by Paolo Vineis, Irene Bruni
Regeneration is gaining traction in today’s environmental debate. Though the term is not completely clear and not yet fully operationalized, it is substituting the term of sustainability, under the assumption that the current extractive model of economy is in fact not sustainable and the lost natural capital needs to be replaced, i.e. regenerated.
For a formal definition see Illy-Vineis “No Sustainability Without Regeneration: A Manifesto from an Entrepreneurial Viewpoint”. Here we address two aspects in particular, natural regeneration in relation to human health, and in relation to social inequalities. In the Appendix we list a selection of 20 papers that were the most cited in these fields in 2025-26.
Concerning health, there is an increasing awareness in the medical field that the health of the soil (including micronutrients but also the quality and diversity of the microbiome) is an essential component of human health.
Hence, the concept of “Regenerative Agriculture as Medicine”. These concepts are expressed in particular in the new edition of the EAT-Lancet guidelines, that show the important co-benefits of restoring soil health for both the environmental crisis and human health. Obviously, the transfer of scientific knowledge into policy decisions is not straightforward. As he EAT-Lancet Commission 2.0 has pointed out, “power dynamics and competing interests need to be addressed as they create barriers to adoption … Implementing the EAT Lancet recommendations is complex and requires collaboration across multiple layers of governance, from local to global.”
Concerning inequities, there is now a growing concern towards a misguided concept of urban regeneration, that benefits mainly the urban élites rather than the population at large and the underserved in particular.
For example, the UN-Habitat (2025) and Land (2026) reports serve as critical warnings that urban regeneration can be a “double-edged sword”, if not paired with strict social equity and housing protections. Evaluating outcomes of regenerative approaches, in particular in urban contexts, is more difficult in comparison with diet and agriculture. In spite of the vast amount of literature on mental health impacts of urban greenness and regeneration (whose meaning, however, is extremely variable), epidemiological studies have not yet resolved the issue of confounding from multiple characteristics of social stratification. Wealthier strata of the population have access to multiple benefits in addition to living in greener and cleaner areas, for example to public transportation and healthcare. Also the issue of “reverse causation” needs to be taken into account, since “regenerated” areas tend to attract wealthier and healthier citizens. Other health outcomes are clearly related to the built environment and lack of exposure to biodiversity, starting in intra-uterine life. This is particularly true for allergic diseases including asthma and rhinitis. In general, emphasis on a “biophilic” environment is investigated in relation to immunological conditions, including possibly autoimmune diseases, with a contribution of the microbiome as a mediator.
The risk of “green gentrification” is real and now visible in several large cities in Europe, and needs to be redressed with appropriate policies that consider the poorer outskirts.
Papers have reviewed and summarized the commonest policies that have been proposed. One review (https://jech.bmj.com/content/80/4/259) outlines the main characteristics of five commonly cited approaches: asset-based, place-based, upstream, systems-based and proportionate universalism. According to the authors, “although rarely acknowledged explicitly, it was implied that these approaches seek to reduce health inequalities through focussing on more socially disadvantaged sub-groups in a population, identifying the most impactful intervention levers and/or working to minimise stigma and minimise inequalities in access and uptake of interventions.” The review concludes that there is much variablity, both conceptual and practical, in the proposed solutions, and KPI have not been standardized yet.
Finally, a group of papers analyses the business models in relation to regeneration, health and inequalities.
In particular, a narrative review stresses that strengthening the concept of sustainability by companies is accompanied by greater reference to inequalities. This is clearly limited to a handful of enterprises in a general context that seems to go in the opposite direction. As shown by the Business School of Imperial College, however, companies that have invested more into sustainability and regeneration are those that proved more successful economically, and this is not due to reverse causation.
To conclude, the nexus between regeneration of agriculture and of cities, in addition to being a necessary strategy in relation to the exhaustion of natural capital, goes together with a suite of benefits for health. However, the transition will be effective only if it will be equitable, avoiding the addition of green gentrification to the already existing social inequalities.
Appendix
In the scientific literature of 2025 and 2026, the term “regeneration” has moved beyond biology into the socio-economic and environmental realms. The following 20 papers and articles are identified as the most impactful and frequently cited in their respective niches, focusing on urban renewal, regenerative agriculture, and business models as they relate to health and social equity.
1. Regeneration and Health
How systemic restoration of environments and food systems impacts human well-being.
- “EAT-Lancet Commission 2.0: Building a Just and Sustainable Food Future” | The Lancet (Late 2025 / 2026)
This seminal update to the 2019 report establishes the “Planetary Health Diet” with new data on how regenerative agriculture (soil health, biodiversity) directly correlates with reduced non-communicable diseases and nutrient density.
Analyses how urban renewal programs in Europe act as “social prescriptions,” showing a 15–20% improvement in mental health outcomes for residents in regenerated green-zones.
A systematic review linking soil microbiome health in regenerative farming to the increased presence of phytonutrients in crops, proposing a “soil-to-gut” healthcare model.
Introduces the concept of “One Urban Health,” where the physical regeneration of streets (biophilic design) is used to mitigate the “Urban Heat Island” effect, preventing heat-related respiratory issues.
A multi-case study of regenerative companies demonstrating how business models that “give back” more than they take result in improved occupational health and community trust.
- “Where regenerative farming practices could increase yields: a global assessment” | Sustainable Agriculture (March 2026)
Proves that while “net-zero” was the old goal, “nature-positive” yields in regenerated soils are the new benchmark for food security and health.
- “The Regenerative Shift: Archetypes of Net-Positive Business Models” | HEC Paris Research Paper (Oct 2025)
Analyzes 39 leading regenerative companies, finding that “cultures of care” in business lead to significantly lower employee burnout and higher community well-being.
- “Urban regeneration and SDGs: Design approaches for reducing urban inequalities” | AGATHÓN
Focuses on architectural strategies to prevent “green gentrification” during city renewal.
- “Digitalising Social Value for Sustainable Urban Regeneration” | MDPI Sustainability
Explores how digital governance in regeneration projects often ignores the “lived experience” of the poor.
- “Commonly cited approaches to reducing health inequalities” | Journal of Epidemiology & Community Health
A 2025 critical review of “upstream” vs. “downstream” regeneration interventions.
2. Regeneration and Inequalities
The “Equity Gap”—how regeneration can either bridge or widen the social divide.
- “Convergence of Transitions: The Inequality–Climate–Health Nexus” | ORF Middle East (February 2026)
Explores how the shift to regenerative practices in the Global South must be “just” to avoid “green gentrification,” where regenerated areas become too expensive for the vulnerable populations they were meant to help.
- “Regenerative businesses: A framework for justice and fairness in planetary health” | ResearchGate / Organizational Studies (March 2026)
Defines the “Regenerative Business Model” not just as carbon-neutral, but as a structure that actively addresses income inequality through multi-capital accounting (valuing social capital alongside profit).
Findings from the Horizon “EXIT” project on using localized agricultural regeneration to revitalize “depressed” rural areas in Italy and Europe, reducing the “isolation gap.”
- “Connecting Health and Nutrition to Regenerative Agriculture” | Forum for the Future / Climate and Health Coalition Report (2025/2026)
A major cross-sector report identifying that while regenerative agriculture is a health boon, it faces an equity barrier: smallholder farmers often lack the capital to transition, deepening the divide between industrial and local farming.
- “Urban Renewal and SDG 10: Mapping the Negative Impacts of Gentrification” | University of the Built Environment (January 2025)
A critical look at 10 global projects, citing that unless social regeneration (housing rights) is integrated with physical renewal, regeneration scores high on “Environment” but low on “Inequality”.
- “Urban Regeneration for Reducing Inequality: A Clarification Note” | UN-Habitat (October 2025)
The definitive 2025 guide on how city renewal can bridge the “spatial divide” without triggering green gentrification and social displacement.
- “The Urban Stress Model: Understanding the Persistence of Health Disparities” | Cities & Health / Taylor & Francis (2025)
A high-impact framework showing how regeneration must address “chronic stress pathways” in marginalized urban populations to be effective.
- “Emerging Regenerative Business Paradigm: Narrative Review and Research Agenda” | Journal of Circular Economy (June 2025)
Synthesizes how regenerative companies are shifting from “CSR” to “Strong Sustainability,” specifically targeting income inequality in supply chains.
- “Resistance as Regeneration: Resurgence of more-than-human farming worlds” | Taylor & Francis (Sept 2025)
Examines the “North-South” divide in regenerative agriculture, arguing that land access remains the primary barrier to equitable regeneration for smallholders.
- “Green Space Exposure and Social Vulnerability in Highly Urbanized Districts” | MDPI Land (Feb 2026)
A 2026 study demonstrating that urban regeneration often allocates the highest-quality “green assets” to affluent areas, worsening spatial inequality.
3. Regeneration and Business Models
“Corporate sustainability and shareholder returns: the role of business impact maturity” | Imperial College Business School
A report that lays the foundation of their concept for understanding how a company’s stage of sustainability development—its “Business Impact Maturity”—affects shareholder returns.
Photo credits: Raphael Brasileiro, Pexels