Economic values of metro nature health benefits: A life course approach
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.
References (82)
- et al.
Urban trees and the risk of poor birth outcomes
Health Place
(2011) - et al.
The relationship between trees and human health: evidence from the spread of the Emerald Ash Borer
Am. J. Prev. Med.
(2013) - et al.
Integrating ecosystem services analysis into scenario planning practice: accounting for street tree benefits with i-Tree valuation in central Texas
J. Environ. Manag.
(2014) - et al.
Towards a better understanding of the relationship between greenspace and health: development of a theoretical framework
Landsc. Urban Plan.
(2013) - et al.
Green spaces and pregnancy outcomes in Southern California
Health Place
(2013) - et al.
Surrounding greenness and birth weight: results from the GINIplus and LISAplus birth cohorts in Munich
Health Place
(2014) Student performance and high school landscapes: examining the links
Landsc. Urban Plan.
(2010)- et al.
Effect of exposure to natural environment on health inequalities: an observational population study
Lancet
(2008) - et al.
Tree and forest effects on air quality and human health in the United States
Environ. Pollut.
(2014) - et al.
The economic impact of attention-deficit/hyperactivity disorder in children and adolescents
Ambul. Pediatr.
(2007)
Gender differences in relationships between urban green space and health in the United Kingdom
Soc. Sci. Med.
Relating ecosystem services to domains of human well-being: foundation for a U.S index
Ecol. Indic.
Views to nature: effects on attention
J. Environ. Psychol.
Valuing environmental goods and services using benefit transfer: the state-of-the art and science
Ecol. Econ.
Does vegetation encourage or suppress urban crime? Evidence from Philadelphia, Pennsylvania
Landsc. Urban Plan.
The costs of low birth weight
Q. J. Econ.
Alzheimer's Disease Fact and Figures
Small-for-gestational-age births in the United States: an age-period-cohort analysis
Epidemiology
From the cradle to the labor market? The effect of birth weight on adult outcomes
Q. J. Econ.
Summary Health Statistics for U.S. Children: National Health Interview Survey, 2011
A difference-in-difference analysis of health, safety, and greening vacant urban space
Am. J. Epidemiol.
The impacts of nature experience on human cognitive function and mental health
Ann. N.Y. Acad. Sci.
About Healthy Places
Heart Disease Facts
National Health Expenditure Data
Assessment and valuation of the ecosystem services provided by urban forests
Evaluating Prescription Drugs Used to Treat Attention Deficit Hyperactivity Disorder (ADHD): Comparing Effectiveness, Safety, and Price
Surrounding greenness and pregnancy outcomes in four Spanish birth cohorts
Environ. Health Perspect.
Making Healthy Places: Designing and Building for Health, Well-Being, and Sustainability
Scheduled medications and falls in dementia patients utilizing a wander garden
Am. J. Alzheimer's Dis. Other Dement.
The effect of trees on crime in Portland, Oregon
Environ. Behav.
Garden and the Alzheimer's patients
Am. Hortic.
Population Ageing in Europe: Facts, Implications and Policies
Coping with ADD: the surprising connection to green play settings
Environ. Behav.
Children with attention deficits concentrate better after walk in the park
J. Atten. Disord.
Could exposure to everyday green spaces help treat ADHD? Evidence from children's play settings
Appl. Psychol. Health Well-Being
National Incident-Based Reporting System, Washington, DC
A perspective on the development of the healthy people 2020 framework for improving U.S. population health
Public Health Rev.
Rethinking MCH: The Life Course Model as an Organizing Framework
Health, equity, and the built environment
Environ. Health Perspect.
Life course health development: an integrated framework for developing health, policy, and research
Milbank Q.
Cited by (39)
Can restoring vacant lots help reduce crime? An examination of a program in Baltimore, MD
2022, Urban Forestry and Urban GreeningIs urban green space associated with lower mental healthcare expenditure?
2022, Social Science and MedicineTotal area greenness is associated with lower per-capita medicare spending, but blue spaces are not
2021, City and Environment InteractionsBuilding biodiversity into the urban fabric: A case study in applying Biodiversity Sensitive Urban Design (BSUD)
2021, Urban Forestry and Urban GreeningUrban forests: Biophysical features and benefits
2020, Encyclopedia of the World's Biomes