Ecosystem Restoration and Human Health: A Scoping Review (2015-2025)

Background: Ecosystem restoration, used here as an umbrella term (e.g., rewilding, reforestation, wetland rehabilitation, river re-naturalisation, species reintroduction, soil regeneration), is gaining momentum as a potential nature-based solution with public health co-benefits. However, evidence that specifically links exposure to restored/rewilded ecosystems (beyond generic greenspace) to measured health outcomes remains fragmented. Objective: To map and characterise evidence on associations between exposure to recently restored or rewilded ecosystems and human health and well-being outcomes. Methods: A scoping review (2015–2025) was conducted following JBI guidance and reported per PRISMA-ScR. Databases searched: PubMed, Scopus, GreenFILE, Environment Complete, and Discovery (last search 10 March 2025). Title/abstract screening was undertaken independently by two reviewers in Rayyan with multidisciplinary consensus resolution; a third reviewer adjudicated persistent uncertainties. Data were charted using a pre-piloted extraction framework and were synthesised thematically; no critical appraisal was undertaken, consistent with scoping methodology. Results: Included studies (N = 19) spanned multiple continents and restoration modalities (e.g., forest landscape restoration, natural regeneration, wetland/coastal rehabilitation, species reintroductions). Mental well-being and broader quality-of-life outcomes predominated; physical health outcomes were less common. The overall direction of effect was largely beneficial, with isolated negative perceptions in certain concepts. Framing varied: a subset explicitly examined restoration (more likely to measure biodiversity/quality), while others treated exposure implicitly as access to "natural" areas, often assuming ecological quality. Conclusions: Restored and rewilded ecosystems appear promising interventions for human health and wellbeing. Furthermore, an integrated approach to human and environmental health has been proposed to aid future research, which should integrate biodiversity/quality metrics with health outcomes, adopt equity-centred designs, and employ longer-term approaches to inform policy and practice.