Effects of open spaces in urban areas on human health

We review the academic literature (n=113) that addresses effects on human health and well-being that occur when people interact with open spaces and nature in urban settings and identify key environmental design and research principles, and commonly used research methodologies and outcome variables. We identify and discuss a critical balance between reductionism and a holistic and integrative approach. That balance is as critical to successful designs of open spaces intending to improve human health and well-being as it is to successful research to document those effects. We address gaps in the existing evidence base and recommend directions which researchers and practitioners should adopt in order to further advance design and research in this area. In terms of research, there is currently no single ‘gold standard' methodology used when examining the effects of open spaces in urban places upon health and/or the healing process. This presents a clear opportunity to advance the field by developing an effective, efficient, and equitable approach to researching the health effects of visiting an open space in an urban area. In terms of design, there are six overarching design criteria: 1) Create outdoor spaces that are compatible with and encourage human activities; 2) Construct a setting for sensory stimulation; 3) Develop the space for safety and security; 4) Encourage present moment awareness; 5) Consider the culture of the population using the space; and 6) Promote nature as a metaphor for healing. A surprising shortcoming of the field is the minimal attention given to human culture as an important consideration for the design of the spaces and the design of the research methodologies. Overall, our findings and recommendations provide a solid basis for how open spaces in urban places targeting improvements in human health and well-being should be designed and researched in the future.