Article

Longitudinal Effects on Mental Health of Moving to Greener and Less Green Urban Areas

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Abstract

Despite growing evidence of public health benefits from urban green space there has been little longitudinal analysis. This study used panel data to explore three different hypotheses about how moving to greener or less green areas may affect mental health over time. The samples were participants in the British Household Panel Survey with mental health data (General Health Questionnaire scores) for five consecutive years, and who relocated to a different residential area between the second and third years (n = 1064; observations = 5,320). Fixed-effects analyses controlled for time-invariant individual level heterogeneity and other area and individual level effects. Compared to pre-move mental health scores, individuals who moved to greener areas (n=594) had significantly better mental health in all three post-move years (P=.015; P=.016; P=.008), supporting a 'shifting baseline' hypothesis. Individuals who moved to less green areas (n=470) showed significantly worse mental health in the year preceding the move (P=.031) but returned to baseline in the post-move years. Moving to greener urban areas was associated with sustained mental health improvements, suggesting that environmental policies to increase urban green space may have sustainable public health benefits.

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... Moreover, the kidney is susceptible to air pollution because of its ltration function [4] . A study conducted on a cohort of US veterans found that long-term exposure to particulate matter less than 10 µm [PM 10 ], nitrogen dioxide [NO 2 ], and carbon monoxide [CO], increased the risk of CKD incidence by 7%, 9%, and 10%, respectively [5] . In addition, research conducted in Korea between 2007 and 2011 showed that increases in annual mean concentrations of PM 10 and NO 2 were associated with a decrease in the estimated glomerular ltration rate (eGFR) by 46% and 15%, respectively [6] . ...
... A study conducted on a cohort of US veterans found that long-term exposure to particulate matter less than 10 µm [PM 10 ], nitrogen dioxide [NO 2 ], and carbon monoxide [CO], increased the risk of CKD incidence by 7%, 9%, and 10%, respectively [5] . In addition, research conducted in Korea between 2007 and 2011 showed that increases in annual mean concentrations of PM 10 and NO 2 were associated with a decrease in the estimated glomerular ltration rate (eGFR) by 46% and 15%, respectively [6] . As shown in the abovementioned research, exposure to ambient air pollution has been one of the major risk factors for the loss of kidney function. ...
... Considering the threat of air pollutant exposure to humanity, adaptation of green infrastructure is emerging as a solution; generally, this is directly related to the ability to reduce extreme heat and precipitation [7] . Furthermore, it is widely understood that exposure to greenery has positive effects on health by moderating ground temperature [8] , ltering pollutants from the air [9] , improving cardiovascular and mental health issues [10] , and providing space for exercise and social interaction [11] . In particular, previous studies have investigated the preventive role of exposure to green spaces on the adverse health effects of ambient air pollution. ...
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With increasing air pollution, the association between green space exposure and health outcomes is a global health concern. The relationship between air pollution and the survival of patients with chronic kidney disease (CKD) who are exposed to residential greenness is yet to be elucidated. This study aimed to determine this relationship in Seoul between 2002 and 2015. A time-varying survival analysis was conducted to investigate the association between long-term exposure to air pollutants and mortality in 29,602 patients with CKD living in residential environments with small and large green infrastructure. The low and high index groups were defined using continuous and percentile thresholds of the satellite data—the derived average Normalized Difference Vegetation Index within 250 m and 1,250 m of residence, respectively. During the observation, 3,863 (14%) deaths occurred. The effect of air pollution exposure on mortality was worse in the low index group than in the high index group. Particularly, exposure to SO2 was associated with increased mortality risk, regardless of the greenness threshold. Consistent results were observed in co-pollutant models. High greenery exposure significantly reduced the risk of air pollution related mortality. Our results emphasize the need for creating environmental infrastructures that include green spaces.
... Cross-sectional studies predominate in neighborhood health effects research but a recent shift toward more longitudinal studies-in part facilitated by increasing ability to link hospital records and routine data to population-based cohorts with geographical data on neighborhood environments-is creating rich opportunities to examine whether neighborhood environmental exposures are associated with objectively recorded, prospective outcomes, thus helping to better elucidate the true causal relationships and mechanisms involved, e.g., [9][10][11]. However, recent reviews reveal a paucity of longitudinal research on built environments and cancer risk, and substantial heterogeneity among the studies that do exist, in terms of cancer sites, exposure and outcome measures, and populations [3,12]. ...
... 'Greenspace' in the GLUD includes all public or private vegetated areas larger than 5 m 2 in area, with the exception of domestic gardens, which are classified separately. We combined 'greenspace' and 'gardens' into a single measure, consistent with previous research using the GLUD to examine relationships with health [9]. A 300 m buffer was chosen to capture greenspace in the immediate vicinity of a person's home. ...
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Purpose Neighborhood environments may influence cancer risk. Average population effect estimates might mask differential effects by socioeconomic position. Improving neighborhood environments could inadvertently widen health inequalities if important differences are overlooked. Methods Using linked records of hospital admissions in UK Biobank, we assessed associations between admission with a primary diagnosis of cancer (any/breast/colorectal), and exposure to neighborhood greenspace, physical activity facilities, and takeaway food stores, and whether household income and area deprivation modify these associations. We used adjusted Cox proportional hazards models, and estimated relative excess risks due to interaction (RERI) to assess effect modification. Results Associations between neighborhood exposures and cancer-related hospitalizations were weak to null overall, but with some evidence of effect modification. Most notably, more greenspace near home was associated with 16% lower hazard of cancer-related hospital admission in deprived areas (95% CI 2–29%). This was further pronounced for people in low-income households in deprived areas, and for breast cancer. Conclusion In deprived neighborhoods, increasing the amount of greenspace may help reduce cancer-related hospitalizations. Examining effect modification by multiple socioeconomic indicators can yield greater insight into how social and environmental factors interact to influence cancer incidence. This may help avoid perpetuating cancer inequalities when designing neighborhood environment interventions.
... Even short physical engagements with nature appear to boost mood and self-esteem, additionally enhanced by the presence of water [42]. A review of seven UK studies [42][43][44][45][46][47][48][49] observed a statistical association between greater access to green space and improvements in mental health outcomes [50]. Regular weekly use of a natural environment was associated with a 43% lower risk of poor general health [46]. ...
... Regular weekly use of a natural environment was associated with a 43% lower risk of poor general health [46]. People who moved from less green to greener areas had significantly better mental health scores in the three years following the move than previously [43]. People with a high amount of local green space appeared less affected by stressful life events than those with a low amount within the same 3Km radius [51]. ...
Article
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Background Reducing health inequalities in the UK has been a policy priority for over 20 years, yet, despite efforts to create a more equal society, progress has been limited. Furthermore, some inequalities have widened and become more apparent, particularly during the Covid-19 pandemic. With growing recognition of the uneven distribution of life expectancy and of mental and physical health, the current research was commissioned to identify future research priorities to address UK societal and structural health inequalities. Methods An expert opinion consultancy process comprising an anonymous online survey and a consultation workshop were conducted to investigate priority areas for future research into UK inequalities. The seven-question survey asked respondents (n = 170) to indicate their current role, identify and prioritise areas of inequality, approaches and evaluation methods, and comment on future research priorities. The workshop was held to determine areas of research priority and attended by a closed list of delegates (n = 30) representing a range of academic disciplines and end-users of research from policy and practice. Delegates self-selected one of four breakout groups to determine research priority areas in four categories of inequality (health, social, economic, and other) and to allocate hypothetical sums of funding (half, one, five, and ten million pounds) to chosen priorities. Responses were analysed using mixed methods. Results Survey respondents were mainly ‘academics’ (33%), ‘voluntary/third sector professionals’ (17%), and ‘creative/cultural professionals’(16%). Survey questions identified the main areas of inequality as ‘health’ (58%), ‘social care’ (54%), and ‘living standards’ (47%). The first research priority was ‘access to creative and cultural opportunities’ (37%), second, ‘sense of place’ (23%), and third, ‘community’ (17%). Approaches seen to benefit from more research in relation to addressing inequalities were ‘health/social care’ (55%), ‘advice services’ (34%), and ‘adult education/training’ (26%). Preferred evaluation methods were ‘community/participatory’ (76%), ‘action research’ (62%), and ‘questionnaires/focus groups’ (53%). Survey respondents (25%) commented on interactions between inequalities and issues such as political and economic decisions, and climate. The key workshop finding from determining research priorities in areas of inequality was that health equity could only be achieved by tackling societal and structural inequalities, environmental conditions and housing, and having an active prevention programme. Conclusions Research demonstrates a clear need to assess the impact of cultural and natural assets in reducing inequality. Collaborations between community groups, service providers, local authorities, health commissioners, GPs, and researchers using longitudinal methods are needed within a multi-disciplinary approach to address societal and structural health inequalities.
... Unplanned high-speed urban development has led to the destruction of green areas (Li et al., 2019). In this process, urbanization, which has been realized within the framework of the principles of sustainable urban development, has been becoming a crucial requirement for the physical and mental health of future generations (Alcock et al., 2014). ...
... 90% of the respondents stated that the green areas had a significant impact on human health, as claiming Dunnett and Kingsbury's (2004) findings. As Alcock et al. (2014) pointed in their study, the green area led people to be happier. It has been measured that the green roof had a positive impact on the development of the city. ...
Article
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As a solution to the rapid urbanization problem, green roof applications in urban centers have gained popularity. This study aims to investigate the green roof awareness of the casual users of Zorlu Center located in Besiktas, Istanbul. The social perception of the green roof, which is defined as an urban balcony,-by its architect, located in an intensively used area, has been handled as a case study. Perception enables people to critique, interpret, distinguish, and analyze their environment according to their core values to adapt to the environment. In this study, the perception has been associated with socio-demographic characteristics such as age, education, and attitudes. A field survey, designed to measure the impact of the green roof, was conducted with the 100 users of Zorlu Center. The most significant result of this study is that most of the participants are aware of the need to develop green roofs in Istanbul. This study shows that the commercial environment in the urban area, which has green elements such as the green roof, helps to renew and revitalize the city. It has been found that the green roof application of Zorlu Center attracted the users from the settlements in its close vicinity. The people came to Zorlu Center, especially to this green area, for leisure time activities. The green roof application of Zorlu Center has positively affected the users in terms of physical and mental health. Also, it has been found that green roof applications have a contribution to sustainable urban development, especially in high-density city centers, considering the positive effects on the city silhouette and urban quality of life.
... Increased area-level socioeconomic deprivation was associated with poor mental health among movers (Norman et al., 2005;Tunstall et al., 2014) and non-movers (Blair et al., 2015). In contrast, moving to greener neighbourhoods was associated with mental health improvements (Alcock et al., 2014), although others observed null (Weimann et al., 2015) or even health-threatening associations (Tunstall et al., 2014). ...
... Studies on neighbourhood change and health either included movers (Alcock et al., 2014;Darlington-Pollock et al., 2018;Green et al., 2017;Shackleton et al., 2018;Weimann et al., 2015) or non-movers (Aretz et al., 2019;Blair et al., 2015;Boyle et al., 2004;Xiao et al., 2018). Little is known on whether health outcomes related to neighbourhood change differ between movers and non-movers. ...
Article
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Associations between the residential neighbourhood environment and suicide mortality are well-established; however, most evidence is cross-sectional not capable of incorporating place-based and residential moving-related neighbourhood changes. We studied how suicide mortality is associated with changes in the physical and social neighbourhood environment for movers and non-movers. Our retrospective analysis was based on longitudinal register data for the entire Dutch population aged 25–64 years enriched with annually time-varying data on the residential neighbourhood environment between 2007 and 2016. A total of 8,741,021 people were followed-up between 2007 and 2016 of which 10,019 committed suicide. Upward and downward neighbourhood change was measured by comparing neighbourhood conditions separately at two time points. Cox proportional hazard models indicated that movers had a significantly lower risk of suicide compared to non-movers. Suicide risk was lower for people experiencing improvements in social fragmentation and deprivation compared to those remaining in poor conditions. Change from rural to semi-urban/urban conditions also resulted in lower suicide risk, while a gain in green space put people at increased risk. For those stable neighbourhood conditions over time, suicide mortality was lower for men and women in urban vs. rural neighbourhoods as well as for women in neighbourhoods with low vs. high social fragmentation. Stable exposure to high levels of green space resulted in higher suicide risk among women. Interactions and stratification by moving type revealed associations between neighbourhood change and suicide were more pronounced in non-movers. Our findings suggest that neighbourhood improvements might contribute to a lower suicide risk, especially for long-term residents in poor neighbourhood conditions.
... Many studies use self-reported improvement in mental health when discussing the benefits of green space (Cohen-Cline et al., 2015;Sturm & Cohen, 2014;Nutsford et al., 2013) including reduction in stress and anxiety when moving to greener areas (Alcock et al., 2014;White et al., 2013), improvements in mood, and lower frustration when walking through green areas (Aspinall et al., 2013;Berman et al., 2012) and a reduction in prescription of antidepressants with increased tree coverage (Taylor et al., 2015). Many of these 'social prescribing' programmes can be specifically targeted to suit the needs of patients (Mind, 2013;Bragg et al., 2015). ...
... However, most research was cross-sectional and did not always investigate a comprehensive range of exposures or outcomes. A recent metaanalysis of cohort studies found evidence of an inverse association between surrounding greenness and all-cause mortality (29) and another study found that moving to greener urban areas was related to mental health improvements (30). Despite this, different aspects of the neighbourhood environment such as fast-food outlets and physical activity facilities may act together and as such accounting for their co-location is an important consideration (31)(32)(33). ...
Article
Background The determinants of health behaviours and health outcomes are multifaceted and the surrounding environment is increasingly considered as an important influence. This pre-registered study investigated the association between the geospatial environment people live within and their health behaviours as well as mental and physical health outcomes. Method We used the newly developed Healthy Location Index (HLI) to identify health-promoting and health-constraining environmental features that people live around. We then used Time 10 (2018) data from the New Zealand Attitudes and Values Survey (NZAVS; N = 47,951), a national probability sample of New Zealand adults, to gauge mental health outcomes including depression, anxiety and psychological distress, physical health outcomes including BMI and type II diabetes, and health behaviours such as tobacco smoking and vaping. Linear and logistic multilevel mixed effect regression models with random intercepts of individuals nested within geographical areas (meshblocks) were employed. Results The presence of health-constraining environmental features were adversely associated with self-reported mental health outcomes of depression, anxiety, and psychological distress, physical health outcomes of BMI and type II diabetes, and negative health behaviours of tobacco smoking and vaping. By contrast, health-promoting environmental features were uniquely associated with physical health outcomes of BMI and type II diabetes. Conclusion The current study advances research on environmental determinants of health behaviours by demonstrating that close proximity to health-constraining environmental features is related to a number of self-reported physical and mental health outcomes or behaviours. We provide some evidence to support the notion that preventive population-health interventions should be sought.
... Health benefits that stem from the provision of green spaces include urban cooling, physical fitness opportunities, ecological education, improvement of water and air quality, and protection from traffic pollution (Hartig et al., 2014;Heerwagen, 2009;Schäfer et al., 2017;Wells & Rollings, 2012) and noise (Koprowska et al., 2018;Peris & Fenech, 2020). The presence of greenery also contributes to mental health, providing relaxation, reducing stress, and enabling mindfulness and various recreational activities (Alcock et al., 2014;Coon et al., 2011;Davis, 2004;Grahn & Stigsdotter, 2010;Gruebner et al., 2017;Hartig et al., 2003;Marselle et al., 2019). Greenery has beneficial effects on longevity and lowers mortality (Kühn et al., 2017). ...
Article
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Urban forms can have numerous direct and indirect effects on the health of residents. This article focuses on the relationship between health and urban form, in particular the role of green open spaces. The goal is to identify criteria for evaluating the impact of physical forms such as streets and open spaces, green infrastructure, and built structures on urban health. These criteria are then used to identify paths for the redevelopment of modernist housing estates with the aim of improving living conditions. This challenge remains particularly significant in Poland and Eastern Europe, where a large share of the urban population lives in modernist blocks of flats. First, we examine the modernist housing concept in Europe and Poland and the guiding principles for their development, including the role of green, open spaces. Then, we refer to several studies on urban health to identify normative factors that define the open space design conditions in modernist housing estates. We apply the typo-morphological approach with qualitative and quantitative assessment of building forms and forms of green open spaces to examine the structures of two modernist housing estates in Poland: Lodz and Gdansk. We evaluate their living conditions, especially the organisation of outdoor space, in terms of their impact on the health of residents. A comparison of the two housing estates reveals common factors defining the relationship between urban form and health.
... Cities with a large and dense populations usually have less available ecological land [68], and residents of densely populated areas therefore experience limited interactions with nature, which negatively affects their ecological well-being [69,70]. To eliminate this negative effect, ecological land is urgently needed in such cities. ...
Article
Full-text available
Land use change and demographic factors directly or indirectly affect ecosystem services value, and the analysis of ecosystem services contributes to optimization of land planning, which is essential for regional sustainable development. In this study, ArcGIS 10.2, IDRISI 17.0 Selva and MATLAB software, value coefficient method, CA-Markov prediction model and population growth model were applied to analyze the spatial and temporal changes of land use trends and ecosystem service values in Guanzhong region, and further predict the impacts of land type changes and population changes on ecosystem services in the context of urbanization. Results showed that the expansion of construction land was the most intense, and the transfer process mainly crowded out arable land; the total ecosystem services value grew spatially in a “low center-high periphery” ring with large differences at the bottom, and forest land was the most important value provider. The total ecosystem services value was estimated to decline in the future, with low-value areas spreading northward and differences in the per capita ecosystem services value increasing. This study provides a reference for optimal simulation of urban expansion and ecological conservation.
... Many studies in psychiatric epidemiology have been dedicated to understanding the role of each of these elements in urban life, exploring plausible associations between exposure to risk factors and mental health outcomes (Helbich, 2018;Lecic-Tosevski, 2019;Shanahan et al., 2015). For instance, there is evidence of a causal relationship between the low number of parks or green areas with higher prevalences of psychiatric disorders, such as anxiety (Moreira et al., 2021); the direct relationship between urban violence and the level of stress; or between the quality of public transport and anxiety, or the relationship between the strength of family ties or social networks and mental health in city centres (Astell-Burt & Feng, 2019;Alcock et al., 2014;Callaghan et al., 2021;Nutsford et al., 2013;Sturm & Cohen, 2014). ...
Article
Urban mental health studies traditionally search for causal relationships between elements of the city and the prevalence of mental disorders. This paper discusses the importance of (re)thinking the 'lived urban experience' from the perspective of city residents about how the immediate environment affects their mental health and how people cope with inequalities. A participatory-action research was implemented in a peripheral area of São Paulo-Brazil, in which volunteers from the territory made phone calls to neighbours to provide emotional support during the COVID-19 pandemic. Weekly supervision meetings were held between volunteers and researchers to discuss the experiences shared by community counterparts. Narratives have shown that the lived experience in the city is mediated by multiple layers of 'urban inse-curities'. These difficulties pressured people to organise and resist in face of pervasive inequalities as well as to respond to unfolding experiences of social suffering. We highlight the potential of participatory methodologies to observe the ways in which subjects face their structural issues and the suffering that emerge in these circumstances. The understanding of how these conflicts are lived at a subjective level can support studies that are wondering about the mechanisms of how social conflicts 'get under the skin'. ARTICLE HISTORY
... Measures of residential greenspace were estimated for England residents using the 2005 Generalized Land Use Database for England. It provides data on land use distribution for 2001 Census Output Areas in England and is consistent with the previous related research (9,10). Residential distance to the coast was defined as the participant's residence location to the coast according to the participant's address, measured in Kilometers (km). ...
Article
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Background Little is known about how the residential distance to the coast is associated with incident myocardial infarction (MI) and which mechanisms may explain the association. We aim to explore this association using data from a prospective, population-based cohort with unprecedented sample size, and broad geographical coverage. Methods In this study, 377,340 participants from the UK Biobank were included. Results It was shown that 4,059 MI occurred during a median 8.0 years follow-up. Using group (<1 km) as reference, group (20–50 km) was associated with a lower risk of MI (hazard ratio, HR 0.79, 95% CI 0.64–0.98) and a U -shaped relation between distance to the coast and MI was shown with the low-risk interval between 32 and 64 km ( p non−linear = 0.0012). Using participants of the intermediate region (32–64 km) as a reference, participants of the offshore region (<32 km) and inland region (>64 km) were both associated with a higher risk of incident MI ( HR 1.12, 95% CI 1.04–1.21 and HR 1.09, 95% CI 1.01–1.18, respectively). HR for offshore region (<32 km) was larger in subgroup with low total physical activity (<24 h/week) ( HR 1.24, 95% CI 1.09–1.42, p interaction = 0.043). HR for inland region (>64 km) was larger in subgroup in urban area ( HR 1.12, 95% CI 1.03–1.22, p interaction = 0.065) and in subgroup of high nitrogen dioxide (NO 2 ) air pollution ( HR 1.29, 95% CI 1.11–1.50, p interaction = 0.021). Conclusion We found a U -shaped association between residential distance to the coast and incident MI, and the association was modified by physical activity, population density, and air pollution.
... This further suggests that studies related to green and blue environments with socioeconomic conditions need to be further investigated. Alcock et al(Alcock, White et al. 2013), ranked tenth, with 52 citations recorded; by using British panel survey data with 5320 observations, this study investigated the effect on mental health by moving in less green environments and lush green urban areas. The results found that moving in green urban areas is highly positive and signi cantly correlated with improving mental health, as well as reducing stress. ...
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Currently, the world is facing challenges of environmental pollution and public health owing to increasing urbanization. Therefore, many researchers from developed and developing countries are considering environmental pollution and public health to be the most important topics for sustainable development alongside a healthy and green environment. Although in the literature many researchers have investigated a pictorial view of green environment by defining the urban green space and blue space effects on public health, the green environments and public health research trend remains unclear. Thus, this study aimed to contribute to the literature by visualizing the bibliometric for green environments and public health, and to identify the missing research pathway. Data for this study was collected from the Web of Science from 2003-2019 in order to facilitate a visualization and bibliometric analysis carried out by CiteSpace. The visualization results reveal the most influential studies, institutions, authors, countries, keywords, and category cloud in the green environments and public health research field. Furthermore, this study suggests that researchers need to pay attention to how the genome changes due to climate change, as well as environmental pollution and its effect on human health. Mental health and research related to green environment and social health is also missing. In addition, there is also a missing link regarding green environment, underground water and public health. Additionally, this study could help authors and publishers make decisions concerning research on green environments and public health and planning for future perspectives to contribute to both academic development and applied methodology.
... The latter pattern has been taken by some researchers as evidence that city residents suffer from "nature deficit disorder" (Kuo, 2013). To ameliorate this lack of contact with nature, urban design could increase the number of or access to green spaces (Alcock, White, Wheeler, Fleming, & Depledge, 2014;Peschardt, Schipperijn, & Stigsdotter, 2012). For example, offices can be greened to mitigate workplace stress (Sadick, & Kamardeen, 2020), classrooms could be greened (Van den Bogerd et al., 2020) to combat high levels of depression amongst students , and finally, people could be encouraged to have micro breaks with nature videos or even virtual reality to reduce stress and negative affect at home (Valtchanov, Barton, & Ellard, 2010). ...
Thesis
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Background: Natural scenery is known to have restorative qualities, such as recovery from stress, mood enhancement, and replenishment of attention. These restorative qualities of nature may contribute to the prevention and treatment of mental health problems and promote well-being. Previous research about the restorative effects of nature concluded that the field would benefit from studies with high methodological rigour that concern psychological mechanisms that (in part) explain the restorative benefits of nature. Besides a value for the field of restorative environments research, such studies also have value from a societal standpoint, because it could facilitate the further development of preventive initiatives and even nature therapy practice. Aim: Therefore, the aim of the present dissertation was: To further the understanding of the restorative effects of exposure to nature in order to inform both preventive and clinical interventions that consider nature as a supportive environment. Methods: Chapter 2 described two lab studies (N = 257) that investigated a clinically relevant personal characteristic that might constrain or bolster the effectiveness of the restorative benefits of exposure to nature: depressive symptoms. Chapter 3 presented three lab studies (N = 506) that examined whether nature influences cognitive coping with psychological distress. Chapter 4 (N = 127) also studied the psychological process of cognitive coping but with a different experimental manipulation (i.e. feelings of stress) to induce a capacity for restoration before environmental exposure. Chapter 5 presented a phenomenological qualitative study (N = 12) that investigated how clients experience nature during individual outpatient psychotherapy. More specifically, it was concerned with clients’ inner world experiences regarding nature during treatment. Results: Chapter 2 suggests that nature-based interventions may be especially beneficial for people suffering from depressive symptoms, because the two presented experiments show that participants with more (rather than less) depressive symptoms displayed more stress reduction after viewing nature rather than built settings. The studies presented in Chapter 3 are the first to reveal that viewing nature influences cognitive coping with psychological distress. It described a novel potential two-step pathway as an underlying mechanism of restoration. In the first step of this pathway the capacity for directed attention replenishes. Second, this renewed capacity is directed towards internal processes, creating the optimal setting for reflection. Chapter 4 shows that even though restoration occurred, viewing nature did not seem to evoke restoration by means of cognitive coping. It establishes a difference in personal circumstances, i.e. between the affective states of psychological distress and feelings of stress, with regard to whether cognitive coping is influenced by nature exposure or not. Chapter 5 reveals that nature brings clients closer to their inner worlds. It is the first to unfold in a conceptual model the way observations of the natural outside world impact clients’ inner worlds. Conclusion: The present dissertation indicates that the natural world is especially effective for people with an emotional vulnerability and that nature seems to foster reflection by facilitating cognitive coping with psychological distress. In addition to these effects, or maybe because of these effects, the natural outside world seems to bring clients closer to their inner worlds. The present dissertation is the first to really unfold how nature brings this about in a two-step pathway of restoration and reflection, and additionally with a conceptual model of nature’s lived experience. Together with the broader line of research about the value of nature for mental health, the present dissertation underlines the importance of considering nature as a supportive environment for both preventive as well as treatment interventions. More specifically, the present dissertation states that numerous evidence based treatments can be enriched by considering nature as a supportive environment for psychotherapy.
... Residential green space was estimated using land use data obtained from the 2005 Generalized Land Use Database (GLUD) for England, provided by the Department for Communities and Local Government of the Government of the UK (https://www.gov. uk/government/statistics). The GLUD includes information on land use distribution at 2001 Census Output Areas (COA) level and was consistent with previous studies (Alcock et al., 2014;White et al., 2013a). Each home location polygon was allocated an area-weighted mean of the land use percentage coverage. ...
Article
Background We investigated the associations between residential green space and blue space (water) and inflammatory bowel disease (IBD) incidence, which have rarely been examined. Methods We performed a longitudinal analysis using data of the UK Biobank study, a large prospective cohort. Incident cases of IBD were ascertained through linkage to health administrative datasets. Residential green space, blue space and natural environment (land coverage percentage) were estimated using land use data. Cox proportional hazard regression models were used to determine the associations between the exposures and IBD incidence with adjustment for a wide array of potential confounders. Results A total of 216,868 participants without IBD at baseline were studied with an average follow-up of 11.7 years, contributing to 2.5 million person-years. During the follow-up, 1271 incident IBD cases were identified. In fully adjusted models, participants with green space coverage at 300 m buffer in the 2nd and 3rd tertiles had 18.2% [HR = 0.818, 95% confidence interval (CI): 0.715, 0.936] and 15.4% (HR = 0.846, 95%CI: 0.736, 0.972) lower risks of incident IBD compared with those in the 1st tertile, respectively. Similar results were found for blue space [HR = 0.858 (95%CI: 0.750, 0.982) for 2nd vs 1st tertile; HR = 0.785 (95%CI: 0.685, 0.899) for 3rd vs 1st tertile]. Negative associations were also observed for natural environment. Stronger associations were observed in participants from more deprived areas. Conclusions Our study suggests that residential green space, blue space and natural environment might be protective factors against IBD.
... Studies suggest that natural environments and green spaces provide ecosystems and services that are considered to enhance human health and well-being in multiple ways (Aerts et al., 2018). Increasing people's exposure to, and use of, green spaces has been linked to increased social contacts and higher self-rated mental health, as well as reductions in physical health problems including heart disease, cancer and musculoskeletal conditions and obesity (Alcock et al., 2014;Nieuwenhuijsen et al., 2017;. In one field experiment, gardening was found to promote neuroendocrine and affective restoration from stress more rapidly than other calming activities such as reading (Van Den Berg and Custers, 2011). ...
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The last decade has seen a surge of interest and investment in green social prescribing, however, both healthcare and social enterprise has been impacted by the COVID-19 crisis, along with restricted access to public green spaces. This study examines the challenges and opportunities of delivering green social prescribing during and in the aftermath of COVID-19, in the light of goals of green social prescribing to improve mental health outcomes and reduce health inequalities. Thirty-five one-to-one interviews were conducted between March 2020 and January 2022. Interviewees included Link Workers and other social prescribers, general practitioners (GPs), managers, researchers, and volunteers working in urban and rural Scotland and North East England. Interview transcripts were analyzed in stages, with an inductive approach to coding supported by NVivo. Findings revealed a complex social prescribing landscape, with schemes funded, structured, and delivered diversely. Stakeholders were in general agreement about the benefits of nature-based interventions, and GPs and volunteers pointed out numerous benefits to participating in schemes such as parkrun. Link Workers were more circumspect about suggesting outdoor activities, pointing out both psychological and practical obstacles, including health anxieties, mobility issues, and transport deficits. Exacerbated by the pandemic, there was a way to go before older and/multi-morbidity clients (their largest cohort) would feel comfortable and safe to socialize in open air spaces. Our findings support the premise that time spent in open green spaces can alleviate some of the negative mental health effects compounded by the pandemic. However, the creation of healthy environments is complex with population health intrinsically related to socioeconomic conditions. Social disadvantage, chronic ill health and health crises all limit easy access to green and blue spaces, while those in the most socially economically deprived areas receive the lowest quality of healthcare. Such health inequities need to be borne in mind in the planning of schemes and claims around the potential of future nature-based interventions to reduce health inequalities.
... Green spaces and gardens provide a place for exercise, sports, play and the development of motor skills (Kabisch et al., 2019;Tan et al., 2021) and can serve as a refuge from busy city life with restorative, stress-reducing effects (Alcock et al., 2014;Cervinka et al., 2016;Tillmann et al., 2018;Young et al., 2020;Yao et al., 2021). Green environments are associated with a decreased risk on mental health issues and chronic diseases, and this association seems to be stronger in low-income neighborhoods compared to high-income neighborhoods (Brown et al., 2016(Brown et al., , 2018. ...
Article
p>The evidence is piling: contact with nature is good for our health. But today’s reality is that nature is not by default part of our lives, particularly not for citizens living in deprived urban neighborhoods. One strategy to increase nature contact locally, is through green citizen initiatives: gardens and urban agriculture projects initiated and run by citizens. We studied eight green citizen initiatives in Arnhem and Nijmegen in The Netherlands to explore what well-being benefits residents experience with regards to their participation in local green initiatives. This paper presents the methods developed to measure well-being outcomes, plus the first results. We conducted a questionnaire among 109 participants of green citizen initiatives in 2020. We found that participation in green initiatives creates positive experiences for six dimensions of well-being: meaningful involvement, personal development, social connection, sense of ownership, sense of safety and trust, and healthy lifestyle. Participants feel part of the initiative, gain social contacts and get to spend time outdoors. The greatest wellbeing benefit of green initiatives turned out to be a sense of safety and trust. We found less evidence of increased healthy food intake and other lifestyle aspects. This raises the question whether participants have already adopted relatively healthy lifestyles and/or whether the green initiatives attract a certain group of residents – and other groups not. With our study we provide a method and the first evidence on the value of green citizen initiatives as a bottom-up strategy to improve the health and well-being of citizens in deprived urban neighborhoods.</p
... Greenspace supports urban inhabitants' health by way of mitigation (reducing exposure to noise, pollution, and heat), instoration (encouraging physical activity) and restoration (cognitive and psychophysiological recovery) (Markevych et al., 2017). The restoration pathway has received particular attention because psychological restoration is increasingly recognised as indispensable for coping with the stress of urban life (Hartig & Kahn, 2016), and greenspace exposure might safeguard mental health (Alcock, White, Wheeler, Fleming, & Depledge, 2014;Beyer et al., 2014;van den Berg, Maas, Verheij, & Groenewegen, 2010). One meta-analysis reported higher prevalence of depression in cities as compared with rural areas (Peen, Schoevers, Beekman, & Dekker, 2010), but another meta-analysis did not find this association (Lim et al., 2018). ...
Thesis
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This thesis addresses the need for urban landscapes that provide resilient contributions to inhabitants’ well-being while also limiting impacts on the Earth system. It aims to (1) advance a nuanced understanding of how urban environments relate to urban dwellers’ well-being, and (2) formulate guidelines for planning that supports urban dwellers’ well-being and align with global sustainability. The thesis consists of five empirical studies of Swedish and Danish urban landscapes in which day-to-day experiences and mental disorders were studied as different components of well-being. A variety of spatial and statistical analysis methods were leveraged, including public participation geographic information systems, remote sensing, deep learning, accessibility analysis, and spatial regression. Results convey that urban environments relate to well-being in substantial ways, but these map poorly onto the simplistic urban-nature or urban-rural dichotomies that dominate current discourse. Support of well-being instead seems to depend on spatial conditions comprised of the street network’s topological configuration, the population distribution, and the accessibility of natural settings. Since the 1990s, contrasts have intensified between stressful urban cores that are increasingly full of people and peripheral areas that are “left behind” and high-risk in terms of mental illness. Results show that urban neighbourhoods could contribute to well-being through fulfilment of three guidelines: (1) a balance of residential and daytime populations, (2) no extreme concentration of movement, and (3) accessible natural settings. Strategies in accordance with the guidelines can increase so-called topodiversity, which refers to variation in spatial conditions across an urban landscape that permits support of well-being through different pathways. Increasing topodiversity in both central and peripheral areas could improve urban landscapes’ ability to resiliently support well-being.
... There is a significant negative correlation between the green coverage rate and the particulate matter concentration in a block. Every 10% increase in the green coverage rate can lead to reduction of the PM10 and PM2.5 concentration by 13.83% and 7.58%, respectively [10]. However, the research into plants' impact on abatement of particulate matter on the road space has always been controversial. ...
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The global outbreak of COVID-19 has exposed the deficiency of urban space quality in terms of health and awareness of respiratory infectious diseases.This article analyzes the influencing factors of urban health mechanisms and simulates through infectious disease mechanisms and approaches. Finally Propose corresponding strategies and optimization methods for the optimization of urban space form and structure, and provide corresponding strategies and basis for healthy urban space planning.
... Green urban areas (GUA) have recently been recognized as dynamic refuges of biodiversity and landscape connectivity in the city (Tzoulas et al. 2007;Alcock et al. 2014;De Montis, Ledda, and Calia 2021). According to the nomenclature of Copernicus Land Monitoring Service (https://land.copernicus.eu/), ...
Article
We investigated whether green urban areas (GUA) improve the urban environment. Field measurements were conducted to record noise and light pollution as well as other environmental characteristics in four GUA in Athens. The biodiversity status of the examined areas was derived from the existing data. Not all GUA represent ecological refuges, mostly depending on their configuration. Special attention should be drawn to planning and designing GUA so that human pressures could not penetrate. Soundscape assessment combined with artificial lighting, environmental and biodiversity status investigation of a site clarifies the edge effect of ecosystems leading to an alternative, integrated, multidimensional management approach.
... In regard to mental health, studies have shown that green spaces are positively associated with fewer days of mental health complaints (Akpinar, Barbosa-Leiker, & Brooks, 2016) and greater mental well-being (Wood et al., 2017). Studies found that moving to greener urban areas as well as visiting green spaces are associated with mental health improvements (Alcock et al., 2014;Van den Berg et al., 2016). Studies also revealed that spending time in green spaces are linked to lower levels of anxiety (Beyer et al., 2014;Mackay and Neill, 2010) and depression (Berman et al., 2012;Reklaitiene et al., 2017). ...
Article
This study investigates associations between perceived sensory dimensions (PSDs) of urban green spaces (UGSs) and adults’ perceived restoration, stress, and mental health. Data were collected through surveys with 426 adults in 2019 in seven different UGSs in Aydın, Turkey. The PSDs of UGSs (nature, serene, space, rich in species, social, prospect, culture, and refuge) were evaluated and rated by two professional landscape architects. The perceived restorativeness (being away, fascination, coherence, and compatibility) was measured with the Perceived Restorativeness Scale, and health indicators (stress, mental health, mental health diagnosis, mental health treatment, general health, and quality of life) were measured with self-reported questions. Multivariate multiple regression analyses were conducted to examine associations controlling for confounding factors. Four of the eight PSDs were analyzed due to multicollinearity issues in the study. Regression analyses showed that ‘nature’ was positively associated with perceived restorativeness, stress, and mental health, while ‘refuge’ was only positively associated with perceived restorativeness. On the other hand, ‘serene’ was negatively associated with perceived restorativeness. Whereas ‘rich in species’ was found to be negatively associated with perceived restorativeness and positively associated with mental health diagnosis. In addition, findings showed that frequency of and duration of UGSs visit were negatively associated with perceived restorativeness. The findings suggest that providing characteristics of ‘nature’ and ‘refuge’ in UGSs may provide restorative effects and mental benefits to adults. However, unexpected results suggest that further research is needed before using these characteristics as a tool by landscape architects and city planners.
... We paid attention to different components, which can improve human well-being, making cities more eco-friendly (Secretariat of the Convention on Biological Diversity, 2012). Specifically, we evaluated a) the cover and heterogeneity of vegetation around the building areas, a feature strongly linked with recreation and human health (Alcock et al., 2014;de Vries et al., 2003), but also associated with the connectivity for wildlife (Pena et al., 2017), refuge for native birds (Villaseñor et al., 2021), as well as source of many ecosystem services (Roeland et al., 2019); b) the level of light pollution as a potential factor of risk for the health of humans as well as for wildlife (Dominoni et al., 2016) and c) the potential resilience of the urban avian assemblages as an insurance of the ecosystem functioning (Morelli et al., 2020a). Based on these measures, we identified high environmental quality (HEQ) urban areas as those with large abundance and heterogeneity of greenery, relatively low light pollution and simultaneously avian communities with high potential resilience (Fig. S1). ...
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Urban and suburban areas are among the fastest-growing land-use types globally, reducing and fragmenting natural habitats for many animal species and making human-wildlife interactions more common. However, cities also create habitat for several species considered urban tolerant or urban exploiter species. Additionally, the environmental characteristics of urban areas can strongly affect the life quality of citizens. This study aimed to assess the effectiveness of common bird species as indicators of urban areas with high environmental quality within cities. Our study recorded 128 bird species in 1441 point counts distributed in fifteen different European cities. We classified urban areas as “high environmental quality” – HEQ when they were simultaneously characterised by a high green cover and heterogeneity, low level of light pollution, and avian communities with high potential resilience to face ecological stress. Species indicators of HEQ urban areas were identified using the species-level indicator value (IndVal) analysis. Such species can be used as ecological indicators of HEQ in different European cities. The list of top ten birds indicators of HEQ in European cities is led by the Eurasian blackcap, selected as an indicator in more than half of the survey cities. Other birds indicators of HEQ in multiple cities are Blackbird (47%), Great tit (40%), Blue tit, Tree sparrow and Magpie (all 33%). The mean specificity of the top-ranked bird indicator of HEQ urban areas (Eurasian blackcap) was 0.778. Most of the HEQ-indicators are resident or resident/short migratory species characterised by territorial behaviour. Our findings support using multiple species as bioindicators of urban changes by using specific groups with few common species as surrogates of HEQ urban areas. The approach proposed in this study can be applied in different European cities to monitor biodiversity status periodically, even involving citizen science initiatives.
... This would benefit biodiversity (including invertebrates), compensate the water savings gained from artificial grass and reduce the consequent heat island effect (Domene et al. 2005, Yaghoobian et al. 2010). In addition, natural green urban areas also provide services for humans by improving our physical and mental health, and increasing sustainability (Phillips 1993, Alcock et al. 2014). ...
Article
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Green areas are key habitats for urban avifauna. Urban parks stand out from other anthropic habitats especially in providing trophic resources for many bird species. Consequently, modifications of these green zones can imply major changes in urban biodiversity. Potential pernicious urban remodelling is taking place in parks of eastern Spain because natural grass is being replaced with artificial grass to save water and to avoid management. This study aimed to determine whether remodelled parks with artificial grass harbour lower avian diversity (alpha, beta and gamma diversity) than traditional parks with natural grass. We surveyed 21 parks with artificial grass and 24 parks with natural grass in 18 towns of the Valencia Region in autumn 2020. In each park, we carried out 5-minute and 25-m radius point counts for determining bird species and their abundance. The effects of park area and grass type on alpha diversity (species richness, Shannon diversity index, Pielou’s Evenness and total abundance) were tested by means of GLMs. Differences in beta diversity and its components (nestedness and turnover) were also analyzed with the Bray-Curtis dissimilarity index. Gamma diversity was assessed by means of species accumulation curves. Finally, differences in community composition were tested by PERMANOVA and SIMPER tests. The parks with natural grass always harboured higher gamma diversity, species richness and abundance. Turnover was higher in parks with natural grass, whereas nestedness was higher in artificial grass parks. Differences in community composition were due mainly to abundance differences in common ground-feeding birds. We highlight that the trend of replacing natural by artificial grass in urban parks has harmful effects on urban bird communities and is a threat to bird conservation. Although artificial grass might save water, the effects on urban biodiversity should be carefully evaluated.
... A higher proportion of green space close to the home is related to lower prevalence of many diseases, particularly anxiety disorders and depression (Maas et al., 2009). There is evidence that moving home from a less green urban area to a greener area has sustained positive effects on mental health (Alcock et al., 2014). The negative effects of socio-economic inequalities on health may also be attenuated by a greater availability of greenspace (Mitchell and Popham, 2008). ...
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This mixed-methods paper examines the experience and effects of the loss of an allotment garden among gardeners in Zurich, Switzerland. The paper explores the subjective experience of garden loss using qualitative material gathered in field conversations with gardeners from an allotment area which was soon to be cleared for construction. In parallel, gardeners from the same area were surveyed before (2018) and after (2019) the clearance, thus constructing a natural experiment to measure effects on gardeners’ social networks, social support and general and mental health. The analysis of the qualitative material shows the (imminent) loss of the garden was a distressing experience for most participants, a result which is strongly supported by the descriptive analysis of several survey questions. Analysis of the quantitative data with ANCOVA models gives support to a negative effect of garden loss on the number of social contacts and on emotional well-being, but not on other factors. The experience of garden loss shows strong parallels to that of loss of a home, but also differs from it in relevant ways. Improved designs of similar natural experiments could lead to more reliable results. These would, however, require researchers to observe planning processes from a very early stage.
... In recent years, there has been a growing interest in measuring the impacts of urban blue-green spaces on the health of residents. The literature on the subject shows that living in areas with well-maintained parks decreases the risks of cardiovascular diseases [22,23], respiratory diseases [24], depression [25], and generally improves mental wellbeing [26,27]. ...
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This paper aims to expand the current debate concerning the implementation of health-related innovations by employing the rights-based approach. Specifically, we address the challenges related to the implementation of technological and Nature-Based Solutions (NBS) from the right to the city perspective. As a result, we present a comprehensive Civil City Framework that involves the synergic use of ICT tools and participation models to mobilize grassroots potential for building healthier cities, while ensuring equity and respect for diverse needs. We explain the participatory and technological aspects of implementing and monitoring innovative NBS, involving data gathering through environmental sensors, personal wristbands, and smartphone apps. Finally, we highlight opportunities and challenges stemming from the use of health- and environment-monitoring technologies. To build such a vision one needs to reconceive the city as commons, enabling collective action of city residents and cooperation between different local stakeholders. This can be achieved by embedding a pentahelix approach of multi-governance in urban planning, based on a close interaction between five key stakeholders, including public authorities, industry and business sector, academia, civil society organizations, and individual citizens.
... This suggests that there is still a large amount of variance being unaccounted for in our models and may be explained by time-varying omitted variables in our model specifications. However, this is in-line with other similar studies that estimate well-being and nature relationships, for example R 2 = 0.04-0.05 in Alcock et al. (2014) and R 2 = 0.05-0.06 in White et al. (2013a), and reflects the complexity in capturing the determinants of well-being in humans. Additionally, we are still not fully able to imply a causal relationship, for example, we cannot rule out that some individuals with higher subjective well-being will chose to live closer to more biodiverse natural sites. ...
Article
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There is now considerable evidence that the natural environment provides health and well-being benefits in urban environments. However, little is understood about the role of ecological quality in maximising well-being gains. We examine the relationship between the accessibility of public natural spaces of high ecological quality and two measures of subjective well-being for adults, using the British Household Panel Survey (BHPS), a large, longitudinal panel dataset. We then compare this relationship with that found with all Public Open Spaces, regardless of their ecological quality. We use the designation of Sites of Importance for Nature Conservation (SINC) as an objective indication of high-quality green-or bluespace, and life satisfaction and mental distress as measures of well-being. We use the Areas of Deficiency dataset from Greenspace Information for Greater London CIC (GiGL) to identify residential areas with more than a 1 km walk from a SINC, based on actual walking routes from known access points. Postcode-level analysis using regression modelling reveals that living beyond a 1 km walk of a SINC decreases an individual's life satisfaction by 0.117 points on a scale of 1 to 7. No relationship is found for mental distress. We also do not find any significant relationship between either well-being measure and all Public Open Spaces. These findings suggest that the ecological quality of publicly accessible open spaces is important for the well-being of residents in Greater London and highlights the need for improving the provision of high-quality green-and bluespaces in urban areas.
... The positive association between urban green space (UGS) and human health is increasingly supported by evidence from a wide range of studies. These include cross-sectional studies (Beyer et al., 2014;Gascon et al., 2018;van den Berg et al., 2016;Zhang, Tan, & Richards, 2021), longitudinal studies (Alcock et al., 2014;Astell-Burt et al., 2014;Feng & Astell-Burt, 2017;White et al., 2013) and experimental studies (Aspinall et al., 2015;Barton & Pretty, 2010;Martens et al., 2011). Recent reviews (Reyes-Riveros et al., 2021;Shuvo et al., 2020) also largely substantiate the collective evidence on the positive role of UGS on human health. ...
Article
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Although urban green spaces (UGS) are widely known to confer health benefits, evidence of the specific mechanisms that mediate the pathways from UGS provision and exposure to health outcomes remains limited. In particular, the question of whether exposure to UGS is an independent variable or a mediator in UGS-health linkages remains inadequately addressed. Using a nationally representative household survey in Singapore, this study investigated two models of the pathways linking UGS provision, UGS exposure, three mediators (emotional regulation, social interaction, and physical activities conducted in UGS) and self-reported mental and general health. The first model regarded both UGS provision and exposure as the independent variables and the second treated UGS exposure as the intermediate variable. Path analysis and structural equation modelling were employed to measure the theorised pathways. Good model fit for both models were found. Emotional regulation mediated 52% of the associations of perceived UGS provision and UGS exposure with mental health. Social interaction mediated 100% of the association of UGS with general health. However, green physical activities did not show any significant mediating effect. UGS exposure mediated only 11.5% of the pathways linking perceived UGS provision to other three mediators. Direct use of UGS is not a requisite for obtaining health benefits from UGS, as UGS provision independent of direct use is a significant variable. The use of UGS, however, provides undeniable benefits as UGS exposure was related to both health outcomes with full mediating effects. This study contributes to the understanding of underlying mechanisms in UGS-health associations.
... Active transport use in urban green space is well recognized as a stress reduction behavior and for having positive benefits for mental and public health [46][47][48][49]. Awareness can be defined as the state of being cognizant of something and, importantly, it is the Perugini and Bagozzi [40] suggest that desires can be defined as the proximal cause of behavioral intentions and fully mediate between anticipated emotions, attitudes, subjective norms, perceived behavioral control, and intentions. ...
Article
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Public green spaces (e.g., parks, green trails, greenways) and motivations to engage in active transport are essential for encouraging walking and cycling. However, how these key factors influence walker and cyclist behavior is potentially being increasingly influenced by the use of smart apps, as they become more ubiquitous in everyday practices. To fill this research gap, this work creates and tests a theoretically integrated study framework grounded in an extended model of goal-directed behavior, including public green space and motivation with perceived usefulness of smart apps. In order to accomplish the purpose of this study, we conducted an online survey of Korean walkers (n = 325) and cyclists (n = 326) between 10 and 25 July 2021 and applied partial least squares, structural equation, and multi-group analysis to validate the research model. Results revealed that active transport users' awareness of public green space positively influences attitude toward (γ = 0.163), as well as behavioral intention of (γ = 0.159), walking and cycling. Additionally, motivation (extrinsic and intrinsic) greatly influences attitude (γ = 0.539) and behavioral intention (γ = 0.535). Subjective norms (γ = 0.137) and positive (γ = 0.466) and negative anticipated emotions (γ = 0.225) have a significant impact on the desire that leads to behavioral intention. High and low perceived smart app usefulness also significantly moderates between public green space and attitude (t-value = 25.705), public green space and behavioral intention (t-value = 25.726), motivation and attitude (t-value = −25.561), and motivation and behavioral intention (t-value = −15.812). Consequently , the findings are useful to academics and practitioners by providing new knowledge and insights.
... Further investigation is needed in this regard. Nevertheless, previous literature found that moving to greener areas bring better health outcomes, particularly mental health and wellbeing (Alcock et al., 2014). ...
Thesis
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Background: While a legion of evidence indicates green spaces (e.g., parks) support health, there is a paucity of studies investigating their potential role in the development of prosocial behaviour (i.e., a range of behaviours that benefit others or promote positive relationships with others) across childhood and adolescence. The review of current evidence suggests that exposure to nearby green space may increase prosocial behaviour, but most of the evidence is cross-sectional, hindering causal inferences and understandings of temporality. Furthermore, most of this research has focused on the quantity of green space (i.e., the amount of green space available in the residential environment), neglecting the potentially critical importance of green space quality (i.e., aspects or attributes of green space that influence its utilisation) as a key determinant in its use and in the development of prosocial behaviour. Besides, candidate mediators and effect modifiers have not been comprehensively examined by previous studies, limiting understandings of plausible pathways and potential contingencies in who benefits. Therefore, research on green space quality and prosocial behaviour is important to improve the quality of current evidence and inform avenues on how to maximise the role of green space in shaping the development of prosocial behaviour. Enhancing the development of prosocial behaviour from a young age is important due to health, psychological, and social benefits. Aims: This PhD thesis primarily aimed to examine the longitudinal association between green space quality and prosocial behaviour among children and adolescents. This thesis also investigated whether the accumulation of, or changes in, green space quality during childhood and adolescence were associated with the development of prosocial behaviour. Potential effect modifiers of the association and plausible pathways in which green space quality may influence prosocial behaviour were also assessed. In addition, the potential role of prosocial behaviour as a missing link – a candidate mediating variable – on the causal chain from green space quality to child health-related outcomes was tested. Methods: This thesis used 10-year longitudinal data retrieved from the K-cohort of the Longitudinal Study of Australian Children. Data pertaining to green space quality, child prosocial behaviour, health-related outcomes (mental health, physical activity, and health-related quality of life (HRQOL)), and socioeconomic measures were biennially recorded from 4,983 children for a 10-year period, from 2004 (children aged 4-5 years: Wave 1) to 2014 (14-15 years: Wave 6). Green space quality was measured using caregiver reports on the availability of good parks, playgrounds, and play spaces in the neighbourhood. Caregivers also evaluated their child’s prosocial behaviour using the prosocial subscale from the Strengths and Difficulties Questionnaire (SDQ). Multilevel linear regression was applied to assess the association between green space quality and prosocial behaviour. Trajectories in green space quality experienced across childhood and adolescence were examined using latent class analysis. Causal mediation analysis was used to identify mechanistic pathways between green space quality and prosocial behaviour, as well as to test prosocial behaviour as a candidate mediator of the associations between green space quality and child health-related outcomes. Results: The presence of quality neighbourhood green space was positively associated with child prosocial behaviour, irrespective of residential relocation. In addition, children whose caregiver perception of green space quality was ‘very good’ over time, trended from ‘good’ to ‘very good’ or from ‘very good’ to ‘good’ had higher prosocial behaviour than children of caregivers who consistently perceived nearby green space as low in quality. Evidence also indicated that the accumulation of very good quality green space over time may attenuate socioeconomic inequalities in prosocial behaviour. The association between green space quality and prosocial behaviour was found to be stronger among boys, children speaking only English at home, and children living in more affluent and/or remote areas. Moreover, physical activity enjoyment, social interaction, child and caregiver mental health, and HRQOL served as mechanistic pathways in which green space quality influenced prosocial behaviour. Prosocial behaviour was found as a mediator of the associations between green space quality and child health (mental health, HRQOL), and physical activity enjoyment. Conclusions: The findings indicate that policies on provisioning and maintaining the quality of green space across childhood and adolescence in a targeted manner (e.g., prioritised in more disadvantaged and remote areas) can potentially buffer the negative impact of growing up in unfavourable socioeconomic circumstances and foster the development of prosocial behaviour. Improving the quality of neighbourhood green space that also encourages social interactions, physical activity enjoyment, and mental health might provide better support for the development of prosocial behaviour and vice versa. In addition, ensuring the neighbourhood to be safe and friendly for ethnic minorities is vital as it removes impediments to such populations gaining benefits from quality green space. Furthermore, identifying attributes of quality green space suitable for both boys and girls, and children from different age groups forms an important next step to maximise the benefits of quality green space for all.
... Greenness surrounding home addresses is often used in research to characterize the general greenness exposure of the study subjects. A number of health benefits of greenness exposure have been reported including reduced obesity (Kondo et al., 2018;Lachowycz & Jones, 2014), improved cardiovascular health (Donovan et al., 2013;Pereira et al., 2012;Seo et al., 2019), improved mental health (Alcock et al., 2014;Gascon et al., 2015;Engemann, et al., 2020a;Engemann, et al., 2020b;Engemann et al., 2021), boosted immune system (Li et al., 2008;Egorov et al., 2017;Rook, 2013) and improved birth outcomes (Hystad et al., 2014). Several ecological and crosssectional studies have provided evidence on the association of greenness with reduced premature mortality (Hu et al., 2008;Jonker et al., 2014;Lachowycz & Jones, 2014;Mitchell & Popham, 2008;Richardson & Mitchell, 2010). ...
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Background The majority of studies has shown higher greenness exposure associated with reduced mortality risks, but few controlled for spatially correlated air pollution and traffic noise exposures. We aim to address this research gap in the ELAPSE pooled cohort. Methods Mean Normalized Difference Vegetation Index (NDVI) in a 300-m grid cell and 1-km radius were assigned to participants’ baseline home addresses as a measure of surrounding greenness exposure. We used Cox proportional hazards models to estimate the association of NDVI exposure with natural-cause and cause-specific mortality, adjusting for a number of potential confounders including socioeconomic status and lifestyle factors at individual and area-levels. We further assessed the associations between greenness exposure and mortality after adjusting for fine particulate matter (PM2.5), nitrogen dioxide (NO2) and road traffic noise. Results The pooled study population comprised 327,388 individuals who experienced 47,179 natural-cause deaths during 6,374,370 person-years of follow-up. The mean NDVI in the pooled cohort was 0.33 (SD 0.1) and 0.34 (SD 0.1) in the 300-m grid and 1-km buffer. In the main fully adjusted model, 0.1 unit increment of NDVI inside 300-m grid was associated with 5% lower risk of natural-cause mortality (Hazard Ratio (HR) 0.95 (95% CI: 0.94, 0.96)). The associations attenuated after adjustment for air pollution [HR (95% CI): 0.97 (0.96, 0.98) adjusted for PM2.5; 0.98 (0.96, 0.99) adjusted for NO2]. Additional adjustment for traffic noise hardly affected the associations. Consistent results were observed for NDVI within 1-km buffer. After adjustment for air pollution, NDVI was inversely associated with diabetes, respiratory and lung cancer mortality, yet with wider 95% confidence intervals. No association with cardiovascular mortality was found. Conclusions We found a significant inverse association between surrounding greenness and natural-cause mortality, which remained after adjusting for spatially correlated air pollution and traffic noise.
Chapter
The study aims to guide the assisted living facility (ALF) design, in which biophilic design, which is observed to have positive physiological, psychological, and sociological effects on humans, is observed, and the principle of universal design is accessible and designed for everyone. Since there is no place called a biophilic ALF, the study is supported by a nature-oriented design method called Green Building Rating Tools. Green building certificate systems are explored in terms of biophilic and universal design, and three of the certifications show credits linked to the theories researched. With these certificates, green building certified ALFs located in the same region are selected. With the methodology applied on the case studies of three ALFs that received these certificates, how and where biophilic and universal design patterns can be transferred from theory to practice has been examined. The study observed the extent of 14 biophilic design patterns in ALFs and tabulated how to find each pattern in these facilities according to the methods and places.
Article
Background Outdoor swimming is increasingly popular, with enthusiasts claiming benefits to mental health. However, there is limited research into its effectiveness as an intervention for people with depression and/or anxiety. We aimed to establish recruitment rates and explore potential benefits, for a sea swimming course offered to people with depression and/or anxiety. Methods This was a singlearm, unblinded feasibility study. 61 participants, were recruited to an eight-session sea-swimming course. Attendance rates were recorded. Self-administered questionnaires were completed at baseline, post-course and at three-month follow-up. Free-text descriptions of thoughts about the course were collected using surveys, and 14 participants kept a diary. Results 53 participants (47 female, 5 male, 1 non-binary) were included in the final analysis. Overall attendance was 90.1%. There were reductions showing large effect (between d = 1.4 to 1.7) in the severity scores of both depression and anxiety between the beginning and end of the course. While severity scores marginally increased at three-month follow-up, a reduction from baseline scores for depression, anxiety (d = 1.2 and 1.4, respectively) and functioning scores (d = 0.8) remained. The qualitative analysis identified that ‘confronting challenges', ‘becoming a community’ and ‘appreciating the moment’ were key to the impact, or the 'mechanisms', that resulted in participants experiencing the 'outcomes' of ‘immediate positive changes in mood’, ‘improved mental and physical health’ and ‘increased motivation to swim’. Conclusions This study provides preliminary support for the engagement and acceptability of sea swimming as a novel intervention for depression and/or anxiety. Participants reported positive changes in mental health, indicating the intervention's potential as a public health resource. There was a clear gender difference, which requires further exploration. Larger scale trials are warranted.
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El artículo presenta las iniciativas de mitigación y adaptación al cambio climático adoptadas por las ciudades del sur global que forman parte de la red municipal transnacional C40. Las propuestas son de una amplia diversidad, siendo el mayor número en el área de la energía, la movilidad, los residuos y el urbanismo. Todas ellas han sido impulsadas desde el C40 como áreas prioritarias para la acción climática, lo que muestra la influencia de este tipo de redes en la gobernanza climática global. The paper presents the climate change mitigation and adaptation initiatives adopted by cities from the global South that are part of the transnational municipal network C40. The proposals are very diverse, the most numerous being in the fields of energy, mobility, waste and urban planning. All of these areas have been promoted by the C40 as priority for climate action, showing the influence of this type of networks on global climate governance.
Article
We study the effect of urbanicity (metro v nonmetro) on life satisfaction, or Subjective WellBeing (SWB). The literature agrees that residents of metropolitan areas tend to be less satisfied with their lives than residents of smaller settlements in the developed world. But the existing evidence is cross-sectional only. This is the first study using longitudinal dataset to test the “unhappy metro” hypothesis. Using the 2009–2019 US Panel Study of Income Dynamics (PSID), we find support for the cross-sectional findings: metros are less happy than nonmetros. The effect size is practically significant, the negative effect of metro v nonmetro is equivalent to the effect of one’s health deteriorating about a third from “fair” to “poor.” Given extremely large scale of urbanization, projected 6b of people from 1950 to 2050, the combined effect of urbanicity on human wellbeing is large.
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Background: Coronary artery disease (CAD) is one of the crucial reasons for cardiovascular mortality in middle-aged people worldwide. The most typical tool is angiography for diagnosing CAD. The challenges of CAD diagnosis using angiography are costly and have side effects. One of the alternative solutions is the use of machine learning-based patterns for CAD diagnosis. Methods: Hence, this paper provides a new hybrid machine learning model called genetic support vector machine and analysis of variance (GSVMA). The analysis of variance (ANOVA) is known as the kernel function for the SVM algorithm. The proposed model is performed based on the Z-Alizadeh Sani dataset so that a genetic optimization algorithm is used to select crucial features. In addition, SVM with ANOVA, linear SVM (LSVM), and library for support vector machine (LIBSVM) with radial basis function (RBF) methods were applied to classify the dataset. Results: As a result, the GSVMA hybrid method performs better than other methods. This proposed method has the highest accuracy of 89.45% through a 10-fold crossvalidation technique with 31 selected features on the Z-Alizadeh Sani dataset. Conclusion: We demonstrated that SVM combined with genetic optimization algorithm could be lead to more accuracy. Therefore, our study confirms that the GSVMA method outperforms other methods so that it can facilitate CAD diagnosis.
Conference Paper
La metrología o más conocida como ciencia de las mediciones tiene sus bases en el conocimiento de la investigación y el desarrollo, dentro del sistema de producción ésta lleva a cabo un papel importante; sin embargo, los fabricantes locales enfrentan un problema de rentabilidad. Por otra parte, la ecología Industrial es una disciplina que promueve revertir las problemáticas industriales internacionalizando impactos y a su vez controlándolos. Este articulo tiene como objetivo determinar la influencia de la metrología en el logro de los objetivos de desarrollo sustentable (ODS), así como proponer y caracterizar un sistema de aseguramiento metrológico (SAM) y de calidad conforme a las necesidades poblacionales relacionadas con salud pública, seguridad y medio ambiente.
Conference Paper
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Today, cities, especially cities in developing countries, are involved with many issues and problems, including mental illnesses. Correcting these diseases requires attention and spending a lot of time and money. But so far no study has been done in this direction. For this purpose, this research has been done with the aim of explaining the strategies for improving urban mental health. The research method in this research is review and library methods are used to collect data. The findings of the research indicate the identification of strategies for holding mental health promotion workshops, improving access to mental health services, improving the lighting of houses and urban spaces, improving the access and quality of green spaces, compiling and implementing a comprehensive plan for mental health, urban design promoting mental health, reducing waste. time and pressure of time on citizens, promotion of urban therapeutic gardening, control of population density and building density, promotion of urban resilience, promotion of identity and sense of belonging to the city, revival of cultural and religious rituals, promotion of social support and reduction of social deprivation, activities at the time of separation, Promoting local integration, promoting people's control over the environment, applying the principles of smart growth and neo-urbanism, not using outdated styles such as modern style, reducing economic deprivation, reducing pollution in urban environments, promoting justice, encouraging proper diet and reducing malnutrition, promoting diversity in The urban environment and the implementation of urban improvement strategies. As a result, by applying these solutions, the mental health of citizens can be significantly improved.
Article
Introduction: This paper explores how the built environment impacts upon health and well-being and suggests that there are opportunities for more integrated working between professionals and citizens to create healthier, happier places. Sources of data: Policy and practice guidance is presented from the urban planning and design fields. Evidence and data are presented from a range of disciplines on housing, green infrastructure and mental well-being. Areas of agreement: There is an overwhelming agreement around the principles and rationale of incorporating health in planning and design processes. Areas of controversy: These principles are not always implemented in practice. Challenges also exist around how different disciplines create and use evidence. Growing points: More innovative ways of working which incorporates health, public health, planners, designers and citizens, which responds to the needs of communities, should be tested. Areas timely for developing research: Health and public health professionals can contribute to the evidence base using objective measures to assess the impact of the built environment on mental health and well-being.
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The use of urban green spaces (UGS) depends on its quality, which is perceived very differently by diverse socio-demographic groups. In particular, elderly people have special demands on the UGS quality. It is essential to know these demands to create an equitable UGS supply. We present an approach to determining some qualitative aspects and the supply of cultural ecosystem services of diverse forms of UGS. This is realised by combining user demands with actual UGS features. In a concrete example, we assessed the UGS quality and supply for both the general population and the subset of elderly people. For the latter group, the activities of relaxing and observing nature, as well as the UGS feature of benches, were found to be significantly more important than for the general population. Nevertheless, this had only a minor impact on the assessed aspects of UGS quality and supply, with little differences detected between the two groups. In Dresden (Germany), we determined that almost half of the elderly population are not provided with high-quality UGS. In these areas, urban planning must increase the UGS quality while taking user demands into account to ensure just access to the positive benefits of UGS for the elderly.
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The subject matter of the article is the effect of a visual stimulation in the form of visual environment formed by dynamic laser images with preset fractality parameters on human. The structural and restorative characteristics of this environment are similar to those of the natural visual environment known for its restorative properties: it reduces the level of loading of sensory systems, recovers functional (general) state of humans, etc. Such analogue environment is formed using a laser optoelectronic RGB device designed with a non-conventional optical element, which transforms the structure of light beams from sources of radiation into an abstract light field with fractal dimensions of D = 1.3–1.5 optimal for perception, which is a positive criterion of evaluation of correspondence between this field and the natural visual environment. To estimate the level of the effect of the visual analogue environment, the electroencephalography (EEG) method was used which is based on analysis of activity of human brain α rhythm related to relaxed wakeful state. The estimation demonstrated that the proposed visual stimulation causes a valid positive effect as a light therapy instrument. The obtained percentage data on the difference between median values of α rhythm power in 18 derivations before and after the visual stimulation has demonstrated increase of α rhythm power by 40 % as compared to the baseline level. Minimal growth was equal to 17.8 % which corresponds to parietal derivation P3-A1 whereas the maximum growth was 51.4 % and corresponded to the mid-temporal derivation T4-A2. Also valid reductions of systolic and diastolic blood pressure (BP) and cardiac rate (CR) by 8.5 % and 10 % respectively were observed. The obtained data are indicative of reduction of anxiety level, unloading of sensory systems and positive dynamics of the effect of dynamic laser images on human functional state. The statistical analysis confirms validity of the positive dynamics of α rhythm power, BP and CR changes.
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Humanity faces an unprecedented existential threat from climate instability and global temperature rise caused by human activities, most notably the emission of greenhouse gases from combustion of fossil fuels. The threat to human health from climate instability has been called the greatest of the 21st century.4 New York State does not escape this threat. The Medical Society of the State of New York acknowledges that immediate action is needed to prevent catastrophic health effects related to climate instability.4 Physicians must warn society and advocate for protecting the health of our patients and communities. The pandemic of SARS CoV2 has revealed many weaknesses in our ability to meet large scale disasters that must be rapidly addressed if New York is to meet the challenges posed by climate change. The Medical Society of the State of New York (MSSNY) presents this white paper to guide stakeholders including physicians, MSSNY members, healthcare organizations, community members, policy makers and legislators on actions needed to protect the health of New Yorkers. This paper focuses on direct (e.g., injuries/deaths) and indirect (e.g., reduced nutrients in crops) health effects driven by fossil fuel combustion and climate instability. We address: 1) the evidence for global warming and climate instability; 2) the observed and projected environmental changes in New York State; 3) the observed and projected health and safety consequences of these changes; and 4) recommendations to mitigate, adapt and protect New Yorkers from climate change. The path ahead will stress the health sector in unprecedented ways, yet solutions bring profound opportunities to provide immediate benefits—if New York State converted to 100% renewables, reductions in air pollution would save 4000 lives and $33 billion annually in health care costs.7 Therefore, we also highlight the specific and immediate health benefits from reducing greenhouse gas emissions. MSSNY aligns with climate science experts who have sounded the alarm—the threats to New York are profound and time is limited. Climate instability is already hurting New Yorkers and will continue to do so for decades to come even with aggressive reductions in emissions. We therefore make specific calls to action by key stakeholders to protect all New Yorkers, especially the most vulnerable. The silver lining is that—if everyone acts—we will see immediate health benefits. The challenges ahead cannot be met by the medical community alone. Every sector of society must come together to create a unified and sustained response to the looming threats. MSSNY therefore recommends that governmental and non-governmental leaders join with the medical and scientific communities to combat global warming and to create a healthier, safer environment for all New Yorkers.
Conference Paper
Üniversiteler, konumlandıkları kenti öğrencileştirmekte ve sosyo-ekonomik ve mekânsal boyutlarda kentin gelişimi üzerinde etkileşimler yaratmaktadır. Öğrencileşen kentler arasında öğrenci nüfusu artışı barınma ihtiyacı-konut sorunu etkileşimin en tipik örneklerinden biride Uşak Üniversitesi’nin içinde yer seçtiği Uşak Kenti’dir. Uşak Üniversitesi, 2006 yılında 4 fakülte 5 meslek yüksekokulu ile Afyon Kocatepe Üniversitesi’nden ayrılarak, ayrı bir üniversite olarak kurulmuştur. 2011 yılından önce 9.704 öğrencisi bulunan üniversite, 2011 yılı itibariyle izlenen gelişim stratejisi çerçevesinde yeni açılan fakülte, yüksek okul ve bölümleri ile önemli bir kırılma noktası yaşamış ve öğrenci sayısı 22.145’e ulaşarak %128,2 artmıştır. 2011 yılından sonra da ortalama 4000-5000 öğrenci artışı daha gerçekleştirmiştir. Bugün öğrenci sayısı 26.466’dır. TÜİK’e göre nüfusu 20.000’i aşan yerleşmelerin kent sayıldığı düşünüldüğünde, Uşak Üniversitesi öğrenci nüfusu ile bir kent büyüklüğüne ulaşmıştır. Üniversite, Uşak Kenti’ni öğrencileştirmektedir. Bu hızlı nüfus artışının barınma ihtiyacına koşut olacak şekilde konut üretimi gerçekleştiremeyen ve hazırlıksız yakalanan kent ise, konut sorunu ile karşı karşıya kalmıştır. Bu çalışmada, öğrencileşen bir kentte yaşanmakta olan/ortaya çıkan konut sorunu, üniversitenin nüfus değişiminin kente etkisi, üretilen konut miktarlarındaki değişimler, nüfus değişimlerinin üretilen konut miktarlarına etkisi, bu etkileşim sonucunda yeni konut alanlarının oluşum durumu/düzeyi ve mevcut yerleşik konut dokusunda yaşanan değişimler çerçevesinde ele alınmaktadır. Öğrencileşen kentlerde konut sorunu etken-neden belirleyicileri ile birlikte değerlendirilerek tanımlanmakta ve ortaya konulmaktadır. Anahtar Kelimeler: Yeni Kurulan Üniversiteler, Öğrenci Nüfusu, Öğrencileşen Kent, Barınma Gereksinimi, Konut Sorunu.
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Opioid consumption, both legal and illicit, has risen precipitously in the past few decades in the U.S., as has the number of deaths due to the use and misuse of opioids. Exposure to green spaces might help to alleviate the problematic levels of opioid use, as such exposure has been tied to health benefits relevant to opioid use. To explore the potential influence of green space on opioid-related health outcomes, we analyzed the association between the density of tree canopy cover and mortality attributable to opioid use and abuse using 2008 to 2018 death rate data on a county level (n = 3087) across the lower 48 United States. We fitted spatial general additive model while controlling for socioeconomic factors, healthcare access measures, opioid prescription rates, and particulate air pollution. We found a significant positive association between tree canopy cover and opioid mortality. A sensitivity analysis with forest land cover showed similar results, and a that with total greenness was inconclusive. Suburban and rural counties were found to drive the national results in a stratified analysis. These findings are unexpected, given the myriad health benefits of green spaces and highlight the need for further research on the matter, especially in studies with individual-level data. Entities with responsibility or interest in reducing the incidence of deaths from opioids are cautioned that green spaces might not be a viable answer as they are in improving other health outcomes.
Article
“Green space” effects on health have been amply demonstrated, but whether specific features of green space exert differential effects remains unknown. Driven by developmental psychology theory highlighting the importance of play for young children, we investigated the association between parks with playgrounds, as a subtype of “green space”, and young child mental health. After adjusting for individual race, sex, income, and cumulative risk as well as neighborhood disadvantage, we find that children (N = 95) living near parks with playgrounds have better mental health than those near parks without playgrounds (β̂ = −1.22 (95% CI: −3.82–1.38, p = 0.36) Child Behavior Checklist scale). While not statistically significant, the observed difference, which is equivalent to 11% of the baseline mean score, is meaningful. Our results, while only suggestive, indicate that moving beyond “green space” to investigate developmentally-specific features may be worthwhile.
Article
Urban green spaces and the biodiversity therein have been associated with human health and well-being benefits, but the contribution of domestic gardens to those benefits is insufficiently known. Using data from a cross-sectional sample (n = 587) of domestic garden owners in Flanders and Brussels (northern Belgium), associations between residential green space quality in and around domestic gardens, green space related activities and socioeconomic background variables of the gardeners, and self-reported health (stress and depression) were investigated with structural equation models. Socioeconomic security was associated with lower stress and depression. Nature relatedness and green space in the neighbourhood of the house were associated with higher exposure to green space, which was in turn negatively associated with stress and depression. Garden quality, indicated by biodiversity values and size, and nature relatedness were associated with being active in the garden, which was in turn associated with lower values of depression, but not stress. Nature relatedness seems to play a key role in the pathway linking gardens to improved health. Improving biodiversity and ecosystems services in gardens may increase exposure to green space and help to restore and enhance nature relatedness. This, in turn, could potentially improve human health and well-being, and contribute to the conservation of biodiversity in urban environments.
Chapter
One of the first times the effect of nature on stress relief was investigated, the results were so remarkable that the top journal Science devoted space to them. The study, published in 1984, showed that American patients who had undergone gall bladder surgery recovered faster when they could see a tree from their hospital window than when they could only see a blank wall. In 2003, in the Netherlands, one of the first epidemiological studies was conducted in which the amount of green space in the residential environment was objectively assessed and shown to be related to the health of residents. This chapter provides an overview of more recent research on the relation between nature in cities and the health and well-being of their inhabitants. Implications of the available knowledge for urban planning and design are discussed.
Article
Introduction Greenery in the residential environment and in the hospital has been associated with improved surgical outcomes and recovery. We investigated the association between the level of residential greenness of patients with coronary disease and their heart disease-related Quality of Life (HRQoL) 1-year after a coronary artery bypass grafting (CABG) surgery. Methods Participants in a prospective cohort study who underwent CABG surgery at seven cardiothoracic units throughout Israel during the years 2004–2007 filled in the MacNew HRQoL one day before and one year after surgery. Successful recovery was defined as ≥0.5 increase in the MacNew score between baseline and follow-up. Exposure to residential greenness in 90 m and 300 m buffers around the patient's home was assessed with Linear Spectral Unmixing analysis of Landsat 30 m imagery. Results The cohort comprised of 861 patients (22% female) with a mean age of 65.5 years, and 59.2% classified as low-income. In the total cohort, higher residential greenness was associated with an improvement in emotional HRQoL (OR = 1.33 (95%CI: 0.99–1.79)), adjusting for demographic and socio-economic factors, living in the periphery/center, presence of diabetes, attending cardiac rehabilitation following surgery, BMI, and change in physical fitness and depression over the 1-year follow-up. Although no association was found between greenness and change in the physical or social subscales, a positive association was specifically observed among the low-income patients for the global HRQoL score, OR = 1.42 (95%CI: 0.97–2.10), as compared to the higher-income patients, p for interaction = 0.03. Conclusions Residential greenness is associated with improvement in HRQoL 1-year after CABG surgery, but not the physical and social scales, only in low-income patients. Ensuring greenery in the living environment may act as a social intervention that supports human health and disease recovery.
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The aim of this thesis study is to propose a method that will set an example for all cities, and that will enable the multi-storey mass housing structures in the city of Ankara to be produced with living spaces more related to nature and to contribute positively to the existing urban environment. In order to achieve this aim, the historical process of the production of "housing" and "open and green spaces in buildings" in cities around the world and in Ankara has been examined in detail from technical and theoretical perspectives. Following this examination, the open and green spaces system in low-density city settlements was used as an example model, and a theoretical idea was developed to produce an open and green spaces system that could be included in the multi-storey mass housing buildings in the city of Ankara. The theoretical idea developed was applied on three multi-storey mass housing examples in Ankara, and the open and green spaces system proposal for multi-storey mass housing structures in the city of Ankara was revealed as a finding. Then, the system that emerged as a finding was examined and compared with the components that make up the open and green spaces system in low-density city settlements and selected examples in cities around the world. Subsequently, the changes that need to be made in the design method while the system in question was put into practice were revealed. As a final step, changes that need to be made in the field of legislation and policy proposals that need to be developed in order to put all these studies into practice were put forward. As a result, the effects of the emerged open and green spaces system on nature and people were evaluated. As a result of the evaluation, it has been observed that the system in question has revealed the potential to create positive effects on nature and people, which can be a turning point.
Article
We carried out a longitudinal study on the associations between residential greenness and depression risk in urban areas in Finland. Residential greenness indicators were estimated within various buffer sizes around individuals' home locations (selected n = 14424) using time-series of normalized differential vegetation index (NDVI) and CORINE land cover data (CLC). We estimated individuals’ cumulative exposure to residential greenness over a 5-years and 14-years follow-up. We used doctor-diagnosed depression and Beck Depression Inventory for depression assessment. Our multi-logistic model showed an inverse association between residential greenness and depression, implying lowered depression risk for individuals with higher residential greenness. The association was particularly evident when using NDVI-based residential greenness (within a buffer of 100 m radius) and doctor-diagnosis depression data, adjusted with individual-level covariates. The odds ratio was 0.56 (95% CI 0.33 to 0.96) for the 5-years follow-up, and 0.54 (95% CI 0.30 to 0.98) for the 14-years follow-up. The associations between CLC-based total residential green space and depression varied across the different buffer sizes. In general, all the associations depended on the type of depression assessment, quality of greenness indicators, and the spatial scale of analysis. The associations also varied across the socio-demographic groups and neighborhood socioeconomic disadvantage level.
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Background: Although a number of environmental and policy interventions to promote physical activity are being widely used, there is sparse systematic information on the most effective approaches to guide population-wide interventions. Methods: We reviewed studies that addressed the following environmental and policy strategies to promote physical activity: community-scale urban design and land use policies and practices to increase physical activity; street-scale urban design and land use policies to increase physical activity; and transportation and travel policies and practices. These systematic reviews were based on the methods of the independent Task Force on Community Preventive Services. Exposure variables were classified according to the types of infrastructures/policies present in each study. Measures of physical activity behavior were used to assess effectiveness. Results: Two interventions were effective in promoting physical activity (community-scale and street-scale urban design and land use policies and practices). Additional information about applicability, other effects, and barriers to implementation are provided for these interventions. Evidence is insufficient to assess transportation policy and practices to promote physical activity. Conclusions: Because community- and street-scale urban design and land-use policies and practices met the Community Guide criteria for being effective physical activity interventions, implementing these policies and practices at the community-level should be a priority of public health practitioners and community decision makers.
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This review summarizes the current meta-analysis literature on treatment outcomes of CBT for a wide range of psychiatric disorders. A search of the literature resulted in a total of 16 methodologically rigorous meta-analyses. Our review focuses on effect sizes that contrast outcomes for CBT with outcomes for various control groups for each disorder, which provides an overview of the effectiveness of cognitive therapy as quantified by meta-analysis. Large effect sizes were found for CBT for unipolar depression, generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, posttraumatic stress disorder, and childhood depressive and anxiety disorders. Effect sizes for CBT of marital distress, anger, childhood somatic disorders, and chronic pain were in the moderate range. CBT was somewhat superior to antidepressants in the treatment of adult depression. CBT was equally effective as behavior therapy in the treatment of adult depression and obsessive-compulsive disorder. Large uncontrolled effect sizes were found for bulimia nervosa and schizophrenia. The 16 meta-analyses we reviewed support the efficacy of CBT for many disorders. While limitations of the meta-analytic approach need to be considered in interpreting the results of this review, our findings are consistent with other review methodologies that also provide support for the efficacy CBT.
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Green space has been associated with a wide range of health benefits, including stress reduction, but much pertinent evidence has relied on self-reported health indicators or experiments in artificially controlled environmental conditions. Little research has been reported using ecologically valid objective measures with participants in their everyday, residential settings. This paper describes the results of an exploratory study (n = 25) to establish whether salivary cortisol can act as a biomarker for variation in stress levels which may be associated with varying levels of exposure to green spaces, and whether recruitment and adherence to the required, unsupervised, salivary cortisol sampling protocol within the domestic setting could be achieved in a highly deprived urban population. Self-reported measures of stress and general wellbeing were also captured, allowing exploration of relationships between cortisol, wellbeing and exposure to green space close to home. Results indicate significant relationships between self-reported stress (P < 0.01), diurnal patterns of cortisol secretion (P < 0.05), and quantity of green space in the living environment. Regression analysis indicates percentage of green space in the living environment is a significant (P < 0.05) and independent predictor of the circadian cortisol cycle, in addition to self-reported physical activity (P < 0.02). Results also show that compliance with the study protocol was good. We conclude that salivary cortisol measurement offers considerable potential for exploring relationships between wellbeing and green space and discuss how this ecologically valid methodology can be developed to confirm and extend findings in deprived city areas to illuminate why provision of green space close to home might enhance health.
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This paper describes the design of the sample for Understanding Society. The sample consists of five components. The largest component is a newly-selected general population sample. The other four components are an ethnic minority boost sample, a general population comparison sample, the ex-BHPS (British Household Panel Survey) sample, and the innovation panel sample. For each component, the paper outlines the design and explains the rationale behind the main features of the design.
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The question of whether there is a connection between income and psychological well-being is a long-studied issue across the social, psychological, and behavioral sciences. Much research has found that richer people tend to be happier. However, relatively little attention has been paid to whether happier individuals perform better financially in the first place. This possibility of reverse causality is arguably understudied. Using data from a large US representative panel, we show that adolescents and young adults who report higher life satisfaction or positive affect grow up to earn significantly higher levels of income later in life. We focus on earnings approximately one decade after the person's well-being is measured; we exploit the availability of sibling clusters to introduce family fixed effects; we account for the human capacity to imagine later socioeconomic outcomes and to anticipate the resulting feelings in current well-being. The study's results are robust to the inclusion of controls such as education, intelligence quotient, physical health, height, self-esteem, and later happiness. We consider how psychological well-being may influence income. Sobel-Goodman mediation tests reveal direct and indirect effects that carry the influence from happiness to income. Significant mediating pathways include a higher probability of obtaining a college degree, getting hired and promoted, having higher degrees of optimism and extraversion, and less neuroticism.
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Europe is a highly urbanised continent. The consequent loss and degradation of urban and peri-urban green space could adversely affect ecosystems as well as human health and well-being. The aim of this paper is to formulate a conceptual framework of associations between urban green space, and ecosystem and human health. Through an interdisciplinary literature review the concepts of Green Infrastructure, ecosystem health, and human health and well-being are discussed. The possible contributions of urban and peri-urban green space systems, or Green Infrastructure, on both ecosystem and human health are critically reviewed. Finally, based on a synthesis of the literature a conceptual framework is presented. The proposed conceptual framework highlights many dynamic factors, and their complex interactions, affecting ecosystem health and human health in urban areas. This framework forms the context into which extant and new research can be placed. In this way it forms the basis for a new interdisciplinary research agenda.
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Green exercise is activity in the presence of nature. Evidence shows it leads to positive short and long-term health outcomes. This multistudy analysis assessed the best regime of dose(s) of acute exposure to green exercise required to improve self-esteem and mood (indicators of mental health). The research used meta-analysis methodology to analyze 10 UK studies involving 1252 participants. Outcomes were identified through a priori subgroup analyses, and dose-responses were assessed for exercise intensity and exposure duration. Other subgroup analyses included gender, age group, starting health status, and type of habitat. The overall effect size for improved self-esteem was d = 0.46 (CI 0.34-0.59, p < 0.00001) and for mood d = 0.54 (CI 0.38-0.69, p < 0.00001). Dose responses for both intensity and duration showed large benefits from short engagements in green exercise, and then diminishing but still positive returns. Every green environment improved both self-esteem and mood; the presence of water generated greater effects. Both men and women had similar improvements in self-esteem after green exercise, though men showed a difference for mood. Age groups: for self-esteem, the greatest change was in the youngest, with diminishing effects with age; for mood, the least change was in the young and old. The mentally ill had one of the greatest self-esteem improvements. This study confirms that the environment provides an important health service.
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This study examines the association between objectively measured access to green space, frequency of green space use, physical activity, and the probability of being overweight or obese in the city of Bristol, England. Data from the 2005 Bristol Quality of Life in your Neighbourhood survey for 6821 adults were combined with a comprehensive GIS database of neighbourhood and green space characteristics. A range of green space accessibility measures were computed. Associations between accessibility and the odds of respondents achieving a recommended 30min or more of moderate activity five times a week, or being overweight or obese, were examined using logistic regression. Results showed that the reported frequency of green space use declined with increasing distance. The study also found that respondents living closest to the type of green space classified as a Formal park were more likely to achieve the physical activity recommendation and less likely to be overweight or obese. The association with physical activity, but not with overweight or obesity, remained after adjustment for respondent characteristics, area deprivation, and a range of characteristics of the neighbourhood environment. The findings suggest that the provision of good access to green spaces in urban areas may help promote population physical activity.
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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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Reviews of urban-rural differences in psychiatric disorders conclude that urban rates may be marginally higher and, specifically, somewhat higher for depression. However, pooled results are not available. A meta-analysis of urban-rural differences in prevalence was conducted on data taken from 20 population survey studies published since 1985. Pooled urban-rural odds ratios (OR) were calculated for the total prevalence of psychiatric disorders, and specifically for mood, anxiety and substance use disorders. Significant pooled urban-rural OR were found for the total prevalence of psychiatric disorders, and for mood disorders and anxiety disorders. No significant association with urbanization was found for substance use disorders. Adjustment for various confounders had a limited impact on the urban-rural OR. Urbanization may be taken into account in the allocation of mental health services.
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In recent years the 12-item General Health Questionnaire (GHQ-12) has been extensively used as a short screening instrument, producing results that are comparable to longer versions of the GHQ. The validity of the GHQ-12 was compared with the GHQ-28 in a World Health organization study of psychological disorders in general health care. Results are presented for 5438 patients interviewed in 15 centres using the primary care version of the Composite International Diagnostic Instrument, or CIDI-PC. Results were uniformly good, with the average area under the ROC curve 88, range from 83 to 95. Minor variations in the criteria used for defining a case made little difference to the validity of the GHQ, and complex scoring methods offered no advantages over simpler ones. The GHQ was translated into 10 other languages for the purposes of this study, and validity coefficients were almost as high as in the original language. There was no tendency for the GHQ to work less efficiently in developing countries. Finally gender, age and educational level are shown to have no significant effect on the validity of the GHQ. If investigators wish to use a screening instrument as a case detector, the shorter GHQ is remarkably robust and works as well as the longer instrument. The latter should only be preferred if there is an interest in the scaled scores provided in addition to the total score.
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People are generally unaware of the operation of the system of cognitive mechanisms that ameliorate their experience of negative affect (the psychological immune system), and thus they tend to overestimate the duration of their affective reactions to negative events. This tendency was demonstrated in 6 studies in which participants overestimated the duration of their affective reactions to the dissolution of a romantic relationship, the failure to achieve tenure, an electoral defeat, negative personality feedback, an account of a child's death, and rejection by a prospective employer. Participants failed to distinguish between situations in which their psychological immune systems would and would not be likely to operate and mistakenly predicted overly and equally enduring affective reactions in both instances. The present experiments suggest that people neglect the psychological immune system when making affective forecasts.
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According to adaptation theory, individuals react to events but quickly adapt back to baseline levels of subjective well-being. To test this idea, the authors used data from a 15-year longitudinal study of over 24.000 individuals to examine the effects of marital transitions on life satisfaction. On average, individuals reacted to events and then adapted back toward baseline levels. However, there were substantial individual differences in this tendency. Individuals who initially reacted strongly were still far from baseline years later, and many people exhibited trajectories that were in the opposite direction to that predicted by adaptation theory. Thus, marital transitions can be associated with long-lasting changes in satisfaction, but these changes can be overlooked when only average trends are examined.
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It is commonly believed that people adapt rather easily to noise. This article reviews the available research, finding little evidence that any adaptation occurs in community settings. Much of this research, however, is open to alternative interpretations. The present study, examining reactions to traffic noise from the opening of a major new highway, was designed to remedy many of the problems with previous research. The investigation incorporated both a repeated measures design (the same respondents were interviewed 4 and 16 months after the highway opening) and an independent groups design (separate groups were interviewed either 4 or 16 months after opening). In addition, a pre-opening interview was carried out with the repeated measures panel. There was no evidence of appreciable adaptation in self-reported noise effects, annoyance, or tendency to focus attention on the noise. Instead respondents became more pessimistic about their ability to adapt to noise as time went by.
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Objective To compare the effects on mental and physical wellbeing, health related quality of life and long term adherence to physical activity, of participation in physical activity in natural environments compared with physical activity indoors. Design Systematic review. Data sources Medline, Embase, Psychinfo, GreenFILE, SportDISCUS, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, Arts and Humanities Citation Index, Conference Proceedings Citation Index – Science and BIOSIS from inception to June 2010. Internet searches of relevant websites, hand searches of relevant journals and the reference lists of included papers and other review papers identified in the search. Methods Controlled trials (randomised and non-randomised) were included. Eligible trials compared the effects of outdoor exercise initiatives with those conducted indoors and reported on at least one physical or mental wellbeing outcome in adults or children. Screening of articles for inclusion, data extraction and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. Heterogeneity of outcome measures precluded formal meta-analysis. Results Eleven trials (833 adults) were included. Most participants (6 trials; 523 adults) were young students. Study entry criteria and methods were sparsely reported. All interventions consisted of a single episode of walking or running indoors with the same activity at a similar level conducted outdoors on a separate occasion. A total of 13 different outcome measures were used to evaluate the effects of exercise on mental wellbeing and four outcome measures were used to assess attitude to exercise. Most trials (n=9) showed some improvement in mental wellbeing on one or other of the outcome measures. Compared with exercising indoors, exercising in natural environments was associated with greater feelings of revitalisation and positive engagement, decreases in tension, confusion, anger and depression and increased energy. Participants reported greater enjoyment and satisfaction with outdoor activity and declared a greater intent to repeat the activity at a later date. None of the identified studies measured the effects of physical activity on physical wellbeing, or the effect of natural environments on exercise adherence. Conclusions The results show some promising effects on self-reported mental wellbeing immediately following exercise in nature which are not seen following the same exercise indoors. However, the interpretation and extrapolation of these finding is hampered by the poor methodological quality of the available evidence and the heterogeneity of outcome measures employed. The influence of these effects on the sustainability of physical activity initiatives also awaits investigation.
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UK policy interest in the health effects of the outdoors has grown rapidly in recent years. In parallel, the research community's effort to strengthen the evidence base for the relationships between the outdoors and health has also increased. However, little has been done to explore quantitative secondary public data sets conducted by government departments and agencies to improve the evidence base on understanding such links. This paper aims to provide an overview of potentially valuable secondary public data sets and to assess their relevance for adding to the existing evidence base on the health effects of the natural outdoors. The search identified 41 data sets dealing with the outdoors/outdoor use, health or both. Review results indicated that, due to their large scale, extensive coverage, and continuous or longitudinal nature, knowledge included in secondary public data sets could be a valuable addition to the current evidence base and provide useful baseline information for future studies. This paper also identifies some aspects of secondary public data which could be improved, establishing a stronger knowledge base for the health effects of the natural outdoors.
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This paper provides a self-contained introduction to the British Household Panel Survey (BHPS), concentrating on aspects relevant to analysis of the distribution of household income. I discuss BHPS design features and how data on net household income are derived. The BHPS net household income definition is modelled on that used in Britain�s official personal income distribution statistics (Households Below Average Income, HBAI). I show that cross-sectional BHPS distributions track corresponding HBAI ones relatively well over time.
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This study investigates whether the presence of green space can attenuate negative health impacts of stressful life events. Individual-level data on health and socio-demographic characteristics were drawn from a representative two-stage sample of 4529 Dutch respondents to the second Dutch National Survey of General Practice (DNSGP-2), conducted in 2000-2002. Health measures included: (1) the number of health complaints in the last 14 days; (2) perceived mental health (measured by the GHQ-12); and (3) a single item measure of perceived general health ranging from 'excellent' to 'poor'. Percentages of green space in a 1-km and 3-km radius around the home were derived from the 2001 National Land cover Classification database (LGN4). Data were analysed using multilevel regression analysis, with GP practices as the group-level units. All analyses were controlled for age, gender, income, education level, and level of urbanity. The results show that the relationships of stressful life events with number of health complaints and perceived general health were significantly moderated by amount of green space in a 3-km radius. Respondents with a high amount of green space in a 3-km radius were less affected by experiencing a stressful life event than respondents with a low amount of green space in this radius. The same pattern was observed for perceived mental health, although it was marginally significant. The moderating effects of green space were found only for green space within 3 km, and not for green space within 1 km of residents' homes, presumably because the 3-km indicator is more affected by the presence of larger areas of green space, that are supposed to sustain deeper forms of restoration. These results support the notion that green space can provide a buffer against the negative health impact of stressful life events.
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Are people living in greener areas healthier than people living in less green areas? This hypothesis was empirically tested by combining Dutch data on the self-reported health of over 10 000 people with land-use data on the amount of greenspace in their living environment. In the multilevel analysis we controlled for socioeconomic and demographic characteristics, as well as urbanity. Living in a green environment was positively related to all three available health indicators, even stronger than urbanity at the municipal level. Analyses on subgroups showed that the relationship between greenspace and one of the health indicators was somewhat stronger for housewives and the elderly, two groups that are assumed to be more dependent on, and therefore exposed to, the local environment. Furthermore, for all three health indicators the relationship with greenspace was somewhat stronger for lower educated people. Implications for policymaking and spatial planning are discussed briefly.
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Studies have shown that exposure to the natural environment, or so-called green space, has an independent effect on health and health-related behaviours. We postulated that income-related inequality in health would be less pronounced in populations with greater exposure to green space, since access to such areas can modify pathways through which low socioeconomic position can lead to disease. We classified the population of England at younger than retirement age (n=40 813 236) into groups on the basis of income deprivation and exposure to green space. We obtained individual mortality records (n=366 348) to establish whether the association between income deprivation, all-cause mortality, and cause-specific mortality (circulatory disease, lung cancer, and intentional self-harm) in 2001-05, varied by exposure to green space measured in 2001, with control for potential confounding factors. We used stratified models to identify the nature of this variation. The association between income deprivation and mortality differed significantly across the groups of exposure to green space for mortality from all causes (p<0.0001) and circulatory disease (p=0.0212), but not from lung cancer or intentional self-harm. Health inequalities related to income deprivation in all-cause mortality and mortality from circulatory diseases were lower in populations living in the greenest areas. The incidence rate ratio (IRR) for all-cause mortality for the most income deprived quartile compared with the least deprived was 1.93 (95% CI 1.86-2.01) in the least green areas, whereas it was 1.43 (1.34-1.53) in the most green. For circulatory diseases, the IRR was 2.19 (2.04-2.34) in the least green areas and 1.54 (1.38-1.73) in the most green. There was no effect for causes of death unlikely to be affected by green space, such as lung cancer and intentional self-harm. Populations that are exposed to the greenest environments also have lowest levels of health inequality related to income deprivation. Physical environments that promote good health might be important to reduce socioeconomic health inequalities.
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According to set-point theories of subjective well-being, people react to events but then return to baseline levels of happiness and satisfaction over time. We tested this idea by examining reaction and adaptation to unemployment in a 15-year longitudinal study of more than 24,000 individuals living in Germany. In accordance with set-point theories, individuals reacted strongly to unemployment and then shifted back toward their baseline levels of life satisfaction. However, on average, individuals did not completely return to their former levels of satisfaction, even after they became reemployed. Furthermore, contrary to expectations from adaptation theories, people who had experienced unemployment in the past did not react any less negatively to a new bout of unemployment than did people who had not been previously unemployed. These results suggest that although life satisfaction is moderately stable over time, life events can have a strong influence on long-term levels of subjective well-being.
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One of the famous questions in social science is whether money makes people happy. We offer new evidence by using longitudinal data on a random sample of Britons who receive medium-sized lottery wins of between 1000 pounds and 120,000 pounds (that is, up to approximately US$ 200,000). When compared to two control groups -- one with no wins and the other with small wins -- these individuals go on eventually to exhibit significantly better psychological health. Two years after a lottery win, the average measured improvement in mental wellbeing is 1.4 GHQ points.
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To determine the association between the percentage of greenspace in an area and the standardised rate of self-reported "not good" health, and to explore whether this association holds for areas exhibiting different combinations of urbanity and income deprivation. Cross-sectional, ecological study in England. All residents of England as at the 2001 Census. Age and sex standardised rate of reporting "not good" health status. A higher proportion of greenspace in an area was generally associated with better population health. However, this association varied according to the combination of area income deprivation and urbanity. There was no significant association between greenspace and health in higher income suburban and higher income rural areas. In suburban lower income areas, a higher proportion of greenspace was associated with worse health. Although, in general, higher proportion of greenspace in an area is associated with better health, the association depends on the degree of urbanity and level of income deprivation in an area. One interpretation of these analyses is that quality as well as quantity of greenspace may be significant in determining health benefits.