A systematic review and meta-analysis published in BMC Public Health suggests that therapeutic gardening offers a moderate uplift to mental health for adults living with chronic conditions, though its effects on physical health are less clear. The research was led by Feifei Wang, a public health researcher at Fudan University, and Szilvia Boros, a psychologist at Széchenyi István University.
Chronic health conditions cover a wide spectrum of long-lasting illnesses, from cardiovascular disease and arthritis to diabetes, dementia and depression. With an aging global population placing increasing demand on healthcare systems, nature-based therapies such as therapeutic gardening are frequently explored as a way to support long-term health management. In the UK, social prescribing is sometimes used to encourage patients to visit parks and community gardens as part of their care plans.
To quantify the benefits of gardening for those with existing medical diagnoses, Wang and Boros conducted a systematic review and meta-analysis, pooling data from multiple studies to identify overarching trends. They included research involving adults aged 18 and over who had at least one diagnosed chronic condition and compared gardening programmes against standard control conditions.
The team identified 23 eligible studies, comprising a total of 4,535 participants. The individuals studied faced a range of chronic conditions, including physical pain, obesity, high blood pressure, cognitive dysfunction and cancer. The average participant age was about 54, and roughly two-thirds were women. The evidence base included both randomised controlled trials and quasi-experimental designs.
Researchers grouped reported health outcomes into three domains: mental health (encompassing anxiety, stress, depression, mood and loneliness), physical health (such as blood pressure and cognitive function) and general health (quality of life indicators, pain, sleep and social connectedness). They then calculated effect sizes to determine how gardening interventions performed compared with controls.
Across the mental health domain, gardening was associated with a moderate improvement. Participants who took part in activities like digging, watering and harvesting reported fewer depressive and anxious symptoms relative to those who did not participate, with some trials involving older adults experiencing cognitive decline benefiting from the social and active nature of community gardening.
By contrast, effects on physical health and broader general health measures were less pronounced. The analysis found only small gains in general health and virtually no significant improvements in physical health outcomes such as blood pressure or cognitive function linked directly to the gardening interventions.
To test the robustness of their findings, the researchers conducted a sensitivity analysis that excluded studies with higher risk of bias or poorer quality. After this adjustment, the positive impact on mental health became even stronger, while the evidence for physical and general health benefits remained weak and not statistically significant.
The authors note several limitations in the available research. There was high heterogeneity among the included trials, with wide differences in the type, duration and intensity of gardening programmes. Methodological challenges such as selection bias and a lack of participant blinding could influence reported outcomes, and high dropout rates in community-based studies may skew results toward those who enjoy the activity. Given these factors, it is difficult to prescribe a specific gardening regimen as a therapy for physical ailments.
Looking ahead, the researchers call for more standardised gardening interventions and higher-quality trials to better quantify health impacts. They emphasise that, while horticultural activity can support psychological well-being, it should not be treated as a primary treatment for physical conditions until stronger evidence emerges from uniform, rigorous research.
The study, titled “Effect of gardening activities on domains of health: a systematic review and meta-analysis,” was authored by Feifei Wang and Szilvia Boros.
