Page - 234 - in Biodiversity and Health in the Face of Climate Change

234 10.4.1 Conceptualising Relationships Our review has stimulated an awareness of the challenges inherent in understanding these aspects of nature and human health. We began with a simple model (Fig.  10.1) of the overlapping relationship between spiritual well-being and spiritual beliefs and considered how these constructs might relate to behaviour, nature and biodiversity. There is suggestive, but not robust, evidence about specific elements of nature, including biodiversity, that appear to contribute to spiritual outcomes or to potential mediators for the relationship. Species diversity (trees/birds), habitat diversity and tree cover are associated with place processes and reflection; the same parks pro- vided tranquility and connection with nature. Extraordinary nature, with beauty and grandeur, such as mountains, sunsets or big waterfalls, are associated with awe, humility and inspiration. Wilderness contributes to a sense of solitude, timelessness, transcendence, putting people in touch with the divine and experiencing serenity or harmony. Open nature scenes are associated with feelings of deep flow, wholeness and belonging, while ordinary nature, such as lawns or parks, tends one towards spiritual caring and connections to others. These findings highlight a need to mea- sure both biodiversity and the composite type of environment of interest. Another challenge uncovered is the lack of clarity as to whether or how spiritual well-being is different from spirituality/spiritual beliefs. Some conceptualise differ- ences; some overlap or conflate them. Table  10.1 synthesised elements from across these concepts, structured by four relational aspects of spiritual well-being, i.e. rela- tion with self, community, the environment and transcendent Other(s), that create wholeness. What is clear is the fundamental and growing intersection of spiritual beliefs with the natural environment, whether among indigenous groups, world religions or new eco-spiritual practices. These beliefs and values are associated with actions or practices that may preserve biodiversity, a link noted in many models of environ- mental behaviour (e.g. Stern 2000). Additionally, such beliefs and values may pre- dispose one to experience spiritual well-being within nature. Incorporating both spiritual beliefs and spiritual well-being measures will thus be important. An overarching challenge is how to parse relationships between spiritual beliefs/ well-being and nature/biodiversity. Studies investigating nature and spiritual well- being are largely qualitative; few account for the biodiversity of the setting. The evidence is almost exclusively correlational, which leads to a circularity of associa- tive relationships, and causality is  difficult, if not impossible, to ascribe. A way forward is to take what we have learned here and map it onto existing causal models of how nature may affect human health and well-being. In Fig.  10.2 we propose such a model. Structured using the four relational elements of spiritual well-being, it overlays Heintzman’s nature-spirituality model (Box 10.2) onto Hartig et  al.’s (2014) nature-health model while also incorporating insights from others (Irvine et  al. 2013; Marselle et  al. 2016; Shanahan et  al. 2016; Yeh et  al. 2016). This model is framed in terms of public health notions of an exposure (that affects health) and K. N. Irvine et al.