Cheshire’s Natural Health Service uses the best of the county’s green space assets to help tackle recognised local health inequalities. This initiative builds on the growing body of evidence that activities in the natural environment can have a significant impact on keeping people healthy.
The programme is made up of health-promoting, enjoyable group activities within some of Cheshire West & Chester’s wonderful green spaces. It targets the Borough’s most at-risk groups and areas of local inequality highlighted in the Joint Strategic Needs Assessment (JSNA). Since its launch in 2017, Cheshire’s Natural Health Service in Cheshire West has seen nearly 3,000 participants take part in one of the largest community led evidenced-based programmes to date, contributing to influential UK policy and international academic research.
An increasing body of evidence shows that engagement with our natural environment promotes good mental and physical health. Spending time in green spaces can reduce stress, encourage physical activity, boost social cohesion and reduce our exposure to harms such as air pollution. There is a hypothesis that humans are hardwired to need a connection with nature – so called ‘biophilia’ – and that spending time in green surroundings is an important factor in our overall health and wellbeing.
Evidence suggests that exercise undertaken within green spaces is more beneficial than that taken in an indoor environment. For instance, a study of the Scottish population showed an association between physical activity in natural environments and reduced risk of poor mental health, while activity in other types of environment was not linked to the same health benefit. Another study found that walking in nature produced stronger cognitive benefits than walking in an urban environment, while others have found that exposure to green space reduces chronic stress in adults living in deprived urban neighbourhoods in the UK.
The Natural Health Service programme seeks to utilise these proven benefits of green space, introducing more people to the value of undertaking activities within a natural environment in a social setting, improving wellbeing and building lasting friendships. In doing so, we also hope to encourage people to become more involved with their local green spaces. Studies have shown that spending time in natural environments may encourage greater pro-environmental behaviour.
The Natural Health Service provides a targeted approach, working in areas identified through the JSNA as those of greatest need across the Borough, and with the most affected communities. It is enhanced by:
- Health asset approach: Developing our own green spaces as health assets, such as services being provided in Whitby Park Community Garden. The garden is a hidden gem, and had been attended to on an ad hoc basis by a retired volunteer, George, for over twenty years. George had worked with many people and organisations to keep the garden open for the benefit of the community, but was getting older and concerned about the future of the garden With funding through Cheshire’s Natural Health service this has been turned into a health asset. Prior to the current restrictions every week there were up to 20 people participating in the ‘Gardening For All’ activities, helping to grow vegetables, fruit and flowers. Once involved, most people return to the garden because of the friendly atmosphere and because they know that the garden needs them, just as much as they need the garden. There are plenty of gardening activities to do and the group are keen to explore new creative activities so there is something to suit every one of all levels. Vegetables grown are sold at the back gate to park users, and the group have set up as a charitable organisation (Whitby Park Garden – Facebook)
- Evidence-based products: Interventions targeted at specific conditions within those communities. These are informed by our knowledge of working in the communities and knowing what works best where, and with which cohort of the community. Eg. Mindful Contact with Nature with isolated elderly people in Frodsham /Helsby.
- Research: Robust data analysis, providing detailed powerful feedback on our performance. To read more about our research, visit Outcomes – Natural Health Service
Each of these elements will be familiar to Councils up and down the country. However, their use in such a collective, strategic and targeted way - with interventions shaped by the specific needs of local communities; evidenced at every stage; and using assets within the borough - represents a unique and effective approach, and one which continues to support a range of positive outcomes for a considerable number of the residents who need it most.
Objective 1: Engaging over 3,000 people in evidence-based activities over a three-year period.
We have engaged more than 3,000 people from our targeted, hard-to-reach communities in the service.
Objective 2: Increasing physical activity by 40 per cent
Participants complete two nationally-validated questionnaires (The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) and International Physical Activity Questionnaire (IPAQ)), during the first and final weeks of their programme. Results from these show that walking, moderate and vigorous activity levels have increased by 83 per cent, 50 pre cent and 18 per cent respectively.
Objective 3: Increasing the overall wellbeing of those who participate.
Questionnaire results show a 13.7 per cent increase in overall participant wellbeing. Academic data provides a wealth of measurable evidence, but some of the most powerful evidence that we have relates to participant feedback. Many testimonials have included reference to a reduced level of medication, less reliance on the National Health Service and finding new friends and exploring new areas; all of which can radically impact the quality of life of each individual.
Furthermore, a Social Return on Investment study was conducted into an expanded Natural Health Service, predicting a return on investment where for every £1 invested in the service, £6.75 social return will be generated.