Thomas Astell-Burt

University of Wollongong | UOW · Population Wellbeing and Environment Research Lab (PowerLab)

Epidemiological studies on green space and health have relied almost exclusively on cross-sectional designs, restricting understanding on how this relationship could vary across the lifecourse. We used multilevel linear regression to analyse variation in minor psychiatric morbidity over nine annual waves of the British Household Panel Survey (1996-...

Introduction: There are few studies on the potential benefits of green space quantity and quality for child well-being. The authors hypothesized that more and better quality residential green space would be favorable for well-being and that these associations could be subject to effect modification across childhood. Method: Multilevel linear reg...

Persistent loneliness troubles people across the life span, with prevalence as high as 61 % in some groups. Urban greening may help to reduce the population health impacts of loneliness and its concomitants, such as hopelessness and despair. However, the literature lacks both a critical appraisal of extant evidence and a conceptual model to explain...

Background: Outdoor air pollution, a persistent threat since the Industrial Revolution, continues to pose a global challenge with severe implications for public health. Despite advancements, air quality issues —particularly particulate matter —are associated with diseases like coronary artery disease (CAD) and stroke. The unknown pathophysiology th...

Link worker social prescribing programs are gaining recognition in Australia for addressing health and social needs outside routine medical care. The evaluation of these programs is essential for informing future social prescribing programs, research and evolving policy. However, diverse outcome evaluation measures present challenges for benchmarki...

Urban greening is threatened by the concern that street trees increase traffic-related injury/death. Associations between all serious and fatal traffic crashes and street tree percentages were examined in Sydney, Australia. Associations were adjusted for confounding factors relating to driver behavior (speeding, fatigue, and use of alcohol) and roa...

Objectives: In this study, the trends and current situation of the injury burden as well as attributable burden to injury risk factors at global, regional, and national levels based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 are presented. Study design: To assess the attributable burden of injury risk factors, th...

Numerous studies set in high-income countries document the potential benefits of urban green spaces for mental health, and a growing number of related studies have been conducted in mainland China. In this chapter, we summarized the current studies examining associations between green space and mental illness, sleep or cognition-related outcomes se...

Governments across the world are facing challenges in urgently responding to the adverse impacts of climate change. Australian cities have been proactively working on various climate action plans. Despite this, the Climate Action Tracker rates Australia’s climate net zero targets, policies, and climate finance as “Insufficient”, highlighting the ur...

A healthy ocean is essential for human health, and yet the links between the ocean and human health are often overlooked. By providing new medicines, technologies, energy, foods, recreation, and inspiration, the ocean has the potential to enhance human health and wellbeing. However, climate change, pollution, biodiversity loss, and inequity threate...

Background: The Australian population aged 70 and above is increasing and imposing new challenges for policy makers and providers to deliver accessible, appropriate and affordable health care. We examine pre-COVID patterns of health loss between 1990 and 2019 to inform policies and practices. Methods: Using the standardised methodology framework an...

Increasing evidence indicates contact with nature supports mental, physical and social health. However, beyond a widely reported number of barriers to nature contact, the constellation of motivations for human contact with nature is under‐theorised and under‐studied. We begin to develop indicators of autonomous and controlled motivations for nature...

The COVID-19 pandemic has caused major disruptions to people’s daily life and travel. This paper aims to reveal the impact of the COVID-19 pandemic on people’s travel in New South Wales (NSW), Australia, and to explore potential measures to recover public transport patronage in the new normal. Research data is collected from a survey of 1,045 resid...

Increasing evidence demonstrates the psychological benefits of nature contact. However, the evidence is often established at the population level, and the individual differences in the psychological benefits gained from nature are considered negligible variations. In this study, we performed a cross-sectional online survey in Brisbane and Sydney, A...

Metabolic Syndrome presents a significant public health challenge associated with an increased risk of noncommunicable diseases such as cardiovascular conditions. Evidence shows that green spaces and the built environment may influence metabolic syndrome. We conducted a systematic review and meta-analysis of observational studies published through...

Views on gentrification and intersections with health and well-being were explored via semi-structured interviews with nineteen residents (≥60 years) in Porto (Portugal). Participants acknowledged that gentrification led to noticeable transformations in recreational areas, food/beverage establishments, housing, and commercial activities. Participan...

Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature examining green space exposure and its association...

Metabolic Syndrome presents a significant public health challenge associated with an increased risk of noncommunicable diseases such as cardiovascular conditions. Evidence shows that green spaces and the built environment may influence metabolic syndrome. We conducted a systematic review and meta-analysis of observational studies published through...

Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature examining green space exposure and its association...

There is a significant amount of evidence highlighting the health, wellbeing and social benefits of gardening during previous periods of crises. These benefits were also evident during the COVID-19 pandemic. This paper presents a narrative review exploring gardening during the early stages of the COVID-19 pandemic to understand the different forms...

Background: A comprehensive understanding of temporal trends in the disease burden in Australia is lacking, and these trends are required to inform health service planning and improve population health. We explored the burden and trends of diseases and their risk factors in Australia from 1990 to 2019 through a comprehensive analysis of the Global...

We developed and validated a composite healthy ageing score (HAS) to address the absence of a definitive composite score comprising multiple health domains that measure healthy ageing in epidemiology. The HAS is developed from 13 health domains reported to influence healthy ageing. Data to measure these domains was extracted from the 45 and Up Stud...

Background: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimat...

The health benefits of nature are well recognised. However, nature prescriptions (nature-based health interventions) are not routine in many health systems. We interviewed health stakeholders (n = 13) who prescribe and provide nature prescriptions, to identify enablers and barriers surrounding nature prescriptions in Australia. Participants emphasi...

Urban tree canopy is associated with lower dementia risk, but no mediation analysis has been attempted to reveal potential mechanisms. We examined 3,639 dementia diagnoses in 109,688 participants of the Sax Institute's 45 and Up Study. Adjusted models indicated ≥20% tree canopy lowered the odds of developing dementia by 14% over 11 years (Odds Rati...

Nature prescriptions are gaining popularity as a form of social prescribing in support of sustainable health care. This systematic review and meta-analysis aims to synthesise evidence on the effectiveness of nature prescriptions and determine the factors important for their success. We searched five databases from inception up to July 25, 2021. Ran...

How we engage in and with nature is of growing interest in relation to our health and well-being. For nurses with stressful workloads that are contributing to fatigue, psychological burden, insomnia, and decreased coping strategies, interactions with nature or green space are essential as it has been demonstrated to facilitate better environments a...

There is increasing awareness for beneficial health effects of green space surrounding the home, but the underlying mechanisms are not yet fully understood and challenging to study given the correlation with other exposures. Here, the association of residential greenness and vitamin D including a gene-environment interaction is investigated. 25-hyd...

This chapter provides an overview of the empirical evidence regarding the association between green space in general, and forests and trees in particular, and health outcomes. The evidence is organised by life stage, and within the three life stages – early life (Section 3.2.), adulthood (Section 3.3.) and the elderly (Section 3.4.) – by type of he...

Background In China, road traffic injury (RTI) is the seventh-leading cause of death More than 1.5 million adults in China live with permanent disabilities due to road traffic accidents. In 2011, the Chinese government implemented a more severe law that increased the penalty points and fines for persons charged with drink-driving as a criminal offe...

Urban parks provide a multitude of health benefits for citizens navigating the challenges of 21st-century living. And while this is well known by both scholars and practitioners, there is less understanding about the differential impacts of park size, type of facilities, community accessibility, and management. This is the central concern of the re...

Urban dwellers’ use of public and private green spaces may have changed during the early years of the Covid-19 pandemic due to movement restriction. A survey was deployed in Brisbane and Sydney, Australia 1 year after the start of Covid-19 restrictions (April 2021) to explore relationships of mental health and wellbeing to different patterns of pri...

The COVID-19 pandemic has severely challenged mental health and wellbeing. However, research has consistently reinforced the value of spending time in green space for better health and wellbeing outcomes. Factors such as an individual’s nature orientation, used to describe one’s affinity to nature, may influence an individual’s green space visitati...

Introduction Avoidance of health services, in particular hospital and community services, is problematic for people with diabetes. Evidence has demonstrated that such missed attendances are associated with worse health, faster declines in functioning, and higher rates of mortality long-term. This paper investigated the impact of the pandemic on hea...

Objective: "Nature prescriptions" are increasingly being adopted by health sectors as an adjunct to standard care to attend to health and social needs. We investigated levels of need and interest in nature prescriptions in adults with cardiovascular diseases, psychological distress and concomitants (e.g. physical inactivity, sedentary behaviour, o...

Introduction Associations between green space type and social loneliness (a scarcity of people one feels they can depend on) were investigated in city-living participants in the Sax Institute’s 45 and Up Study. Methods Availability of green space, tree canopy and open grass were measured as a percentage of land-use within 1.6 km road−network dista...

Objective: Green space reduces cardiovascular disease (CVD) risk, but few studies examine what types of green space matter, which is an important consideration as cities densify and apartments become more common. Method: Participants were 86,727 in houses and 17,998 in apartments from the 45 and Up Study (Sax Institute) baseline survey with 10 y...

This systematic review synthesized literature on potential impacts of protracted isolation and other disruptions during the COVID-19 pandemic on deaths of despair (suicide, overdoses, and drug-related liver diseases). Five electronic databases were searched yielding 70 eligible articles. Extant evidence mostly from high-income countries indicates C...

Introduction Momentum for urban densification is increasing opportunities for apartment-living, but can result in reduced green space availability that negatively influences mental health. However, in contexts where apartment-living is atypical and commonly viewed as secondary to house-ownership, it may be a stressful antecedent condition (or marke...

Growing number of evidence have reported that exposure to air pollution was associated with unfavourable birth outcomes while increased exposure to green spaces was associated with better birth outcomes. However, the effect of interactions between air pollution and green spaces on pregnancy outcomes remain unclear. Using the data on all the live bi...

Background No studies appear to examine potential associations between changes in built environments across childhood and the developmental trajectories of child weight status. Objective Examine the developmental trajectories of child weight status with respect to changes in childhood exposure to the built environments. Methods This study used da...

Background The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods For this analysis,...

Supplementary data

Background Mental health conditions are one of the largest burdens of disease in Australia and globally. There is a need to seek innovative and alternative interventions that can prevent and alleviate mental health symptoms. Nature-based interventions (NBIs), namely programs and activities where individuals engage with natural environments with the...

We investigated how the perceived quality of natural spaces influenced levels of visitation and felt benefits during the COVID-19 pandemic in Australia via a nationally representative online and telephone survey conducted on 12–26 October (Social Research Centre’s Life in AustraliaTM panel aged > 18 years, 78.8% response, n = 3043). Our sample was...

Introduction Avoidance of health services, in particular hospital and community services, is problematic for people with diabetes. Evidence has demonstrated that such missed attendances are associated with worse health, faster declines in functioning, and higher rates of mortality long-term. This paper investigated the impact of the pandemic on hea...

Introduction Avoidance of health services, in particular hospital and community services, is problematic for people with diabetes. Evidence has demonstrated that such missed attendances are associated with worse health, faster declines in functioning, and higher rates of mortality long-term. This paper investigated the impact of the pandemic on hea...

Urban greening may help to reduce the population health impacts of loneliness and its concomitants, such as hopelessness and despair. However, the literature lacks both a critical appraisal of extant evidence and a conceptual model to explain how green space would work as a structural intervention. Both are needed to guide decision making and furth...

Background: Mental health conditions are one of the largest burdens of disease in Australia and globally. There is a need to seek innovative and alternative interventions that can prevent and alleviate mental health symptoms. Nature-based interventions (NBIs), namely programs and activities where individuals engage with natural environments with th...

Objective To systematically review the literature on the impact of the COVID-19 pandemic on deaths of despair (suicide, overdoses and drug-related liver diseases). Methods Five electronic databases were searched using search terms on deaths of despair and COVID-19. Results The review of 70 publications included indicates that there is no change o...

Background This study aimed to investigate prosocial behaviour—those behaviours that benefit others or enhance relationships with others—as a mediator of the associations between green space quality and child health-related outcomes (physical activity, mental health, and health-related quality of life (HRQOL)). Methods This study involved data fro...

Background Studies from high income ‘western’ countries indicate that green space visit duration is associated with better health. However, scant comparable research has been done in developing countries with rapid urbanization and on the potential health impacts of specific green infrastructure. Objective Associations between green space visit du...

Background "Nature prescriptions" are gaining popularity as a form of social prescribing and in response to calls for sustainable healthcare. Our review and meta-analysis appraised evidence of effectiveness of nature prescriptions on various health outcomes. In doing so, we sought to determine the factors that are critical for the success of nature...

Background A large multicentre European study reported later onset of menopause among women residing in greener areas. This influence on the timing of a reproductive event like menopause, raises the question whether similar associations can be observed with timing of menarche. We investigated whether exposure to residential green space was related...

Background This study assessed the associations between changes in exposure to green space quality, heavy traffic conditions, and asthma symptoms among children. Methods 10-year cohort data of 9589 children, retrieved from the Longitudinal Study of Australian Children, were analysed. Caregiver-reported neighbourhood green space quality, heavy traf...

Introduction The benefits of physical activity for glycaemic control in type 2 diabetes (T2D) are well-known. However, whether established glycaemic and cardiovascular benefits can be maximised by exercising at a certain time of day is unknown. Given postprandial glucose peaks contribute to worsening glycated haemoglobin (HbA1c) and cardiovascular...

The WHO recommends front-of-package labeling (FOPL) to help parents make healthier food choices for their children. But which type of FOPL resonates with parents in China? We performed a cross-sectional study to investigate parental preferences for five widely used formats of FOPL. A multi-stage cluster sampling method was applied to selected paren...

Background: Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods: We...

Background Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.