Trees: an overlooked healthcare ally
Trees save lives by providing significant health and wellbeing benefits. The NHS Forest project, launched by the Centre for Sustainable Healthcare in 2009, acknowledges trees' positive impact on mental and physical health and offers free trees to healthcare sites. Thanks to funding and support from Defra and the Forestry Commission, we have committed to planting 150,000 trees on sites in England between November 2023 and March 2025.
Health benefits of trees
Trees offer numerous benefits: improving air quality, cooling buildings, creating wildlife habitats, and storing carbon. They play a vital role in saving lives and valuable NHS resources by enhancing population health. For example, it’s estimated that between 2017 and 2025, the total cost to the NHS and social care system for caring for individuals affected by air pollutants will reach £1.6 billion. One recent study has shown that areas with low tree cover are associated with higher levels of need for non-urgent and urgent medical care. In this way, planting trees and woodlands on the NHS estate can play a key role in disease prevention.
The impact of green spaces on staff wellbeing is also crucial. Rising NHS staff sickness rates result in increased spending on emergency staff cover. Access to green spaces can mitigate this issue. Recent research by Business in the Community revealed that employees with a view of nature take 23% less sick leave. Moreover, our own research published in the Space to Breathe report found NHS staff who said they regularly spent time in their sites’ green spaces during the working day reported significantly higher levels of wellbeing.
The NHS Forest project has already made a tangible difference. Ginnie Abubakar of Mount Vernon Cancer Centre shared how greater use of outdoor spaces has significantly improved wellbeing:
“Since collaborating with the NHS Forest project, there has been fantastic engagement on site. We've observed patients strolling through our woodland walkway, taking time to sit and appreciate the environment, which has been amazing. Additionally, more staff than ever before are suggesting outdoor meetings, greatly enhancing staff wellbeing and morale. Our goal is to involve everyone in creating a greener future and positively impacting our communities' wellbeing.”
The importance of tree equity for health equity
The Centre for Sustainable Healthcare has also collaborated with the Woodland Trust and American Forests on the new UK Tree Equity Score — an online map displaying urban tree cover disparities. It generates a score out of 100 for nearly all UK urban areas, providing a Tree Equity rating. The lower the score, the greater the need for more trees.
The Tree Equity Score tool reveals that having trees in your neighbourhood is closely linked to health equity issues. Analysis from the tool indicates that neighbourhoods with higher income levels have more than double the tree cover per person than less affluent neighbourhoods, with nearly 20% less toxic pollutant nitrogen dioxide (NO2). Poor air quality was described by Public Health England (now the Office for Health Improvement and Disparities) as "the largest environmental risk to public health in the UK.” This underscores the importance of planting trees in areas with low tree cover. Additionally, a report in Nature highlighted that the benefits of trees can have an even greater impact on those living in higher levels of deprivation, directly addressing health inequalities.
“Successive lockdowns have emphasized the importance of access to green spaces for all of us. 12% of people in the UK faced the pandemic without any outdoor space of their own. This figure rose to 24% in Greater London and 41% among BAME Londoners,” says GP Dr. Richard Claxton. “Shinrin Yoku (Forest Bathing) trials in Japan demonstrate reductions in blood pressure, heart rate, and cortisol levels within one hour, and increased natural killer (cancer surveillance) cells in the bloodstream. These benefits can last for up to four weeks.”
Tree equity helps prioritise tree planting
The Tree Equity Score empowers decision-makers to address health inequalities by planting trees where they're most needed. NHS sites, in particular, can champion access to trees' benefits for their communities and help drive national tree equity policies. Sarah Jordan, Director of Green Space for Health at the Centre for Sustainable Healthcare, explains why the Tree Equity Score tool will be essential for healthcare sites:
“Trees are an overlooked healthcare ally and every community deserves equitable access to the health benefits of trees. As an organisation focused on sustainability in healthcare, we recognise not only the significant benefits trees offer to health but also their capacity to address health inequalities. The benefits of trees on health have a heightened effect on those living in higher deprivation. Hence, the Tree Equity Score will assist in placing the right trees in the right places to deliver these benefits to those who need them most. We're already collaborating with NHS sites to utilise the tool for maximum impact with our tree planting projects.”
To find your neighbourhood’s Score, visit uk.treeequityscore.org.
NHS sites can register to receive free trees at nhsforest.org.
Author: Una Devlin, Green Space for Health Communications, Marketing & Engagement Lead, The Centre for Sustainable Healthcare