No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Research note: Urban street tree density and antidepressant prescription rates—A cross-sectional study in London, UK
Abstract
Growing evidence suggests an association between access to urban greenspace and mental health and wellbeing. Street trees may be an important facet of everyday exposure to nature in urban environments, but there is little evidence regarding their role in influencing population mental health. In this brief report, we raise the issue of street trees in the nature-health nexus, and use secondary data sources to examine the association between the density of street trees (trees/km street) in London boroughs and rates of antidepressant prescribing. After adjustment for potential confounders, and allowing for unmeasured area-effects using Bayesian mixed effects models, we find an inverse association, with a decrease of 1.18 prescriptions per thousand population per unit increase in trees per km of street (95% credible interval 0.00, 2.45). This study suggests that street trees may be a positive urban asset to decrease the risk of negative mental health outcomes.
... Eleven studies reported the temporal alignment between green space exposure and the outcome. Alignments ranged from one year (Taylor et al., 2015;Helbich et al., 2018) to six years in duration (Gidlow et al., 2016). Of these, three studies reported exposure within the outcome time measurement (Aerts, Dujardin, et al., 2020;Aerts et al., 2022;Chi et al., 2022), while one reported exposure after the outcome (Taylor et al., 2015) (Table S7). ...
... Alignments ranged from one year (Taylor et al., 2015;Helbich et al., 2018) to six years in duration (Gidlow et al., 2016). Of these, three studies reported exposure within the outcome time measurement (Aerts, Dujardin, et al., 2020;Aerts et al., 2022;Chi et al., 2022), while one reported exposure after the outcome (Taylor et al., 2015) (Table S7). ...
... Electronic health records (EHRs) were the most commonly used data sources. Six studies used questionnaires, while two used the Scotland Census dataset (Maantay and Maroko, 2015;Roberts, Irvine and McVittie, 2021), and one study each used the World Development Indicators (WDI) data (Anwar, Madni and Yasin, 2021), National Health Insurance (NHI) annual reports (Kabaya, 2020) and Greater London Authority data (Taylor et al., 2015). ...
Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature examining green space exposure and its associations with healthcare prescriptions and expenditures. We applied Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to search MEDLINE, Scopus, and Web of Science for observational studies published in English through May 6, 2023. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 26 studies that met the inclusion criteria and were included in our review. Among these, 20 studies (77 % of the total) showed beneficial associations of green space exposure with healthcare prescriptions or expenditures. However, most studies had risks of bias, and the overall strength of evidence for both outcomes was limited. Based on our findings and related bodies of literature, we present a conceptual framework to explain the possible associations and complex mechanisms underlying green space and healthcare outcomes. The framework differs from existing green space and health models by including upstream factors related to healthcare access (i.e., rurality and socioeconomic status), which may flip the direction of associations. Additional research with lower risks of bias is necessary to validate this framework and better understand the potential for green space to reduce healthcare prescriptions and expenditures.
... These findings are consistent with published research on the beneficial effects of trees on human health 12,[44][45][46][47][48][49][50][51][52][53][54][55][56] . In general, trees have been associated with reducing harms (excessive heat, air pollution, noise, ultraviolet radiation, crime), restoring capacities (effects on cognition and attention, mental health, mood, anxiety, psychophysiological stress and clinical outcomes), and building capacities (impacts on birth outcomes, immune system, active living, weight status, cardiovascular function, social cohesion) 12,44,45 . ...
... Similarly, in a cross-sectional study conducted in London, UK, Taylor and colleagues found that street tree density was lower in areas where smoking and antidepressant prescription rates were higher. Prescriptions for antidepressants were correlated with smoking levels, but the relationship between the number of trees and depression prescriptions persisted even after confounding variables were taken into account 50 . Strong evidence for the benefits of trees to human health can also be found in Donovan and colleagues' analysis of the consequences of city tree removal. ...
Green spaces have been shown to be beneficial to humans, but quantifying these benefits is a challenge for epidemiology. In this health impact assessment study, we exploit satellites to estimate for the whole of Italy the number of deaths that could be prevented in the 49 million adult population by greening residential areas. The exposure was assessed by calculating the normalized difference vegetation index at 10-m resolution within a 300-m distance from homes in 7904 municipalities. In this study we estimate, by achieving nationwide the level of residential greenness currently reached by the 25% of the population, a total of 28,433 (95% confidence interval: 21,400–42,350) preventable deaths and 279,324 (210,247–415,980) preventable years of life lost in Italy in 2022, representing the 5% of the total mortality burden. More green means fewer deaths, thus strong action is needed to increase the amount and accessibility of green spaces in all human settlements.
... Prior epidemiological studies on greenspace and antidepressants or depression diagnosis have mainly assessed aggregated area-level greenspace and area-level health outcomes, and not egocentric and individual body scale exposure and health, with variable findings. Some studies found links between higher levels of residential greenspace and lower depression rates (Gonzales-Inca et al., 2022;Sarkar, Webster, & Gallacher, 2018), and antidepressant medication rates (Helbich, Klein, Roberts, Hagedoorn, & Groenewegen, 2018;Marselle et al., 2020;Taylor, Wheeler, White, Economou, & Osborne, 2015), while other studies investigating general greenness or greenspace at the neighborhood, district or city level, observed no associations or mixed results for mental health outcomes, including medication prescriptions for mental health conditions (Astell-Burt, Navakatikyan, Eckermann, Hackett, & Feng, 2022;Roberts, Irvine, & McVittie, 2021;White et al., 2017). The variable findings across prior epidemiological studies may be due to methodological aspects, including greenspace assessments varying in the type of greenspace cover included and the level of aggregation and specificity of greenspace measures in relation to the individual's actual point of residence (use of area-level measures rather than being based on individual addresses)-which raises the modifiable areal unit problem and prevents evaluation of individual exposure in the immediate residential surroundings-as well as context, size and generalizability of study samples (Labib et al., 2020). ...
... However, this study included no data on individual exposures and health outcomes (Sarkar et al., 2018). Higher greenspace was associated with lower antidepressant redemptions at the municipality level in a Dutch study (n = 400 municipalities) (Helbich et al., 2018), and higher density of street trees around the home location (at 100 m buffer) was associated with lower antidepressant redemptions in the city of Leipzig, Germany (Marselle et al., 2020) and in London, where boroughs with more street trees had lower antidepressant dispense rates at the borough level (Taylor et al., 2015). However, some epidemiological studies did not find beneficial associations between residential greenspace and affective health outcomes (Astell-Burt et al., 2022;Roberts et al., 2021;White et al., 2017). ...
... With 70% of the world's population living in urban areas by 2050 (United Nations, 2014), more efforts are needed to address this problem. UGS's role in promoting mental health has been widely acknowledged, including contributing to positive moods [9][10][11], restoring attention [12,13], recovering from stresses [1,[14][15][16], and reducing depression [17,18]. For example, a study involving 9186 nursing homes found elderly residents who lived in nursing homes with more surrounding green coverage had fewer depression symptoms [17]. ...
... As shown in Figure 4b, elderly people have higher restoration means (symbol "×") than young people. For example, for the lawn, the perceived restorations are 8.09 (age 50+) > 6.61 (age 26-50) > 5.87 (age [18][19][20][21][22][23][24][25]. These results indicated that elderly people generally receive higher restoration from small urban open spaces, which is consistent with current studies. ...
Small urban open spaces are critical components of high-density urban environments, and could bring multiple health benefits. However, the factors related to the restorative effect of these small urban open spaces are not well studied. This study explored how site type (lawn, water, and plaza) and spatial scales (10 × 10 m, 20 × 20 m, 30 × 30 m, and 40 × 40 m) might be associated with small urban open space’s restorative effects. We created the virtual scene images of the 12 sites and used PRS-11 to measure 1130 participants’ perceived restoration when viewing those images. The results indicated that lawn has the highest restorative effects, and are the most preferred. No significant differences in the restorative effects of sites with different spatial scales were detected, even a 10 × 10 m site has considerable restorative effects. We found high preference contributes to larger differences in the restorative effects of lawns and plazas. Those who prefer the sites may gain more restoration increases when viewing lawn scenes compared to plaza scenes. Moreover, adults over 50 years old have higher perceived restorations, and young adults aged 18–25 have a greater increase in restoration between plaza scenes and natural scenes, indicating young adults could benefit more from the building of small green spaces. These findings have direct implications for design practice. More small urban open spaces of lawn and water should be built to provide more restoration benefits, especially for young people.
... White et al., (2013) found through a survey of ten thousand people in the UK that green spaces reduce mental discomfort and improve mental wellbeing in a socioeconomically diverse region. Furthermore, a study discovered a potential link between the number of trees per kilometer of the street and a drop in the number of antidepressant prescriptions per thousand people (Taylor et al., 2015). The benefits of green spaces include their beneficial effects on stress reduction, enhanced social and cognitive functioning (including for people with attention deficit disorder), decreased rates of depression, including mood symptoms related to dementia, and a decrease in violent crime (Barton and Rogerson, 2017;Völker and Kistemann, 2015). ...
... Past studies have stated that accessibility is the primary mediator that evaluates the efficiency of green spaces Pedersen et al., 2019;Tannous et al., 2020). A London study found that accessibility to green spaces is proportional to good mental health, and tree density is inversely proportional to antidepressant prescriptions (Taylor et al., 2015). In another study in Mexico, accessibility to green spaces was studied concerning women's health to conclude a notable drop in the depression scale of women who have accessible green spaces within 400 meters of their homes (Bojorquez and Ojeda-Revah, 2018). ...
The fields of urban design and public health play an important role in the success and failure of the city. Research combining the two fields to improve citizens' lives is rare, particularly in a rapidly developing city like Doha. This study highlights the urban planning efforts of the municipality of Doha city to improve the mental health of its citizens and aims to understand the impact of urban design elements on mental health by analyzing the physical form and characteristics of green urban areas in Doha. The methods employed include an observational study and a structured survey interview, where visitors' responses to selected green urban areas are analyzed. The results show how Doha officials are working to improve the mental health of its citizens by providing accessible, child-friendly, older citizen-friendly, and equitable green urban spaces and suggesting policies that could provide more opportunities for people and the government to provide a healthier environment in Doha. The implications encompass shaping urban design strategies, raising public awareness, enhancing healthcare initiatives, and ultimately emphasizing the positive impact of well-designed green spaces for mental well-being in Doha and other Gulf countries.
... One of the most common investments cities make when enhancing urban nature is the addition of trees to street margins and parks (e.g., ref. 35). Nineteen studies (15%) in our sample (16,17,(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) explicitly considered the presence, density, or proximity of trees as a factor. Eleven (36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46) of these studies found positive associations between trees and well-being, three (16,17,47) found a mixture of positive and null results, and five (48)(49)(50)(51)(52) found only null relationships. ...
... Nineteen studies (15%) in our sample (16,17,(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) explicitly considered the presence, density, or proximity of trees as a factor. Eleven (36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46) of these studies found positive associations between trees and well-being, three (16,17,47) found a mixture of positive and null results, and five (48)(49)(50)(51)(52) found only null relationships. None found that trees made things worse. ...
Concern about humanity’s detachment from nature has spawned a global push to increase the availability of green spaces within cities. One impetus for this movement is a growing collection of studies documenting an association between improved human well-being and exposure to nature. The challenge lies in translating this research into pragmatic recommendations for cities. The usefulness of the existing research portfolio is diminished by the limitations of prevailing research designs. For example, most nature exposure studies (>80%) are observational. The rare randomized manipulative experiments tend to be indoors or virtual and rely on nature exposures on the order of ten to fifteen minutes. “Nature” and “biodiversity” are commonly invoked together as benefiting human well-being despite little evidence that biodiversity has particular importance for human psychological and emotional health. The most glaring gap in nature exposure research is the neglect of differences among cultures and ethnic groups with respect to the nature they prefer. In the few cases where researchers looked for differences among groups, they often found heterogeneous responses. Finally, few studies have compared greening interventions to other possible efforts to improve urban life. Thus, the utopian city of the future might be resplendent with urban parks on every block, but it is not clear whether those parks should offer basketball and pickleball courts, or small woodlands with a cornucopia of birds. We advocate for the next generation of nature exposure research that better informs the envisioning of our future sustainable cities with enhanced and equitable access to nature.
... Trees are vital contributors to urban greenery, offering critical benefits such as temperature regulation (Willis and Petrokofsky, 2017), air filtration (Nowak and Ogren, 2021), stress reduction (de Vries et al., 2013) and contribution to walkability (Sarkar et al., 2015) and health and wellbeing of humans and more-than humans living in cities (de Vries et al., 2013;Sarkar et al., 2015;Taylor et al., 2015). However, these benefits are not distributed uniformly across urban populations, leading to disparities in tree-related benefits among different population groups and spatial locations within cities (Landry and Chakraborty, 2009;Li, 2020). ...
Trees play a crucial role in urban ecosystems, such as enhancing air quality, mitigating climate change impacts, and promoting community well-being. However, their distribution within cities often reflects socio-spatial disparities, disproportionately benefiting some neighbourhoods over others. This study examines the distribution of trees, particularly street trees, in Pōneke Wellington, Aotearoa New Zealand and investigates whether urban layout and socio-economic indicators explain the observed disparities in street tree distribution and planting potential. Using spatial analysis of a comprehensive city-wide tree dataset, we explore spatial patterns of (street) tree distribution and employ spatial error models to explore the influence of urban layout and socio-economic indicators on street tree distribution. Our findings reveal significant spatial disparities in tree coverage across the urban area. Notably, only a small fraction of trees (7%) are located on roadside reserves, despite substantial non-treed roadside areas suitable for additional planting (17%). The spatial error model indicates that factors such as building set-backs, parcel irregularity, and road complexity significantly influence street tree distribution and planting potential, while socio-economic indicators alone provide limited explanatory power. These results highlight the critical role of urban design in shaping urban greening justice within cities, while also illustrating the complex interrelations between urban layout and socio-economic factors in shaping tree distribution. The study suggests that targeted street tree planting and informed urban planning have potential to address observed disparities in (street) tree distribution.
... On contrary to these negative results, numerous scientific research shows the benefits for physical and psychological health through interacting with nature (Hartig et al. 2014;Peter H. Kahn 1997), in reducing depression (M. S. Taylor et al. 2015), in improving immune functions (Rook 2013) and lastly it fosters positive environmental attitudes and values (Gill 2014). Abraham et al. (2007) emphasises in his research report, that the attractiveness, in terms of aesthetics, ease of movement, vegetation richness of landscape spaces in urban and rural areas, has a beneficial and motivating effect on the practice of physical activity. ...
Modern society is becoming increasingly digitalised and with all the current crises a sense of disconnection to the environment is present within mankind. This articles investigates the current state of environmental generational amnesia and the corresponding disconnectedness to nature and it further describes how simple nature experiences can be used to approach these. In order to write this paper, a broad literature research on the topic was done and the findings are presented in 7 chapters. The aim of this paper is present how a pro-ecological worldview may be fostered through schools and within tourism and to awake a sense of necessity for Environmental Education, instead of education about the environment.
This article has been written as an examination form of the module Nature-based tourism and cultural identity within the Masters-Program Biosphere Reserves Management. It is a reflection of the topic Environmental Education incorporating different perspectives and the authors personal opinion.
... Research has consistently shown that individuals who have access to green spaces or scenic natural views within their living environments experience mental health benefits (Grinde & Patil, 2009;James et al., 2015). For example, epidemiological studies showed reduced rates of depression and anxiety, lower stress levels, reduced prescription of antidepressants and greater reported well-being among individuals with greater exposure to greenness (e.g., Beyer et al., 2014;Taylor et al., 2015;Ward Thompson, 2016). These effects are likely to be multifaceted and extend beyond subjective experiences to encompass physiological processes. ...
... Tree lined avenues can support eco-friendly behaviors such as walking and cycling (Lusk, da Silva Filho, and Dobbert 2020). More broadly, urban neighborhoods with trees are often associated with better mental and physical health (Beyer et al. 2014;Taylor et al. 2015;Triguero-Mas et al. 2015). However, street trees are multifunctional and there are often trade-offs between their services and risks such as damage to property and infrastructure, pollen load and associated allergies, where positive perceptions of trees co-exist with 'Not-In-My-Backyard' attitudes (Fernandes et al. 2019). ...
Although 41% of the global urban population lives in smaller cities, the nature and trajectories of urban nature, ecosystem services and human-nature connections in smaller centers is relatively unknown. While megacities in developed countries move towards biophilic urban planning and participatory decision making, basic information on tree communities and their perceived services is a bottleneck in achieving these goals in such small urban centers. Through a combination of field measurements (258 transects, 931 trees) and semi-structured interviews (497 individuals), we assessed the street tree community and resident perceptions of ecosystem service values in two coastal cities on the west coast of India that are under rapid change. We found that mean street tree density is low in both cities, and corresponds to perceptions of recent change in tree cover (−28% in Kochi, −11% in Panjim). The street tree community in both cities were dominated by ornamental avenue trees such as Albizia saman and Peltophorum pterocarpum, but native coastal species like Cocos nucifera, Terminalia catappa and Thespesia populnea were also common. Despite recent urban growth, residents in both cities reported low value of trees for food, fodder and medicine, but high value for regulating services like shade and water. Moreover, we found strong evidence for aesthetic and cultural values of trees in both cities. Our study establishes critical baselines for biophilic planning in these small urban centers towards urban sustainability in India.
... Geometric considerations may extend greenspace characteristics beyond availability and accessibility to visibility, quality, and dosage ( Fig. 2.3). For instance, contiguous natural areas tend to have high ecological value [76]. Meanwhile, spread-out areas with uneven shapes may provide greater access to residents than compact, even shapes [74]. ...
The importance of greenspace for human health is demonstrated by a large, rapidly growing literature base. As with any environmental exposure, researchers have used many ways to define greenspace and estimate exposure. This chapter comprehensively reviews the various measures and attributes of greenspace. It begins with an exploration of greenspace definitions and continues with an overview of greenspace indicators. These indicators or measures span subjective and objective measures of greenspace availability, accessibility, and visibility. We describe various geographic containers for greenspace exposure evaluation and the datasets and calculations, such as the normalized difference vegetation index, to quantify exposure. The reviewed measures have universal application across jurisdictions, including China. We conclude with suggestions for future direction of greenspace measurement research.
... A favorable urban environment has a positive effect on mood [20,21]. Meanwhile, the street environment plays an important role in residents' emotions [22][23][24], but most of the studies on the effect of street space on emotions have focused on vegetation [25], and the relationship between the role of other street view elements and emotions has yet to be investigated. Due to the limitations of science and technology, most of the previous measurements on the effect of environment on mood have been conducted by questionnaires, interviews, and on-site observation research methods [26][27][28], through participant ratings or GIS-derived measures [29]. ...
The campus environment directly impacts college students’ psychological and emotional well-being, influencing their behavioral performance and the development of their personalities. Investigating the complex relationship between the campus spatial environment and students’ emotions is crucial for designing urban environments that support mental health. Using Yuelu Mountain National University Science and Technology City as a case study, this research developed a framework to analyze campus environment characteristics and emotional perception. The study quantitatively assessed emotional perceptions, examined the specific contributions of different campus environment elements to individual emotions, and created an emotion prediction map to explore these relationships in depth. The results indicate that “campus greenery” and “diversity” negatively affect “disappointment” and “depression”, while “sky views” positively impact “happiness” and “sense of security”. Additionally, “diversity” positively affects “relaxation”, and “campus greenery” and “diversity” have negative effects on “disappointment” and “depression”, with “diversity” having a particularly strong positive effect on “relaxation”. The pronounced spatial clustering of emotional perceptions on campus further underscores the significant influence of the campus environment on individual emotional experiences. As the first study to explore the mechanisms underlying the emotional perceptions of Chinese college students in relation to the campus environment, this research overcomes the limitations of traditional environmental assessment indicators by identifying campus environmental elements and psychological factors that better align with the psychological needs of college students. This provides a scientific basis for optimizing campus environments based on the emotional perceptions of students, thereby supporting mental health promotion and guiding campus environment construction. Moreover, the research methodology is broadly applicable. The integration of campus environment image data and deep learning offers a significant tool for assessing campus space and environmental perception, thereby enhancing human-centered environmental assessment and prediction while more accurately reflecting architectural space perception.
... The tree density in Macapá (15.7 trees per linear km) is the highest among the states of the Brazilian Amazon (Soares et al. 2021). However, it is still a low density compared to other urban centers in Brazil (e.g., 24.8 trees/km in Campinas) and the rest of the world (e.g., 40.2 trees/km in London and 46.6 trees/km in California) (Álvarez et al. 2015;Taylor et al. 2015;McPherson et al. 2016). Considering that the presence of green areas in cities has been associated with a range of benefits to increase people's life quality (e.g., stress reduction, improvement of mental health and air quality, reduction of urban heat) (Tzoulas et al. 2007;Lee and Maheswaran 2011), it is essential to promote the presence and maintenance of urban vegetation. ...
Urban areas with low tree cover in Brazil are found mainly in the Amazon, highlighting the disparities in access to benefits of urban greening. The goal of this study was to analyze how urban afforestation is associated with sociodemographic factors to understand the distribution of trees (and their benefits) among different social segments in the city of Macapá, in the extreme Northeastern Amazon. We conducted a floristic inventory in 217 blocks belonging to 32 neighborhoods, and classified species according to origin (exotic or native) and fruit use (fruit-bearing or non-fruit-bearing). Additionally, we selected 12 variables to represent sociodemographic gradients among neighborhoods. We reduced the dimensionality of floristic and sociodemographic data using ordination techniques, and used their first axes to represent gradients of species composition and sociodemographic factors. The effect of sociodemographic gradients on tree abundance, species richness and composition was tested using generalized linear models. The results indicate that most urban trees are exotic, non-fruit-bearing, and of medium size (10–30 cm in diameter). Older neighborhoods with higher human population age and income showed higher tree abundance and higher species richness. The species composition was related to the gradient of human population density, proportion of old people, income, and household occupancy. Large non-fruit trees were more frequent in neighborhoods with low population density. Exotic trees were more frequent in older neighborhoods with older people and high income, and large fruit trees showed higher abundance in neighborhoods with low household occupancy rates. Ensuring that low-income neighborhoods and historically marginalized communities have equal access to green spaces and adequate tree coverage is a key element to promote environmental justice and to develop healthier and more sustainable cities.
... With urban areas expanding and an increasing amount of people living in urban areas, people tend to experience reduced access to green environments [17,18]. There are also considerable differences in greenness exposure among geographical areas; greenness in urban areas is rather represented by green alleys, trees alongside the sidewalk [19], or flower pots [20], while in more suburban to rural environments, greenness is rather represented by forests, or green fields. Several studies have shown the importance of street greenery for PA, and specifically cycling as a means of active transport [21,22]. ...
Background
Greenness exposure has been associated with many health benefits, for example through the pathway of providing opportunities for physical activity (PA). Beside the limited body of longitudinal research, most studies overlook to what extent different types of greenness exposures may be associated with varying levels of PA and sedentary behavior (SB). In this study, we investigated associations of greenness characterized by density, diversity and vegetation type with self-reported PA and SB over a 9-year period, using data from the ORISCAV-LUX study (2007–2017, n = 628).
Methods
The International Physical Activity Questionnaire (IPAQ) short form was used to collect PA and SB outcomes. PA was expressed as MET-minutes/week and log-transformed, and SB was expressed as sitting time in minutes/day.
Geographic Information Systems (ArcGIS Pro, ArcMap) were used to collect the following exposure variables: Tree Cover Density (TCD), Soil-adjusted Vegetation Index (SAVI), and Green Land Use Mix (GLUM). The exposure variables were derived from publicly available sources using remote sensing and cartographic resources. Greenness exposure was calculated within 1000m street network buffers around participants’ exact residential address.
Results
Using Random Effects Within-Between (REWB) models, we found evidence of negative within-individual associations of TCD with PA (β = − 2.60, 95% CI − 4.75; − 0.44), and negative between-individual associations of GLUM and PA (β = − 2.02, 95% CI − 3.73; − 0.32). There was no evidence for significant associations between greenness exposure and SB. Significant interaction effects by sex were present for the associations between TCD and both PA and SB. Neighborhood socioeconomic status (NSES) did not modify the effect of greenness exposure on PA and SB in the 1000 m buffer.
Discussion
Our results showed that the relationship between greenness exposure and PA depended on the type of greenness measure used, which stresses the need for the use of more diverse and complementary greenness measures in future research. Tree vegetation and greenness diversity, and changes therein, appeared to relate to PA, with distinct effects among men and women. Replication studies are needed to confirm the relevance of using different greenness measures to understand its’ different associations with PA and SB.
... In addition to benefits for reducing heat exposure, trees offer a number of benefits, including biodiversity, stormwater management, air pollution removal, and carbon storage and sequestration [42]. Green spaces have been shown to have a positive influence on physical activity, stress, social contacts, and restoration [56], and increased urban street tree density is associated with reduced mental health issues [57]. In the UK, all-cause mortality was found to be 6% lower in the quintile with the most greenspace compared to the quintile with the lowest [58]. ...
Increasing temperatures and more frequent heatwave events pose threats to population health, particularly in urban environments due to the urban heat island (UHI) effect. Greening, in particular planting trees, is widely discussed as a means of reducing heat exposure and associated mortality in cities. This study aims to use data from personal weather stations (PWS) across the Greater London Authority to understand how urban temperatures vary according to tree canopy coverage and estimate the heat-health impacts of London’s urban trees. Data from Netatmo PWS from 2015–2022 were cleaned, combined with official Met Office temperatures, and spatially linked to tree canopy coverage and built environment data. A generalized additive model was used to predict daily average urban temperatures under different tree canopy coverage scenarios for historical and projected future summers, and subsequent health impacts estimated. Results show areas of London with higher canopy coverage have lower urban temperatures, with average maximum daytime temperatures 0.8 °C and minimum temperatures 2.0 °C lower in the top decile versus bottom decile canopy coverage during the 2022 heatwaves. We estimate that London’s urban forest helped avoid 153 heat attributable deaths from 2015–2022 (including 16 excess deaths during the 2022 heatwaves), representing around 16% of UHI-related mortality. Increasing tree coverage 10% in-line with the London strategy would have reduced UHI-related mortality by a further 10%, while a maximal tree coverage would have reduced it 55%. By 2061–2080, under RCP8.5, we estimate that London’s current tree planting strategy can help avoid an additional 23 heat-attributable deaths a year, with maximal coverage increasing this to 131. Substantial benefits would also be seen for carbon storage and sequestration. Results of this study support increasing urban tree coverage as part of a wider public health effort to mitigate high urban temperatures.
... The role of demographic factors like gender, age, and genetic polymorphism should also be taken into consideration not only as covariant of drug effect but also of the response to the environmental context per se. Among the latter, socioeconomic status has been shown to covariate with pharmacological response (Viglione et al., 2019), for instance when greenery intervention based on tree density was shown to be correlated to drug use (Marselle et al., 2020;Taylor et al., 2015). ...
... The analysis of the systematic review are summarized in Table 1, which details the benefits that have been derived from the peri-urban ecosystem. Based on the literature review findings, street trees, despite their small-scale nature, offer numerous advantages to residents, particularly as ecosystem services that contribute to a tranquil and pleasant environment for motorists traversing roadways [29], [30]. Additionally, they play a role in preventing the impacts of air pollution [31], [32] and enhancing environmental temperatures [33], [34]. ...
... Multiple mechanisms have been identified to explain this. For instance, a significant body of research identifies the positive impact of nature on cortisol levels, stress and blood pressure, decreasing propensity for anger and aggressive behaviours and increasing selfcontrol (Butler and Friel, 2006;Kuo and Sullivan, 2001;Taylor et al., 2015). Whereas others attribute the connection between public green spaces and lower crime rates to increased community cohesion through social interaction and recreation in these spaces (Keniger et al., 2013). ...
Purpose
This paper aims to explore how environmental employment can promote desistance among criminalised children. Research demonstrates that being immersed in and interacting with the natural environment has a positive impact upon well-being and behaviour, including reduced aggressive and violent behaviours. However, how exposure to the natural environment might promote desistance amongst children with persistent criminal involvement is unclear.
Design/methodology/approach
This paper examines, through semi-structured interviews and participant observations, the experiences of n = 23 criminalised children aged 16–18 employed in outdoor work at a UK social enterprise.
Findings
The findings demonstrate how working in the natural environment can provide a safe space for children, where they can build positive relationships, learn valuable skills and reconnect with the world outside of the high-pressure, conflict-driven spaces in which they typically occupy.
Originality/value
This research highlights the relevance of the setting in which child rehabilitation takes place and the potential role of natural environments in providing places and opportunities which support pro-social identity development and desistance for children.
Keywords
... Häuser umgebende Grünflächen oder Gärten sind weltweit zu finden (Hanson et al. 2021) und haben verschiedene Funktionen, indem sie neu gierige Nachbarn auf Distanz halten, Ziele fast ungebremsten Gestaltungswillens sind, die Pro duktion eigener Nahrungsmittel erlauben oder zum Aufenthalt im Freien dienen (Abbildung 1). Gärten fördern erwiesenermaßen die Lebens qualität (Taylor et al. 2015) und das Naturerleb nis, die soziale Integration und die biologische Vielfalt. Sie haben einen hohen Freizeitwert, tragen zur Anpassung an den Klimawandel bei und werten das Wohnumfeld auf (DieTricH 2014; Hanson et al. 2021;KirK et al. 2021 ...
German: Untersucht wurde ein 250 m² großer, relativ isolierter Hausgarten im Innenstadtbereich einer mittelgroßen Stadt in Südbayern. Insgesamt konnten dabei 1.083 Arten festgestellt werden. Dies dokumentiert, dass auch Gärten oder andere Kleinflächen ohne besondere Strukturausstattung eine bedeutende Artenvielfalt beherbergen können. Es unterstreicht, wie sehr es sich lohnt, alle Flächen zum Schutz der Biodiversität zu begrünen und naturschutzfachlich zu optimieren. Viele Millionen Menschen haben so die Möglichkeit, direkt zum Artenschutz beizutragen.
English: Every area counts – Even small home gardens can contribute to biodiversity
Focus of the analysis was an isolated 250 m² big downtown private garden in a medium sized city in southern Bavaria. A total of 1,083 different animal and plant species was recorded. This shows that gardens and other naturalized patches can be inhabited by a handsome number of species, even without special microhabitats. This underlines how important and effective greening of every area is to promote biodiversity. Additional simple measures are suggested to accelerate nature conservation. By this means millions of people are able to join nature conservation.
... Urban forests have the potential to provide many other health benefits to the population, including the capacity to reduce, prevent and restore physical, mental, psychological, and emotional health issues by providing access to physical activities and viewing and interacting with diverse forest resources. Higher tree crown volumes were associated with lower medication sales for psychological and cardiovascular health issues among residents due to the restorative benefits associated with regular walking, jogging, strolling, or cycling in urban forest environments [86,87]. In addition, a lower prevalence of obesity has been reported for children living in areas with good access to urban green spaces compared to children with limited or no access to urban green spaces [88]. ...
Urban forests provide direct and indirect benefits to human well-being that are increasingly captured in residential property values. Remote Sensing (RS) can be used to measure a wide range of forest and vegetation parameters that allows for a more detailed and better understanding of their specific influences on housing prices. Herein, through a systematic literature review approach, we reviewed 89 papers (from 2010 to 2022) from 21 different countries that used RS data to quantify vegetation indices, forest and tree parameters of urban forests and estimated their influence on residential property values. The main aim of this study was to understand and provide insights into how urban forests influence residential property values based on RS studies. Although more studies were conducted in developed (n = 55, 61.7%) than developing countries (n = 34, 38.3%), the results indicated for the most part that increasing tree canopy cover on property and neighborhood level, forest size, type, greenness, and proximity to urban forests increased housing prices. RS studies benefited from spatially explicit repetitive data that offer superior efficiency to quantify vegetation, forest, and tree parameters of urban forests over large areas and longer periods compared to studies that used field inventory data. Through this work, we identify and underscore that urban forest benefits outweigh management costs and have a mostly positive influence on housing prices. Thus, we encourage further discussions about prioritizing reforestation and conservation of urban forests during the urban planning of cities and suburbs, which could support 10.13039/100004420UN Sustainable Development Goals (SDGs) and urban policy reforms.
... Cinderby and Bagwell's (2017) longitudinal study of an innovation in urban green infrastructure in central London reveals the immense benefits of these spaces for office workers. Likewise, Taylor et al. (2015) highlight how even urban treescapes offer opportunities within the GSP context, by using mundane landscapes to reduce reliance on antidepressants in city dwellers. Although these studies perhaps do not necessarily conform to GSP in its strictest sense (which often involves structured programmes linked to the environment), they do highlight the exploratory nature of how geographers are engaging with debates and possibilities in this field, and centring much of their work around the urban environment, due to population, development, and associated pressures. ...
... Decreased stress [50,52,[63][64][65][66][67] Decreased anxiety [53,54,[68][69][70] Decreased depression [25,51,53,69,[71][72][73][74][75][76][77] Decrease in mental distress [78,79] Outcomes related to social isolation Sense of belonging/positive social interaction [21, 64,[80][81][82][83][84][85][86] Greater happiness or life satisfaction [44,49,71,[87][88][89] Outcomes related to wellbeing Emotional wellbeing [1,68,[90][91][92][93] ...
Active engagement in green spaces has been shown to improve physical, mental, and social well-being. Blending the topics of forest bathing, therapeutic sensory gardens, and nature meditations, this chapter will unpack the therapeutic effects of active and passive engagement in green spaces. Frequent exposure to and engagement in green spaces has been found to decrease feelings of anxiety, social isolation, and stress levels. Spending time in green spaces can promote restoration and recovery from daily stressors. With the perspectives of the authors' expertise in holistic health as occupational therapy practitioners, the chapter will explore how the influence of usage and dosage of green spaces potentially impact stress, social isolation, and well-being to facilitate occupational balance (flow). This chapter will report how green spaces have been assessed in the current evidence and the questions that remain regarding the impact on personal, group, and population well-being.
... Studies have been conducted to investigate the characteristics of forests and assess the ESV of urban forests in specific urban spaces, such as street trees (Taylor et al. 2015;Thaiutsa et al. 2008) and urban parks (Collins et al. 2019;Wolf et al. 2020). However, in a highly developed urban area with limited plant space, to achieve the planning goal of urban green space ratio, it is not negligible to research the flexible use of urban forests for fragmented green space in the built-up area (Wolf et al. 2020). ...
Urban forest, as an essential urban green infrastructure, is critical in providing ecosystem services to cities. To enhance the mainstreaming of ecosystem services in urban planning, it is necessary to explore the spatial pattern of urban forest ecosystem services in cities. This study provides a workflow for urban forest planning based on field investigation, i-Tree Eco, and geostatistical interpolation. Firstly, trees across an array of land use types were investigated using a sampling method. Then i-Tree Eco was applied to quantify ecosystem services and ecosystem service value in each plot. Based on the ecosystem services estimates for plots, four interpolation methods were applied and compared by cross-validation. The Empirical Bayesian Kriging was determined as the best interpolation method with higher prediction accuracy. With the results of Empirical Bayesian Kriging, this study compared urban forest ecosystem services and ecosystem service value across land use types. The spatial correlations between ecosystem service value and four types of point of interest in urban places were explored using the bivariate Moran’s I statistic and the bivariate local indicators of spatial association. Our results show that the residential area in the built-up area of Kyoto city had higher species richness, tree density, ecosystem services, and total ecosystem service value. Positive spatial correlations were found between ecosystem service value and the distribution of urban space types including the tourist attraction distribution, urban park distribution, and school distribution. This study provides a specific ecosystem service-oriented reference for urban forest planning based on land use and urban space types.
... Ports may contain industrial facilities, piles of waste/scrap metals, large cranes and stacks of containers and security fencing, amongst others, which reduces the quality of visual amenity in the area. A loss of visual amenity may contribute to poor mental health and wellbeing [25]. This means the visual impact of the port should also be considered as an important aspect in sustainable port development. ...
The potential detrimental environmental impact of ports is vast, and port-cities bear the brunt of this. It is essential that future port-city development proceeds in such a way as to reduce the environmental impact that port activity creates for the city and local area. This global study of port authorities in 26 countries and city authorities in 13 countries investigated the current views on pollution, levels of adoption of mitigation measures, future plans, levels of interest in adoption and barriers to key measures for reducing a port’s environmental impact. This reveals consensus on key areas between port and city authorities for the first time. Water pollution was found to be the number one environmental concern of port authorities globally. Air, noise and waste were also found to be important forms of pollution in ports, both from the perspective of port and city authorities and in terms of complaints received. Ports largely have facilities for recycling, although the majority have no set recycling plans, with 62% of ports having none in place. Targets should be encouraged, as well as circular economy approaches, if this is to be addressed. Renewable energy, electric port equipment, building efficiency improvements, electric port and harbour vessels and shore-to-ship power all have high levels of support from port and city authorities, although costs provide the largest barriers to implementation. Greater cooperation between port-city stakeholders is necessary to overcome the large financial barriers that appear to be preventing ports from pursuing the environmental improvements they are interested in.
... The results indicate that such interventions can significantly enhance the affective perception of urban sites, with particularly strong impacts on positive relative to negative affective measures. The findings build on previous work that has identified negative associations between small-scale green infrastructure and mental health problems 29 and feelings of stress [30][31][32] , suggesting that it can promote positive affect as well as protecting from negative states. Table A2. ...
The largest public space in any city is its streets. Investments which incorporate small-scale green infrastructure into streetscapes can bring more nature into the lives of urban residents worldwide, including those living in even the most economically and spatially constraint places. However, little is known about the impact of such small-scale investments on urban residents’ affective perceptions of their local environments and how to design these investments to maximise their positive impacts. In the current study, we use photo simulation techniques and an adapted form of the Positive and Negative Affective Schedule to examine the impact of small-scale green infrastructure interventions on the affective perceptions of low, middle and high-income sites in Santiago Chile. Our results, based on 62,478 reports of affective perceptions from 3,472 people, indicate that green infrastructure investments can both promote positive affect and, to a lesser, but still substantial extent reduce negative affect. The magnitudes of these relationships vary across discrete affective measures and for many of these measures, both positive and negative, a minimum of 16% increase in green coverage is required to see an impact. Finally, we find people associated lower affect with low, compared to middle and high, income sites but that these affective inequalities can be addressed, at least in part, through green infrastructure interventions.
... Jiang et al. (2014) discussed stress reduction in relation to the level of tree cover near one's place of residence, and they reported that the highest level of stress reduction was achieved with a cover density between 1.7 and 24%. A study conducted in the United Kingdom revealed a negative correlation between the density of street trees in residential areas and the rate of antidepressant prescription; specifically, the rate of such prescriptions decreased by 1.18 (per 1000 people) with every unit increase in street trees per kilometer (Taylor et al. 2015). de Vries et al. (2013) found that high vegetation cover is associated with a high level of physical activity. ...
Vegetation is an essential natural feature in urban greening and a crucial indicator of an advanced city; it also enhances people’s quality of life. The maintenance of vegetation with wide coverage in an urban park is crucial. However, few studies have discussed the effects of vegetation quality and quantity on human health. The current study discusses how the quantity and quality of park vegetation affect people’s behavior pertaining to park visitation (i.e., frequency and duration of park visits) and explores the effect of vegetation on people’s physical activity and life satisfaction. A total of nine parks were included, and 730 participants were recruited to answer a questionnaire concerning perceived vegetation conditions, park visit behaviors, physical activity, and life satisfaction. The results indicate that the perceived maintenance of vegetation significantly and positively influences the frequency and duration of people’s park visits, which in turn exhibit a positive association with their physical activity and life satisfaction. People’s overall satisfaction with park vegetation also positively affects their physical activity and life satisfaction. The results revealed the key roles of plant design, maintenance, and management in increasing the frequency and duration of park visits, which enhance people’s physical activity and health.
... The lack of hygiene in human and animal tences (restoration) [51]. Thereby, urban green spaces and street trees correlate with several health outcomes, including lower antidepressant prescriptions [52], healthcare facilities at the community and the household levels [46] are important reasons for the increased burden of AMR. Moreover, environmental aspects, such as waste disposal and water compartments [47,48] that allow for ABR elements to further spread through various interactions with the water cycle, e.g., swimming, bathing, washing, or using surface or groundwater sources as irrigation or drinking water, play a role in this context. ...
The world is now distressed with the coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although vaccination is not done in full fledge and a particular drug is not available to treat COVID-19, modern technologies help humanity fight against it. Data science is a part of modern technological approaches which involve many technologies
like artificial intelligence (AI) and machine learning under a single roof. This chapter focuses on using AI in the management of COVID-19 pandemic for various purposes and making the dichotomy between intelligent man and intelligent machine. AI can function as a radar, robot, computer, machine for medical uses, engine driving, teaching in educational institutions, and other purposes at micro-business and macro-business levels during the current pandemic. AI also brings hope for the prevention of this deadly infection using drones and robots for the disinfection of public places and the cities under
lockdown, for quickly transfer of samples for testing, to deliver medical supplies, food, and small medical devices to a health care provider, and for cleaning and testing in quarantine centers. AI has already arrived in every sector, but few doubts exist asking us: can AI act like a sagacious person? Until now, ‘do not,’ but it is believable that it can be possible soon.
Introduction
With the acceleration of urbanization and social changes, loneliness among university students is becoming increasingly common. The urban built environment is closely related to loneliness. This study explores the impact of the urban built environment on the loneliness of university students from multiple built environment elements such as road network density, land use mix, and service facilities. It is of great significance to optimize urban planning and improve the mental health of university students.
Methods
Based on questionnaire data and point interest data of various facilities, Spearman correlation analysis, Ridge regression model and geographic detector were used to explore the impact mechanism of urban built environment on loneliness of university students.
Results
The study shows that loneliness is widespread and relatively severe among university students. The urban built environment is closely related to university students’ loneliness: the number of catering, transportation, tourist attractions, leisure and entertainment, healthcare, and sports facilities, as well as road network density, are significantly negatively correlated with loneliness, while the number of shopping facilities and land use mix are positively correlated with loneliness. Geographic detector analysis shows that tourist attractions, health care facilities and land mix have a significant impact on university students’ loneliness, and the interaction of multidimensional factors significantly improves the explanatory power of loneliness.
Conclusion
To alleviate loneliness among university students, interventions should be approached from the perspective of urban planning and management. Firstly, it is essential to improve leisure, landscape, transportation, healthcare, and fitness facilities, enhancing their accessibility to foster social interactions. Secondly, increasing the availability of socially-oriented public spaces, such as student activity centers, community squares, and shared learning spaces, can strengthen interaction and communication. Additionally, policymakers should optimize the layout of urban transportation networks to encourage students to use public transit. Urban planners can support active transportation modes, such as walking and cycling, by rationally allocating road space. Lastly, the strategic placement of green and open spaces, such as parks and squares, should be prioritized to enhance access to natural environments, promote social activities, and mitigate feelings of loneliness.
The connotation of public health and well-being, a goal of social development, changes over time, and this kind of dynamic social needs have promoted the continuous evolution of urban parks. This article traces the interaction between British urban parks and public health topics. Based on the social background, political-economic context and health conditions in which Great Britain is situated, public health appeals have experienced six phases: prevention of infectious diseases, solution of urban environmental problems, attention to leisure sports, exploration of social integration and promotion of mental health, cultivation of healthy lifestyles, and the construction of healthy social and ecological systems. Accordingly, urban parks have experienced isolation-based site selection, forming wind corridor, adding sports facilities, establishing communication space systems, refining target population space, constructing park-habitat network layout. This research finds that the planning and design of British urban parks from the perspective of public health and well-being has emerged from the establishment of urban parks to the construction of park cities, from the attention to individual physiological health to the pursuit of individual, society and ecosystem health, from broadly promoting health to boosting health for some specific population. This research aims to draw on Britain's experience in this field to explore the way of urban park planning and construction in China under the "Healthy China" planning strategy. 关键词： 英国城市公园 ；公共健康和福祉 ；健康景观 ；发展脉络 ；发展趋势
Rapid growth of infrastructure facilities has seen the growth of small and big cities at a very fast pace, neglecting the growth potential of the respective areas. This has affected areas that should be preserved and not disturbed for any development work. These areas are oddly growing, which is not good, especially given the case of hills, where ecological aspects are of prime importance. Such development also degrades the visual quality aspects of hill towns, which define the urban-scape and overall image of a region. In the hilly region of Dharamshala, located in the north-western Himalayas, India; the structuring and designing of urban spaces has become a difficult task for city planning. Present research work is aimed at identification and analysis of degraded visual place quality aspects of the hilly town of Dharamsala for the purpose of suggesting appropriate remedial measures for improving the visual aesthetics of the area to enhance tourist potential and quality of life for residents alike. For this purpose, questionnaire-based surveys and visual place quality measurements were taken and then analysed for problems and problematic areas by the Analytic Hierarchy Process technique. The study included examination of different physical and non-physical parameters of specific areas in Dharamshala town like ISBT, Kotwali Bazar, Chilgari, Depot Bazar, and Sheela Chowk/Dari by making an analytic hierarchy process comparison decision matrix for criteria and using a consistency index involving priority ranking. Results revealed appropriate solutions like address of street square, street sidewalk and street width in addition to amendments in existing acts and byelaws pertaining to planning and development, etc. These solutions, if adopted, would be helpful for upgrading overall aspects related to the degradation of the visual place quality of Dharamshala town. These results can be advantageously applied to other similar hilly regions.
Anxiety, a prevalent mental health issue amongst the urban population, has risen in the past decade. Currently, cities are more than often referred to as ‘anxious’, implying the observed anxiety levels of residents. Residents engage with almost every scale of space in the city as part of their daily activities. However, it is established that one of the most vital everyday urban spaces is the ‘street’. It may further be conjectured that ‘streets’ and ‘streetscape design’ are associated with the anxiety levels of urban residents. This study attempts to explore the plausible association between streetscape design and the anxiety levels of residents through a comprehensive literature review. The search strategy involved databases, namely Science Direct, PubMed, MDPI, and JSTOR, and only high-quality journal’s peer-reviewed articles were included. The data was extracted from 25 shortlisted articles for the review. It concludes with the theoretical framework of the impact of streetscape elements on state anxiety, highlighting the direct and indirect impact through plausible mediators such as safety and personal space. Conclusion also includes an inventory of these elements categorized into positive and negative impactors on residents’ anxiety levels, further intending to guide the design of streetscapes for alleviating anxiety in the future.
As the world population ages, the role of environmental design in promoting the health and well-being of older adults becomes increasingly important. This study aims to explore the concept of nearby nature and its potential benefits for the aging population, focusing on the specific needs and preferences of older adults. The study adopts a multi-disciplinary approach, involving researchers and practitioners from various fields including environmental psychology, urban planning, plant sciences, and landscape architecture. Through systematic steps of data compilation, categorization, and integration, the study identifies key themes related to designing for older adults as individuals and as a stage of life. These themes encompass aesthetics, thermal comfort, personal experiences, social cohesion, embracing changes and losses, sensory perceptions, and risks.The resulting design recommendations address both the physical requirements, such as accessibility and mobility, and the mental requirements, such as feelings, perceptions, and emotions, of older adults. The guidelines provide insights for creating inclusive and accessible nearby nature spaces that cater to the unique needs of older adults. This study emphasizes the importance of collaboration between researchers and practitioners in developing design solutions for the aging population. By bridging the gap between scholarly knowledge and practical expertise, the study contributes to the maturation of landscape architecture as a discipline. The findings and recommendations can serve as valuable tools for designers, planners, and decision makers in creating environments that promote the well-being and quality of life of older adults in urban areas.
Nature-based solutions including urban forests and wetlands can help communities cope better with climate change and other environmental stressors by enhancing social-ecological resilience. Natural ecosystems, settings, elements and affordances can also help individuals become more resilient to various stressors, although the mechanisms underpinning individual-level nature-based resilience, and their relations to social-ecological resilience, are not well articulated. We propose ‘nature-based biopsychosocial resilience theory’ (NBRT) to address these gaps. Our framework begins by suggesting that individual-level resilience can refer to both: a) a person’s set of adaptive resources; and b) the processes by which these resources are deployed. Drawing on existing nature-health perspectives, we argue that nature contact can support individuals build and maintain biological, psychological, and social (i.e. biopsychosocial) resilience-related resources. Together with nature-based social-ecological resilience, these biopsychosocial resilience resources can: i) reduce the risk of various stressors (preventive resilience); ii) enhance adaptive reactions to stressful circumstances (response resilience), and/or iii) facilitate more rapid and/or complete recovery from stress (recovery resilience). Reference to these three resilience processes supports integration across more familiar pathways involving harm reduction, capacity building, and restoration. Evidence in support of the theory, potential interventions to promote nature-based biopsychosocial resilience, and issues that require further consideration are discussed.
Green space matters for mental health but is under constant pressure in an increasingly urbanising world. Often there is little space available in cities for green areas, so it is vital to optimise the design and usage of these available green spaces. To achieve this, experts in planning, design and nature conservation need to know which types and characteristics of green spaces are most beneficial for residents' mental health.
A scoping review of studies that compare different green space types and characteristics on mental health was conducted. A total of 215 (experimental, observational and qualitative) papers were included in the scoping review.
This review highlights a high level of heterogeneity in study design, geographical locations, mental health outcomes and green space measures. Few of the included studies were specifically designed to enable direct comparisons between green space types and characteristics (e.g. between parks and forests). The included studies have predominantly experimental research designs looking at the effects of short‐term exposure to green space on short‐term mental health outcomes (e.g. affect and physiological stress). More studies enabled only indirect comparisons, either within the same study or between different studies.
Analysis of the direction of the mental health outcomes (positive, neutral, negative) from exposure to various types and characteristics of green space found positive (i.e. beneficial) effects across all green space types. However, green space characteristics did appear to render more diverse effects on mental health, which is especially the case for vegetation characteristics (e.g. higher vegetation density can be negative for mental health).
The scoping review reveals gaps in the present evidence base, with a specific need for more studies directly comparing green space types and characteristics within the same study. Proposed future research directions include the use of longitudinal research designs focusing on green space characteristics, considering actual exposure and systematically addressing heterogeneity in factors influencing the relation between green spaces and mental health (e.g. type of interaction, user experience).
Read the free Plain Language Summary for this article on the Journal blog.
Daily walks are recommended for health gains, and walkable urban environments are recommended as one strategy to combat climate change. Evidence of the relationship between physical environments and psychological health is increasing. The aim of this study was to systematically review and compile evidence regarding micro-scale characteristics in urban outdoor environments that impacted pedestrian short-term experience and/or long-term psychological health. The databases ScienceDirect, Scopus, PubMed, PsychInfo, and Google Scholar were used. To explore the area, a large heterogeneity in publications was allowed; therefore, it was not possible to conduct a meta-analysis. From 63 publications, data items were extracted from full text and categorized according to the main study characteristics. Environmental characteristics impacting pedestrians psychologically were identified and categorized into themes: grey, green, blue, and white areas, and weather, temporalities, topography, person factors, and safety. Environmental factors were analyzed from the perspective of the circumplex model of human affect (negative/positive dimensions and activation/deactivation). The findings included the fact that urban pedestrians need both positively activating and deactivating (restorative) areas during walkabouts. Perceived safety is essential for experiencing the positive aspects of urban environments. Some characteristics interact differently or have different importance for health in different groups. To further develop research on pedestrian environments, psychological experiences should be included.
This chapter explores the implications for the health of humans, animals, and the environment derived from the provision and utilization of conventional public services (e.g., healthcare and water and sanitation supply) and non-conventional services (e.g., provision of green spaces). Public services are services like education, health, and sanitation, entitled to a population, and so are important for achieving development goals. Here, the integration of public services under the One Health (OH) perspective, which is key for promoting health and early detection of risks of future epidemics, is exemplified by the cases of food systems, land use, and land cover change. The discussion section of this chapter addresses how to reduce the risks of future epidemics by making public services enablers of health. Finally, we call for more integrative research and action under the OH approach.
Research suggests that the formation of neighborhood social ties (NSTs) may substantially depend on the informal social contact which occurs in neighborhood common spaces, and that in inner‐city neighborhoods where common spaces are often barren no‐man's lands, the presence of trees and grass supports common space use and informal social contact among neighbors. We found that for 145 urban public housing residents randomly assigned to 18 architecturally identical buildings, levels of vegetation in common spaces predict both use of common spaces and NSTs; further, use of common spaces mediated the relationship between vegetation and NSTS. In addition, vegetation and NSTs were significantly related to residents' senses of safety and adjustment. These findings suggest that the use and characteristics of common spaces may play a vital role in the natural growth of community, and that improving common spaces may be an especially productive focus for community organizing efforts in inner‐city neighborhoods.
Research suggests that the formation of neighborhood social ties (NSTs) may substantially depend on the informal social contact which occurs in neighborhood common spaces, and that in inner-city neighborhoods where common spaces are often barren no-man's lands, the presence of trees and grass supports common space use and informal social contact among neighbors. We found that for 145 urban public housing residents randomly assigned to 18 architecturally identical buildings, levels of vegetation in common spaces predict both use of common spaces and NSTs; further, use of common spaces mediated the relationship between vegetation and NSTS. In addition, vegetation and NSTs were significantly related to residents' senses of safety and adjustment. These findings suggest that the use and characteristics of common spaces may play a vital role in the natural growth of community, and that improving common spaces may be an especially productive focus for community organizing efforts in inner-city neighborhoods.
The rapidly expanding research record concerning aesthetic, emotional and physiological response to visual landscapes is summarized, with emphasis on aesthetic preferences for views containing trees and other vegetation. The survey is set within a conceptual perspective suggesting that affective responses such as aesthetic preference are central to a landscape observer's thoughts, conscious experience and behavior. Substantial progress has been made in developing models that relate aesthetic responses to specific visual properties of environments. When aesthetic preferences are compared for urban and unspectacular natural views, American and European adult groups evidence a strong tendency to prefer nature. However, liking for urban scenes usually increases when trees and other vegetation are present. Views of nature, compared to most urban scenes lacking natural elements such as trees, appear to have more positive influences on emotional and physiological states. The benefits of visual encounters with vegetation may be greatest for individuals experiencing stress or anxiety. Recent research demonstrates that responses to trees and other vegetation can be linked directly to health, and in turn related to economic benefits of visual quality.
Different conceptual perspectives converge to predict that if individuals are stressed, an encounter with most unthreatening natural environments will have a stress reducing or restorative influence, whereas many urban environments will hamper recuperation. Hypotheses regarding emotional, attentional and physiological aspects of stress reducing influences of nature are derived from a psycho-evolutionary theory. To investigate these hypotheses, 120 subjects first viewed a stressful movie, and then were exposed to color/sound videotapes of one of six different natural and urban settings. Data concerning stress recovery during the environmental presentations were obtained from self-ratings of affective states and a battery of physiological measures: heart period, muscle tension, skin conductance and pulse transit time, a non-invasive measure that correlates with systolic blood pressure. Findings from the physiological and verbal measures converged to indicate that recovery was faster and more complete when subjects were exposed to natural rather than urban environments. The pattern of physiological findings raised the possibility that responses to nature had a salient parasympathetic nervous system component; however, there was no evidence of pronounced parasympathetic involvement in responses to the urban settings. There were directional differences in cardiac responses to the natural vs urban settings, suggesting that attention/intake was higher during the natural exposures. However, both the stressor film and the nature settings elicited high levels of involuntary or automatic attention, which contradicts the notion that restorative influences of nature stem from involuntary attention or fascination. Findings were consistent with the predictions of the psycho-evolutionary theory that restorative influences of nature involve a shift towards a more positively-toned emotional state, positive changes in physiological activity levels, and that these changes are accompanied by sustained attention/intake. Content differences in terms of natural vs human-made properties appeared decisive in accounting for the differences in recuperation and perceptual intake.
While urban disamenities and pollution sources have received considerable attention in environmental justice research, few studies have examined sociospatial inequities associated with the distribution of desirable land uses. In this paper we focus on addressing this limitation by investigating the environmental equity implications of street trees—an important publicly financed amenity that provides several direct and indirect benefits to urban residents. The specific objective was to determine if the spatial distribution of public right-of-way trees is equitable with respect to race and ethnicity, income, and housing tenure in the city of Tampa, Florida, USA. We seek to extend research on equity analysis of urban amenities through several methodological innovations, including: (a) accounting for the heterogeneity of urban land use; (b) utilizing high-resolution remote sensing techniques to quantify parcel-specific tree cover; and (c) using multivariate regression models that control for spatial dependence within the data. The results support the inequity hypothesis by indicating a significantly lower proportion of tree cover on public right-of-way in neighborhoods containing a higher proportion of African-Americans, low-income residents, and renters. These findings have important implications for local public investment and policy strategies.
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.
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.
Both physical activity and exposure to nature are known separately to have positive effects on physical and mental health. We have investigated whether there is a synergistic benefit in adopting physical activities whilst being directly exposed to nature ('green exercise'). Five groups of 20 subjects were exposed to a sequence of 30 scenes projected on a wall whilst exercising on a treadmill. Four categories of scenes were tested: rural pleasant, rural unpleasant, urban pleasant and urban unpleasant. The control was running without exposure to images. Blood pressure and two psychological measures (self-esteem and mood) were measured before and after the intervention. There was a clear effect of both exercise and different scenes on blood pressure, self-esteem and mood. Exercise alone significantly reduced blood pressure, increased self-esteem, and had a positive significant effect on 4 of 6 mood measures. Both rural and urban pleasant scenes produced a significantly greater positive effect on self-esteem than the exercise-only control. This shows the synergistic effect of green exercise in both rural and urban environments. By contrast, both rural and urban unpleasant scenes reduced the positive effects of exercise on self-esteem. The rural unpleasant scenes had the most dramatic effect, depressing the beneficial effects of exercise on three different measures of mood. It appears that threats to the countryside depicted in rural unpleasant scenes have a greater negative effect on mood than already urban unpleasant scenes. We conclude that green exercise has important public and environmental health consequences.
Despite an increased prevalence of depression among people of low socio-economic position, it remains unclear whether their treatment with antidepressants appropriately matches their increased need compared with people from more affluent backgrounds. This study examined socio-economic differences in antidepressant prescriptions and mortality related to depressive disorders.
A longitudinal register study of 17947 male and 47458 female local government employees with linked information on socio-economic indicators (education and occupational status) and data on antidepressant use and mortality associated with depressive disorder (suicide, alcohol-related deaths) during the years 1994 to 2000.
In men, antidepressant treatment was less common among low educational groups than among high educational groups (OR 0.87, 95% CI 0.76-0.99) and a corresponding difference was seen between occupational statuses (OR for manual v. upper non-manual 0.72, 95% CI 0.62-0.84). In women, socio-economic position was not associated with antidepressant use. However, both among the men and women, employees with low socio-economic position had increased risk for mental-health-related mortality, as indicated by suicides, deaths from alcohol-related causes, and all-cause mortality.
These data suggest a mismatch in the treatment of depression relative to apparent clinical need, with the lowest levels of treatment concentrated in the lower socio-economic groups, despite evidence of their increased prevalence of depression and suicide.
Epidemiological studies on green space and health have relied almost exclusively on cross-sectional designs, restricting understanding on how this relationship could vary across the lifecourse.
We used multilevel linear regression to analyse variation in minor psychiatric morbidity over nine annual waves of the British Household Panel Survey (1996-2004). The sample was restricted to residents of urban areas who remained within their neighbourhoods for at least 12 months. The 12-item General Health Questionnaire and confounders were reported for 29 626 male and 35 781 female observations (person-years). This individual-level dataset was linked to a measure of green space availability within each ward of residence. Regression models included age, gender, employment status, household tenure, marital status, education, smoking status and household income.
When not considering age, green space was associated with better mental health among men, but not women. Interaction terms fitted between age and green space revealed variation in the association between green space and mental health across the lifecourse and by gender. For men, the benefit of more green space emerged in early to mid-adulthood. Among older women, a curvilinear association materialised wherein those with a moderate availability of green space had better mental health.
These findings illustrate how the relationship between urban green space and health can vary across the lifecourse, and they highlight the need for longitudinal studies to answer why green space may be better for health at some points in the lifecourse than others.
Urbanization, resource exploitation, and lifestyle changes have diminished possibilities for human contact with nature in urbanized societies. Concern about the loss has helped motivate research on the health benefits of contact with nature. Reviewing that research here, we focus on nature as represented by aspects of the physical environment relevant to planning, design, and policy measures that serve broad segments of urbanized societies. We discuss difficulties in defining "nature" and reasons for the current expansion of the research field, and we assess available reviews. We then consider research on pathways between nature and health involving air quality, physical activity, social cohesion, and stress reduction. Finally, we discuss methodological issues and priorities for future research. The extant research does describe an array of benefits of contact with nature, and evidence regarding some benefits is strong; however, some findings indicate caution is needed in applying beliefs about those benefits, and substantial gaps in knowledge remain. Expected final online publication date for the Annual Review of Public Health Volume 35 is March 18, 2014. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
Several studies have shown a positive relationship between local greenspace availability and residents' health, which may offer opportunities for health improvement. This study focuses on three mechanisms through which greenery might exert its positive effect on health: stress reduction, stimulating physical activity and facilitating social cohesion. Knowledge on mechanisms helps to identify which type of greenspace is most effective in generating health benefits. In eighty neighbourhoods in four Dutch cities data on quantity and quality of streetscape greenery were collected by observations. Data on self-reported health and proposed mediators were obtained for adults by mail questionnaires (N = 1641). Multilevel regression analyses, controlling for socio-demographic characteristics, revealed that both quantity and quality of streetscape greenery were related to perceived general health, acute health-related complaints, and mental health. Relationships were generally stronger for quality than for quantity. Stress and social cohesion were the strongest mediators. Total physical activity was not a mediator. Physical activity that could be undertaken in the public space (green activity) was, but less so than stress and social cohesion. With all three mediators included in the analysis, complete mediation could statistically be proven in five out of six cases. In these analyses the contribution of green activity was often not significant. The possibility that the effect of green activity is mediated by stress and social cohesion, rather than that it has a direct health effect, is discussed.
This paper considers the attitudes of residents, living in currently treeless streets in a Scottish town, to street trees. Tour streets were selected for the study to provide a gradation from underprivileged to affluent. Most respondents did not see trees as important in improving the quality of their street. Trees were seen as most important in the two affluent streets, and least important in a low income street with a preponderance of elderly residents. Male respondents were significantly more likely to favour street tree planting than females. Other factors investigated, such as respondent age, and the degree of maintenance care and structural complexity demonstrated by respondents’ front gardens, did not show statistically significant associations with the expressed preference for street trees.
The article reaches two conclusions counter to accepted transportation engineering theory. First, the traffic environments of dense urban areas appear to be safer than the lower-volume environments of the suburbs. The reason is that many fewer miles are driven on a per capita basis, and the driving that is done is at lower speeds that are less likely to produce fatal crashes. Second, at least in dense urban areas, less-“forgiving” design treatments—such as narrow lanes, traffic-calming measures, and street trees close to the roadway—appear to enhance a roadway's safety performance when compared to more conventional roadway designs. The reason for this apparent anomaly may be that less-forgiving designs provide drivers with clear information on safe and appropriate operating speeds.
Urbanization is a potential threat to mental health and well-being. Cross-sectional evidence suggests that living closer to urban green spaces, such as parks, is associated with lower mental distress. However, earlier research was unable to control for time-invariant heterogeneity (e.g., personality) and focused on indicators of poor psychological health. The current research advances the field by using panel data from over 10,000 individuals to explore the relation between urban green space and well-being (indexed by ratings of life satisfaction) and between urban green space and mental distress (indexed by General Health Questionnaire scores) for the same people over time. Controlling for individual and regional covariates, we found that, on average, individuals have both lower mental distress and higher well-being when living in urban areas with more green space. Although effects at the individual level were small, the potential cumulative benefit at the community level highlights the importance of policies to protect and promote urban green spaces for well-being.
We compared psychophysiological stress recovery and directed attention restoration in natural and urban field settings using repeated measures of ambulatory blood pressure, emotion, and attention collected from 112 randomly assigned young adults. To vary restoration needs, we had half of the subjects begin the environmental treatment directly after driving to the field site. The other half completed attentionally demanding tasks just before the treatment. After the drive or the tasks, sitting in a room with tree views promoted more rapid decline in diastolic blood pressure than sitting in a viewless room. Subsequently walking in a nature reserve initially fostered blood pressure change that indicated greater stress reduction than afforded by walking in the urban surroundings. Performance on an attentional test improved slightly from the pretest to the midpoint of the walk in the nature reserve, while it declined in the urban setting. This opened a performance gap that persisted after the walk. Positive affect increased and anger decreased in the nature reserve by the end of the walk; the opposite pattern emerged in the urban environment. The task manipulation affected emotional self-reports. We discuss implications of the results for theories about restorative environments and environmental health promotion measures.
Constraint of restorative activities prolongs chronic stress and may exacerbate depressive symptoms. Treating unseasonable weather as an ecological constraint on restorative activities in outdoor settings, we investigated the relationship between cold summer temperatures and the dispensation of selective serotonin reuptake inhibitors (SSRIs) in Sweden. We obtained nationally aggregated data on defined daily doses of SSRIs dispensed monthly from 1991 through 1998. We analyzed the data using autoregressive, integrated, moving average time-series modeling methods. Dispensation of SSRIs correlated negatively with monthly mean temperature for July, the peak vacation period. The association held for both men and women, net of trends, seasonality, and other statistical controls. The constrained restoration hypothesis augments response style, restricted activity and seasonality explanations for depression. The study provides a novel perspective on green spaces and other outdoor settings as mental health resources.
The visible landscape is believed to affect human beings in many ways, including aesthetic appreciation and health and well-being. The aim of this paper is to analyse the range of landscapes used in environmental psychology studies, and the evidence of health effects related to viewing these landscapes. A literature review of publications linking landscapes and health effects was conducted. This reported evidence of health and well-being effects related to exposure to visual landscapes. The results of the review include an overview of the types of landscape used in the studies, the evidence on health effects, the methods and measures applied and the different groups of respondents. The analysis reveals a predominance of studies using only coarse categories of landscapes. Most landscape representations have been classed as “natural” or “urban”. Few studies were found to use subcategories within these groups. Generally, the natural landscapes gave a stronger positive health effect compared to urban landscapes. Urban landscapes were found to have a less positive and in some cases negative effect on health. Three main kinds of health effects have been identified in the study; short-term recovery from stress or mental fatigue, faster physical recovery from illness and long-term overall improvement on people's health and well-being.The study provides an overview of the relationships between health and landscapes arranged in an accessible format, identifying gaps in our knowledge requiring further research. The identification of quantifiable landscape attributes that affect health is seen as an important factor in enabling future landscape design to be of benefit to human health.
Previous research shows a positive link between the amount of green area in one's residential neighbourhood and self-reported health. However, little research has been done on the quality of the green area, as well as on quantity and quality of smaller natural elements in the streetscape. This study investigates the link between the objectively assessed quantity and quality of (1) green areas and (2) streetscape greenery on the one hand and three self-reported health indicators on the other.
80 Dutch urban neighbourhoods were selected, varying in the amount of nearby green area per dwelling, as determined by Geographic Information System analysis. The quality of green areas, as well as the quantity and quality of streetscape greenery, was assessed by observers using an audit tool. Residents of each neighbourhood were asked to complete a questionnaire on their own health (N=1641). In multilevel regression analyses, we examined the relationship between greenspace indicators and three health indicators, controlling for socio-demographic and socioeconomic characteristics.
Both indicators for the quantity of greenspace were positively related to all three health indicators. Quantity and quality indicators were substantially correlated in the case of streetscape greenery. Nevertheless, the quality indicators tended to have added predictive value for the health indicators, given that the quantity information was already included in the model.
The quantity and also the quality of greenspace in one's neighbourhood seem relevant with regard to health. Furthermore, streetscape greenery is at least as strongly related to self-reported health as green areas.
The article presents the result from a Danish survey on access and use of green areas and the impact on experienced stress and obesity. The statistical results indicate that access to a garden or short distances to green areas from the dwelling are associated with less stress and a lower likelihood of obesity. The number of visits cannot explain the effects of green areas on the health indicators. It is suggested that the significance of distance to green areas is mainly derived from its correlation with the character of the neighbourhood and its conduciveness to outdoor activities and "healthy" modes of travel.
To estimate the prevalence and incidence of depression; investigate its association with risk factors including comorbidities and drug and health care use; and describe treatment patterns of depression in primary care using The Health Improvement Network database.
In this cohort study, subjects with a first recorded diagnosis of depression (Read code) between January 1, 2002, and December 31, 2004 (n=47,170) were identified from a source population of 1,287,829 subjects aged 10-79 years. A comparison group was sampled from the same population and frequency matched to the depression cohort by age, sex, and calendar year (n=50,000). Depression diagnoses were validated using physician-completed questionnaires. Odds ratios and 95% CIs for the relationship of depression with a range of factors were estimated using unconditional logistic regression in a nested case-control analysis.
The prevalence of depression was 11.23% (95% CI, 11.18-11.28). This prevalence decreased with increasing age and was higher in women than in men. The incidence was 13.89 per 1,000 person-years (95% CI, 13.82-14.08). Depression was associated with frequent use of health services, smoking, pregnancy in the previous year, anxiety, stress, sleep disorders, digestive and respiratory disorders, and pain. In the trimester following diagnosis, 82% of cases were treated-98% with antidepressants and 81.5% with selective serotonin reuptake inhibitors (SSRIs).
We found a high prevalence and incidence of depression diagnoses in primary care in the United Kingdom. Following diagnosis, the majority of individuals were prescribed SSRIs. A diagnosis of depression is associated with a number of prior comorbidities, which could mask the depression. This fact should be taken into account when screening individuals in primary care.
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.
This chapter reviews recent research on the relationship between stressful life experiences and depression. A distinction is made between aggregate studies of overall stress effects and focused studies of particular events and difficulties. A distinction is also made between effects of life stress on first onset of depression and on the subsequent course of depression. Although the available evidence suggests that acute stressful life events can lead to the recurrence of episodes of major depression, a series of methodological problems compromise our ability to make clear causal inferences about the effects of life events on first onset of major depression or about the effects of chronic stress on either onset or recurrence of depression. The main problems of this sort are discussed, and recommendations made for ways of addressing these problems in future studies.
Major depression is a widespread, often chronic disorder affecting the individual, his or her family, and society as a whole. It incurs tremendous social and financial costs in the form of impaired relationships, lost productivity, and lost wages. Although chronic major depression is eminently treatable, it continues to be undertreated and underrecognized. This is particularly true in primary care settings, where physicians are usually the first to encounter chronic depression but are seldom trained to distinguish depression from other medical illnesses with similar symptoms. In addition, because of the stigma attached to depression, patients often characterize their symptoms as part of a physical illness or fail to report them to a clinician at all. This article discusses the epidemiology of depression, its impact and burden on society, and its special character (including diagnosis and treatment) as a chronic illness.
To investigate the population impact on the incidence of suicide and non-fatal self harm of regulatory action in 2003 to restrict the use of selective serotonin reuptake inhibitors (SSRIs) in under 18s.
Ecological time series study.
United Kingdom. Populations Young people in the UK aged 12-19 years (prescribing trends), in England and Wales aged 12-17 years (mortality), and in England aged 12-17 years (hospital admissions).
Deaths from suicide and hospital admissions for self harm.
Antidepressant prescribing doubled between 1999 and 2003 but fell to the 1999 level between 2004 and 2005. These large changes in prescribing did not seem to be associated with temporal trends in suicide or self harm. In the years 1993 to 2005 the annual percentage reduction for suicide among 12-17 year olds was -3.9% (95% confidence interval -6.2% to -1.5%) in males and -3.0% (-6.6% to 0.6%) in females, with no indication of a substantial change in this rate of decrease during that period. Similarly, hospital admission rates for self harm in the years 1999 to 2005 indicated an annual percentage increase for males of 1.1% (-0.5% to 2.7%) and for females of 5.7% (3.6% to 7.8%), again with no statistical evidence of a change in rate after the regulatory action.
The noticeable reduction in prescribing of antidepressants since regulatory action in 2003 to restrict the use of SSRIs in under 18s does not seem to have been associated with changes in suicidal behaviour in young people. Specifically, these data for England do not indicate that reductions in antidepressant use have led to an increase in suicidal behaviour.
e wrong, which is even worse. Please let us know of any successes or failures. Beware - Gibbs sampling can be dangerous!. BUGS c flcopyright MRC Biostatistics Unit 1995. ALL RIGHTS RESERVED. The support of the Economic and Social Research Council (UK) is gratefully acknowledged. The work was funded in part by ESRC (UK) Award Number H519 25 5023. 1 2 Contents 1 Introduction 5 1.1 What is BUGS? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 1.2 For what kind of problems is BUGS best suited? . . . . . . . . . . . . . . . . . . . . . 5 1.3 Markov Chain Monte Carlo (MCMC) techniques . . . . . . . . . . . . . . . . . . . . 5 1.4 A simple example . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 1.5 Hardware platforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 1.6 Software . . .
Contents 1 Getting started 2 1.1 Getting the software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.2 The script file for `bugs' (Sparc) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.3 The script file for `backbugs' (Sparc) . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2 New Facilities in 0.6 3 2.1 Checkpoint command . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2.2 Metropolis sampling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2.3 Minor changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 Corrected bugs from Version 0.5 3 4 Known restrictions still existing in Version 0.6 4 5 Examples 4 BUGS c flcopyright MRC Biostatistics Unit 1997. ALL RIGHTS RESERVED. The support of the Economic and Social Research Council (UK) is gratefully acknowledged. The work wa
Stress and animal welfare The Netherlands Streetscape greenery and health: Stress, social cohesion and physical activity as mediators Natural environments—Healthy environments? An exploratory analysis of the rela-tionship between greenspace and health
- S De Vries
- S M E Van Dillen
- P P Groenewegen
- P Spreeuwenberg
http://dx.doi.org/10.1136/jech-2013-203767 Broom, D. M. (1993). Stress and animal welfare. Dordrecht, The Netherlands: Springer. de Vries, S., van Dillen, S. M. E., Groenewegen, P. P., & Spreeuwenberg, P. (2013). Streetscape greenery and health: Stress, social cohesion and physical activity as mediators. Social Science and Medicine, 94(0), 26–33, http://dx.doi.org/10.1016/j.socscimed.2013.06.030. de Vries, S., Verheij, R. A., Groenewegen, P. P., & Spreeuwenberg, P. (2003). Natural environments—Healthy environments? An exploratory analysis of the rela-tionship between greenspace and health. Environment and Planning A, 35(10), 1717–1731.
Stress recovery during exposure to natural and urban environments Greenspace in urban neighbourhoods and residents
- R S Ulrich
- R F Simons
- B D Losito
- E Fiorito
- M A Miles
- M Zelson
- S M Van Dillen
- S De Vries
- P P Groenewegen
- P Spreeuwenberg
- M S Adding
- Taylor
Ulrich, R. S., Simons, R. F., Losito, B. D., Fiorito, E., Miles, M. A., & Zelson, M. (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology, 11(3), 201–230. http://dx.doi.org/10.1016/ s0272-4944(05)80184-7 van Dillen, S. M., de Vries, S., Groenewegen, P. P., & Spreeuwenberg, P. (2012). Greenspace in urban neighbourhoods and residents' health: Adding M.S. Taylor et al. / Landscape and Urban Planning 136 (2015) 174–179 quality to quantity. Journal of Epidemiology Community Health, 66(6), e8. http://dx.doi.org/10.1136/jech.2009.104695
http://data.gov.uk/dataset/healthy lifestyle behaviours
- Hm Government
HM Government. (2013). http://data.gov.uk/dataset/healthy lifestyle behaviours.
Retrieved December 2012.
Population estimates for
- England Wales
- Northern Ireland
Office for National Statistics. (2010). Population estimates for UK, England and Wales,
Scotland and Northern Ireland. Office for National Statistics (Retrieved 03 July,
2011).
British national formulary
Joint Formulary Committee. (2011). British national formulary (62nd ed.). London:
BMJ Group and Pharmaceutical Press.
London datastore. Greater London Authority
- Greater London Authority
Greater London Authority. (2011). London datastore. Greater London Authority. Retrieved 03/06/2011, 2011 from http://data.london.gov.uk/taxonomy/
categories/health.
The English indices of deprivation 2010. London: Department for Communities and Local Government
- D Mclennan
- H Barnes
- M Noble
- J Davies
- E Garratt
- C Dibben
McLennan, D., Barnes, H., Noble, M., Davies, J., Garratt, E., & Dibben, C. (2011). The
English indices of deprivation 2010. London: Department for Communities and
Local Government.
Population estimates for UK
- England
- Scotland Wales
- Northern Ireland
Office for National Statistics. (2010). Population estimates for UK, England and Wales,
Scotland and Northern Ireland. Office for National Statistics (Retrieved 03 July,
2011).
Greater London Authority
Greater London Authority. (2011). London datastore. Greater London Authority. Retrieved 03/06/2011, 2011 from http://data.london.gov.uk/taxonomy/
categories/health.
- Hm Government
HM Government. (2013). http://data.gov.uk/dataset/healthy lifestyle behaviours.
Retrieved December 2012.
Study of a cohort of patients newly diagnosed with depression in general practice: Prevalence, incidence, comorbidity, and treatment patterns
- E Martin-Merino
- A Ruigomez
- S E Johansson
- M A Wallander
- L A Garcia-Rodriguez
Martin-Merino, E., Ruigomez, A., Johansson, S. E., Wallander, M. A., & Garcia-Rodriguez, L. A. (2010). Study of a cohort of patients newly diagnosed
with depression in general practice: Prevalence, incidence, comorbidity, and
treatment patterns. Primary Care Companion to Journal of Clinical Psychiatry,
12(1).
- E O Wilson
Wilson, E. O. (1984). Biophilia. Cambridge, Massachusetts: Harvard University Press.