Ecopsychology: Science, Totems, and the Technological Species

5. Building the Science Base: Ecopsychology Meets Clinical Epidemiology

5 Building the Science Base: Ecopsychology Meets Clinical Epidemiology Howard Frumkin Is nature contact good for health? In recent years, this question has earned increasing attention from scholars and advocates in fields as diverse as recreation, conservation, and medicine. An important locus of attention has been in the mental health field, where psychologists, social workers, and other therapists have turned to the theory (ecopsychology ) and practice (ecotherapy) of nature contact in treating their patients. Simultaneously, health scientists have increasingly emphasized evidence-based medicine as the basis for health care decisions. Those two trends have rarely said hello to each other. Does that matter? This chapter reviews recent evidence that nature contact confers health benefits. It then introduces the field of clinical epidemiology, which epitomizes the evidence-based approach now accepted in the biomedical sciences. Finally, it considers the intersection of the two—both the advantages inherent in a closer affiliation and the limits to this affiliation. A Review of the Evidence Linking Nature Contact with Health Several reviews have examined the evidence of health benefits of nature contact (Charles & Senauer, 2010; Frumkin, 2001, 2010; Health Council of the Netherlands and Dutch Advisory Council for Research on Spatial Planning, Nature, and the Environment, 2004; Largo-Wight, 2011; Maller et al., 2008). Acclaimed author Richard Louv has brought the topic to the public arena with two influential and compelling books: Last Child in the Woods (2005) and The Nature Principle (2011). This evidence can be categorized in many ways, but four categories of nature contact are convenient for this discussion—animals, plants, landscapes, and wilderness experiences. 142 Howard Frumkin Animals Animals have played a prominent part in human life since the dawn of history (Clutton-Brock, 1981). Nearly two in three U.S. households have pets (American Pet Products Association, 2011). Pet owners report that when times are tough, they are more likely to cut back on groceries, clothing, and entertainment than on pet supplies (Fleishman-Hillard International Communications, 2007). During natural disasters, some pet owners refuse to evacuate if they cannot take their pets (Heath, Kass, Beck, & Glickman, 2001), which led Congress to promulgate the Pets Evacuation and Transportation Standards (PETS) Act in 2006, and those who lose their pets suffer considerable psychological distress (Hunt, Hind, & Johnson, 2008). Most people—50% of adults and 70% of adolescents—confide in their animals (Beck & Meyers, 1996). Virtually all the data, ranging from zoo attendance to the prominence of animal images in early education, suggest that animals are enormously important to people (Beck & Katcher, 1983; Johnson, 2010; Wilson & Turner, 1997). A wide body of evidence links animals with human health (Barker & Wolen, 2008; Headey, 2003; Johnson, 2010; McCardle, McCune, Griffin, & Maholmes, 2010; McNicholas et al., 2005; Wells, 2007). This evidence comes from observational studies of pet owners, short-term experiments that expose people to animals, and studies of therapeutic animal contact. Pet ownership has been studied in the general public, in the elderly, and in patients with specific diseases such as cardiovascular disease and mental illness. In general, the evidence has shown health benefits (Barker & Wolen, 2008; Friedmann & Son, 2009; McNicholas et al., 2005; Wells, 2007). In a study in a Melbourne cardiovascular disease risk clinic, nearly 6,000 patients were divided into those who owned pets and those who did not. The pet owners had lower systolic blood pressure, cholesterol, and triglycerides than those who did not own pets, an effect that reached statistical significance among men but not women. These findings could not be explained by differences in exercise levels (say, from dog walking), diet, social class, or other confounders (Anderson, Reid, & Jennings, 1992). In a 1995 study, 369 survivors of myocardial infarction were followed for one year. Of these, 112 owned pets, and 257 did not. The dog owners had a one-year survival rate six times higher than that of those who did not own dogs, and this benefit was not due to physiological differences (cat owners showed no such advantage) (Friedmann & Thomas, 1995). Building the Science Base 143 Investigators in Cambridge, England, followed 71 adults who had just acquired pets and compared them with 26 petless controls over a 10-month period. Within a month of acquiring the pet, the pet owners showed a statistically significant decrease in minor health problems. In the dog owners (but not the cat owners), this improvement was sustained for the entire 10 months of observation (Serpell, 1991). In another study, this one in the...