White and colleagues radically enlarge the empirical scale of the nature–health question. Across 18 countries and more than sixteen thousand analysed respondents, they distinguish residential exposure, recreational visits, green space, inland blue space, coastal blue space and psychological connectedness to nature. The crucial result is that proximity alone is insufficient: associations between greener or coastal neighbourhoods and wellbeing often weaken when actual recreational visits are included. Environmental benefit therefore appears as a relation between spatial provision and enacted contact rather than a passive consequence of residence. Cross-country heterogeneity further resists universalisation. The methodological achievement lies in multi-exposure, multi-response and multi-country comparison while openly retaining limits of cross-sectional inference. Its bridge to urbanism is precise: accessibility must be understood as more than geometric distance. Planning provides possibilities, but health effects depend on visitation, cultural context, connectedness, season and social inequality. The paper pushes environmental design from distribution toward activation and from universal provision toward context-sensitive ecological capacity.
