Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities.
04 Mar 2021-International Journal of Environmental Research and Public Health (MDPI AG)-Vol. 18, Iss: 5, pp 2563
TL;DR: In this article, the authors examined whether green space shows stronger associations with physical health for disadvantaged groups than for privileged groups and found that lower-SES people show more beneficial effects than affluent people, particularly when concerning public green spaces/parks rather than green land covers/greenness.
Abstract: Disadvantaged groups worldwide, such as low-income and racially/ethnically minoritized people, experience worse health outcomes than more privileged groups, including wealthier and white people. Such health disparities are a major public health issue in several countries around the world. In this systematic review, we examine whether green space shows stronger associations with physical health for disadvantaged groups than for privileged groups. We hypothesize that disadvantaged groups have stronger protective effects from green space because of their greater dependency on proximate green space, as they tend to lack access to other health-promoting resources. We use the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method and search five databases (CINAHL, Cochrane, PubMed, Scopus, and Web of Science) to look for articles that examine whether socioeconomic status (SES) or race/ethnicity modify the green space-health associations. Based on this search, we identify 90 articles meeting our inclusion criteria. We find lower-SES people show more beneficial effects than affluent people, particularly when concerning public green spaces/parks rather than green land covers/greenness. Studies in Europe show stronger protective effects for lower-SES people versus higher-SES people than do studies in North America. We find no notable differences in the protective effects of green space between racial/ethnic groups. Collectively, these results suggest green space might be a tool to advance health equity and provide ways forward for urban planners, parks managers, and public health professionals to address health disparities.
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TL;DR: There is extensive empirical literature on the association between exposure to nature and health as mentioned in this paper, and the strength of evidence from recent experimental and observational studies on nature exposure and health, highlighting research on children and youth where possible.
Abstract: There is extensive empirical literature on the association between exposure to nature and health. In this narrative review, we discuss the strength of evidence from recent (i.e., the last decade) experimental and observational studies on nature exposure and health, highlighting research on children and youth where possible. We found evidence for associations between nature exposure and improved cognitive function, brain activity, blood pressure, mental health, physical activity, and sleep. Results from experimental studies provide evidence of protective effects of exposure to natural environments on mental health outcomes and cognitive function. Cross-sectional observational studies provide evidence of positive associations between nature exposure and increased levels of physical activity and decreased risk of cardiovascular disease, and longitudinal observational studies are beginning to assess long-term effects of nature exposure on depression, anxiety, cognitive function, and chronic disease. Limitations of current knowledge include inconsistent measures of exposure to nature, the impacts of the type and quality of green space, and health effects of duration and frequency of exposure. Future directions include incorporation of more rigorous study designs, investigation of the underlying mechanisms of the association between green space and health, advancement of exposure assessment, and evaluation of sensitive periods in the early life-course.
87 citations
TL;DR: In this article, the authors estimate the number of premature deaths among adult residents that could be prevented in cities in 31 European countries, if the WHO recommendation for universal access to green space was achieved.
83 citations
TL;DR: In this article, the authors synthesize the results of studies that examined how the greenspace and health relationship varies by urbanicity and found that more urban areas had stronger associations for cardiovascular-related, birth, and mortality outcomes and for greenspace measured within 500 meters.
60 citations
TL;DR: In this article, the authors describe how the built environment has both affected infectious disease transmission and evolved in response to infectious diseases, and the COVID-19 illustrates both dynamic dynamics.
Abstract: Background: Since the dawn of cities, the built environment has both affected infectious disease transmission and evolved in response to infectious diseases. COVID-19 illustrates both dynamics. The...
56 citations
TL;DR: Wang et al. as mentioned in this paper assessed the effects of a large-scale greenway intervention (i.e., the opening of East Lake greenway) on walking behaviors in Wuhan, China.
Abstract: Extensive evidence from cross-sectional studies has revealed a positive link between greenspace access and walking behaviors. However, the inherent weaknesses of the cross-sectional research design have provided little causal inference. In this natural experimental study, we assessed the effects of a large-scale greenway intervention (i.e., the opening of East Lake greenway) on walking behaviors in Wuhan, China. Longitudinal survey data on 1,020 participants were collected before and after the intervention in 2016 and 2019, respectively. The results of the mixed-effect difference-in-difference (DID) models showed that the greenway intervention had a significantly positive effect on the walking time, especially for residents living within two kilometers from the greenway. Furthermore, women and socio-economically disadvantaged people benefited most from the greenway implementation regarding walking time. Our findings provided compelling evidence that public investment in transportation infrastructure (e.g., greenway) effectively promotes walking behaviors and mitigates social inequities in physical activity.
17 citations
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TL;DR: Moher et al. as mentioned in this paper introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses, which is used in this paper.
Abstract: David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses
62,157 citations
TL;DR: The Commission on Social Determinants of Health (CSDH) as mentioned in this paper was created to marshal the evidence on what can be done to promote health equity and to foster a global movement to achieve it.
7,335 citations
TL;DR: It is argued that a focus on structural racism offers a concrete, feasible, and promising approach towards advancing health equity and improving population health.
2,615 citations
TL;DR: In this paper, the authors reviewed the Anglo-American literature on urban green space, especially parks, and compared efforts to green US and Chinese cities and found that the distribution of such space often disproportionately benefits predominantly white and more affluent communities.
2,459 citations
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TL;DR: This work focuses on nature as represented by aspects of the physical environment relevant to planning, design, and policy measures that serve broad segments of urbanized societies and considers research on pathways between nature and health involving air quality, physical activity, social cohesion, and stress reduction.
Abstract: Urbanization, resource exploitation, and lifestyle changes have diminished possibilities for human contact with nature in many societies. Concern about the loss has helped motivate research on the health benefits of contact with nature. Reviewing that research here, we focus on nature as represented by aspects of the physical environment relevant to planning, design, and policy measures that serve broad segments of urbanized societies. We discuss difficulties in defining “nature” and reasons for the current expansion of the research field, and we assess available reviews. We then consider research on pathways between nature and health involving air quality, physical activity, social cohesion, and stress reduction. Finally, we discuss methodological issues and priorities for future research. The extant research does describe an array of benefits of contact with nature, and evidence regarding some benefits is strong; however, some findings indicate caution is needed in applying beliefs about those benefits,...
2,046 citations