Ana Isabel Ribeiro works as an integrated PhD researcher at the Public Health Institute of University of Portugal, and also as an assistant professor in the Faculty of Medicine. She coordinates the Research Lab called Health and territory, where she explores the places where people live, including nature, and how it affects health throughout the life course.
Deeply connected with nature, she grew up in Esposende, a small town located in a natural park near Porto, in Portugal, with a river and mountains, and spent many three-month summer breaks at the beach. “And when the night was very warm, we also used to stargaze and identify constellations and comets”.
Ana has been instilled with this notion that we are one with nature, so her office is filled with plants, she takes her students to field work in parks, keeps rocks in her desk, and even what she eats is aligned with nature, proximity and seasons. The same FTHub Forest Therapy Practitioner that as been part and conducted brilliant pioneering research shedding light on people’s lives close to nature.
Nature-Children’s research
« My bachelor degree is in geography and in the last years at that time I started to see connections between these natural environments and health. So I studied in my Master’s and later did a PhD in Public Health in the Faculty of Medicine. I wanted to explore how healthy aging and survival among older people is affected by the places where people live.
During this investigation, I discovered that green space is a key determinant of active aging. We found that older people living near parks were more likely to engage in leisure time physical activity. And we know that leisure time physical activity is a very important predictor of health.
During my PhD, I was very lucky to be a visiting scholar at several universities, and one of them was University of Glasgow, where I worked very closely with the Professor Richard Mitchell, one of the persons that launched this idea that green space can be equigenic so they can help us mitigate health inequality. It also inspired me a lot to keep studying and after my PhD, I started to use a lot of cohort data we have available in Porto, people that we follow through time. And I was able to explore how nature affects these trajectories of health.
So in 2018, I received funding from the Portuguese Science foundation to understand how urban environments, namely nature and natural features like green spaces and blue spaces, influence children’s health. More precisely, respiratory health and neurologic diseases, which have a very big burden among kids.
And we were able to reach very interesting conclusions. Children living in a green space have better respiratory function, lung function, they have lower odds of getting asthma, of having allergic sensitization. And we then started to look at other health outcomes not necessarily connected with respiratory health. So I have a PhD student that is focused on children’s health, and he was able to find that children living near green space in urban environments have higher IQ. And they also have less behavioral problems like hyperactivity. Very interesting things with important policy implications ».
The elder and nature
« I tend to focus on the extremes, like old people and young people. And I have a scientific employment grant from the Science foundation for six years and my focus is understanding what are the features in the urban environment that influence older people’s health. And recently we conducted a study looking at whether having green space nearby and different types of green spaces in urban environments influence depression and depression symptoms among older people.
So depression among older people is a very prevalent condition and it affects the risk of mortality. And we found that older people that are in gardens, in close proximity to their homes, even if they are small, had lower levels of depression. And this seems to happen because these individuals have higher social support.
Our interpretation is that these people spend more time with others socializing in this space. And the socialization and social support make them less depressed. And of course this suggests that parks, even if they are small, can be important venues to promote population health in cities through their environmental benefits.
I’m a full time researcher, but I also keep teaching medical doctors that are doing the MD specialization in public health and students doing the Master’s degree in Public Health and the PhD in Public Health ».
A new date with nature
« Forest Bathing and Forest Therapy was a natural progression. We know a lot about the benefits of green space. So we have so much evidence that in my perspective, we need to move to a more interventional kind of research and based on that knowledge, to try to implement individual level and community level interventions that put people into contact with nature. So.
And I found this can be done through green prescriptions, nature based therapies, and I wanted to learn more about that. So I decided to join the FTHub training and to learn about the FTHub method with basically two objectives. First, to learn from myself and to help other people around me to use nature as a way to improve their health and well being. And then, to learn so that I can start to conduct more experimental studies and interventional studies within the research environment that I work, where we use these methodologies to test, then to measure the benefits in terms of different health outcomes.
It has been great to try to bridge academic work that is very detached from people’s reality, to actually building a program, a nature based well-being plan, and to plan these forest bathing walks.
I think it has been truly interesting and I hope to get funding to be able to implement this in Porto and to actually bring a more immediate benefit to the population, because urban planning interventions are very good and they are very wide reaching.
The future ahead
« If we manage to create an intervention and to actually put people into contact with nature in different senses, so with forest bathing, horticultural therapy, etcetera, and we can prove that this brings benefits in terms of diabetes control or depression symptoms or loneliness, we are better equipped to convince authorities to value these resources that are such sometimes already available in the cities.
Forest Therapy brings a more immediate effect on people’s health. And we have people that live in very poor health conditions, for instance, older people, that is quite a big group in Portugal, they are lonely, they have a lot of comorbidities.
And if we are able to offer a nature based service like this and they feel the benefits in a more immediate way, I think this makes my work as a researcher and my life more fulfilling as well.
I take my students outside. If I need to talk with someone I work with, I say, well, let’s go to the park and brainstorm a little bit. And I feel it makes everything much more productive and the ideas flow. I feel creative and other people are also creative when in touch with nature. We need to build green spaces that actually are attractive and safe for different population groups.
Photos: Courtesy Ana Isabel Ribeiro
