Session 4: Economic & social ROI of horticulture on health &

wellbeing

1410 Dr Kieron Doick (Forest Research)

iTree – Economic & Social ROI Health & Wellbeing

1420 Craig Lister (The Conservation Volunteers)

Impact & Social Return on Investment

1430 David Buck (The King’s Fund)

Financial Overview

1440 Keith Oliver

Gardening & Living with Dementia

1445 Questions on Session 4

Valuing urban trees’i-Tree’ and other approaches

Dr Kieron J. DoickLand Regeneration and

Urban Greenspace

Research Group

&

Kenton Rogers

6-Jul-164

Why value urban trees?

• To raise the [policy] profile of trees woods forests

• To justify and grow planting and maintenance budgets

• Quantification enables an asset value approach to management

• Tackle questions of urban forest structure, composition and resilience to climate change

The benefit of trees in towns is widely accepted. To increase the level of benefit, we need to increase canopy cover – but How? Where? When? With what trees? And, Who will pay?

i-Tree: peer-reviewed software suite

+ many collaborators

Canopy

What is i-Tree?

Who is using i-Tree Eco in the UK?

Local authorities

Community groups

Developers

Business

improvement districts

Large land asset

owning agencies

Reports available from www.forestry.gov.uk/fr/itree and http://www.treeconomics.co.uk/

i-Tree Eco Overview

FIELD DATA STRUCTURE

Number of trees

Species comp.

Age/Size structure

Leaf area

Leaf and tree biomass

FUNCTIONS VALUES

Carbon storage &

sequestration

Air pollution

removal

Stormwater

attenuation

Visual amenity

Habitat provision

Building energy use

Sample plot inventory- Land use

- Tree cover

- Impervious cover

- Plantable space

- Etc, etc

£

as annual benefit

as amenity value

&

as a total

=

policy

=

understanding

=budgets / funding

(ROI)

REPORT

ECOSYSTEM

SERVICE

VALUES (£)

Torbay

(2010)

Edinburgh

(2011)

Glasgow

(2013)

Wrexham

(2013)

Bridgend

(2014)

Swansea

(2014)Average

Number of trees

('000s)818 638 2000 364 439 530 798

Avoided

sewerage

charge/yr/tree

N/A N/A 0.55 1.26 0.37 1.12 0.83

Net Carbon

sequestered/

yr/tree

0.21 1.52 1.02 0.72 1.04 1.25 0.96

Pollution

removal/yr/tree1.63 3.16 0.70 1.92 0.41 0.10 1.32

Asset value /tree N/A N/A 2,000 3,846 1,563 1,540 2,237

Assumes 1/3 trees are LA owned and £271,000 average annual tree budget

(Figures courtesy of Helen Davies, Uni. Of Southampton and Forest Research)

Return on Investment

6-Jul-167

Budget = £1.03 tree-1

Benefit = £3.10 tree-1 yr-1

Env. Return = £2.07 tree-1 yr-1

Budget = £1.85 tree-1

Benefit = £2.73 tree-1 yr-1

Env. Return = £0.88 tree-1 yr-1

6-Jul-168

CAVAT: Capital Asset Value for Amenity Trees

• Quick Method for tree stock as a whole e.g.

across a whole local authority area

• target setting, based on performance

• analysis of strength of tree stock across a

town, city or borough

• aids decision making

• Full Method for single trees

• Basis for the Joint Mitigation Protocol (for settling subsidence claims against public trees in London)

• Used alongside i-Tree Eco

London 8 million trees valued at £43 billion

Glasgow 2 million trees valued at £4 billion

For further info visitwww.cavattv.orgwww.ltoa.org.uk/resources/cavat

(by Chris Neilan and London Tree Officers Assoc.)

i-Tree Eco - makes a difference

• Torbay, England study information led to an additional

£25,000 to the tree budget in 2011, and again in 2014!

• Victoria BiD, London study highlighted dependence on

London Plane for benefits. Tree planting strategy

commissioned to improve age, size and species composition

• Wrexham, Wales information used as based for revising

urban woodland strategy including a target to increase

canopy cover by 20% to 37%! (from the baseline of 17%)

• Edinburgh, Scotland social enterprise (www.tree-time.com)

set up with elgt.org.uk to fund increase in canopy cover

Plus: report instrumental in case building to protect budget

06/07/20169

6-Jul-1610

Where next?

• More i-Tree Canopy and Eco surveys

• Data = informed decisions

• Species choice / canopy size / location

• More High-level Champions

• A report on a shelf is just information

Leading to

• Targets/plans to increase canopy cover

• Public/private coordination/communication

• Better budgets for trees/greenspace

• Novel funding sources

• E.g. health service sponsored tree walks

• Green Infrastructure approach within new developments, & existing towns

6-Jul-1611

Mapping and valuing

the UK’s urban trees

Treezilla – the monster map of trees

www.treezilla.org/

• Citizen science

• Education

• Recreation

• Research

• Fun!

My thanks to:

• Davey Institute, esp. Scott Maco

• Forestry Commission

• Natural Resources Wales

• Open University

• Woodland Trust, for data

• My group: Phil Handley, Madalena Vaz Monteiro, Joe Moss, Angiolina Albertini and Vicki Lawrence

Thanks to our partners

6-Jul-1612

Craig Lister Green Gym Managing Director

TCV’s vision:

Healthier, happier communities

for everyone

Join in, feel good © The Conservation Volunteers 2016

01:37

How long have we been here?

00:00.17

Join in, feel good © The Conservation Volunteers 2016

Facts and personal thoughts

• Habitual PA and socialising is good for you

• Inactivity and isolation are bad for you but…

• Being active is not easy (inherently lazy)

• Eating lots is (inherently greedy)…

• as is getting fat (thrifty/drifty gene hypothesis)

• We like to achieve things (especially in groups)

• We like to be appreciated (remember Maslow?)

Join in, feel good © The Conservation Volunteers 2016

Natural exercise for community health

Join in, feel good © The Conservation Volunteers 2016

Meet and

greet

Safety talk

Warm up

Activity session

Mid session break

Activity session

Cool down

Join in, feel good © The Conservation Volunteers 2016

http://www.neweconomics.org/projects/entry/five-ways-to-well-being

Overall Impact Pathway (PWC)Inputs Outputs Outcomes

Learning Action Condition

£30,000 per annum over 2 years*

Outdoor space

Tools and shed

Project Officer

Partner (LA, school, land owner)

Referral partners

Volunteer time

Training

Vehicle hire

Conservation skills and knowledge of the environment

Reduced isolation

Form community groups / networks

Leadership

Ongoing sustainability

Increased interaction outside of the sessions

Community cohesion, better understanding of others

Become physically active

Better health

Sharing different perspectives

Improved dietSafe physical activity

Increased employability

Health literacy

Increased use of space by public

Job readiness skills e.g. time keeping, teamwork, office skills

Self efficacy / esteem

Social interaction skills

Safe tool use

Intergenerational skill sharing e.g. web skills

Community resilience

Individual resilience

Increased management of green spaces and pro-environmental behaviour

Increased confidence and become more skilled to find a job

Increased the time spent in outdoor green spaces

No. volunteers engaged per session (12 – 20)

48 sessions per year per group

15% growth in community groups per annum

Green Gym leaders trained (2-3 per annum)

15% growth in number of spaces brought into active management

(Designation of sites -SINCs)

Increased connection with nature

© The Conservation Volunteers 2016What PWC say…

Join in, feel good © The Conservation Volunteers 2016Activity with purpose

In 2015 TCV helped to distribute and plant almost 160,000 trees - working with

over 560 community groups across the UK.

Through the Big Tree Plant in 2014 TCV helped to plant almost 60,000 trees.

Join in, feel good

60% of participants improved their knowledge of good nutrition and healthy lifestyle basics

55% of participants reported increased

consumption of fruit and fresh

foods.

74% will continue with the healthy

eating skills they have learned

79% have grown their own food as a result of participation in the programme, and 40% ofparticipants are now growing their own food at home.

77% will continue to grow their ownfood.

74% have become

more active

85% will continue with physicalexercise as a result of participationin the programme

© The Conservation Volunteers 2016What the volunteers say…

Join in, feel good © The Conservation Volunteers 2016Social value

TCV worked with over 16,000 children in

2013‒2014. Children’s Activities

provide ￡3.52 in benefit for every ￡1

invested.

…It gives my daughter so much confidence

being out getting messy in nature rather

than being nervous about it.

In 2013‒2014, BATs supported 5,002

volunteers: 1,667 who had been

involved with BATs for over a year, and

3,335 new volunteers.

“TCV creates excellent social value

across social, environmental, and

economic dimensions”

Join in, feel good

22%

29%

21%

-26%

Life Satisfaction Worthwhile Happiness Anxiety

ONS wellbeing improves by a fifth or more and anxiety drops by more than a quarter

% change

n=92(baseline)n=79 (2nd follow-up)

© The Conservation Volunteers 2016

Join in, feel good

TCV won the coveted three year Health and Wellbeing Award from the Royal Society for Public Health (RSPH), one of only four organisations nationwide.

Social Return On Investment:

For every £1 spent on Green Gym, £4.02 is returned

Social, Environmental & Economic outcomes (NEF).

© The Conservation Volunteers 2016

TCV (in partnership with Mind) have been awarded £557,164 from the Department of Health (HSCVF) to run a pioneering ecotherapy scheme called Pro-Active Minds, which will run in four sites across London.

Join in, feel good © The Conservation Volunteers 2016

http://www.kingsfund.org.uk/publications/g

ardens-and-health

Next Steps

↑ GG Delivery

NIHR/local research

Population awareness

Primary funding

Collaborative achievement

Gardens and health policy: a need for health economics

David Buck, Senior fellow public health and health inequalities, The King’s Fund

4th July 2016

Industry Ornamental Horticulture Roundtable Health and Horticulture Conference, RHS Hampton Court

Palace Flower Show, KT8 9AU

To contribute to the understanding, assessment, and development of the links between gardens, gardening and health

Sets out the evidence base on how gardens and gardening relate to health across the life-course

Shows how, at many points in the health and care system, gardens and gardening can make a strong contribution to keeping us well and independent

Sets out a menu of recommendations and options at strategic and local level.

Gardens and health

Half of the average cities’ green space is private gardens, and half of adults report gardening as a free-time activity

Gardening becomes more important to us, in terms of identity and source of physical activity, stimulation and contact as we age

The scale and reach of gardens and gardening

School gardens and growing have been shown, in RCTs, to increase fruit and vegetable intake and in other studies to improve sense of achievement and pride, particularly for children with behavioural problems.

Family gardens are highly valued as places of physical activity, particularly through play.

Those who use of allotments have been shown to have improved mental health on a range of measures compared to controls; gardening has repeatedly been linked to better mood, less anxiety and depression.

As we age gardening becomes more important to sense of self, may help prevent falls and cognitive decline, although gardens can “become burdens”.

Gardens have positive effects on climate, pollution off-setting, and flood risk. These environmental benefits reduce population health risks.

Effects across the life-course

A menu of recommendations

A menu of recommendations

Strategic policy

•Alignment of DH, Defra, DCLG e.g. ‘healthy natural economy’ plans

•Underpinning NHS 5YFV programmes e.g. Healthy New Towns, Models of Care, Social Movement for Health, Realising the Value etc

•Role in planning healthy weight environments

•Contribution to social action and volunteering

Local action

•HWB Boards and DPHs consider contribution

•CCG support social prescribing with gardening components

•Innovative funding models and maintenance of high quality public gardens

•Longer term influence over NHS STPs, devo plans and use of excess NHS and other estate

Evidence

•Priority should be a programme of dissemination of existing evidence across life-course and health and care system entry points

•Further research, focussed on what works, where, when, for who to inc but not restricted to RCTs

•Economic evaluation incpossible RoI tools

The economic case needs developing

There is no simple general case that can be used to prove the business case for gardening.

The health economic case needs to be more strongly developed, to increase the likelihood of investment from the NHS and wider health sector, and to strengthen the wider collective RoI case for gardens as a focus of legitimate policy action, not simply a private activity.

Need to develop the (health) economics of gardening

Google search for economics of gardening returns results about

– individuals saving expenditure vs bought goods

– economics of organic growing

– A small number of academic studies for example on the impacts of community gardens on wider social capital in communities

Public health and wider wellbeing

Increasing access to parks and open spaces could reduce NHS costs of treating obesity by more than £2bn; several SROI cases.

Green walls and trees could remove some air pollution, though overall effects are low, and some noise pollution; overall value of London’s tree cover (including amenity value) estimated at £130bn.

NHS demand

Access to green space can reduce mental health admissions; Ecomindsevaluation (of 5 cases) suggests benefits in terms of reduced NHS costs, welfare benefits etc; SROI cases include NHS demand reduction.

BTCV evaluation of green gyms suggests for every £1 spent, £2.55 is saved in reduction in physical illness

The current “economic” case relies on wider case for green space

Need more economic evidence, with clear focus

Strategic policy

•The economic case that supports alignment of DH, Defra, DCLG e.g. ‘healthy natural economy’ plans

•The cost-benefit case, meeting multiple objectives including but not exclusively health (health a big hitter in valuation terms and can easily swing decisions if in or out of calculations)

NHS

• How gardening “works” (physical, mental) and for “who” (young to elderly) and impacts on…

• NHS demand reduction and £ impact (especially on hospital care)

•Economic evaluation

evidence of gardening vs alternatives in terms of cost per QALY

•Social prescribing, moving up the NHS agenda.

Local government

•Gardening as a social intervention

•The economics of impact on public health, and the return on investment of that, £1 = £x return

•SROI and the distribution of benefits and costs to different population groups, with a focus on inequality reduction

Local Health and wellbeing

Board

Gardens and gardening are important to us, over half of adults garden and it is important across the life course, increasingly as we age.

Gardening influences health in complex and multiple ways. The weight of evidence on gardening and health is convincing, despite a lack of RCTs. More and better quality evidence is always good, but we have enough to act.

There are excellent examples of where the health and care system is already integrating gardens and health from social prescribing to dementia gardens.

There is no simple general case that can be used to prove the business case for gardening. If gardens are to become part of the mainstream of health policy and practice, the health economics case needs to be developed further and needs to be focussed differently for audiences.

Conclusions

A personal perspective on living with dementia from someone who knows!

The benefits and challenges of enjoying gardening Hampton Court Health & Horticultural Conference 4 July 2016

Keith Oliver

Person living with dementia

Alzheimer’s Society Ambassador

Kent & Medway NHS Partnership Trust Dementia Envoy

The “Kitwood Flower”

From “Dementia Reconsidered” by Tom Kitwood (1997)

OUR garden in July

For further information related to what Keith Oliver is trying to achieve you might like to look at the following....

• www.kmpt.nhs.uk/keith-oliver

• www.youtube.com/keitholiver

• Or simply google “Keith Oliver/dementia”!!

Session 4: Economic & social ROI of horticulture on health &

wellbeing

1410 Dr Kieron Doick (Forest Research)

iTree – Economic & Social ROI Health & Wellbeing

1420 Craig Lister (The Conservation Volunteers)

Impact & Social Return on Investment

1430 David Buck (The King’s Fund)

Financial Overview

1440 Keith Oliver

Gardening & Living with Dementia

1445 Questions on Session 4