Unjust green care: environmental justice framing by actors across seven countries
Abstract
Background: More than one billion people live with a mental disorder, with marginalized groups disproportionately affected. Green care, a novel public health approach, supports mental health through everyday nature experiences (NEL), nature-based health promotion (NBP), and nature-based therapies (NBT). However, green care actors may (re)produce environmental injustices through decision-making, design, or implementation practices, resulting in unequal access to or benefit from green care. We examined how green care actors incorporate six dimensions of environmental justice in their discourse, and whether differences exist between countries.
Methodology: We analysed 119 semi-structured interviews from green care actors across seven European and one US study area representing diverse urbanicity and natural characteristics. Using a deductive–inductive approach, we applied pre-defined codes corresponding to six environmental justice dimensions: distributive, recognition, procedural, epistemic, testimonial, and hermeneutic. Emerging themes and patterns were identified within each dimension and across countries.
Results: Environmental justice appeared weakly in green care actor discourse, most evident in Spain and the UK. Distributive justice (e.g., physical, cultural, and economic access barriers) and recognition justice (acknowledging socio-economic and historical contexts) were mentioned more frequently. Other dimensions were scarce (procedural, testimonial, hermeneutic) or framed negatively (epistemic justice). References to epistemic injustice reflected prejudices against marginalized groups’ knowledge.
Conclusions: These findings suggest a current state of “unjust green care,” limiting green care’s potential to promote mental health equity. Our study offers insights in how (un)just green care is shaped and reproduced, and the need to challenge these discourses to achieve just green and sustainable healthy futures.
Key messages: • Green care can support mental health, but our findings show actors often overlooks environmental justice—risking unequal access and benefits for marginalized groups.
• To realise green care’s public health potential, actors must integrate justice into decision-making, ensuring inclusive participation and diverse knowledge are incorporated.
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BibTeX
@article{domenechpanicello2026unjust,
title = {{Unjust green care: environmental justice framing by actors across seven countries}},
author = {C Domènech-Panicello and P De Prado-Bert and SJ Knight and A Åshage and V Cioncoloni and B Gawryszewska and R Giedych and C Iodice-Kraft and HVS Cole and M Triguero-Mas},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1179},
url = {https://doi.org/10.1093/eurpub/ckag169.1179},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Unjust green care: environmental justice framing by actors across seven countries
AU - C Domènech-Panicello
AU - P De Prado-Bert
AU - SJ Knight
AU - A Åshage
AU - V Cioncoloni
AU - B Gawryszewska
AU - R Giedych
AU - C Iodice-Kraft
AU - HVS Cole
AU - M Triguero-Mas
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1179
UR - https://doi.org/10.1093/eurpub/ckag169.1179
AB - Background: More than one billion people live with a mental disorder, with marginalized groups disproportionately affected. Green care, a novel public health approach, supports mental health through everyday nature experiences (NEL), nature-based health promotion (NBP), and nature-based therapies (NBT). However, green care actors may (re)produce environmental injustices through decision-making, design, or implementation practices, resulting in unequal access to or benefit from green care. We examined how green care actors incorporate six dimensions of environmental justice in their discourse, and whether differences exist between countries. Methodology: We analysed 119 semi-structured interviews from green care actors across seven European and one US study area representing diverse urbanicity and natural characteristics. Using a deductive–inductive approach, we applied pre-defined codes corresponding to six environmental justice dimensions: distributive, recognition, procedural, epistemic, testimonial, and hermeneutic. Emerging themes and patterns were identified within each dimension and across countries. Results: Environmental justice appeared weakly in green care actor discourse, most evident in Spain and the UK. Distributive justice (e.g., physical, cultural, and economic access barriers) and recognition justice (acknowledging socio-economic and historical contexts) were mentioned more frequently. Other dimensions were scarce (procedural, testimonial, hermeneutic) or framed negatively (epistemic justice). References to epistemic injustice reflected prejudices against marginalized groups’ knowledge. Conclusions: These findings suggest a current state of “unjust green care,” limiting green care’s potential to promote mental health equity. Our study offers insights in how (un)just green care is shaped and reproduced, and the need to challenge these discourses to achieve just green and sustainable healthy futures. Key messages: • Green care can support mental health, but our findings show actors often overlooks environmental justice—risking unequal access and benefits for marginalized groups. • To realise green care’s public health potential, actors must integrate justice into decision-making, ensuring inclusive participation and diverse knowledge are incorporated.
SN - 1101-1262
SN - 1464-360X
ER -