New Tree Equity Score tool shows the connection between trees and health inequalities

Trees save lives by providing significant benefits for health and wellbeing, but trees are not fairly distributed in a way that will benefit urban population centres. The Tree Equity Score UK is a new online interactive map which shows for the first time the disparities in urban tree cover across the UK. Importantly, it shines a light on how less affluent areas have fewer trees and are missing out on essential health benefits like cleaner air and cooler temperatures in summer.

The Centre for Sustainable Healthcare's NHS Forest project is proud to have worked alongside American Forests, the US non-profit organisation that created Tree Equity Score and the Woodland Trust to bring the Tree Equity Score to the UK. This is a pioneering programme to ensure that developers have the tools and resources they need to calculate tree density in urban areas and help them to plan for the future, ensuring that there are enough trees to provide show a net positive impact on the health and wellbeing of local communities.

What is the Tree Equity Score?

The UK Tree Equity Score was created through a partnership between American Forests, the US non-profit organisation that created Tree Equity Score, the Woodland Trust and the Centre for Sustainable Healthcare (CSH). It uses new tree canopy datasets from Google, as well as six other datasets relating to climate, UK health and socioeconomics, to provide the most accurate picture of Tree Equity in the UK.

It is a data-driven, evidence-based tool utilising pioneering methods developed by American Forests. It generates a score out of 100 for nearly all urban neighbourhoods in the UK, providing a rating of Tree Equity. The lower the score, the greater the need to prioritise tree canopy cover in that neighbourhood. A score of less than 100 means there is still work to be done. A score of 100 means the neighbourhood has met the standard for proper urban tree canopy and has achieved Tree Equity. However, even with a score of 100 trees still need to be maintained, cared for and made accessible and usable by the community.

Every community deserves equitable access to the health and wellbeing benefits of trees.

Trees have been consistently shown to have a positive impact on health and to reduce the need for healthcare interventions which in turn support a more financially and environmentally sustainable healthcare model. Having a view of trees has even been shown to reduce recovery time and the need for painkillers after an operation.

Trees are linked to:

• Fewer instances of respiratory disease due to improved air quality
• Fewer deaths related to summertime heat thanks to the cooling effect of tree canopy cover
• improved mental health

The Tree Equity Score tool shows that having trees in your neighbourhood is tightly linked to issues of health equity. In fact, analysis from the tool shows that neighbourhoods with the highest income levels have more than double the tree cover per person than less affluent neighbourhoods and have nearly 20% less of the toxic pollutant nitrogen dioxide (NO2). Poor air quality has been described by Public Health England as “the largest environmental risk to public health in the UK.” Failure to plant trees in areas of low tree cover is a failure to meet the health needs of those communities. Furthermore, a report in Nature showed that the benefits of trees can have an even greater effect on those living in higher levels of deprivation, meaning they can help to directly tackle health inequalities.

Successive lockdowns have reinforced to all of us the importance of access to green spaces. 12% of people in the UK faced the pandemic with no outdoor space to call their own, this figure rose to 24% of all people in Greater London, and 41% of BAME Londoners. 

 

We know from studies dating back to the 1980s that a view of Silver Birch trees from a hospital bed enhances recovery from surgery, reduces pain and complications, and sees the patient getting home quicker. Multiple other studies since then have shown similar benefits to health and wellbeing. Shinrin Yoku (Forest Bathing) trails in Japan demonstrate reduction 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.

 

To me as a doctor and a nature-lover, all of this makes perfect sense. As a species we have spent 99.9% of our history living and integrating with nature, and only very recently have we started to turn our backs on it. It's time to reverse this trend and embrace our natural environment and green spaces as part of our commitment to the planet and its environment, as well as to our own wellbeing.

 

Dr Richard Claxton, GP

The mental health benefits of trees are also well documented. Dr Tom Fisher, who is leading a project to develop nature-based training for psychiatrists within his NHS trust, explains: “Trees can provide comfort and companionship to those in distress; their consistent presence can offer people a sense of reassurance and familiarity, and support the development of nature connections even when connecting in the human world can feel difficult and unsafe. Trees offer opportunities to pause and notice the beauty of the natural world around us, and to attune to the rhythms of the seasons. In psychiatry, many of the people we work with live in highly urban environments, disconnected from the natural world and with multiple barriers to accessing natural environments. These people deserve the health benefits offered by trees, experienced by those in less deprived areas. They deserve the opportunity to re-connect with nature through trees and experience the sense of belonging and wellbeing that re-connection brings.”

Transforming health and communities through data.

The Tree Equity Score tool is for everyone from individuals to large organisations and governments. It will enable decision makers to address health inequalities by planting the right trees in the right place to have the greatest benefits to those who need it most. At CSH we work with healthcare professionals and the wider public to help develop the knowledge, skills and tools people need to play their part in the transformation to sustainable healthcare. We particularly want healthcare sites in the UK to embrace the Tree Equity Score, both to benefit their own communities and to help drive national policy around tree planting and tree equity. We know that trees have a huge positive impact on people’s health and wellbeing, and healthcare providers are uniquely placed to champion access to these benefits. From individuals through to anchor institutions such as the NHS, Tree Equity Score can be used at any scale to help get trees where they’re needed most and reduce health inequalities.

We are starting to work with healthcare sites to use Tree Equity Score to determine where trees should be planted on their own sites to have the greatest benefit for communities. We will also use the tool to determine our own tree planting as we have 150,000 trees to plant on healthcare sites over the next 2 years. Tree Equity Score will enable us to plan where to plant these trees for the greatest impact.

Want to find out more?

To read more about the Centre for Sustainable Healthcare's work on the Tree Equity Score, please visit the NHS Forest website, or visit the Tree Equity Score UK website to find out your neighbourhood's own Tree Equity Score.