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The NHS ten-year health plan is missing a crucial ingredient: nature

The NHS ten-year health plan is missing a crucial ingredient: nature

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The UK government has finally unveiled its much anticipated ten-year Plan for improving England's health. It contains a long overdue focus on prevention, after years of sidestepping by previous administrations.
The plan rightly recognises that preventing illness before it begins is the most effective way to improve people's wellbeing. It should have the added benefit of reducing strain on the NHS and easing the nation's financial burden.
Mental health, too, is given the attention it deserves. Recognised as integral to our overall health, its inclusion couldn't be more timely. A 2023 international study found that one in two people will experience a mental health condition in their lifetime — a much higher figure than previously estimated.
But one striking omission threatens to undermine the plan's success: nature. Evidence tells us that it's one of the most powerful means of supporting physical and mental health. And yet is not mentioned once in the plan's 168 pages.
If this plan is about prevention, then nature should be central to it. The science is unequivocal: contact with the natural world supports human health in wide ranging and profound ways. It lowers stress, improves mood, and alleviates symptoms of anxiety.
For children, time in nature can even aid brain development. Nature helps reduce exposure to air pollution, moderates urban heat, and fosters physical activity and social connection.
It can also reduce feelings of loneliness, improve the diversity of our gut microbiota – by exposing us to a wider range of environmental microbes that help train and balance the immune system – and support the immune system by reducing inflammation. All of these play a vital role in protecting against chronic disease.
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Then there are the intangible yet no less important benefits. Nature provides a sense of awe and wonder – feelings that help us gain perspective, boost emotional resilience and find deeper meaning in everyday life.
Our own research, conducted in collaboration with Nick Bridge, UK special representative for climate change 2017-2023, and Michael Smythe, artist, activist and researcher and supported by a growing body of evidence, shows that even small, everyday moments in nature, watching birds from your window, for example, or pausing under a blooming tree on your way to the shop, can significantly boost mental wellbeing.
Consider this: a Danish study found that growing up near green spaces during the first ten years of life reduces the risk of developing mental health problems in adulthood by a staggering 55%. A UK study similarly showed that people living in greener neighbourhoods were 16% less likely to experience depression and 14% less likely to develop anxiety.
And as heatwaves become more frequent and intense – with soaring illness and mortality rates – the cooling effects of trees and parks will become more vital than ever for protecting our health.
But it's not just access to green space that matters – it's also the quality of that space.
Green areas rich in biodiversity, with a wide variety of plant life, birds, insects and fungi, provide much greater health benefits than sparse or manicured lawns. Biodiversity builds resilience not just in ecosystems, but in our bodies and minds.
A recent study in The Lancet Planetary Health found that people living in areas with greater bird diversity were significantly less likely to experience depression and anxiety, even after accounting for socioeconomic and demographic factors.
This research underlines a simple but urgent truth: we cannot talk about human health without talking about biodiversity.
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To deliver true prevention and resilience, we need a joined-up approach across government: one that aligns health policy with environmental protection, housing, urban design, education and transport. This means rethinking how we plan and build our communities: what kind of housing we develop, how we move around, what we grow and eat and how we live in relationship with the ecosystems that support us.
There are many ways this vision can be put into action. The Neighbourhood Health Service outlined in the ten-year plan could be tied directly to local, community-led efforts such as Southwark's Right to Grow campaign, which gives residents the right to cultivate unused land. This kind of initiative improves access to fresh food, promotes physical activity, strengthens community bonds and increases green cover – all of which support long-term health.
School curricula could be revised to give children the opportunity to learn not just about nature, but also in nature – developing ecological literacy, emotional resilience and healthier habits for life. Health professionals could be trained to understand and promote the value of time outdoors for managing chronic conditions and supporting recovery. Green social prescribing – already gaining ground across the UK – should be fully integrated into standard care, with robust resourcing and cross-sector support.
Scotland's Green Health Partnerships show what's possible. These initiatives bring together sectors including health, environment, education, sport and transport to promote nature-based health solutions – from outdoor learning and physical activity in parks, to conservation volunteering and nature therapy.
They don't just improve health; they strengthen communities, build climate resilience and create cost-effective, scaleable solutions for prevention.
The ten-year plan is a once-in-a-generation opportunity. It could help remove departmental silos and unify national goals across health, climate, inequality and economic recovery, while saving billions in the process. But in its current form, it misses a crucial ingredient.
By failing to recognise the centrality of nature in our health, the government overlooks one of the simplest and most effective ways to build resilience – both human and ecological. Surely it is not beyond a nation of nature lovers to put nature at the heart of our future health?
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Andrea Mechelli receives funding from Wellcome Trust.
Giulia Vivaldi, Michael Smythe, and Nick Bridge do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
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What do King Charles, Lulu, Gerry Adams, Eliza Manningham-Buller, Ian McEwan and Ozzy Osbourne have in common? The answer is that they were all born in Britain in 1948, widely thought to be the luckiest birth year of the 20th century. 'Everything dropped unexpectedly on our plate at exactly the time we wanted it to,' says Deborah Moggach, born in June 1948 and the award-winning author of 20 novels, including These Foolish Things, which was adapted into the film The Best Exotic Marigold Hotel. 'It was very unfair but also very reassuring, as if the world reflected one's own burgeoning feelings – of rebellion or ecology or sex or music. You felt a sense of companionship: as if you were leading the world, or the world leading you.' There is always, of course, a danger of generalisation with social history. The experiences of Moggach, an English graduate of Bristol University who was brought up by a literary family in London, are different to those of a coal miner's daughter in Durham – or indeed those of King Charles or Ozzy Osbourne. Not only has no reputable study officially anointed the 1948-ers as the most fortunate cohort in history, a poll commissioned to generate publicity for Call the Midwife, a television show set in the mid-1950s, concluded – unconvincingly and unsurprisingly – that 1956 was actually the best year to be born. The Telegraph dived into the data and the experiences of the 1948 generation – from healthcare to housing, education to employment, music to social mobility – to test the theory. The 1948-ers were the first babies delivered by the National Health Service. 'If you were born that year, you benefited from a well-funded NHS throughout your life,' says Mark Dayan, a policy analyst at think tank Nuffield Trust. They also benefitted, he argues, from the rapid improvement in healthcare since 1890, a period that established the basics of modern medicine, from widespread vaccinations to blood transfusions. And although infant mortality rates in 1948 were nearly 10 times higher than today, maternity care had also made significant improvements during the first half of the 20th century. As soon as the 1948-ers were safely home from hospital – and as long as they avoided the worst of polio and tuberculosis – the Family Allowances Act of 1945 provided a universal benefit of five shillings per week per child. Few children born in 1948 would have strong memories of rationing, which finally ended in 1954. None would have been old enough to take part in National Service, which stopped in 1960. Meanwhile, many of their parents were enjoying the fastest rises in living standards in modern history. Amid low inflation, men's wages almost doubled between 1951 and 1961, despite working two fewer hours per week over the decade (42 vs 44). Families were increasingly lavish with this disposable income and leisure time. Car ownership rose by 25 per cent between 1957 and 1959, television ownership by 32 per cent. Sixty thousand people per week took a holiday at Butlins, while foreign holidays doubled in the 1950s (and doubled again the following decade). This rising consumption, coupled with generous tax cuts, famously led Harold Macmillan to declare in 1957: 'Most of our people have never had it so good.' The 1948-ers' parents seemed to agree, returning 'Supermac' with a majority of 100 seats in the general election of 1959. A cartoon in the Spectator pictured the prime minister surrounded by televisions and washing machines with the caption: 'Well, gentlemen, I think we all fought a good fight.' This rising leisure time, coupled with a post-war baby boom and increased urbanisation, led to the relatively new concept of the 'teenager', a word imported from America. By 1960, when the 1948-ers were on the verge of this milestone, there were some four million teenagers in Britain, fuelling significant spending on burgeoning industries such as fashion, cinemas, magazines and music. 'People start talking a lot about teenagers just when you yourself are becoming a teenager,' explains Dominic Sandbrook, an historian of post-war Britain and co-host of The Rest is History podcast. 'You have a sense of having your own tribe, a cultural self-confidence. If you're born in 1948, you're about to turn 15 when the Beatles break through – the perfect age. There's a popular culture that exists just for you, which didn't really exist before.' According to Sandbrook, the 1948-ers also avoided the sense of cultural alienation experienced by many other generations. 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And although it's true that women born later have had it easier from the start, those born in and around 1948 knew it was going to be tough. Today, young women often say when they have children, 'I didn't know it was going to be this hard.' Women back then knew it.' A working woman born in 1948 would have benefitted from the Equal Pay Act in 1970, passed when she was 22, and the Employment Protection Act of 1975, introducing paid maternity leave (ideal timing given that the average age of a mother that year was 26.4). The 1960s were generally a good time for anyone to enter the workforce. GDP per capita rose almost every year until 2008, while the average hours worked continued to fall steadily. Real wages increased by an average of 4.6 per cent every decade until 2008, whereupon many of the 1948-ers retired aged 60, the last year in which a majority could still take a final salary pension (this figure had fallen to 30 per cent only a year later). 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The only area in which the over-70s are more negative than younger people is in their hopefulness for the future – perhaps partly in the suspicion that no subsequent generation will ever have it quite so good again. Broaden your horizons with award-winning British journalism. Try The Telegraph free for 1 month with unlimited access to our award-winning website, exclusive app, money-saving offers and more.

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