Gardens and health: it’s time for health policy to bring gardens in from the cold

Green space – and its link to improving the public’s health – was one of the areas included in our 2013 report on the evidence around how local authorities could make the most of their existing functions – from housing to supporting employment – to improve their citizens’ health.

I admit, I started out as a bit of a sceptic when it came to the link between green space and health, thinking that the observed relationship between access to more green space and health was primarily driven – especially in urban areas – by the fact that more-wealthy people live nearer green space than less-wealthy people, and the wealthier you are, the healthier you tend to be. The evidence included in our 2013 report started to challenge my scepticism.

I therefore welcomed the opportunity to explore the many and diverse relationships between gardens, gardening and health more thoroughly as part of work commissioned by the National Gardens Scheme, the findings of which are published today in an editorially independent report.

Fortunately, several high-quality systematic reviews of specific aspects of gardening and their contribution to health have recently been published. Gardens and health brings the wide range of evidence on gardens and health together for the first time, and organises the material across the life-course from school gardening and gardens as part of family homes, through to gardening as an older person. The report also considers gardening and its role in supporting mental health, tackling social isolation and maintaining independence. While there are relatively few randomised controlled trials about the benefits of gardening on health, the sheer weight of evidence – qualitative and quantitative – on how gardening and access to gardens affect our health and wellbeing is overwhelming. The figure below, from the report, reflects some of the many routes by which this can happen.

The good news is that there are lots of examples where gardens and gardening are being used to improve health in areas such as social prescribing, community gardens, volunteering, recovery from illness, dementia care and end-of-life care. One particularly impressive example is Lambeth’s GP Food Co-op, an innovative co-operative of patients, doctors, nurses and people living in Lambeth who have created a food-growing network. The Co-op has built gardens at 11 GP surgeries and other sites, including King’s College Hospital, where patients (especially those with long-term conditions) learn how to grow food in a safe and secure environment. The Co-op has been so successful it now sells some of the food it grows to King’s College Hospital, completing a virtuous circle where NHS patients are now helping provide other NHS patients with good-quality food.

The report finishes with reflections and a ‘menu’ of recommendations on how the benefits of gardens and gardening can be reflected in health and care policy and practice at the national and local level. It is a wide-ranging menu because we accept that different parts of the system and different places will want to focus on different things and because, when considered seriously, it is clear that gardening has a strong strategic fit and relevance to a wide range of the initiatives that support the objectives of the NHS five year forward view and the broader shift to a place-based population health system.

Our hope is that this report will help bring gardening in from the cold and closer to the mainstream of health and care policy debate and practice.

• Read the report, Gardens and health, commissioned by the National Gardens Scheme.