Cardiovascular disease (CVD) and cancer are the two leading causes of global morbidity and mortality. Because both pathologies are impacted by the environment, it is important to understand how using innovative, nature-based interventions (NBIs) may affect health outcomes for these populations in the U.S. and beyond. In a new PLOS One review, MCW researchers aim to describe nature’s benefit to human health by summarizing evidence on the impact of greenspaces or NBIs on cardiovascular health and cancer-related outcomes.
“Our findings overwhelming support that exposure to greenspace or NBIs such as forest bathing, green exercise, nature viewing, and gardening, have positive effects on both CVD and cancer-related outcomes, with few studies reporting null findings. Taking a closer look at this extensive body of research helped us identify knowledge gaps to inform future research and potential innovations in clinical practice,” said graduate student Jean Bikomeye, MPH.
CVD and cancer are linked by multiple shared risk factors, the presence of which exacerbate adverse outcomes for individuals with either disease. With several common risk factors, such as poverty, lack of physical activity, poor dietary intake, and climate change, co-occurrence of CVD and cancer is a major clinical problem, explained graduate student Joanna Balza, RN. “Each disease affects the treatment of the other, and therefore, has a detrimental impact on an individual’s quality of life and survival,” she added.
Andreas Beyer, PhD, associate professor, Department of Medicine and Physiology, noted that while the team’s findings showed there are beneficial effects of greenspaces or NBIs on health outcomes, future research could learn more from a mechanistic understanding of how to achieve those benefits. “Particularly, more work should focus on the role of numerous biological markers (clinically used biomarkers of cardiac injury in addition to established markers of systemic inflammation such as cytokines) and exploring the impact nature has on reducing human systemic inflammation. This would be a potential therapeutic target as we look at the role of increasing nature prescription programs in oncology and cardiovascular care,” said Dr. Andreas Beyer.
The review identifies key implications for future research, clinical practice, and policy, all geared toward improving patient outcomes. First, clinicians should consider increasing nature prescription practices in their clinics. Second, advocates can use this knowledge to promote maintenance of existing greenspaces and investment in additional spaces—this will ensure increased greenspace access and potential use by the general public, where cancer survivors will ultimately benefit. And third, research partnerships with community-based organizations are potential venues for comprehensive studies on benefits associated with greenspaces.
“These partnerships should be encouraged so individuals can engage more meaningfully with greenspaces around them, either as citizen scientists or research participants. This will be important for increasing community trust, reducing health disparities, and ensuring intergenerational health equity,” said Jamila Kwarteng, MS, PhD, assistant professor of Community Health.
Currently, the team is expanding this work by investigating the impact of greenspaces on survival among women diagnosed with breast cancer in Milwaukee and the U.S. Kirsten Beyer, PhD, MPH, MS, Director, PhD Program in Public & Community Health, hopes other scholars will join in their efforts to identify all possible pathways from greenspace to improve patient outcomes.
“This knowledge will be critical in informing the potential incorporation of nature prescription programs in complementing existing interventions (i.e., physical activity) in the cancer care continuum to improve the quality of life during cancer survivorship,” said Dr. Kirsten Beyer.