Morbidity is related to a green living environment

EMGO Institute, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
Journal of epidemiology and community health (Impact Factor: 3.5). 10/2009; 63(12):967-73. DOI: 10.1136/jech.2008.079038
Source: PubMed


As a result of increasing urbanisation, people face the prospect of living in environments with few green spaces. There is increasing evidence for a positive relation between green space in people's living environment and self-reported indicators of physical and mental health. This study investigates whether physician-assessed morbidity is also related to green space in people's living environment.
Morbidity data were derived from electronic medical records of 195 general practitioners in 96 Dutch practices, serving a population of 345,143 people. Morbidity was classified by the general practitioners according to the International Classification of Primary Care. The percentage of green space within a 1 km and 3 km radius around the postal code coordinates was derived from an existing database and was calculated for each household. Multilevel logistic regression analyses were performed, controlling for demographic and socioeconomic characteristics.
The annual prevalence rate of 15 of the 24 disease clusters was lower in living environments with more green space in a 1 km radius. The relation was strongest for anxiety disorder and depression. The relation was stronger for children and people with a lower socioeconomic status. Furthermore, the relation was strongest in slightly urban areas and not apparent in very strongly urban areas.
This study indicates that the previously established relation between green space and a number of self-reported general indicators of physical and mental health can also be found for clusters of specific physician-assessed morbidity. The study stresses the importance of green space close to home for children and lower socioeconomic groups.

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    • "Public health professionals have long recognized the connection between neighborhoods and health, and have identified park improvements and creation of new parks as public health interventions (Bassett, 2009; Nordh & Ostby, 2013). Proximity to parks is associated with greater frequency of physical activity (Cohen et al., 2007), reduced weight (Liu et al., 2007; Ellaway et al., 2005), reduced weight gain (Bell et al., 2008), lower coronary heart disease(Maas et al., 2009; Dengel et al., 2009), social cohesion (Sullivan et al., 2004) and longevity (Takano et al., 2002). The strength of these associations varies based on park facilities and programming (Cohen et al., 2006, 2010, 2009; Schipperijna et al., 2013) and by characteristics of the potential park users, including sex, race and ethnicity, and age (Cohen et al., 2006, 2007; Lachowycz and Jones, 2011). "
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    ABSTRACT: Community parks have achieved recognition as a public health intervention to promote physical activity. This study evaluated changes in population-level physical activity when an undeveloped green space adjacent to transitional housing for refugees was transformed into a recreational park. A prospective, nonrandomized study design used the System of Observing Play and Recreation in Communities (SOPARC) to document the number and activity levels of park users over time, and to compare trends pre-and post-construction. T-tests or tests of medians (when appropriate) were used to compare pre-and post-construction changes in use of non-park and park zones for physical activity and changes in park use by age and gender. Pre-and post-comparisons of people observed using non-park zones (i.e., adjacent streets, alleys and parking lots) and park zones indicated a 38% decrease in energy expended in non-park zones and a 3-fold increase in energy expended within the park (P = 0.002). The majority of park users pre-and post-construction were children, however the proportion of adolescent males observed in vigorous activity increased from 11% to 38% (P = 0.007). Adolescent females and elderly continued to be under-represented in the park. Our findings support an association between creation of accessible outdoor spaces for recreation and improvements in physical activity. Community involvement in park design assured that features included in the park space matched the needs and desires of the communities served. Some demographic groups were still under-represented within the park, suggesting a need to develop targeted outreach strategies and programming.
    Urban Forestry & Urban Greening 12/2015; 14(2):293-299. DOI:10.1016/j.ufug.2015.02.011 · 2.11 Impact Factor
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    • "" pleasant pastures " and " mountains green " which Blake explicitly linked to spiritual well-being at the dawn of the industrial age, the idea that physical landscape is intimately involved in well-being persists, and is increasingly the subject of multidisciplinary empirical research (Hartig, Mitchell, de Vries, & Frumkin, 2014). Exposure to the natural environment has been associated with better self-reported general health (Maas, Verheij, Groenwegen, de Vries, & Spreeuwenberg, 2006; Mitchell & Popham, 2007), lower prevalence of diagnosed morbidities (Maas et al., 2009), increased longevity (Takano, Nakamura, & Watanabe, 2002), less premature mortality (Mitchell & Popham, 2008) more rapid recovery from illness (Ulrich, 1984), higher levels of psychological wellbeing (Kaplan & Kaplan, 1989; White, Alcock, Wheeler, & Depledge, 2013a), and lower levels of anxiety and depression (Beyer et al., 2014; de Vries, Verheij, Groenewegen, & Spreeuwenberg, 2003; Maas et al., 2009; van den Berg, Maas, Verheij, & Groenewegen, 2010). Moreover, the research is starting to inform the development of tangible health promotion strategies and practices (St Leger, 2003). "
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    Landscape and Urban Planning 10/2015; 142. DOI:10.1016/j.landurbplan.2015.05.008 · 3.04 Impact Factor
    • "In general, subjective socioeconomic status and perceived health correlate positively (Kallio, 2006). Epidemiological studies have found fewer income-related health inequalities in the greener neighbourhoods (Maas et al., 2009; Mitchell & Popham, 2008). The fourth demographic covariate, household size, was added to control for the bias it could cause in income. "
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    ABSTRACT: The environment surrounding residences and its recreational and commuting opportunities are believed to affect human health and well-being. To provide scientific evidence for the mechanisms of influence of the types of environments on human well-being, this study examined how the presence of and access to green spaces is related to the level of physical activity and self-rated health. The study focused on the mediating role of outdoor physical activity, utilizing a dataset from a comprehensive, cross-sectional nationwide survey, which included the number of outdoor recreation visits to close-to-home green spaces and respondents' self-rated health status. The survey data were supplemented with precise, GIS-derived data of each respondent's exposure to green spaces, and the relationships were tested using path analyses. The study demonstrated that the presence of and access to green space is evident in the suburbs, where outdoor recreation was related to leisure time physical activity and to self-rated health. Thus, in order to promote health to suburban residents, access to close-to-home green spaces suitable for recreation should be secured. In contrast, in more urban residential areas, green spaces were more connected to frequent physical activity in association with commuting, indicating that investing in infrastructure for safe walking and bicycling could promote public health. Management implications The research results contribute to strengthening the role and importance of close-to-home recreational opportunities in urban green spaces. Easy accessibility to green spaces should be an important objective in the management and planning of urban and suburban forests and other green spaces. Close-to-home recreation opportunities are particularly vital for older people. If green spaces are also developed for commuting, health and well-being benefits could be realized via increased overall physical activity.
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