中国自然保护地公共健康价值的系统认知与实现策略

Systematic Understanding and Implementation Strategies of the Public Health Value of China's Protected Areas

关键词:  风景园林  自然保护地  国家公园  自然公园  公共健康  健康中国

Key words:  landscape architecture  protected area  national park  nature park  public health  Healthy China

摘要:

在工业化、城镇化与老龄化交织的背景下，中国公共健康面临多重挑战。以国家公园为主体的自然保护地体系凭借其优质的自然与景观资源，在促进公共健康方面展现出显著潜力，但其相关价值尚未得到系统性认知与有效实现。通过综合梳理政策文本、国内外文献与实践案例，可构建自然保护地公共健康价值的系统认知框架，明确其涵盖自然、文化、支持3类要素，以及自然暴露、行为激励与认知调节3类作用机制。在此基础上，提出涵盖理念、政策、规划设计、管理与保障5个层面的12项实现策略，旨在生态保护前提下实现自然保护地的健康价值，提升居民健康福祉，推动“健康中国”战略与生态文明建设的协同发展，促进人与自然和谐共生的现代化进程。

Abstract:

Rapid industrialization, urbanization, and population ageing have shifted China's disease burden toward non-communicable diseases, which already account for 88% of total deaths and generate escalating economic costs. Unhealthy lifestyles and unequal access to restorative natural environments further widen health disparities, making preventive, nature-based interventions a policy imperative. In this context, protected areas (PAs) - encompassing national parks, nature reserves, and nature parks - retain high ecological integrity and rich cultural resonance, offering strategic yet under-utilized opportunities for public-health promotion. Recognizing this potential, international bodies such as the World Health Organization and the International Union for Conservation of Nature have jointly released technical frameworks and guidance to advance nature-based health solutions through protected areas. Countries including the United States, United Kingdom, and South Korea have developed policy innovations - such as Park Prescriptions, Green Social Prescribing, and natureintegrated public health plans - that systematically mobilize protected areas for population-level health benefits. In parallel, China has also introduced policy directives - such as the Healthy China 2030 Plan and the reform of its protected area system - that endorse the integration of health promotion into the planning and management of protected areas. To synthesize emerging evidence and clarify pathways for action, a systematic review of domestic and international research, policy instruments, and best-practice cases was conducted. An integrated conceptual framework that delineates three foundational elements was built: 1) natural elements (biodiversity, ecosystem functions, clean air and water, and scenic resources); 2) cultural elements (heritage values, environmental education, and place identity); and 3) supporting elements (accessibility, spatial connectivity, recreation infrastructure, and service capacity that enable safe human–nature interactions). Health improvements are mediated through three synergistic mechanisms: 1) nature exposure, whereby direct contact with highquality ecosystems induces physiological relaxation, immune modulation, and stress recovery; 2) behavioral activation, whereby attractive natural settings incentivize physical activity, social engagement, and other healthy behaviors; and 3) cognitive regulation, whereby cultural experience and environmental education reshape values and motivations, sustaining pro-health and proenvironment practices over time. Building on this conceptual foundation, five mutually reinforcing implementation strategies are proposed, spanning concepts, policies, planning and design, management, and support. Conceptually, "health promotion under conservation first" is positioned as a core function of PAs, clarifying boundaries between ecological protection and health-oriented use. Policy strategies include incorporating health indicators into performance assessments, embedding health goals within intersectoral plans, and piloting mechanisms to recognize the health value of ecosystem services. Planning and design recommendations focus on health-oriented access and infrastructure improvements - such as inclusive, graded trail networks and barrier-free facilities - guided by ecological sensitivity, visitor carrying capacity, and spatial equity analyses. Management strategies emphasize adaptive governance through risk communication, seasonal closures, quota systems, and differentiated experience designs, alongside partnerships with healthcare providers to trial Park Rx and green prescribing initiatives. Support measures address financing diversification, crossdisciplinary capacity building, and evidence systems for continuous monitoring and evaluation. This contribution offers three key advances. First, it presents a clear conceptual definition and pathway model of PA-related public health value that integrates ecological quality, cultural meaning, and governance support with exposure-activation-cognition mechanisms. Second, it translates this understanding into implementable strategies that respect ecological limits while enhancing safe, inclusive use. Third, it articulates context-specific pathways - aligned with Healthy China and ecological civilization - that can inform global targets on equitable access to nature and health-promoting environments.