Naturally Healthy

Assessing the value of the natural outdoors for public health purposes

Ecosystems Knowledge Network and Centre for Sustainable Healthcare logosThis Valuing Nature Programme event was delivered by the Ecosystems Knowledge Network in partnership with the Centre for Sustainable Healthcare in March 2017.

Download the report - The cost-effectiveness of addressing public health priorities through improved access to the natural outdoors

Why the topic matters

Pressures on NHS services heighten the need to influence the wider determinants of health and wellbeing. There is already strong research evidence on the connection between access to the natural outdoors and the mental and physical health of individuals and populations. New inter-disciplinary research, including that funded through the Valuing Nature Programme, will build this evidence base even further.

A wide array of natural outdoor spaces can provide specific health benefit. This includes individual 'green infrastructure' features such as public parks, woodlands, waterways and wetlands, as well as the wider landscape. 

It is critically important to assess the cost effectiveness of investment in improved access to the natural outdoors for achieving health outcomes. The assessment needs to cover the prevention of ill health, as well as the promotion of wellbeing. Investment may come from conventional healthcare and public health budgets or from other sources. 

Methods for demonstrating cost-effectiveness are needed by decision-makers to influence health outcomes through improved access to the natural outdoors.

About the event


The morning session was chaired by Professor John Newton, Chief Knowledge Officer for Public Health England. There will be presentations by Professor Rhiannon Tudor Edwards (Centre for Health Economics and Medicines Evaluation at the University of Bangor) and Dr. Mary Dallat (Health and Social Care Northern Ireland). 

Why hold this event?

This is the first meeting of its kind on a vital dimension of the debate about the positive links between the natural environment and public health. It provided the opportunity to understand the practical implications of what is already known about the value of the natural outdoors for clinical and public health purposes, as well as develop ideas for future research.

Cost-effectiveness considerations are an important part of achieving greater collaboration between organisations responsible for our health and those that can deliver improved access to the natural outdoors. This includes, for example, the economic analysis to underpin the forthcoming NICE Guideline for Physical Activity and the Environment. 

Event purpose

This event was organised to improve the availability of methods to demonstrate the cost-effectiveness of addressing local health priorities through increased access to the natural outdoors in the UK.

It was an invitation-only meeting for experts across the UK in public health, clinical commissioning, health economics, environmental economics, spatial planning and leaders in the provision of natural outdoor spaces.


The day was divided into three parts, all aimed at encouraging informed discussion with input from all participants.

1 – Challenges in policy and practice 

  • Presentations and panel discussion involving perspectives from health policy, health economics and environmental economics.

2 – Shared practical exercise to learn from local health priorities and opportunities for improved access to the natural outdoors in and around Birmingham

  • Presentation and small group discussion.

3 – Future research priorities

  • Panel-led discussion of future inter-disciplinary research activity to develop methods.