how long they are expected to live and what constitutes “premature” or “untimely” death (Mayer, 2009). This paper uses the human life course (also referred to as life cycle) as an organizing framework, as it reflects increased public health messaging about the necessity for lifelong health support practices, rather than access to medical services only in times of illness.

The purpose of this overview and study is to estimate and present economic valuations concerning human health and wellness benefits associated with human experiences within the context of metro nature. To date, economic estimates of urban ecosystem services have largely centered on those described by the Millennium Ecosystem Assessment (MEA, 2005) as supporting and provisioning services. Such environmental benefits include surface and stormwater quantities and quality, air pollutant abatement, and microclimate amelioration (Chen and Jim, 2008). Research on psychosocial and public health benefits derived from metro nature have remained largely on the periphery of economic valuation discussions and assessments (Bratman et al., 2012, Smith et al., 2013). Modeling of benefits has led to economic valuations of environmental services (e.g., the USDA Forest Service i-Tree software suite) and provided a justification for local urban forest planning and investment (Hilde and Paterson, 2014); evidence of human health and wellness has only recently been included (Nowak et al., 2014). An expanded valuation effort offers additional opportunities to inform planning and management of metro nature and point to directions for future research.

This paper describes the culmination of an extended process of literature screening and assessment for valuation feasibility. Despite a sizeable and rapidly expanding evidence base concerning metro nature and associated human health and well-being (i.e., cultural ecosystem services), there is limited peer-reviewed literature on economic values associated with human health benefits. Considering trends in preventive health efforts and illness costs, a framework of ‘cradle to grave,’ or a life course perspective, of economic consequences, was used. Valuations were achieved using straightforward, traditional methods applied to benefit estimates derived from prior peer-reviewed literature. A range of potential economic impacts associated with life-long exposure to nearby nature in urban settings was explored, and demonstrates the need for further valuation studies. We acknowledge that this initial overview is schematic in character, but it initiates another public engagement strategy about human health and wellness benefits that can be an important contribution to national, and ultimately regional and local level commitments to metro nature planning, implementation, management, and quality of life issues.

Section snippets

Urban greening benefits and human life course

Life course has become a prominent framework for conceptualizing health (Fine and Kotelchuck, 2010), and scholars and practitioners are exploring its application to disease prevention and wellness (Halfon and Hochstein, 2002). Life course theory (LCT) offers a rich and layered understanding of how health develops over a lifetime and across generations (Hutchison, 2010). Individuals have different challenges, vulnerabilities, and strengths associated with general phases of human development.

Results

The concept of life course describes a temporal progression of age categories with associated contexts and influences. The metro nature situations and associated responses presented are a subset of contexts and conditions that affect health of humans in various age categories. While there are certainly additional nature-based health influences, we present evidence-based examples from the most robust and generalizable prior research.

Discussion

There is published evidence of substantial health concerns and consequences for urban residents at all stages of the human life course. A life course framing for nature-based valuations recognizes that: (1) health care costs are significant and increasing drastically; (2) holistic and preventive health care practices are gaining broader acceptance, including interest in the role of environmental influences; and (3) health promotion is not limited to treatment episodes, but is recognized as a

Conclusions

This overview and assessment was a preliminary demonstration of the range of nature-based economic valuations representing situations that span the entire human life course, from birth to old age. Some cities have begun to develop policies and programs in response to growing evidence of metro nature benefits. But such initiatives often face public challenges, such as other programmatic priorities (e.g., emergency services and housing), that force difficult funding decisions. Economic valuation

Acknowledgements

Support was provided by agreement 2011-CA-11062765-021 with the USDA Forest Service, Urban and Community Forestry Program on recommendation of the National Urban and Community Forestry Advisory Council; the USDA Forest Service, Pacific Northwest Research Station; the Forest and Wildlife Center at Mississippi State University; and the TKF Foundation.

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