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This research aims to identify, review and synthesise recent evidence on the health and well-being benefits, and social and cultural benefits, of visits to forests, and the methods available to measure and assess them. It sets out to assess the robustness of the different strands of evidence, and identify gaps. It aims to assess limitations, as well as the applicability of the evidence reviewed to Scotland. A principal objective is to make recommendations for monitoring health and well-being benefits, and social and cultural benefits, as part of Scotland’s Forestry Strategy.
There is strong evidence that visits to forests deliver a wide range of health and well-being benefits, as well as social and cultural benefits. The benefits include:
The extent to which visits to forests deliver these benefits is influenced by a range of factors:
Measuring Health, Well-being, Social and Cultural Benefits
There is significant overlap between the domains of health. Mental health is important for supporting physical health and vice versa. However, single indicators to measure overall health are often focused towards physical health and can fail to capture fully the importance of mental health and well-being. The use of multiple indicators covering different health domains is best in quantifying the diverse health benefits and to provide a more comprehensive understanding.
There is no consensus on what constitutes ‘gold-standard’ indicators to use for different benefits and contexts. However, cost-effectiveness, specific policy needs, and the extent to which an indicator captures a broad conceptualisation of its health domain make certain health metrics more suitable than others. Recommended indicators include:
To monitor these benefits from visits to Scotland’s forests effectively, we recommend a best-practice ‘in-depth’ approach and highlight key questions for inclusion. A less costly ‘intermediate’ approach is also noted, which may prove more feasible depending upon the level of resources available. Both approaches involve surveys.
In-depth Approach – We recommend a bespoke longitudinal survey with a large, representative sample of participants. A sample size of 5,000 respondents would deliver a demographically representative Scottish sample covering all protected equality characteristics.
Questions should cover duration of visits and frequency of visits over a given time period to understand the effects of exposure and to scale up benefits.
Questions on types of activities conducted and activity duration provide the foundation for estimating physical health benefits. This data can also be readily used to quantify impacts in terms of Quality-Adjusted Life Years (QALYs), a standardised health measurement that can be readily monetised.
A question on Life satisfaction should be included for a broad understanding of well-being benefits. In addition, including questions to measure mental health and well-being on the Short Warwick-Edinburgh Mental Wellbeing Scale would provide additional insight for understanding benefits associated with improvements in psychological functioning.
Social and cultural benefits could be addressed through similar questions included in Public Opinion of Forestry (POF) England that address social and cultural benefits, alongside the inclusion of open-ended questions for qualitative feedback. A quantitative metric, the Nature Connection Index could be used. Inclusion of an opt-in question to take part in focus groups or interviews would offer an opportunity to collect further qualitative data and gain in-depth insights into social and cultural benefits.
For comparison of benefits between visits to different sites, questions could be included to ask participants what type of woodland they last visited, as well as a list of what facilities were present on the site that they visited.
Socioeconomic questions should be included to cover areas including income and health status as well as sex, age, relationship status and education level. Controlling for these factors is important for understanding causality when using health indicators, especially for mental health and well-being benefits. Questions on ethnicity, religion and number of children in households are less important for understanding health and wellbeing causality but may be important inclusions for improving understanding about access to forests and the distribution of benefits.
The above could potentially be complemented by monitoring of biomarkers, e.g. cortisol, before and after a visit.
An online panel, rather than using telephone or household data gathering may be more cost-effective.
Intermediate Approach – A less costly approach would be to add additional questions to an existing survey to improve monitoring. If this approach were adopted, we would recommend adding questions to POF Scotland. A limitation of POF Scotland is the survey’s relatively small sample size of just over 1,000 (in 2017), limiting its potential to separate out results for different equality groups. To address this last issue the sample size should be increased at least to 2,500.
This research examines approaches to valuation of the mental health benefits of forests and proposes how monetary valuation of these benefits can be developed further. It examines metrics to quantify mental health impacts, methodologies to value changes in these and potential for incorporating associated values into natural capital accounting