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Health in the city – How can we all get more Green Care?

Mental health issues such as anxiety, stress and depression are especially since the pandemic on a massive rise around the globe (1) and scientific studies have shown that we spend around 90% of our time indoors (2). At the same time the research is becoming more and more clear: nature does not only help to improve our physical but also psychological wellbeing, summarized under the term “Green Care”, standing for a “range of activities that promote physical and mental health and well-being through contact with nature” (3). Several studies have shown that when we spend time in nature our stress levels are lowered (4), our anxiety level decreases (5) and the time spent in forests can even help in preventing or curing burn-out and depression (6). We can reconnect to our emotions which facilitates personal insights and leaves us feeling more connected to ourselves (7) and cope better with stress, which makes us more resilient and positively affects our mood states (8). Furthermore, our social connection can be facilitated when we deeply experience forests together (7). But it is not only humans who benefit from spending time in nature:  There might also be a positive outcome for nature, because research shows that if we feel connected we are more motivated to behave environmentally responsible (9) and support pro-environmental outcomes (10).
But even though research results are so promising, Green Care initiatives often face difficulties due to uncertainties in financing, low public awareness, recognition of the role of such initiatives and there has hardly been any integration into health policy to date. The Green4C project, co-funded by the Erasmus+ Programme of the European Union, has been working the last three years towards the innovation and promotion of Green Care. In order to find innovative solutions to mainstream Green Care, six hackathons in six countries were organized, one of which was the Green Care Hackathon on the 23rd of November at the EFI office in Bonn.

The aim of the hackathon was to develop useful, creative and/or entertaining ideas on how we can all get Green Care better integrated in practice and daily life. Participants with very different backgrounds such as forest management, the green department of the city of Bonn, forest bathing instructors, students from various study programs and more came together to work together on this question, focusing on the topics of health insurances, education and urban planning respectively.

Photo: Rosa Castañeda

The afternoon started with a fascinating presentation from Thomas Claßen, from the Regional Centre for Health in North Rhine-Westphalia (Landeszentrum Gesundheit NRW), summarizing the state of research around nature and health and the underlying mechanisms. Renate Späth, who was formerly part of the regional Ministry of Environment in NRW followed with a presentation on the topic’s health, well-being and social inclusion from her work experience. During this presentation she highlighted how important nature protection is, but also that nature’s role as an enabling environment for human health should be accounted by forest management and nature conservation agencies, by allowing people to visit the forest and use it for health promotion.

Encouraged by the words of the presenters, the already enthusiastic participants formed groups to work on developing concrete project ideas. After two hours of working, the groups got to pitch their idea to the jury members Renate Späth, Rik De Vreese (European Forest Institute) and Dieter Fuchs (Green Department City of Bonn). Although they had to come up with the ideas in such a short time, all groups proposed great projects. The first pitch proposed a permaculture garden for a full-day school (Ganztagsschule). The problem that they saw is that children and teenagers have increasingly less access to and knowledge about nature. This could potentially result in a decreased valuing of nature. A school garden which brings pupils closer to nature might be just the right solution. Through the garden the kids could learn how sensitive systems in nature are and how much they react to changes. The project would include different generations since many older people still have the knowledge around gardening and nature. Therefore, seniors could help the school with this project. Additionally, the project would also be connecting students from different classes and years and could ideally create a sense of belonging for everyone. It could be implemented and adjusted at any school and the garden could eventually also be used for the school’s sport activities and playing outside. The project would be realized through external funding and set up in collaboration with experts from permaculture gardening as well as biological farmers who could provide knowledge and material to get started.

Photo: Rosa Castañeda

The second group tackled the issue of green spaces being often not easily accessible in cities. This limited green space in cities does not only pose a threat to mental health but also results in decreasing biodiversity and an increase in urban heat islands. The idea that the group presented was to create mobile green city district oases which are set up for six months. The neighborhood would be involved in the planning of the project and the design would be adjusted to whatever the local needs. This way for half a year the oasis could be used for recreation in the neighborhood and citizens can experience the value of nature in their direct surrounding. The district oasis is therefore supposed to be like a seed that is planted. During the evaluation phase at the end of the project, the neighborhood can indicate if they liked the oasis and would therefore wish for more permanent nature in their district. Ultimately, the people in the neighborhood as well as the local nature would benefit from this approach. The project would be realized with funding from ministries or the EU. Universities could be involved in the planning to find out what the most sustainable and best way is of designing such an oasis. Local businesses could also engage by sponsoring the furniture or the plants that are used in the oasis.

The winning idea was presented by the third group. The idea was to set up a program for people who do not have the financial means or time to go into the forest and participate in Green Care activities. The program would be called “Walderleben” (Experiencing forests) and have two different components. Parents could bring their children and one part of Experiencing forests would be forest bathing and relaxing for the parents while the children can run around and experience the forest in activities suitable to them. These activities would take place twice per month at the same location and participants get to join 10 of those moments. The pilot project would be set up in collaboration with the forest department in Bonn to provide a suitable site, with social institutions to get in touch with the target groups and with local health insurances to finance the program. A collaboration with the university would also help monitoring what benefits the target group experienced to strengthen the case for continuing this program or to offer it at a larger scale.

All the teams illustrated that afternoon what is so special about the Green4C project: the potential and creativity that give rise to innovative ideas when people who are passionate about Green Care come together with their diverse background and experiences. If you are curious to get in touch with this network, you can find more information here.


  1. WHO (2022). COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. Retrieved august 4, 2022, from
  2. Diffey, B. L. (2011). An overview analysis of the time people spend outdoors: time spent outdoors. British Journal of Dermatology164(4), 848–854.
  3. Sempik, J., Hine, R. Wilcox, D. eds. (2010). Green Care: A Conceptual Framework, A Report of the Working Group on the Health Benefits of Green Care, COST Action 866, Green Care in Agriculture, Loughborough: Centre for Child and Family Research, Loughborough University.
  4. Mao, G. X., Lan, X. G., Cao, Y. B., Chen, Z. M., HE, Z. H., LV, Y. D., Wang, Y. Z., HU, X. L., Wang, G. F., & Yan, J. (2012). Effects of short-term forest bathing on human health in a broad-leaved evergreen forest in zhejiang province, china. Biomedical and Environmental Sciences25(3), 317–324.
  5. Kagawa, T., Miyazaki, Y., Ikei, H., Komatsu, M., Song, C., Li, Q., Park, B.-J., Takayama, N., Tsunetsugu, Y., Lee, J., & Tyrväinen, L. (2014). Influence of forest therapy on cardiovascular relaxation in young adults. Evidence-Based Complementary and Alternative Medicine2014(2014), 1-7. ­
  6. Karjalainen, E., Sarjala, T., & Raitio, H. (2010). Promoting human health through forests: overview and major challenges. Environmental Health and Preventive Medicine15(1), 1–8.
  7. Clarke, F. J., Kotera, Y., & McEwan, K. (2021). A qualitative study comparing mindfulness and shinrin-yoku (forest bathing): practitioners’ perspectives. Sustainability13(12), 6761–6761.
  8. Takayama, N., Saito, K., Fujiwara, A. & Tsutsui, S. (2018). Influence of Five-day Suburban Forest Stay on Stress Coping, Resilience, and Mood States. Journal of Environmental Information Science, 49-57
  9. Zylstra, M. J., Knight, A. T., Esler, K. J. & Le Grange, L. L. (2014). Connectedness as a Core Conservation Concern: An Interdisciplinary Review of Theory and a Call for Practice. Springer Science Reviews, pp. 119-143.
  10. Cudworth, D., & Lumber, R. (2021). The importance of forest school and the pathways to nature connection. Journal of Outdoor and Environmental Education24(1), 71–85.

Featured image: Rosa Castañeda


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