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Residential green spaces and mortality: A systematic review
... Literature examples have found associations between residential greenness and CVD risk factors, such as hypertension and diabetes [10]. Moreover, studies have shown that a higher amount of greenness in a residential area is associated with a lower mortality rate [11]. There is growing evidence in the literature about the associations between green space exposure and cardiovascular and cerebrovascular health, but no clear effect of UG exposure on CVDs has been stated yet. ...
... As a consequence of the included studies' heterogeneity, the current literature was searched in order to find an existing quality score suitable for this review. The score used by Gascon et al. was selected as the most suitable [11]. This score, ranging from 0 to 100, was used to evaluate the quality of the included studies on the basis of the following eight items: study design, confounding factors, statistics, potential bias, multiplicity, green exposure assessment, effect size, and participants have been living at least 1 year in the studied area [11]. ...
... The score used by Gascon et al. was selected as the most suitable [11]. This score, ranging from 0 to 100, was used to evaluate the quality of the included studies on the basis of the following eight items: study design, confounding factors, statistics, potential bias, multiplicity, green exposure assessment, effect size, and participants have been living at least 1 year in the studied area [11]. ...
Cardiovascular diseases (CVDs) are a leading cause of mortality globally. In particular, ischemic heart diseases (IHDs) and cerebrovascular diseases (CBVDs) represent the main drivers of CVD-related deaths. Many literature examples have assessed the association between CVD risk factors and urban greenness. Urban green (UG) may positively affect physical activity, reduce air and noise pollution, and mitigate the heat island effect, which are known risk factors for CVD morbidity. This systematic review aims to assess the effects of urban green spaces on CVD morbidity and mortality. Peer-reviewed research articles with a quantitative association between urban green exposure variables and cardiovascular and cerebrovascular outcomes were included. Meta-analyses were conducted for each outcome evaluated in at least three comparable studies. Most of the included studies’ results highlighted an inverse correlation between exposure to UG and CVD outcomes. Gender differences were found in four studies, with a protective effect of UG only statistically significant in men. Three meta-analyses were performed, showing an overall protective effect of UG on CVD mortality (HR (95% CI) = 0.94 (0.91, 0.97)), IHD mortality (HR (95% CI) = 0.96 (0.93, 0.99)), and CBVD mortality (HR (95% CI) = 0.96 (0.94, 0.97)). The results of this systematic review suggest that exposure to UG may represent a protective factor for CVDs.
... However, there are also positive environmental exposures for seniors, such as exposure to greenness. Being in contact with nature, which includes having visual access to green space, has been associated with a wide range of positive health effects, from physical to mental health and restorative processes [61][62][63][64]. Urban greenness, commonly measured using the Normalized Difference Vegetation Index (NDVI) [61,62,[65][66][67] can provide optimal places to walk or recreate while also being negatively correlated with other negative urban exposures such as air or noise pollution. ...
... Being in contact with nature, which includes having visual access to green space, has been associated with a wide range of positive health effects, from physical to mental health and restorative processes [61][62][63][64]. Urban greenness, commonly measured using the Normalized Difference Vegetation Index (NDVI) [61,62,[65][66][67] can provide optimal places to walk or recreate while also being negatively correlated with other negative urban exposures such as air or noise pollution. Among seniors, exposure to green space has been linked to many health outcomes, including mortality, social capital, obesity, and most frequently with physical activity [68][69][70]. ...
... NDVI scores can vary from -1 to 1 when the result is < 0 corresponds to areas without vegetation cover corresponding to water or artificial surfaces, for values 0 < NDVI < 0.2 it is expected to find bare soil or dead vegetation, between 0.2 < NDVI < 0, 4 corresponds to soil with sparse or not very vigorous vegetation, in cases of 0.4 < NDVI < 0.6, areas with vigorous and abundant vegetation are estimated, while those exceeding < 0.6 correspond to areas with dense and vigorous vegetation [82]. NDVI use is very common in studies assessing greenness exposure [83][84][85][86] and has also been used before in Barcelona [61,62]. The distribution of NDVI levels in Barcelona is presented in Fig. 2 (right). ...
GPS technology and tracking study designs have gained popularity as a tool to go beyond the limitations of static exposure assessments based on the subject's residence. These dynamic exposure assessment methods offer high potential upside in terms of accuracy but also disadvantages in terms of cost, sample sizes, and types of data generated. Because of that, with our study we aim to understand in which cases researchers need to use GPS-based methods to guarantee the necessary accuracy in exposure assessment. With a sample of 113 seniors living in Barcelona (Spain) we compare their estimated daily exposures to air pollution (PM2.5, PM10, NO2), noise (dB), and greenness (NDVI) using static and dynamic exposure assessment techniques. Results indicate that significant differences between static and dynamic exposure assessments are only present in selected exposures, and would thus suggest that static assessments using the place of residence would provide accurate-enough values across a number of exposures in the case of seniors. Our models for Barcelona’s seniors suggest that dynamic exposure would only be required in the case of exposure to smaller particulate matter (PM2.5) and exposure to noise levels. The study signals to the need to consider both the mobility patterns and the built environment context when deciding between static or dynamic measures of exposure assessment.
... Fourteen of the 33 systematic reviews focused on the associations between NCDs and proximity to major roads [10,[31][32][33][34][35][36][37][38][39][40][41][42][43], 11 on green space [44][45][46][47][48][49][50][51][52][53][54], 4 on walkability [41,43,44,51], 4 on accessibility to infrastructure providing unhealthy food [41,43,51,55], 6 on proximity to industry [56][57][58][59][60][61], 3 on facilities for physical activity or recreation [43,44,51], and 2 on proximity to landfills [57,62]. Most reviews included studies that measured multiple neighborhood risk factors and NCD outcomes (Additional file 1: Table S5). ...
... A meta-analysis conducted by Twohig-Bennett et al. [49] reported a statistically significant reduction in type II diabetes (OR = 0.72; 95% CI, 0.61, 0.85) and a reduction in CHD incidence (OR = 0.92; 95% CI, 0.78-1.07). For lung cancer, green space had a protective effect, but the evidence was weak, which included two ecological studies and one cross-sectional study [45]. Evidence of the protective effect of green space on kidney disease and prostate cancer was limited, and only one individual study was found for each [46]. ...
Background
With rapid urbanization, the urban environment, especially the neighborhood environment, has received increasing global attention. However, a comprehensive overview of the association between neighborhood risk factors and human health remains unclear due to the large number of neighborhood risk factor–human health outcome pairs.
Method
On the basis of a whole year of panel discussions, we first obtained a list of 5 neighborhood domains, containing 33 uniformly defined neighborhood risk factors. We only focused on neighborhood infrastructure-related risk factors with the potential for spatial interventions through urban design tools . Subsequently, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic meta-review of 17 infrastructure-related risk factors of the 33 neighborhood risk factors (e.g., green and blue spaces, proximity to major roads, and proximity to landfills) was conducted using four databases, Web of Science, PubMed, OVID, and Cochrane Library, from January 2000 to May 2021, and corresponding evidence for non-communicable diseases (NCDs) was synthesized. The review quality was assessed according to the A MeaSurement Tool to Assess Systematic Reviews (AMSTAR) standard.
Results
Thirty-three moderate-and high-quality reviews were included in the analysis. Thirteen major NCD outcomes were found to be associated with neighborhood infrastructure-related risk factors. Green and blue spaces or walkability had protective effects on human health. In contrast, proximity to major roads, industry, and landfills posed serious threats to human health. Inconsistent results were obtained for four neighborhood risk factors: facilities for physical and leisure activities, accessibility to infrastructure providing unhealthy food, proximity to industry, and proximity to major roads.
Conclusions
This meta-review presents a comprehensive overview of the effects of neighborhood infrastructure-related risk factors on NCDs. Findings on the risk factors with strong evidence can help improve healthy city guidelines and promote urban sustainability. In addition, the unknown or uncertain association between many neighborhood risk factors and certain types of NCDs requires further research.
... Geospatial investigations indicate that mere proximity to green space harbors psychophysiological health benefits apart from PA alone. Exposure to nature, which can range from walks in green space, living in such an environment, or simply having a window view of nature, is correlated with reductions in ruminating behaviors and associated brain activity (Bratman et al., 2015a;Bratman et al., 2015b;Lambert, 2018); depressive behaviors (Cox et al., 2017); reductions in post-exercise stress indicators like blood pressure and heart rate variability (Duncan et al., 2014;Gladwell et al., 2013;Haluza et al., 2014;Koselka et al., 2019); and mortality risk for cardiovascular, respiratory, and metabolic diseases (Brown et al., 2016;Gascon et al., 2016;Heung et al., 2018;James et al., 2016;Vienneau et al., 2017;Xu et al., 2017). Cox et al. (2017) posit a dose-response mechanism driving these relationships, wherein the intensity, frequency, and duration of nature exposure moderate these outcomes. ...
... When PWDs and MWUs are provided with adequate environmental, psychosocial, and self-rooted motivators and means to participate in UPA, the benefits are plentiful. In particular, engaging in nature-based UPA has repeatedly demonstrated reduced stress biomarkers such as blood pressure and heart rate variability (Bratman et al., 2015a;Bratman et al., 2015b;Gladwell et al., 2013;Haluza et al., 2014;White et al., 2019;Song et al., 2019) and reduced risk of adverse mental health outcomes (Cox et al., 2017;Brown et al., 2016;Gascon et al., 2016;Heung et al., 2018;James et al., 2016;Vienneau et al., 2017;Xu et al., 2017). In addition, direct physical benefits such as reducing pressure ulcers (Requejo et al., 2015;Nary et al., 2000), spasticity and joint contractures (Nary et al., 2000), and improved exercise tolerance may result (Nary et al., 2000;Kehn & Kroll, 2009). ...
... Urban greenspace has an important impact on the health of residents through its provision of various ecosystem services Enssle and Kabisch, 2020;Yu et al., 2020;Yu et al., 2021). For instance, Gascon et al. (2016) found that in residential areas with high green coverage, residents have relatively lower mortality ratesincluding a significantly lower risk of death for people with cardiovascular disease. Related studies have also confirmed that urban greenspace can not only improve positive emotions and happiness index (Cameron et al., 2020;Fong et al., 2018a;Kondo et al., 2018), but also have a positive impact on memory and attention restoration (Moran, 2019), children's cognitive development (Dadvand et al., 2015a), learning behav-ior, as well as imagination and creativity (Dadvand et al., 2015b;Ulrich, 1984). ...
An increasing number of studies aim to improve and perfect the evaluation system for assessing greenspace exposure, yet it may also become more difficult to apply the evaluation index to landscape planning. Here we propose a simple but actionable index system – Greenspace Exposure Inequity index (GEII), for assessing the inequity of residents' greenspace exposure. GEII includes quantity-based availability, distance-based accessibility, and inequity-based Gini index for assessing the difference in greenspace exposure pattern. Then we selected Shanghai as a case to test the feasibility of GEII, analyzing the spatiotemporal evolution of greenspace exposure patterns, and further demonstrating the operability of the index. (1) Availability inequity for 2012, 2015, 2018, and 2021 was 0.603, 0.512, 0.514, and 0.489. The Gini index was between 0.4 and 0.6, and presented a downward trend. (2) Accessibility inequity for 2012, 2015, 2018, and 2021 was 0.372, 0.368, 0.364, and 0.344. It can be clearly seen that it has changed less over ten years, but overall equality has been rising. (3) Using GEII to calculate the inequity of Shanghai, the Gini index for 2012, 2015, 2018, and 2021 was 0.392, 0.378, 0.373, and 0.357. The inequity of greenspace exposure assessed by GEII is gradually decreasing similarly, which illustrates the positive impact of urban greening policies. The GEII has three highlights: serviceability, human-oriented, and expandability. GEII abandons the complex computational evaluation procedures of numerous indicators and bridges the gap between theoretical research on inequity and practical planning, so GEII is of great value for alleviating the uneven exposure of residents' greenspace and scientifically optimizing landscape planning.
... All-cause mortality There is 'strong' and generally consistent evidence that greater amounts of natural environments around the home are associated with lower rates of allcause mortality (death for any reason). 16 Analysis of death records from across England showed higher rates of mortality in the groups exposed to the least amount of green space* around the home. 17 A meta-analysis* of green space and mortality 18 looking at nine studies, compiling 8.3 million people from seven countries, found an inverse relationship between green space exposure and mortality. ...
... promotores de salud). La presencia, acceso, calidad y distribución de las zonas verdes, están relacionadas con la esperanza de vida, mortalidad, y morbilidad, especialmente en lo referente a enfermedades cardiovasculares, respiratorias, diabetes y obesidad (Gascón et al., 2016;Lachowycz & Jones, 2011;Rojas-Rueda et al., 2019); también con la salud mental, especialmente en cuanto a depresión y prevalencia de estrés, con un papel destacado en la restauración psicológica Kaplan, 1987;Ulrich et al., 1991;Wen et al., 2019). Además, la presencia de zonas verdes en los entornos laborales y educativos, está relacionada con mejoras en el aprendizaje y el desarrollo cognitivo (Hartig et al., 1997;Korpela & Hartig, 1996;Zijlema et al., 2017) y son un escenario que favorece la generación de conocimiento científico, la educación ambiental y la sensibilización (Sandifer et al., 2015), así como la facilitación de interacción y cohesión social y bienestar colectivo (Leyden, 2003;. ...
La Unión Europea sostiene que para poder responder a los desafíos de la sociedad actual es imprescindible contar con sistemas e instituciones de educación superior que sean eficaces en el ámbito de la educación, la investigación y la innovación, y que estén conectados a sus sociedades. Por lo tanto es importante, ahora más que nunca, que la universidad forme personas emprendedoras, que sepan gestionar información compleja, que piensen de forma autónoma y creativa, que utilicen los recursos de manera inteligente, que se comuniquen de manera eficaz y que sean resilientes. En definitiva, profesionales que sean capaces de desarrollar las tecnologías y las soluciones de vanguardia para responder a las necesidades de la sociedad actual y futura, y de liderar las necesarias transformaciones sociales y educativas.
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Europar Batasunak dio, egungo gizartearen erronkei erantzun ahal izateko, ezinbestekoa dela hezkuntzaren, ikerketaren eta berrikuntzaren arloan eraginkorrak izango diren goi-mailako hezkuntza-sistemak eta -erakundeak izatea, gizartearekin lotuta egongo direnak. Beraz, orain inoiz baino garrantzitsuagoa da unibertsitateak pertsona ekintzaileak bultzatzea, informazio konplexua kudeatzen dakitenak, modu autonomoan eta sortzailean pentsatzen dutenak, baliabideak modu adimentsuan erabiltzen dituztenak, eraginkortasunez komunikatzen direnak eta erresilienteak direnak. Azken batean, egungo eta etorkizuneko gizartearen beharrei erantzuteko teknologiak eta abangoardiako irtenbideak garatzeko gai diren profesionalak, horrela beharrezkoak diren gizarte- eta hezkuntza-eraldaketak zuzentzeko.
... The relationship between the presence of parks, gardens, trees, and other green elements has been scientifically proven [44][45][46] to be linked to health [47]. The NDVI [48] and the surface area of green areas per inhabitant in square metres [49] were used to study the relationship between the homes and the surrounding greenery. ...
We carried out a search of over 12,000 houses offered on the rental market in Catalonia and assessed the possibility of families below the poverty threshold being able to rent these homes. In this regard, we wanted to evaluate whether the economic situation of families is able to influence their social environment, surroundings, and safety. We observed how their economic situation can allow families the possibility of developing a life without exposure to health risks, and how economic constraints result in disadvantages in several areas of life. The results show how families at risk of poverty live in less favourable conditions and experience a widening of different gaps, with current prices leading to a possible poverty trap for the most disadvantaged groups. The higher the percentage of the population below the threshold, the lower the possibility of not being able to rent a house compared to areas with a lower prevalence of population below the threshold. This association was observed both when considering the risk linearly and non-linearly. Linearly, the probability of not renting a house was reduced by 8.36% for each 1% increase in the prevalence of population at risk of extreme poverty. In the second, third and fourth percentage quartiles, the probability of not being able to rent a house decreased by 21.13%, 48.61%, and 57.79%, respectively. In addition, the effect was different inside and outside of metropolitan areas, with the former showing a decrease of 19.05% in the probability of renting a house, whereas outside metropolitan areas the probability increased by 5.70%.
... A growing body of empirical research suggests that contact with nature is associated with stress reduction (Beil & Hanes, 2013;Jiang, Chang, & Sullivan, 2014), attention recovery (Berto, 2005;Perkins, Searight, & Ratwik, 2011), and happiness (Van Herzele & De Vries, 2012). However, most of these studies investigated the mental health benefits of greenspace (Gascon et al., 2016;Lee & Maheswaran, 2011;Van den Berg et al., 2015), while few studies have examined the beneficial effects of various types of bluespace (Gascon, Zijlema, Vert, White, & Nieuwenhuijsen, 2017;Völker & Kistemann, 2011). ...
A growing body of literature suggests that visual contact with bluespace may benefit people's mental health. However, whether these benefits vary with the type of bluespace and length of contact duration is unclear. We addressed this critical knowledge gap by conducting a photograph-based experimental study to examine individual mental responses (n = 30) to three types of bluespace (Falling, Flowing, and Static bluespaces) and one control condition (Streetspaces).
The participants were assigned to view four conditions in random sequence in a laboratory. The effect of each condition on mental health was primarily measured using a portable electroencephalogram (EEG) device that continuously recorded brainwaves throughout each contact. We then administered the Restorative Components Scale (RCS) questionnaire as a secondary measure to the participants, who reported psychological states immediately after each contact.
We have four main findings. First, contact with all three types of bluespace significantly promoted mental health compared to Streetspace. Second, the promotion effects of bluespaces varied, and the Falling bluespace was found to be the most beneficial type, as contact with it yielded the highest level of alpha brainwaves, the lowest level of beta brainwaves, and the highest score on the RCS questionnaire. Third, the type of environment appears to be the main factor, and contact duration appears to be the minor factor in explaining the differences in the mental health promotion effects. Finally, a 3-min contact with bluespaces is sufficient to promote mental health. We provide suggestions for future research into bluespaces and how bluespaces can be used to promote urban residents' mental health and well-being.
... Interacting with nature has already been linked to a myriad of beneficial effects troughout life: lower risk of adverse birth outcomes [3], enhanced cognitive development in children [4], improved mental health [5], decreased risk of chrionic diseases (e.g. cardiovascular conditions and diabetes) [6], improved healthy ageing [7], and reduced mortality [8]. ...
Background
Cognitive performances of schoolchildren have been adversely associated with both recent and chronic exposure to ambient air pollution at the residence. In addition, growing evidence indicates that exposure to green space is associated with a wide range of health benefits. Therefore, we aimed to investigate if surrounding green space at the residence improves cognitive performance of primary schoolchildren while taking into account air pollution exposure.
Methods
Cognitive performance tests were administered repeatedly to a total of 307 primary schoolchildren aged 9-12y, living in Flanders, Belgium (2012–2014). These tests covered three cognitive domains: attention (Stroop and Continuous Performance Tests), short-term memory (Digit Span Forward and Backward Tests), and visual information processing speed (Digit-Symbol and Pattern Comparison Tests). Green space exposure was estimated within several radii around their current residence (50 m to 2000 m), using a aerial photo-derived high-resolution (1 m ² ) land cover map. Furthermore, air pollution exposure to PM 2.5 and NO 2 during the year before examination was modelled for the child’s residence using a spatial–temporal interpolation method.
Results
An improvement of the children’s attention was found with more residential green space exposure independent of traffic-related air pollution. For an interquartile range increment (21%) of green space within 100 m of the residence, a significantly lower mean reaction time was observed independent of NO 2 for both the sustained-selective (-9.74 ms, 95% CI: -16.6 to -2.9 ms, p = 0.006) and the selective attention outcomes (-65.90 ms, 95% CI: -117.0 to -14.8 ms, p = 0.01). Moreover, green space exposure within a large radius (2000 m) around the residence was significantly associated with a better performance in short-term memory (Digit-Span Forward Test) and a higher visual information processing speed (Pattern Comparison Test), taking into account traffic-related exposure. However, all associations were attenuated after taking into account long-term residential PM 2.5 exposure.
Conclusions
Our panel study showed that exposure to residential surrounding green space was associated with better cognitive performances at 9–12 years of age, taking into account traffic-related air pollution exposure. These findings support the necessity to build attractive green spaces in the residential environment to promote healthy cognitive development in children.
... green and blue space) and mental-health outcomes (Hartig et al. 2014;Pritchard et al. 2020;Skibins et al. 2022). Evidence has suggested that exposure to nature has been associated with a lower risk of stress, depression, and anxiety (Gascon et al. 2016;Roberts et al. 2019;de Keijzer et al. 2020). In particular, research has indicated that gardens (Sofo and Sofo 2020) and green and blue spaces (Dawwas and Dyson 2021) were an important refuge during Covid-19, and access to these spaces has improved participants mental health within the pandemic context (Grima et al. 2020;Xie et al. 2020). ...
Context: The Covid-19 pandemic led to increased use of green/blue space as indoor spaces became frequently inaccessible. These changes impacted the direct interactions between humans and nature. Aims: To investigate the links between mental health, loneliness, wellbeing, and interaction with non-companion animals, proximity to and use of green/blue space. Methods: A cross-sectional online survey of adult UK residents was conducted between April and June 2020. The questionnaire included validated and bespoke items measuring demographics and exposures and outcomes related to mental health, wellbeing, loneliness, human-animal interactions with non-companion animals (wildlife/farm animals), and proximity to and use of green/blue space before and since the first UK Covid-19 lockdown. Key results: Of 5,926 participants, 4,408 (74.4%) reported interacting with non-companion animals at least every other day. Frequent engagement with non-companion animals was significantly associated with smaller decreases in mental health scores (b = .131, 95% CI [.007 – .256], p =.038) and smaller increases in loneliness scores (b = -.135, 95% CI [-.241 – .030], p = .012). Just under half (48.4%, n=2,867) reported living directly next to a green/blue space, and over half (52.3%; n=3,097) reported using such space at least every day since lockdown. Regular use of green/blue space since lockdown was significantly associated with higher mental health (b = .154, 95% CI [.037 – .272], p = .010), lower loneliness (b = -.334, 95% CI [-.430 – -.238], p =.001), and higher wellbeing (b = .810, 95% CI [.572 – 1.047], p = .001). Closer proximity to such space was significantly associated with lower loneliness scores (b = -.224, 95% CI [-.319 - -.130], p = .001), and higher wellbeing scores (b = .632, 95% CI [.319 - .873], p =.001). Conclusion: The multi-faceted human-nature relationship may promote key human health benefits in the context of the lockdown. Implications: These findings highlight the importance of green/blue space and the human-animal relationship, and how they might play a critical role in maintaining people’s mental health within a pandemic context. Further targeted investigations relating to these areas and links with human health, are important within both pandemic and non-pandemic contexts.
... promotores de salud). La presencia, acceso, calidad y distribución de las zonas verdes, están relacionadas con la esperanza de vida, mortalidad, y morbilidad, especialmente en lo referente a enfermedades cardiovasculares, respiratorias, diabetes y obesidad (Gascón et al., 2016;Lachowycz & Jones, 2011;Rojas-Rueda et al., 2019); también con la salud mental, especialmente en cuanto a depresión y prevalencia de estrés, con un papel destacado en la restauración psicológica Kaplan, 1987;Ulrich et al., 1991;Wen et al., 2019). Además, la presencia de zonas verdes en los entornos laborales y educativos, está relacionada con mejoras en el aprendizaje y el desarrollo cognitivo (Hartig et al., 1997;Korpela & Hartig, 1996;Zijlema et al., 2017) y son un escenario que favorece la generación de conocimiento científico, la educación ambiental y la sensibilización (Sandifer et al., 2015), así como la facilitación de interacción y cohesión social y bienestar colectivo (Leyden, 2003;Maas et al., 2009). ...
... Constant research has proven the fact that nature is beneficial for the health of people, animals and all the living organisms on planet earth. Exposure to green and blue spaces helps in a better cardiovascular and respiratory functioning, improved immune system (Cavaleiro Rufo, 2020), better cognitive function and lowered risk of diseases and mortality (Gascon, 2016). Being with nature helps to reduce stress, anxiety and lower the prevalence of somatization symptoms (Triguero-Mas, 2017), improves the biomarkers of stress and it brings an overall finer mental health and wellbeing. ...
... Constant research has proven the fact that nature is beneficial for the health of people, animals and all the living organisms on planet earth. Exposure to green and blue spaces helps in a better cardiovascular and respiratory functioning, improved immune system (Cavaleiro Rufo, 2020), better cognitive function and lowered risk of diseases and mortality (Gascon, 2016). Being with nature helps to reduce stress, anxiety and lower the prevalence of somatization symptoms (Triguero-Mas, 2017), improves the biomarkers of stress and it brings an overall finer mental health and wellbeing. ...
... Furthermore, it is impossible to get the general conclusion from a case study. Therefore, the published research leaves us with a critical knowledge gap in our understanding of VAF in urban green spaces which provide people with many benefits, including relatively low-cost opportunities to connect with nature (Kaplan et al. 2006), benefiting people's health physically and psychologically (Gascon et al. 2016;Zhu et al. 2021;Zhang, et al. 2022), cushioning the effect of urban heat islands , and acting as noise screens (Wang et al. 2022). The aesthetic quality plays a vital role in giving full play to the functions of urban green spaces due to the fact that an ugly place can discourage people access to it (Gobster et al. 2007). ...
Unlabelled:
Life experience suggests that visual aesthetic fatigue (VAF) is quite common. However, few academic works have focussed on VAF in landscapes, thus our understanding of this issue is very poor, not to mention what measures can be taken to mitigate it. To address these gaps, this study investigated VAF using 16 photographs taken in urban green spaces in Xuzhou (local landscapes) and Hong Kong (non-local landscapes) as stimuli. The visual aesthetic quality (VAQ) of 16 photographs was evaluated four times by the same college students at an interval of one week. Statistical analysis demonstrated that VAF occurred in urban green spaces. Male respondents had a higher VAF than females. There were no significant differences in VAQ and VAF between local and non-local landscapes. No landscape characteristic significantly correlated to or predicted VAF, implying that it is very difficult to mitigate VAF through designing and managing static landscapes.
Supplementary information:
The online version contains supplementary material available at 10.1007/s41742-023-00517-x.
... To assess the quality of each included article, we applied an 8-criterion checklist (Supplemental Materials, Table S2) that had been already utilized by the systematic reviews of the available evidence on the human health effects of environmental exposures (de Keijzer et al. 2016;Gascon et al. 2016;Miri et al. 2019). Each criterion could have a point score between 0 and 2, forming a maximum total score of 11. ...
Exposure to polycyclic aromatic hydrocarbons (PAHs) has been associated with many adverse health outcomes. However, the evidence on such associations with the liver function was not reviewed systemically. Therefore in this study, we systemically reviewed the observational studies on exposure to PAHs and liver function. The MOOSE guidelines were applied to perform this review. We systematically searched Scopus, PubMed, and Web of Science for all relevant articles published in English until 10 September 2022. The quality of retrieved studies was evaluated based on the Gascon et al. method. We retrieved a total of 3927 citations through the initial search, of which an overall of five articles (n = 6994 participants) was included in our final review. The quality assessment indicated that three studies had excellent, one had good, and one had fair quality. Three reviewed studies reported a significant negative association between exposure to PAHs and liver function. One study reported a significant correlation between urinary metabolites of PAHs with serum g-glutamyltransferase (GGT), two studies reported that there was an increase in the risk of hepatocellular carcinoma (HCC) related exposure to PAH-albumin adducts as well as benzo[a]pyrene (BPDE)-DNA adducts in the blood, and two studies indicated that higher levels of urinary metabolites of PAHs were associated with higher risk of abnormal levels of alanine transaminase (ALT), aspartate transaminase (AST) and GGT enzymes. Overall, our review indicated that exposure to PAHs has an adverse impact on human liver function.
... This chapter starts with the argument that the association of urban redevelopment with greening creates a paradox and examines the production of inequalities as a result of greening projects. Even while greening certainly provides economic, ecological, health, and social benefits to many (Immergluck & Balan, 2018;Baró et al., 2014;Triguero-Mas et al., 2017;Gascon et al., 2016;Wolch et al., 2014;Connolly et al., 2013;Anguelovski, 2014;Wachsmuth & Angelo, 2018), it may create new and deeper vulnerabilities for historically marginalized residents -working-class groups, minorities, and immigrants -even in the many cases where interventions are meant to redress historic inequalities in the provision of parks or green spaces (Landry & Chakraborty, 2009;Heynen et al., 2006b;Hastings, 2007;Park & Pellow, 2011;Dahmann et al., 2010;Grove et al., 2018). ...
Increases in social metabolism drive environmental conflicts . This proposition, frequently found in the literature on ecological distribution conflicts, has stimulated much research at the interface of ecological economics and political ecology. However, under which conditions is this proposition valid and useful? This chapter briefly reviews the theoretical foundations underlying this proposition and discusses further socio-metabolic properties that may shape the dynamics of environmental conflicts. Furthermore, the chapter relates the socio-metabolic perspective to other ‘grand explanations’ of environmental conflicts, particularly, to the expansion of capitalism under a neo-Marxist perspective. The chapter argues that a socio-metabolic perspective has much to offer to understand some of the structural drivers of environmental conflicts. A socio-metabolic perspective links local environmental conflicts to the resource use profiles of economies as well as to global production and consumption systems, no matter whether these are capitalist societies, resource-intensive planning economies, autocratic monarchies, or illicit resource extractions occurring in the shadow economy. The chapter closes by recalling the need to integrate biophysical and social dynamics in a balanced manner for the nuanced study of environmental conflicts.
... This chapter starts with the argument that the association of urban redevelopment with greening creates a paradox and examines the production of inequalities as a result of greening projects. Even while greening certainly provides economic, ecological, health, and social benefits to many (Immergluck & Balan, 2018;Baró et al., 2014;Triguero-Mas et al., 2017;Gascon et al., 2016;Wolch et al., 2014;Connolly et al., 2013;Anguelovski, 2014;Wachsmuth & Angelo, 2018), it may create new and deeper vulnerabilities for historically marginalized residents -working-class groups, minorities, and immigrants -even in the many cases where interventions are meant to redress historic inequalities in the provision of parks or green spaces (Landry & Chakraborty, 2009;Heynen et al., 2006b;Hastings, 2007;Park & Pellow, 2011;Dahmann et al., 2010;Grove et al., 2018). ...
Joan Martínez Alier has made relevant contributions to the agrarian question by treating the southwestern Spanish latifundio and Latin American hacienda systems as capitalist ways of exploiting land and labour, not as backward feudal remnants. He has also invoked the resistance of Latin American tenant-labourers and other smallholder peasants as an explanation for the limited extent of wage labour. To that end, he helped rescue Alexander Chayanov and the former Narodnik movement from oblivion. With José Manuel Naredo, he paid tribute to Sergei Podolinsky, another member of this peasant neo-populist current, for pioneering the first calculation of energy balances and returns from agricultural systems. As agricultural and environmental historians, we have followed both paths to develop new proposals for a form of agrarian metabolism that, while contributing to ecological economics, is also aligned with agroecology. We summarize our contributions to these topics, developed together with Eduardo Sevilla Guzmán, Victor Toledo and Gloria Guzmán, as well as some of the researchers at the Institute of Social Ecology in Vienna and many other participants in the international project on Sustainable Farm Systems (SFS). Our teams have also started using these socio-metabolic accounts to take up the agrarian question of labour and gender exploitation through the unequal appropriation of natural resources from a historical point of view, as well as contribute to the next agroecology transition to a fairer food regime within planetary boundaries.
... Awareness of the beneficial impacts of exposure to natural vegetation or green environments on individual activities and health is growing. Mounting evidence indicated that exposure to residential green environments was associated with various health-related outcomes, such as depression (Sarkar et al. 2018), obesity (Sarkar 2017), metabolic syndrome (Yang et al. 2020b), mortality (Gascon et al. 2016), cardiovascular diseases (Yang et al. 2020a), and cognitive decline (de Keijzer et al. 2018). The potential mechanisms of greenness exposure enhancing health remain unclear, but they may be explained by three general functions (Markevych et al. 2017): decreasing harm (e.g., reduction of exposure to noise and air pollution), recovering capacities (e.g., restoration of physiological stress), and building capacities (e.g., encouragement of physical activities). ...
Growing evidence shows that residential greenness is beneficial for various health outcomes, but the link between residential greenness and hearing impairment has not been explored. We aimed to explore the link between residential greenness and hearing impairment using baseline data from the UK Biobank. We used data from 107,516 participants between the ages of 40 and 69 years in the UK Biobank from 2006 to 2010. The normalized difference vegetation index (NDVI) was used to measure the residential greenness. We defined hearing impairment using the digital triplet test. Logistic regression models were conducted to examine the association of residential greenness with hearing impairment. Each interquartile increment in NDVI was associated with 19% lower odds of hearing impairment (odds ratio, OR 0.81; 95% confidence interval, 95% CI 0.79–0.83). Compared with participants in the first NDVI quartile, those in the second, third, and fourth NDVI quartiles had lower odds of hearing impairment (OR 0.69, 95% CI 0.65–0.73 for the second; OR 0.76, 95% CI 0.72–0.81 for the third; OR 0.68, 95% CI 0.65–0.72 for the fourth). Age and Townsend deprivation index showed moderating effects on this association. Our findings showed a negative association between residential greenness and hearing impairment, which might provide potential value for developing cost-effective greenness design and configuration interventions to reduce the risk of hearing impairment.
... The link between access and proximity should thus be sufficiently close to justify our paratremization of access to GSs. In other words, the GS in the neighborhood could be easily reached regardless of the resident's physical condition, and hence, residents could gain benefit from it as indicated in many epidemiological studies [61][62][63][64]. Since stress can also be reduced by spending time in one's own household garden [65] or even via the view from home of green areas [20], we also consider the residential greenness immediately around participant's dwellings. ...
Urban areas are continuously growing, and densification is a frequent strategy to limit urban expansion. This generally entails a loss of green spaces (GSs) and an increase in noise pollution, which has negative effects on health. Within the research project RESTORE (Restorative potential of green spaces in noise-polluted environments), an extended cross-sectional field study in the city of Zurich, Switzerland, is conducted. The aim is to assess the relationship between noise annoyance and stress (self-perceived and physiological) as well as their association with road traffic noise and GSs. A representative stratified sample of participants from more than 5000 inhabitants will be contacted to complete an online survey. In addition to the self-reported stress identified by the questionnaire, hair cortisol and cortisone probes from a subsample of participants will be obtained to determine physiological stress. Participants are selected according to their dwelling location using a spatial analysis to determine exposure to different road traffic noise levels and access to GSs. Further, characteristics of individuals as well as acoustical and non-acoustical attributes of GSs are accounted for. This paper presents the study protocol and reports the first results of a pilot study to test the feasibility of the protocol.
... Thirdly, urban green space might facilitate climate mitigation and adaptation while offering health co-benefits, such as reduced exposure to air pollution, local cooling effects, stress relief and increased recreational space for social interaction and physical activity. 20 The implications of a HiAP approach for health equity are shown by Hall and Jacobson, highlighting potential mutually positive effects. 21 The next section highlights, how the HfAP approach, a step towards HiAP, further develops these ideas. ...
The climate crisis constitutes the largest threat to public health in the 21st century, from which several climate-sensitive direct or indirect health risks emerge. It is noteworthy that the health impact of the climate crisis disproportionately falls on groups with lower socio-economic status, which generally have lower adaptation capacities. There is, however, a huge potential for health policy to contribute to climate change mitigation and for climate policy to reduce disease burden. Policymakers are becoming increasingly aware of the link between health and climate. This nexus is further correlated with inequality, the latter here understood as the unequal distribution of social, political, economic and environmental resources, and health inequity. At the EU level, commitments to reducing net GHG emissions by at least 55% compared to 1990, by the year 2030 and to reach net-zero emissions by 2050 have been formulated within the framework of the European Green Deal and the Fit-for-55 package. Yet, neither does the European Green Deal consider health explicitly, nor does the EU4Health Programme include climate change mitigation or adaptation among its key objectives. Against this background, this policy brief explores risks associated with acting in silos and thus neglecting the interactions between climate, health and inequality, and looks for potential synergies when establishing a sound cli- mate-health-inequality nexus. It further addresses the question as to where the barriers lie for successfully exploiting these synergies between health and climate policy fields. This research showcases potential pitfalls when climate policy does not con- sider health, and when health policy does not take into account interactions with climate change. It also demonstrates that the interdependencies of climate and health create various opportunities. This policy brief is concluded with recommendations for policymakers with a view to addressing health, climate and ine- quality in an integrated manner. These recommendations seek to strengthen the climate-health-equality-nexus in the EU.
... The health co-benefits from climate change actions offer strong arguments for transformative change and can be gained across many sectors, including energy generation, transport, food and agriculture, housing and buildings, industry and waste management [80,81]. Many of the same actions that reduce greenhouse gas emissions also improve air quality [82], while other measures-such as facilitating walking and cycling-improve health through increased physical activity, resulting in reductions in respiratory diseases, cardiovascular diseases, some cancers, diabetes and obesity [83], and urban green spaces facilitate climate mitigation and adaptation while also offering health co-benefits, such as reduced exposure to air pollution, local cooling effects, stress relief and increased recreational space for social interaction and physical activity [84,85]. A shift to more nutritious plant-based diets [86] could reduce global emissions significantly; ensure a more resilient food system; and avoid up to 5.1 million diet-related deaths a year by 2050 [87]. ...
The context of urbanism is changing rapidly. The context for working in the field of urban design and planning is influenced by the pace of change; uncertainty; and massive transitions. The urban professional, however, is still used to planning for small changes and repeating traditional approaches. In this paper, we have investigated major future tasks and problems that require rethinking the skills required from people working in the urban arena. By conducting in-depth conversation with leading thinkers in the field, the tension between idealism and the urgency to act versus realism and the trust in current systems dominated by economic laws is present. This results in the conclusion that a different skillset is required in order to face future complexities and to be able to connect design creativity with process sensitivity in short- and long-term periods and at small and large scales.
... In recent years, green space is an emerging factor in environmental health research, which has the potential to promote health through various pathways, including reduction of psychological stress, promotion of physical activity and social contact, mitigation of air pollution and noise, and increased exposure to biodiversity (Markevych et al., 2017). A growing body of epidemiological studies have linked residential green space with reduced risks of morbidity and mortality of various health outcomes, predominately mental and cardiovascular diseases (Di et al., 2020;Fan et al., 2020;Gascon et al., 2016;James et al., 2015;Yang et al., 2021). However, few studies have examined the health effects of green space on IBD development (Elten et al., 2021). ...
Background: We investigated the associations between residential green space and blue space (water) and in-flammatory bowel disease (IBD) incidence, which have rarely been examined. Methods: We performed a longitudinal analysis using data of the UK Biobank study, a large prospective cohort. Incident cases of IBD were ascertained through linkage to health administrative datasets. Residential green space, blue space and natural environment (land coverage percentage) were estimated using land use data. Cox proportional hazard regression models were used to determine the associations between the exposures and IBD incidence with adjustment for a wide array of potential confounders. Results: A total of 216,868 participants without IBD at baseline were studied with an average follow-up of 11.7 years, contributing to 2.5 million person-years. During the follow-up, 1271 incident IBD cases were identified. In fully adjusted models, participants with green space coverage at 300 m buffer in the 2nd and 3rd tertiles had 18.2% [HR = 0.818, 95% confidence interval (CI): 0.715, 0.936] and 15.4% (HR = 0.846, 95%CI: 0.736, 0.972) lower risks of incident IBD compared with those in the 1st tertile, respectively. Similar results were found for blue space [HR = 0.858 (95%CI: 0.750, 0.982) for 2nd vs 1st tertile; HR = 0.785 (95%CI: 0.685, 0.899) for 3rd vs 1st tertile]. Negative associations were also observed for natural environment. Stronger associations were observed in participants from more deprived areas. Conclusions: Our study suggests that residential green space, blue space and natural environment might be protective factors against IBD.
... To assess the quality of each included article, we applied an 8-criterion checklist (Supplemental Materials, Table S2) that had been already utilized by the systematic reviews of the available evidence on the human health effects of the environmental exposures (de Keijzer et al. 2016;Gascon et al. 2016;Miri et al. 2019). Each criterion could have a point score between 0 and 2, forming a maximum total score of 11. ...
Exposure to polycyclic aromatic hydrocarbons (PAHs) during pregnancy has been associated with many adverse child health. However, the evidence on such associations with child brain development was not reviewed systemically. Therefore, in this study, we systemically reviewed the observational studies on prenatal exposure to PAHs and childhood intelligence quotient (IQ). The Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines were applied to perform this review. We systematically searched Scopus, PubMed, and Web of Science for all relevant articles published in English until 15 October 2022. The quality of retrieved studies was evaluated based on the Gascon et al. method. We retrieved a total of 351 citations through the initial search, of which an overall of six articles (n = 1246 participants) were included in our final review. The quality assessment indicated that four studies had excellent and two studies had good quality. Three reviewed studies reported a significant negative association between prenatal exposure to PAHs and children's IQ. One study reported that exposure to PAHs combined with material hardship was associated with lower child IQ and one study indicated lower child IQ through lower LINE1 DNA methylation-related maternal exposure to PAHs. However, another study did not observe a significant association between prenatal PAH exposure and child IQ. Overall, our review indicated that exposure to PAHs during pregnancy has an adverse impact on childhood IQ.
... The most widely used quantitative indicator to evaluate urban green infrastructure is urban green space per capita (Badiu et al., 2016). In addition to this, studies conducted on urban green space inequalities mostly discuss parameters such as green space per capita, percentage of green space and proximity to urban green space (Yenice, 2012;Olgun & Yılmaz, 2019;Gascon et al., 2016). However, it has been stressed in recent research that the quality and accessibility of green spaces are closely related to criteria such as the size diversity and spatial clustering of the green space (Jim, 2013;Zhou et al., 2018). ...
... Interest in other measures of the urban environment, such as the availability and proximity of natural spaces, mostly vegetation and water bodies, referred to as green and blue spaces, respectively, has increased in recent years. Green space exposure has been inversely associated with the risk of cardiovascular disease in adults [3,4]. Evidence for associations of blue space with health outcomes is still sparse [5,6]. ...
Early life is seen as a particularly sensitive period for environmental exposures. Natural space exposure during pregnancy has been associated with offspring health. Epigenetic gestational age acceleration, a discrepancy between clinical and DNA methylation-based gestational age, may underlie these associations. In 1359 mother-newborn pairs from the population-based Generation R Study, we examined the associations of natural space exposure, defined as surrounding greenness, distance to major green and blue (water) space, and size of the blue space during pregnancy with offspring epigenetic gestational age acceleration. Natural space exposure was based on participants' geocoded addresses, and epigenetic gestational age acceleration was calculated from cord blood DNA methylation using Bohlin's and Knight's epigenetic clocks. Sensitivity analyses were conducted in a subgroup of newborns with optimal pregnancy dating, based on last menstrual period. Surrounding greenness, measured in normalized difference vegetation index values, was intermediate (median 0.4, IQR 0.2), and 84% and 56% of the participants had a major green or blue space near their home address, respectively. We did not observe associations of natural space availability during pregnancy with offspring epigenetic gestational age acceleration. This could imply that epigenetic gestational age acceleration in cord blood does not underlie the effects of residential natural space availability in pregnancy on offspring health. Future studies could investigate whether residential natural space availability during pregnancy is associated with offspring differential DNA methylation at other CpGs than those included in the epigenetic gestational clocks.
... There is considerable evidence in the literature that exposure to urban green spaces can be beneficial to a range of dimensions in human health [1][2][3]. Urban green spaces, particularly urban parks, have inherent environmental, aesthetic, and recreational attributes that contribute to human physical, mental, and social well-being [4,5], improve academic and job performance [6,7], and affect overall happiness [8]. Among these, however, the association between urban parks and happiness has received less critical attention. ...
Green spaces, particularly urban parks, provide essential environmental, aesthetic, and recreational benefits to human health, well-being, and happiness. However, traditional forms of investigating people’s perceptions of urban parks, such as questionnaires and interviews, are often time- and resource-intensive and do not always yield results that are transferable across sites. In this study, spatially explicit geolocational information (Sina Weibo check-in data) was utilized to analyze expressions of happiness and well-being in urban parks in Shanghai, China. The results showed significant differences in reported happiness inside and outside urban parks in Shanghai over a 6-month period. Accessibility, naturalness factors, and the frequency of park visits were positively associated with happiness. There existed both commonalities and disparities in the results between residents and non-residents. These findings can provide decision makers and urban planners with a comprehensive and timely overview of urban park use so they can accurately identify park needs and improvements.
... Feinstaub, insbesondere die sehr kleinen Bestandteile (PM2,5), können, bei entsprechenden Konzentrationen und Expositionszeiten, das Herz-Kreislaufsystem, die oberen und unteren Atemwege, sowie das neuronale Netz schädigen (Cadelis et al., 2014 (Ottelé et al., 2010;Pugh et al., 2012;Joshi und Ghosh, 2014;Brantley et al., 2014;Lin et al, 2016;Tong et al., 2016). Damit kann urbane Vegetation einen positiven Effekt auf die Gesundheit und das Wohlbefinden der in Städten lebenden Menschen bewirken (Tzoulas et al., 2007;Dean et al., 2011;Mitchell et al., 2010;Nowak et al., 2014;Gascon et al., 2016;Lambert et al., 2017;. ...
In den Städten leben zunehmend mehr Menschen. Daher ist eine wesentliche Aufgabe der Kommunen für eine gute Lebensqualität der in den Städten lebenden Menschen zu sorgen. Neben vielen anderen Faktoren spielt dabei auch die Luftqualität eine entscheidende Rolle, denn Luft benötigen wir alle zum Leben und konsumieren Tag für Tag viele Liter davon. Diese Arbeit beschäftigt sich daher mit der Frage, ob urbane Vegetation, insbesondere begrünte Dachflächen, zu einer Verbesserung der Luftqualität beitragen kann. Um diese Frage beantworten zu können wurden zum einen auf mehreren Dachflächen Parameter, welche die Luftqualität widerspiegeln, erfasst. Bei den untersuchten Parametern handelte es sich in erster Linie um Partikel der Größenordnung 2,5 bis 80 Mikrometer und um Stickstoffdioxid (NO2). Luftgetragene Partikel wurden mittels Sigma-2-Sammlern und NO2 mittels Palmes-Röhrchen erfasst. Zum anderen wurden morphologische Blatteigenschaften verschiedener Pflanzenarten mikroskopisch untersucht und eine Aussage über die Filterleistungen der Arten getroffen. Unterstützend wurden Schwermetallgehalte im Substrat und Durchflusswasser untersucht. Die Untersuchungen auf den Dachflächen haben gezeigt, dass, bedingt durch die Höhendifferenz, auf den Dachflächen deutlich geringere Schadstoffmengen erfasst wurden, als auf Straßenniveau. Für NO2 wurde etwa 50 % geringere Werte erfasst. Der Vergleich zwischen begrünter und unbegrünter Dachfläche zeigte sowohl für Feinstaub, als auch für NO2 leicht signifikant geringere Werte auf den begrünten Dächern. Die Untersuchungen an den verschiedenen Pflanzenarten haben ergeben, dass Pflanzen mit strukturreicher Blattoberfläche, dichtem und hohem Wuchs, mehr Partikel aus der Umgebungsluft filtern als niedrig wachsende Arten oder Arten mit glatter Blattoberfläche. Zusammenfassend kann gesagt werden, dass begrünte Dachflächen zu einer leichten Verbesserung der Luftqualität, hinsichtlich Feinstaub und NO2, führen können. Entscheidend dabei sind die Wahl der eingesetzten Pflanzen und letztendlich auch der Abstand zu den Emittenten.
... El acceso a la naturaleza contribuye al bienestar, tal como lo han demostrado variadas investigaciones que asocian los beneficios de la cercanía de la naturaleza en la salud física y mental de las personas (Van den Berg et al., 2015;Gascon et al., 2016;Crouse et al., 2018). Ahora bien, el acceso a la naturaleza también puede abordarse desde la distancia, como un aspecto crítico, ya que se refiere no solo a la distancia del hogar o proximidad, sino que a la capacidad de acceder e interactuar con los espacios naturales. ...
Los humedales de las ciudades chilenas constituyen uno de los ecosistemas urbanos más afectados por los desarrollos inmobiliarios. A pesar de sus valores en recreación y en biodiversidad, sufren una constante pérdida de superficie, debido a deficientes procesos de planificación urbana. Sin embargo, ante el auge de las ciudades verdes y sustentables, se están revalorizando por medio de proyectos de restauración y de parques urbanos abiertos, de valor natural para el bienestar de los hábitats y la población. En este sentido, propiciar una accesibilidad con una infraestructura adecuada aportará a mejorar la calidad de vida de los habitantes y por supuesto del entorno urbano, concretamente a través de la integración de infraestructura verde-azul (blue-green infrastructure). Con la finalidad de contribuir al acceso a la naturaleza en ciudades, se realiza aquí un análisis de accesibilidad a pie, a una red de humedales llamada “La Ruta del Agua”, mediante una encuesta de percepción. Los humedales urbanos evaluados son 5 ecosistemas con distintos entornos barriales en Concepción Metropolitano (Chile). Si bien se trata de un caso de estudio local, representa una contribución metodológica relevante, dada la existencia de una gran cantidad de humedales urbanos degradados en Latinoamérica y en peligro de desaparecer. Los resultados de acceso muestran que los humedales son accesibles por vía de la caminata, pero el hecho de que sean poco visitados, pese a su cercanía a las zonas residenciales, revela su falta de integración como espacios abiertos, verdes, ricos en biodiversidad y aptos para la recreación en la ciudad de Concepción. Los resultados de este estudio son valiosos para el diseño de futuros de proyectos de parques en humedales, parques que deben considerar los valores ecosistémicos, la biodiversidad y la recreación para el bienestar de las personas.
Background:
Urban greenspaces could reduce non-communicable disease (NCD) risk. The links between greenspaces and NCD-related mortality remain unclear. We aimed to estimate associations between residential greenspace quantity and access and all-cause mortality, cardiovascular disease mortality, cancer mortality, respiratory mortality, and type 2 diabetes mortality.
Methods:
We linked 2011 UK Census data of London-dwelling adults (aged ≥18 years) to data from the UK death registry and the Greenspace Information for Greater London resource. We calculated percentage greenspace area, access point density (access points per km2), and distance in metres to the nearest access point for each respondent's residential neighbourhood (defined as 1000 m street network buffers) for greenspaces overall and by park type using a geographic information system. We estimated associations using Cox proportional hazards models, adjusted for a range of confounders.
Findings:
Data were available for 4 645 581 individuals between March 27, 2011, and Dec 31, 2019. Respondents were followed up for a mean of 8·4 years (SD 1·4). All-cause mortality did not differ with overall greenspace coverage (hazard ratio [HR] 1·0004, 95% CI 0·9996-1·0012), increased with increasing access point density (1·0076, 1·0031-1·0120), and decreased slightly with increasing distance to the nearest access point (HR 0·9993, 0·9987-0·9998). A 1 percentage point (pp) increase in pocket park (areas for rest and recreation under 0·4 hectares) coverage was associated with a decrease in all-cause mortality risk (0·9441, 0·9213-0·9675), and an increase of ten pocket park access points per km2 was associated with a decreased respiratory mortality risk (0·9164, 0·8457-0·9931). Other associations were observed, but the estimated effects were small (eg, all-cause mortality risk for increases of 1 pp in regional park area were 0·9913, 0·9861-0·9966 and increases of ten small open space access points per km2 were 1·0247, 1·0151-1·0344).
Interpretation:
Increasing the quantity of, and access to, pocket parks might help mitigate mortality risk. More research is needed to elucidate the mechanisms that could explain these associations.
Funding:
Health Data Research UK (HDRUK).
The intersection of ecosystem and exposure science with health concerns has led to a gradual infiltration of these disciplines. Exposure to (urban) natural ecosystems, defined as ecological exposure, has proven to be substantially beneficial to health, providing more effective and preventive measures than dealing with downstream consequences of the disease. Besides, the eco-environment & health field has shifted its paradigm from focusing on negative environmental exposure to exploring the positive health benefits of ecological exposure. However, a unified framework that integrates the nexus of natural ecosystem, exposure, and health is still lacking. To address these challenges, we propose a new framework, Exposure Ecology (EE), and reviewed relevant studies. We suggest the domain and scope of EE include subject-reality, object-reality, subject-virtual, and object-virtual dimensions and that all previous studies can be covered within this coordinate frame. We analyze the trends and shortcomings of each domain and explain the pathways of ecological exposure to health, including reduction, restoration, promotion capacity, and potential harm. Furthermore, we discuss the theoretical basis for the formation of the theoretical framework of EE, as well as the EE-derived hypotheses, implications, and connections to other related fields. In short, the EE-driven holistic critical review enhances our understanding of this frontier topic substantially, and it can serve as a unified framework for understanding the nexus of (urban) natural ecosystems, ecological exposure, and health, and realizing Sustainable Development Goals (SDGs).
Climate change is a defining challenge for today's society and its consequences pose a great threat to humanity. Cities are major contributors to climate change, accounting for over 70% of global greenhouse gas emissions. With urbanization occurring at a rapid rate worldwide, cities will play a key role in mitigating emissions and addressing climate change. Greenhouse gas emissions are strongly interlinked with air quality as they share emission sources. Consequently, there is a great opportunity to develop policies which maximize the co-benefits of emissions reductions on air quality and health. As such, a narrative meta-review is conducted to highlight state-of-the-art monitoring and modelling tools which can inform and monitor progress towards greenhouse gas emission and air pollution reduction targets. Urban greenspace will play an important role in the transition to net-zero as it promotes sustainable and active transport modes. Therefore, we explore advancements in urban greenspace quantification methods which can aid strategic developments. There is great potential to harness technological advancements to better understand the impact of greenhouse gas reduction strategies on air quality and subsequently inform the optimal design of these strategies going forward. An integrated approach to greenhouse gas emission and air pollution reduction will create sustainable, net-zero and healthy future cities.
Background:
Current evidence on the relations of residential greenness with glucose homeostasis and type 2 diabetes (T2D) remained largely uncertain. Most importantly, no prior studies have investigated whether genetic predisposition modifies the above associations.
Methods:
We leveraged data from the UK Biobank prospective cohort study, with participants enrolled between 2006 and 2010. Residential greenness was assessed by using the Normalized Difference Vegetation Index, and the weighting T2D-specific genetic risk score (GRS) was constructed based on previously published genome-wide association studies. Linear regression models and logistic regression models were used to investigate associations of residential greenness with glycated hemoglobin (HbA1c) and T2D prevalence, respectively. Interaction models explored whether genetic predisposition modifies greenness-HbA1c/T2D associations.
Results:
Among 315,146 individuals (mean [SD] age, 56.59 [8.09] years), each one-unit increase in residential greenness was associated with a 0.87% (95% CI: 0.58%-1.16%) reduction in HbA1c and a 12% decrease in odds of T2D (OR: 0.88, 95% CI: 0.79 to 0.98), respectively. Additionally, interaction analyses further demonstrated that residential greenness and genetic risk had cumulative effects on HbA1c and T2D. Compared with individuals who were exposed to low greenness and had high GRS, participants with low GRS and high greenness had a significant decline in HbA1c (β: 2.96, 95% CI: 3.10 to -2.82, P for interaction = 0.04) and T2D (OR: 0.47, 95% CI: 0.45 to 0.50, P for interaction = 0.09).
Conclusions:
We add novel evidence that residential greenness has protective effects on glucose metabolism and T2D, and those beneficial effects can be amplified by low genetic risk. Our findings may facilitate the improvement of the living environment and the development of prevention strategies by considering genetic susceptibility to T2D.
Background:
Subjective well-being (SWB) measures mental health and happiness. Greenspace can have a positive impact on mental health, and higher SWB is associated with lower all-cause mortality. We conducted a mediation analysis on greenspace and all-cause mortality through improving SWB, in a prospective cohort of Chinese older adults.
Methods:
We included older adults over 65 from the 2008-2014 Chinese Longitudinal Healthy Longevity Survey (CLHLS). We used satellite-derived normalized difference vegetation index (NDVI) to measure greenspaces and calculated SWB measured by eight items. Three main statistical approaches were used. First, we used generalized estimating equations (GEE) and Cox proportional hazard models to examine NDVI-SWB and SWB-mortality relationships. Second, we conducted a causal mediation analysis to investigate the mediating effect of greenspace on all-cause mortality through SWB. Third, we conducted subgroup analyses to discover effect modification.
Findings:
Among 13,133 participants, the mean SWB score and NDVI in 2008 were 28·9 (SD 4·34) and 0·41 (SD 0·14), respectively. We found SWB partially mediated the relationship between residential greenspace and mortality in the adjusted model (average causal mediation effect = 0·11, p = 0·04; average direct effect = 1·96, p < 0·001; total effect = 2·07, p < 0·001) with varying proportions in subgroups. The protective influence was more evident for people with impaired cognitive function, living in rural areas and towns, and with lower income.
Interpretation:
We found a positive association between greenspace, SWB, and longevity. Greenness in the living environment confers better mental health and promotes longevity in the elderly population.
The physical environment is crucial for creating an attractive and sustainable neighbourhood centre. Previous research has explored various aspects of the physical environments of community public spaces; however, few studies have focused on neighbourhood centres in China or elucidated how to prioritize those factors to affect willingness to visit. A questionnaire survey was used to capture which potential physical environmental factors most affect residents’ perceived willingness to visit a neighbourhood centre. Three hundred fifty-six valid survey answers were collected online from residents of Zhejiang Province, China. The results highlight key physical environmental factors and their relative priorities; safety factors are the most valued by residents, whereas green spaces, number and quietness (which have been discussed in previous studies) are considered generally unimportant. The key factors were classified into three groups: spatial quality, accessibility and spatial capacity. The results presented herein provide new insights from residents about neighbourhood centres. The research developed a comprehensive framework for assessing the physical environment of a neighbourhood centre based on key factor prioritization and grouping characteristics that can guide designers and decision makers in assessing and enhancing neighbourhood centres in communities with limited resources.
Unprecedented urban growth has placed increasing pressure on cities globally. The intensive land use changes that follow urban growth often result in the degradation of natural ecosystems, with adverse consequences for the wellbeing of urban populations as the potential delivery of ecosystem services diminishes. This thesis: 1) investigated the spatial distribution of urban ecosystem services in Greater Kuala Lumpur, Malaysia, 2) tested the utilisation of two off-the-shelf ecosystem service valuation tools (SolVES and InVEST) in supporting urban planning, and 3) investigated the extent to which urban ecosystem services and urban biodiversity have been considered as part of sustainable development planning in Kuala Lumpur. Chapter One outlines the aim and scope of the thesis and sets out the research questions addressed in subsequent chapters. It also introduces key concepts and tools used in this thesis. Chapter Two provides a systematic review on the nature and extent of urban ecosystem services research in Southeast Asia in the last two decades. The chapter showed that while urban ecosystem services research in the region has burgeoned over the last five years, research is unequally distributed across Southeast Asia. The chapter found that research often assessed regulating and cultural urban ecosystem services at a landscape scale, though research on synergistic and tradeoff interactions between services were limited. It showed that research was biased towards more developed cities and countries in the region, which may overlook less-developed nations as well as rural and peri-urban regions and their unique preferences towards urban ecosystem services management. The chapter discusses challenges and considerations for urban ecosystem services research in Southeast Asia, given the region’s unique and diverse socioeconomic characteristics, and outlines knowledge gaps addressed in subsequent chapters in this thesis. Chapter Three provides a novel assessment of the distribution of social values for ecosystem services across the Greater Kuala Lumpur metropolitan area. A public participatory GIS survey and the SolVES tool were used to determine residents’ development preferences and perceptions of social values. The chapter reveals that the heterogenous spatial distribution of social values across urban and peri-urban areas was influenced by residents’ development preferences and sociodemographic characteristics. The non-spatial differences in residents’ characteristics and development preferences were found to manifest as larger differences in the spatial distribution of social values, leading to conflicts between groups with different development preferences. The work highlights locations where there is potential for land-use conflict with respect to future urban expansion, emphasising the need for further public engagement and the consideration of multiple perspectives in designing cities. Chapter Four presents a systematic method for integrating the outcomes of a multiple urban ecosystem services assessment to support green infrastructure development across urbanising landscapes. The chapter combines biophysical InVEST ecosystem service models with multicriteria suitability analysis to provide spatially explicit recommendations on targeted areas for five future green infrastructure strategies. The realised distribution of urban ecosystem services was high in seminatural areas and low in urban areas, highlighting the lack of green infrastructure in dense urban areas. The ecosystem services-based suitability analysis showed that some parts of the study area were suitable for the implementation of more than one type of green infrastructure strategy. The findings suggest that the selection of appropriate green infrastructure strategies must consider the varying degree of urban development in the study area and the implication of these strategies for local communities. Chapter Five investigates the extent to which ecosystem services and urban biodiversity were considered in sustainable urban development academic and policy literature in Malaysia. The literature review and content analysis indicated that academic literature and policy documents emphasised the aesthetic and cultural aspects of nature in urban design but rarely captured the full suite of ecosystem services found in cities. The chapter also identified several ecological knowledge gaps in academic literature and policy documents and calls for broader ecological perspectives in sustainable urban development research and policy initiatives. Recommendations are made for the adoption of stronger nature-based approaches through the incorporation of ecosystem services in urban planning. The chapter also highlights the need for critical assessments on the effectiveness of sustainable planning policies in the region, to ensure that sustainability initiatives are on track to meet their objectives. Chapter Six concludes this thesis by synthesising the contributions of the work and highlights challenges for future research in integrating urban ecosystem services to support planning of sustainable and resilient cities. The concept of urban ecosystem services investigated in this thesis will become increasingly important in planning sustainable cities globally, but more so in the Global South, where cities are growing rapidly and are more vulnerable to the impacts of climate change. The research conducted in this thesis contributes to the limited and exigently needed body of urban ecosystem services knowledge in a tropical Global South city. The novel application of ecosystem service valuation tools and methods demonstrated in this thesis can be adapted for urban areas in Southeast Asia and other Global South regions to support the planning of resilient urban ecosystems.
Large cities are increasingly using urban greening, nature-centered projects, and green infrastructure to address socio-environmental and health challenges and harness widespread benefits for citizens, industries, and investors, while protecting existing urban ecosystems, resources, environmentally-sensitive areas, and built infrastructure. This chapter starts with the argument that the alliance of urban redevelopment with greening creates a paradox and examines the production of inequalities as a result of greening projects. I argue that even while greening certainly provides economic, ecological, health, and social benefits to many, it may create new and deeper vulnerabilities and processes of green gentrification for historically marginalized residents – working-class groups, minorities, and immigrants – even in the many cases where interventions are meant to redress historic inequalities in the provision of parks or green spaces. Urban greening inequalities are thus particularly acute because of what can be defined as “green gaps” upon which municipalities, private investors, and privileged residents capture a “green rent” through new commercial and residential investments. As a result, as I show in this chapter, urban greening interventions targeting lower-income, minority, and immigrant neighborhoods risk being increasingly associated with a GreenLULU or green Locally Unwanted Land Use (Anguelovski, J Plan Lit, 1–14, 2016). Last, I examine civic responses to green inequalities and close this chapter with a broader discussion around the need to repoliticize urban greening practices.
Background:
A growing body of evidence suggests that exposure to natural environments, such as green space, may have a beneficial role in health. However, there is limited evidence regarding the effects of exposure to blue spaces and mortality. We investigated the association of exposure to blue spaces with natural and cause-specific mortality in Greece using an ecological study design METHODS: Mortality and socioeconomic data were obtained from 1,035 municipal units (MUs) from the 2011 census data. To define exposure to "blue" we used a rate of the land cover categories related to blue space from the COoRdination and INformation on the Environmental (CORINE) 2012 map per 10,000 persons in the municipal unit. We further assessed the exposure to blue space in the MUs that are located in the coastline of Greece using the distance to the coast as a proxy for proximity to blue space. the Annual PM2.5, NO2, BC and O3 concentrations for 2010 were predicted by land use regression models while the normalized difference vegetation index was used to assess greenness. We applied single and two exposure Poisson regression models accounting for spatial autocorrelation and adjusting for unemployment and lung cancer mortality rates, percentages of the population aged 25-64 with upper secondary or tertiary education attainment and of those born in Greece, and urbanicity. The analysis was conducted for the whole country and separately by varying geographical definitions.
Results:
An interquartile range (IQR) increase of blue space per 10,000 persons was associated with decreased risk in natural mortality (Relative Risk (RR): 0.98 (95% confidence interval (CI): 0.98, 0.99), as well as in mortality due to cardiovascular causes, respiratory causes and diseases of the nervous system 0.98 (95% CI: 0.97, 0.99); 0.97 (95% CI: 0.95, 0.99); 0.94 (95% CI: 0.88, 1.00) respectively). We estimated protective associations for ischemic heart disease (IHD) mortality (RR = 0.98, 95% CI: 0.97, 1.00 per IQR); COPD mortality (RR = 0.97, 95% CI: 0.93, 1.00 per IQR) and mortality from cerebrovascular disease (RR = 0.97 (95% CI: 0.96, 0.99 per IQR). We estimated protective associations for the distance from the coast and mortality from the diseases of the nervous system (RR = 0.75, 95% CI: 0.61, 0.92, ≤1 km from the coast versus >1 km). Our results were stronger for inhabitants of the islands, the coastline and in the rural areas of Greece while the estimates were robust to co-exposure adjustment.
Conclusions:
We estimated statistically significant protective effects of exposure to blue space on mortality from natural, cardiovascular and respiratory causes, diseases of the nervous system, cerebrovascular and ischemic heart disease for in Greece with higher estimates in the coastline and the islands. Further research is needed to elaborate our findings.
With the increasing proportion of the world’s population living in cities, urban ecosystems are of great importance as living spaces for humans. The ecological characteristics and services of urban ecosystems, the latter also with regard to the health and well-being of people in cities and urban landscapes are presented. The restoration of urban nature and its services is broadly defined here and the multifaceted initiatives are presented. In principle, for many ecosystem and habitat types, respectively (e.g., grassland, urban forests), the same measures are applied in urban areas as outside cities. The Schöneberger Südgelände Nature Park is documented as an example of passive and active restoration of urban ecosystems that are unique due to the particular historical development of Berlin, but can also be transferred to other urban environments in many respects.
Substantial evidence suggests that access to urban green spaces and parks is associated with positive health outcomes, including decreased mortality. Few existing studies have investigated the association between green spaces and life expectancy (LE), and none have used small-area data in the U.S. Here we used the recently released U.S. Small-Area Life Expectancy Estimates Project data to quantify the relationship between LE and green space in Los Angeles County, a large diverse region with inequities in park access. We developed a model to quantify the association between green space and LE at the census tract level. We evaluated three green space metrics: normalized difference vegetation index (NDVI, 0.6-meter scale), percent tree canopy cover, and accessible park acres. We statistically adjusted for 15 other determinants of LE. We also developed conditional autoregressive models to account for spatial dependence. Tree canopy and NDVI were both significantly associated with higher LE. For an interquartile range (IQR) increase in each metric respectively, the spatial models demonstrated a 0.24 to 0.33-year increase in LE. Tree canopy and NDVI also modified the effect of park acreage on LE. ln areas with tree canopy levels below the county median, an IQR increase in park acreage was associated with an increase of 0.12 years. Although on an individual level these effects were modest, we predicted 155,300 years of LE gains across the population in LA County if all areas below median tree canopy were brought to the county median of park acres. If tree canopy or NDVI were brought to median levels, between 570,300 and 908,800 years of LE could be gained. The majority of potential gains are in areas with predominantly Hispanic/Latinx and Black populations. These findings suggest that equitable access to green spaces could result in substantial population health benefits.
Objective:
Outdoor recreational activity (ORA) has been suggested as a practical strategy for anger management to moderate the risk of cardiovascular disease (CVD). However, there is a lack of evidence pertaining to this topic. Our aim was to examine whether ORA modified the association between anger expression and the risk of CVD.
Methods:
A community-based cohort study was conducted among 1877 Japanese individuals aged 40-79 years at baseline in 1997. The anger expression was measured using the Spielberger Anger Expression Scale. Stratified into low and high ORA (0 and ≥ 1 of the four behaviors), a Cox proportional hazards model was used to assess the anger expression-related risk of incident CVD (ischemic heart disease and stroke).
Results:
We identified 76 incident CVDs during a median follow-up of 18.8 years. Among participants with low ORA, anger expression was associated with an increased risk of CVD, whereas no association was identified among those with high ORA. The standardized hazard ratios were 1.53 (95% CI, 1.23-1.91) and 0.77 (0.51-1.15) among those with low and high ORA, respectively: p for interaction = .004. Similar associations were observed regarding the risk of total and ischemic stroke, and ischemic CVD.
Conclusions:
We found an elevated risk of CVD associated with anger expression among participants with low ORA but not among those with high ORA, suggesting that ORA use may mitigate the association between anger expression and CVD risk.
Species of ornamental trees and shrubs are frequently attacked by invasive species recently introduced in Romania. Of these, the species Metcalfa pruinosa Say. (Hemiptera: Flatidae), native to the United States, is widespread. It is a polyphagous species. The attack is manifested in the leaves causing damage to the aesthetic value of the attacked plants. During the 2020-2021, the species of trees and shrubs attacked by Metcalfa pruinosa Say were identified and the frequency and intensity of the attack was determined. The studies were carried out in the spaces see and on the street alignments in Cluj-Napoca. Observations were made on all plant species to determine the frequency of the attacked leaves. The species we reported on 47 species that systematically belong to 23 families. Metcalfa pruinosa Say. was reported on most plants, and the most attacked plants were: Ligustrum vulgare L., Fraxinus excelsior L., Robinia pseudoacacia L., Aesculus hippocastanum L., Acer platanoides L., Buxus sempervirens L., Thuja accidentalis L.
The research shows the relationship of adolescents with natural environments and some impacts arising from the social isolation imposed by the COVID-19 pandemic. A face-to-face survey was applied with 277 adolescents (mean = 16.08 years; SD = 1.09) before the pandemic was declared, and during the pandemic 79 of them returned to answer an online survey. The results showed that adolescents had different frequencies of contact with natural environments before social isolation, but in that case, the family was the main mediator. Those who went more often to natural environments and who saw themselves as part of nature were the ones who most missed nature and wanted to go to natural spaces, and were also those who expressed greater concern about environmental problems during the pandemic.
Urban Green Spaces (UGSs) provide a wide range of ecosystem services to cities. However, many cities suffer from the uneven spatial distribution of UGSs. This phenomenon can occur not only in cities with growing populations, but also in those with shrinking populations. Today, many cities around the world are continuously shrinking due to population decline. However, there is still a lack of information on urban forms and the distribution of UGSs. Therefore, this study analyzes the relationship between urban form and UGS equity in shrinking cities by mapping and measuring urban form indicators and UGS equity indicators in 147 shrinking cities in seven regions of Japan for the first time. The results show that 1) partial Japanese urban shrinkage affects equitable development of UGSs; 2) cities with compact populations facilitate equitable urban development; 3) the shape and continuity of urban patches affect the distribution of UGSs in shrinking cities in all regions; 4) urban size, centrality, compactness of urban patches, and urban patch fragmentation affect the distribution of UGSs in shrinking cities in local regions. The results of this study can provide city managers with reliable urban development strategies to promote equitable distribution of UGSs in shrinking cities.
Aims
This study aimed to investigate the association between multiple living environmental factors and cardiovascular diseases (CVDs).
Methods
This study was conducted on the China Health and Retirement Longitudinal Study (CHARLS), with 12,489 subjects in the cross-sectional study and 7,932 subjects in the seven-year follow-up. Living environmental factors included ambient fine particulate matter (PM2.5), indoor fuel use, tap water use, and residence type. Logistic regression and Cox proportional hazard regression models were applied to explore the association between living environmental risk factors and CVD events in a cross-sectional and a cohort analysis, respectively.
Results
Compared with subjects in the low-risk groups, those in the middle-risk (odd ratio [OR], 95% confidence interval [CI]: 1.203, 0.943-1.534) and high-risk groups (OR, 95% CI: 1.616, 1.259-2.074) showed increased risks of CVD prevalence when considering the combined effects of their living environment. During the follow-up, similar associations were observed (hazard ratio [HR], 1.541, 95% CI [1.142-2.080] for the high-risk group; HR 1.296, 95% CI [0.968-1.736] for the middle-risk group); P for trend = 0.003).
Conclusion
An overall poor living environmental quality is a potential risk factor for CVD. Future studies should focus more on the effects of exposure to multiple factors.
Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.
Data on person factors were extracted from a longitudinal population health survey (years 1999/2000 and 2005; n = 24 945). The participants were geocoded and linked to data on green qualities from landscape assessments, and stored in the Geographical Information System (GIS). Crude odds ratios (OR) and 95% confidence intervals (CI) were calculated, and multivariate logistic analyses were performed. Relative Excess Risk due to Interaction (RERI) was evaluated. Results: a reduced risk for poor mental health was found at follow-up among women, through a significant interaction effect between physical activity and access to the perceived green urban qualities Serene and/or Space. Hence; the additive effect to physical activity, of "Serene nature" and/or "perceived Space" in urban green open spaces, contributed to better mental health among female urban citizens.
Nearly 40 years of research provides an extensive body of evidence about human health, well-being, and improved function benefits associated with experiences of nearby nature in cities.
We demonstrate the numerous opportunities for future research efforts that link metro nature, human health and well-being outcomes, and economic values.
We reviewed the literature on urban nature-based health and well-being benefits and provide a classification schematic, then propose potential economic values associated with metro nature services.
Economic valuation of benefits derived from urban green systems has largely been undertaken in the environmental and natural resource economics fields, but have not typically addressed health outcomes. Urban trees, parks, gardens, open spaces and other nearby nature elements, collectively termed metro nature, generate many positive externalities that have been largely overlooked in urban economics and policy. Here, a range of health benefits is identified and presented, including benefit context and beneficiaries. Although the understanding of these benefits is not yet consistently expressed, and although it is likely that attempts to link urban ecosystem services and economic values will not include all expressions of cultural or social value, the development of new interdisciplinary approaches that integrate environmental health and economic disciplines are greatly needed.
Metro nature provides diverse and substantial benefits to human populations in cities. This article begins to address the need for development of valuation methodologies, and new approaches to understanding the potential economic outcomes of these benefits.
There is mounting concern for the health of urban populations as cities expand at an unprecedented rate. Urban green spaces provide settings for a remarkable range of physical and mental health benefits, and pioneering health policy is recognizing nature as a cost-effective tool for planning healthy cities.
Despite this, limited information on how specific elements of nature deliver health outcomes restricts its use for enhancing population health. We articulate a framework for identifying direct and indirect causal pathways through which nature delivers health benefits, and highlight current evidence.
We see a need for a bold new research agenda founded on testing causality that transcends disciplinary boundaries between ecology and health. This will lead to cost-effective and tailored solutions that could enhance population health and reduce health inequalities.
Background: Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries.
Methods: We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions.
Findings: Global life expectancy for both sexes increased from 65·3 years (UI 65·0–65·6) in 1990, to 71·5 years (UI 71·0–71·9) in 2013, while the number of deaths increased from 47·5 million (UI 46·8–48·2) to 54·9 million (UI 53·6–56·3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25–39 years and older than 75 years and for men aged 20–49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10·7%, from 4·3 million deaths in 1990 to 4·8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions.
Interpretation: For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.
Noise pollution is one of the four major pollutions in the world. Little evidence exists about the actual preventive benefits of psychological noise attenuation by urban green spaces, especially from the perspective of environmental medicine and, to the best of our knowledge, there is not a systematic analysis on this topic. The aim of this review was to systematically evaluate whether there is conclusive scientific evidence for the effectiveness of urban green spaces as a psychological buffer for the negative impact of noise pollution on human health and to promote an evidence-based approach toward this still growing environmental hazard. MEDLINE and EMBASE databases were searched for experimental and epidemiological studies published before June 04, 2013 in English and Spanish. Data was independently extracted in two step process by the authors. Due to the heterogeneity of the included studies qualitative assessment was performed. We found moderate evidence that the presence of vegetation can generally reduce the negative perception of noise (supported with an electroencephalogram test in one of the experimental studies; consistent with the data from two epidemiological studies; one experiment found no effect and one was inconclusive about the positive effect). This review fills a gap in the literature and could help researchers further clarify the proper implementation of urban green spaces as a psychological buffer in areas with population exposed to chronic noise pollution.
Background:
Residential proximity to green space has been associated with physical and mental health benefits, but whether green space is associated with post-stroke survival has not been studied.
Methods:
Patients ≥ 21 years of age admitted to the Beth Israel Deaconess Medical Center (BIDMC) between 1999 and 2008 with acute ischemic stroke were identified. Demographics, presenting symptoms, medical history and imaging results were abstracted from medical records at the time of hospitalization for stroke onset. Addresses were linked to average Normalized Difference Vegetation Index, distance to roadways with more than 10,000 cars/day, and US census block group. Deaths were identified through June 2012 using the Social Security Death Index.
Results:
There were 929 deaths among 1645 patients with complete data (median follow up: 5 years). In multivariable Cox models adjusted for indicators of medical history, demographic and socioeconomic factors, the hazard ratio for patients living in locations in the highest quartile of green space compared to the lowest quartile was 0.78 (95% Confidence Interval: 0.63-0.97) (p-trend = 0.009). This association remained statistically significant after adjustment for residential proximity to a high traffic road.
Conclusions:
Residential proximity to green space is associated with higher survival rates after ischemic stroke in multivariable adjusted models. Further work is necessary to elucidate the underlying mechanisms for this association, and to better understand the exposure-response relationships and susceptibility factors that may contribute to higher mortality in low green space areas.
Growing evidence suggests that close contact with nature brings benefits to human health and well-being, but the proposed mechanisms are still not well understood and the associations with health remain uncertain. The Positive Health Effects of the Natural Outdoor environment in Typical Populations in different regions in Europe (PHENOTYPE) project investigates the interconnections between natural outdoor environments and better human health and well-being.
The PHENOTYPE project explores the proposed underlying mechanisms at work (stress reduction/restorative function, physical activity, social interaction, exposure to environmental hazards) and examines the associations with health outcomes for different population groups. It implements conventional and new innovative high-tech methods to characterise the natural environment in terms of quality and quantity. Preventive as well as therapeutic effects of contact with the natural environment are being covered. PHENOTYPE further addresses implications for land-use planning and green space management. The main innovative part of the study is the evaluation of possible short-term and long-term associations of green space and health and the possible underlying mechanisms in four different countries (each with quite a different type of green space and a different use), using the same methodology, in one research programme. This type of holistic approach has not been undertaken before. Furthermore there are technological innovations such as the use of remote sensing and smartphones in the assessment of green space.
The project will produce a more robust evidence base on links between exposure to natural outdoor environment and human health and well-being, in addition to a better integration of human health needs into land-use planning and green space management in rural as well as urban areas.
The aims of this study were to explore associations of the distance and use of urban green spaces with the prevalence of cardiovascular diseases (CVD) and its risk factors, and to evaluate the impact of the accessibility and use of green spaces on the incidence of CVD among the population of Kaunas city (Lithuania).
We present the results from a Kaunas cohort study on the access to and use of green spaces, the association with cardiovascular risk factors and other health-related variables, and the risk of cardiovascular mortality and morbidity. A random sample of 5,112 individuals aged 45-72 years was screened in 2006-2008. During the mean 4.41 years follow-up, there were 83 deaths from CVD and 364 non-fatal cases of CVD among persons free from CHD and stroke at the baseline survey. Multivariate Cox proportional hazards regression models were used for data analysis.
We found that the distance from people's residence to green spaces was not related to the prevalence of health-related variables. However, the prevalence of cardiovascular risk factors and the prevalence of diabetes mellitus were significantly lower among park users than among non-users. During the follow up, an increased risk of non-fatal and fatal CVD combined was observed for those who lived >=629.61 m from green spaces (3rd tertile of distance to green space) (hazard ratio (HR) = 1.36), and the risk for non-fatal CVD-for those who lived >=347.81 m (2nd and 3rd tertile) and were not park users (HR = 1.66) as compared to men and women who lived 347.8 m or less (1st tertile) from green space. Men living further away from parks (3rd tertile) had a higher risk of non-fatal and fatal CVD combined, compared to those living nearby (1st tertile) (HR = 1.51). Compared to park users living nearby (1st tertile), a statistically significantly increased risk of non-fatal CVD was observed for women who were not park users and living farther away from parks (2nd and 3rd tertile) (HR = 2.78).
Our analysis suggests public health policies aimed at promoting healthy lifestyles in urban settings could produce cardiovascular benefits.
Despite emerging evidence that access to greenspace is associated with longer life expectancy, little is understood about what causal mechanisms may explain this relationship. Based on social-ecological theories of health, greenspace has multifaceted potential to influence mortality but the potential alternative mediating pathways have not been empirically tested. This study evaluates relationships between access to greenspace, walking and mortality. Firstly, we test for an association between access to greenspace and self-reported levels of walking using a survey of 165,424 adults across England collected during 2007 and 2008. Negative binomial regression multilevel models were used to examine associations between greenspace access and self reported number of days walked in the last month, in total and for recreational and health purposes, after controlling for relevant confounders. Secondly we use an area level analysis of 6781 middle super output areas across England to examine if recreational walking mediates relationships between greenspace access and reduced premature mortality from circulatory disease. Results show clear evidence of better greenspace access being associated with higher reported recreational walking. There were between 13% and 18% more days of recreational walking in the greenest quintile compared with the least green after adjustment for confounders. Tests for mediation found no evidence that recreational walking explain the associations between greenspace and mortality. Futhermore, whilst the relationship between greenspace access and walking was observed for all areas, the relationship between greenspace access and reduced mortality was only apparent in the most deprived areas. These findings indicate that the association between greenspace and mortality, if causal, may be explained by mediators other than walking, such as psychosocial factors. Future research should concentrate on understanding the causal mechanisms underlying observed associations.
Few studies have considered using environmental amenities to explain social health inequalities.Nevertheless, Green spaces that promote good health may have an effect on socioeconomic health inequalities. In developed countries, there is considerable evidence that green spaces have a beneficial effect on the health of urban populations and recent studies suggest they can have a positive effect on pregnancy outcomes. To investigate the relationship between green spaces and the spatial distribution of infant mortality taking account neighborhood deprivation levels.
The study took place in Lyon metropolitan area, France. All infant deaths that occurred between 2000 and 2009 were geocoded at census block level. Each census block was assigned greenness and socioeconomic deprivation levels. The spatial--scan statistic was used to identify high risk cluster of infant mortality according to these neighborhood characteristics.
The spatial distribution of infant mortality was not random with a high risk cluster in the south east of the Lyon metropolitan area (p<0.003). This cluster disappeared (p=0.12) after adjustment for greenness level and socioeconomic deprivation, suggesting that these factors explain part of the spatial distribution of infant mortality. These results are discussed using a conceptual framework with 3 hypothetical pathways by which green spaces may have a beneficial effect on adverse pregnancy outcomes: (i) a psychological pathway, (ii) a physiological disruption process and (iii) an environmental pathway.
These results add some evidence to the hypothesis that there is a relationship between access to green spaces and pregnancy outcomes but further research is required to confirm this.
Epidemiological studies suggest that living close to the natural environment is associated with long-term health benefits including reduced death rates, reduced cardiovascular disease, and reduced psychiatric problems. This is often attributed to psychological mechanisms, boosted by exercise, social interactions, and sunlight. Compared with urban environments, exposure to green spaces does indeed trigger rapid psychological, physiological, and endocrinological effects. However, there is little evidence that these rapid transient effects cause long-term health benefits or even that they are a specific property of natural environments. Meanwhile, the illnesses that are increasing in high-income countries are associated with failing immunoregulation and poorly regulated inflammatory responses, manifested as chronically raised C-reactive protein and proinflammatory cytokines. This failure of immunoregulation is partly attributable to a lack of exposure to organisms ("Old Friends") from mankind's evolutionary past that needed to be tolerated and therefore evolved roles in driving immunoregulatory mechanisms. Some Old Friends (such as helminths and infections picked up at birth that established carrier states) are almost eliminated from the urban environment. This increases our dependence on Old Friends derived from our mothers, other people, animals, and the environment. It is suggested that the requirement for microbial input from the environment to drive immunoregulation is a major component of the beneficial effect of green space, and a neglected ecosystem service that is essential for our well-being. This insight will allow green spaces to be designed to optimize health benefits and will provide impetus from health systems for the preservation of ecosystem biodiversity.
Current day concentrations of ambient air pollution have been associated with a range of adverse health effects, particularly mortality and morbidity due to cardiovascular and respiratory diseases. In this review, we summarize the evidence from epidemiological studies on long-term exposure to fine and coarse particles, nitrogen dioxide (NO2) and elemental carbon on mortality from all-causes, cardiovascular disease and respiratory disease. We also summarize the findings on potentially susceptible subgroups across studies. We identified studies through a search in the databases Medline and Scopus and previous reviews until January 2013 and performed a meta-analysis if more than five studies were available for the same exposure metric.
BACKGROUND: Several recent studies have identified a relationship between the natural environment and improved health outcomes. However, for practical reasons, most have been observational, cross-sectional studies. PURPOSE: A natural experiment, which provides stronger evidence of causality, was used to test whether a major change to the natural environment-the loss of 100 million trees to the emerald ash borer, an invasive forest pest-has influenced mortality related to cardiovascular and lower-respiratory diseases. METHODS: Two fixed-effects regression models were used to estimate the relationship between emerald ash borer presence and county-level mortality from 1990 to 2007 in 15 U.S. states, while controlling for a wide range of demographic covariates. Data were collected from 1990 to 2007, and the analyses were conducted in 2011 and 2012. RESULTS: There was an increase in mortality related to cardiovascular and lower-respiratory-tract illness in counties infested with the emerald ash borer. The magnitude of this effect was greater as infestation progressed and in counties with above-average median household income. Across the 15 states in the study area, the borer was associated with an additional 6113 deaths related to illness of the lower respiratory system, and 15,080 cardiovascular-related deaths. CONCLUSIONS: Results suggest that loss of trees to the emerald ash borer increased mortality related to cardiovascular and lower-respiratory-tract illness. This finding adds to the growing evidence that the natural environment provides major public health benefits.
Background: Most heat-related deaths occur in cities, and future trends in global climate change and urbanization may amplify this trend. Understanding how neighborhoods affect heat mortality fills an important gap between studies of individual susceptibility to heat and broadly comparative studies of temperature–mortality relationships in cities.
Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008).
Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to map vulnerability and residential addresses of persons who died from heat exposure in 2,081 census block groups. Binary logistic regression and spatial analysis were used to associate deaths with neighborhoods.
Results: Neighborhood scores on three factors—socioeconomic vulnerability, elderly/isolation, and unvegetated area—varied widely throughout the study area. The preferred model (based on fit and parsimony) for predicting the odds of one or more deaths from heat exposure within a census block group included the first two factors and surface temperature in residential neighborhoods, holding population size constant. Spatial analysis identified clusters of neighborhoods with the highest heat vulnerability scores. A large proportion of deaths occurred among people, including homeless persons, who lived in the inner cores of the largest cities and along an industrial corridor.
Conclusions: Place-based indicators of vulnerability complement analyses of person-level heat risk factors. Surface temperature might be used in Maricopa County to identify the most heat-vulnerable neighborhoods, but more attention to the socioecological complexities of climate adaptation is needed.
This paper explores the impact of contextual variables at the neighborhood level on a health marker in the city of Hermosillo, Mexico and discusses the importance of collaboration between planners and health professional to minimize the negative effect of contextual factors on urban health.
Few studies in Mexico have assessed health outcomes at the intra-urban scale and their interaction with neighborhood-level contextual variables. Using spatial analysis and geographical information systems, the paper explores the association between infant mortality and an index of socio-environmental vulnerability used to measure urban contextual factors.
Two high infant mortality clusters were detected within neighborhoods characterized by relatively good environmental conditions and one in a neighborhood with a poor environment.
Our results show the clustering of high infant mortality areas and some association with built environment factors in Hermosillo. The results support the need to reconnect public health and urban planning as a way to create healthier environments in Mexican cities.
Previous studies have demonstrated links between cardiovascular disease and physical inactivity and poor air quality, which are both associated with neighborhood greenness. However, no studies have directly investigated neighborhood greenness in relation to coronary heart disease risk. We investigated the effect of neighborhood greenness on both self-reported and hospital admissions of coronary heart disease or stroke, accounting for ambient air quality, socio-demographic, behavioral and biological factors.
Cross-sectional study of 11,404 adults obtained from a population representative sample for the period 2003-2009 in Perth, Western Australia. Neighborhood greenness was ascertained for a 1600 m service area surrounding the residential address using the mean and standard deviation of the Normalized Difference Vegetation Index (NDVI) obtained from remote sensing. Logistic regression was used to assess associations with medically diagnosed and hospitalization for coronary heart disease or stroke.
The odds of hospitalization for heart disease or stroke was 37% (95% CI: 8%, 57%) lower among adults in neighborhoods with highly variable greenness (highest tertile) compared to those in predominantly green, or predominantly non-green neighborhoods (lowest tertile). This effect was independent of the absolute levels of neighborhood greenness. There was weaker evidence for associations with the mean level of neighborhood greenness.
Variability in neighborhood greenness is a single metric that encapsulates two potential promoters of physical activity - an aesthetically pleasing natural environment and access to urban destinations. Variability in greenness within a neighborhood was negatively associated with coronary heart disease and stroke.
Background: Green spaces are reported to improve health status, including beneficial effects on pregnancy outcomes. Despite the suggestions of air pollution–related health benefits of green spaces, there is no available evidence on the impact of greenness on personal exposure to air pollution.
Objectives: We investigated the association between surrounding greenness and personal exposure to air pollution among pregnant women and to explore the potential mechanisms, if any, behind this association.
Methods: In total, 65 rounds of sampling were carried out for 54 pregnant women who resided in Barcelona during 2008–2009. Each round consisted of a 2-day measurement of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) and a 1-week measurement of nitric oxides collected simultaneously at both the personal and microenvironmental levels. The study participants were also asked to fill out a time–microenvironment–activity diary during the sampling period. We used satellite retrievals to determine the surrounding greenness as the average of Normalized Difference Vegetation Index (NDVI) in a buffer of 100 m around each maternal residential address. We estimated the impact of surrounding greenness on personal exposure levels, home-outdoor and home-indoor pollutant levels, and maternal time-activity.
Results: Higher residential surrounding greenness was associated with lower personal, home-indoor, and home-outdoor PM2.5 levels, and more time spent at home-outdoor.
Conclusions: We found lower levels of personal exposure to air pollution among pregnant women residing in greener areas. This finding may be partly explained by lower home-indoor pollutant levels and more time spent in less polluted home-outdoor environment by pregnant women in greener areas.
Poor mental health is a major issue worldwide and causality is complex. For diseases with multifactorial background synergistic effects of person- and place- factors can potentially be preventive. Nature is suggested as one such positive place-factor. In this cohort study we tested the effect of defined green qualities (Serene, Space, Wild, Culture, Lush) in the environment at baseline on mental health at follow-up. We also studied interaction effects on mental health of those place factors and varied person factors (financial stress, living conditions, and physical activity).
Data on person factors were extracted from a longitudinal (years 1999/2000 and 2005) population health survey (n = 24945). The participants were geocoded and linked to data on green qualities from landscape assessments, and stored in the Geographical Information System (GIS). Crude odds ratios (OR) and 95% confidence intervals (CI) were calculated, and multivariate logistic analyses were performed.
Mental health was not affected by access to the chosen green qualities, neither in terms of amount nor in terms of any specific quality. However, we found a reduced risk for poor mental health at follow-up among women, through a significant interaction effect between physical activity and access to the qualities Serene or Space. For men the tendencies were similar, though not significant. Regarding the other three green qualities, as well as amount of qualities, no statistically certain synergistic effects were found. Likewise, no significant synergies were detected between green qualities and the other person-factors. Only advanced exercise significantly reduced the risk for poor mental health among women, but not for men, compared to physical inactivity.
The results do not directly support the hypothesis of a preventive mental health effect by access to the green qualities. However, the additive effect of serene nature to physical activity contributed to better mental health at follow-up. This tendency was equal for both sexes, but statistically significant only for women.Objective landscape assessments may be important in detangling geographic determinants of health. This study stresses the importance of considering interaction effects when dealing with disorders of multifactorial background.
Cities are expanding and accommodating an increasing proportion of the world's population. It is important to identify features of urban form that promote the health of city dwellers. Access to green space has been associated with health benefits at both individual and neighbourhood level. We investigated whether a relationship between green space coverage and selected mortality rates exists at the city level in the USA.
An ecological cross-sectional study. A detailed land use data set was used to quantify green space for the largest US cities (n=49, combined population of 43 million). Linear regression models were used to examine the association between city-level 'greenness' and city-level standardised rates of mortality from heart disease, diabetes, lung cancer, motor vehicle fatalities and all causes, after adjustment for confounders.
There was no association between greenness and mortality from heart disease, diabetes, lung cancer or automobile accidents. Mortality from all causes was significantly higher in greener cities.
While considerable evidence suggests that access to green space yields health benefits, we found no such evidence at the scale of the American city. In the USA, greener cities tend also to be more sprawling and have higher levels of car dependency. Any benefits that the green space might offer seem easily eclipsed by these other conditions and the lifestyles that accompany them. The result merits further investigation as it has important implications for how we increase green space access in our cities.
Greenspace is theoretically a valuable resource for physical activity and hence has potential to contribute to reducing obesity and improving health. This paper reports on a systematic review of quantitative research examining the association between objectively measured access to greenspace and (i) Physical activity, (ii) Weight status and (iii) Health conditions related to elevated weight. Literature searches were conducted in SCOPUS, Medline, Embase and PYSCHINFO. Sixty studies met the inclusion criteria and were assessed for methodological quality and strength of the evidence. The majority (68%) of papers found a positive or weak association between greenspace and obesity-related health indicators, but findings were inconsistent and mixed across studies. Several studies found the relationship varied by factors such as age, socioeconomic status and greenspace measure. Developing a theoretical framework which considers the correlates and interactions between different types of greenspace and health would help study design and interpretation of reported findings, as would improvement in quality and consistency of greenspace access measures. Key areas for future research include investigating if and how people actually use greenspace and improving understanding of the mechanisms through which greenspace can improve health and, in particular, if physical activity is one such mechanism.
The potential for natural environments to be salutogenic has received growing interest from epidemiologists, but there has been no critical examination of the extent to which associations between green space and health might vary according to the indicator of green space coverage used.
Three different indicators of green space coverage were derived for a set of 268 small areas in four cities within Britain. The indicators had different origins and provided a spectrum of sensitivity from larger spaces only, through to ambient greenery. Two indicators reproducible for anywhere in Europe were included. Agreement between the indicators on the quantity of green space in a small area, and their independent association with measures of mortality and self-reported morbidity, were compared.
Overall, the indicators showed relatively close overall agreement (all r(2)>0.89, p<0.001). However, agreement varied by level of area socioeconomic deprivation (p<0.001). The indicator that detected larger spaces only found less green space in areas of socioeconomic deprivation than the other two. Despite this difference, all indicators showed similar protective associations with the risk of mortality and self-reported morbidity suggesting that larger green spaces may be more important for health effects than smaller spaces.
Associations between green space indicator and health were not sensitive to indicator origin and type. This raises the possibility of trans-European epidemiological studies. Larger green spaces may be the most important for health effects, but may also be less prevalent in more deprived areas.
There is increasing interest in the potential role of the natural environment in human health and well-being. However, the evidence-base for specific and direct health or well-being benefits of activity within natural compared to more synthetic environments has not been systematically assessed.
We conducted a systematic review to collate and synthesise the findings of studies that compare measurements of health or well-being in natural and synthetic environments. Effect sizes of the differences between environments were calculated and meta-analysis used to synthesise data from studies measuring similar outcomes.
Twenty-five studies met the review inclusion criteria. Most of these studies were crossover or controlled trials that investigated the effects of short-term exposure to each environment during a walk or run. This included 'natural' environments, such as public parks and green university campuses, and synthetic environments, such as indoor and outdoor built environments. The most common outcome measures were scores of different self-reported emotions. Based on these data, a meta-analysis provided some evidence of a positive benefit of a walk or run in a natural environment in comparison to a synthetic environment. There was also some support for greater attention after exposure to a natural environment but not after adjusting effect sizes for pretest differences. Meta-analysis of data on blood pressure and cortisol concentrations found less evidence of a consistent difference between environments across studies.
Overall, the studies are suggestive that natural environments may have direct and positive impacts on well-being, but support the need for investment in further research on this question to understand the general significance for public health.
There is mounting international evidence that exposure to green environments is associated with health benefits, including lower mortality rates. Consequently, it has been suggested that the uneven distribution of such environments may contribute to health inequalities. Possible causative mechanisms behind the green space and health relationship include the provision of physical activity opportunities, facilitation of social contact and the restorative effects of nature. In the New Zealand context we investigated whether there was a socioeconomic gradient in green space exposure and whether green space exposure was associated with cause-specific mortality (cardiovascular disease and lung cancer). We subsequently asked what is the mechanism(s) by which green space availability may influence mortality outcomes, by contrasting health associations for different types of green space.
This was an observational study on a population of 1,546,405 living in 1009 small urban areas in New Zealand. A neighbourhood-level classification was developed to distinguish between usable (i.e., visitable) and non-usable green space (i.e., visible but not visitable) in the urban areas. Negative binomial regression models were fitted to examine the association between quartiles of area-level green space availability and risk of mortality from cardiovascular disease (n = 9,484; 1996 - 2005) and from lung cancer (n = 2,603; 1996 - 2005), after control for age, sex, socio-economic deprivation, smoking, air pollution and population density.
Deprived neighbourhoods were relatively disadvantaged in total green space availability (11% less total green space for a one standard deviation increase in NZDep2001 deprivation score, p < 0.001), but had marginally more usable green space (2% more for a one standard deviation increase in deprivation score, p = 0.002). No significant associations between usable or total green space and mortality were observed after adjustment for confounders.
Contrary to expectations we found no evidence that green space influenced cardiovascular disease mortality in New Zealand, suggesting that green space and health relationships may vary according to national, societal or environmental context. Hence we were unable to infer the mechanism in the relationship. Our inability to adjust for individual-level factors with a significant influence on cardiovascular disease and lung cancer mortality risk (e.g., diet and alcohol consumption) will have limited the ability of the analyses to detect green space effects, if present. Additionally, green space variation may have lesser relevance for health in New Zealand because green space is generally more abundant and there is less social and spatial variation in its availability than found in other contexts.
The quality-adjusted life-year (QALY) is a measure of the value of health outcomes. Since health is a function of length of life and quality of life, the QALY was developed as an attempt to combine the value of these attributes into a single index number. The QALY calculation is simple: the change in utility value induced by the treatment is multiplied by the duration of the treatment effect to provide the number of QALYs gained. QALYs can then be incorporated with medical costs to arrive at a final common denominator of cost/QALY. This parameter can be used to compare the cost-effectiveness of any treatment.
Nevertheless, QALYs have been criticised on technical and ethical grounds. A salient problem relies on the numerical nature of its constituent parts. The appropriateness of the QALY arithmetical operation is compromised by the essence of the utility scale: while life-years are expressed in a ratio scale with a true zero, the utility is an interval scale where 0 is an arbitrary value for death. In order to be able to obtain coherent results, both scales would have to be expressed in the same units of measurement. The different nature of these two factors jeopardises the meaning and interpretation of QALYs. A simple general linear transformation of the utility scale suffices to demonstrate that the results of the multiplication are not invariant.
Mathematically, the solution to these limitations happens through an alternative calculation of QALYs by means of operations with complex numbers rooted in the well known Pythagorean theorem. Through a series of examples, the new calculation arithmetic is introduced and discussed.
Relatively few studies have examined the association between air pollution and stroke mortality. Inconsistent and inclusive results from existing studies on air pollution and stroke justify the need to continue to investigate the linkage between stroke and air pollution. No studies have been done to investigate the association between stroke and greenness. The objective of this study was to examine if there is association of stroke with air pollution, income and greenness in northwest Florida.
Our study used an ecological geographical approach and dasymetric mapping technique. We adopted a Bayesian hierarchical model with a convolution prior considering five census tract specific covariates. A 95% credible set which defines an interval having a 0.95 posterior probability of containing the parameter for each covariate was calculated from Markov Chain Monte Carlo simulations. The 95% credible sets are (-0.286, -0.097) for household income, (0.034, 0.144) for traffic air pollution effect, (0.419, 1.495) for emission density of monitored point source polluters, (0.413, 1.522) for simple point density of point source polluters without emission data, and (-0.289,-0.031) for greenness. Household income and greenness show negative effects (the posterior densities primarily cover negative values). Air pollution covariates have positive effects (the 95% credible sets cover positive values).
High risk of stroke mortality was found in areas with low income level, high air pollution level, and low level of exposure to green space.
Based on the tested data of Ev2 on the ballastless track subgrade of Beijing-Tianjin inter-city rail transit project, the control index of strain modulus Ev2 is studied for the gravel filling material under different compaction conditions. In order to obtain the distribution rule of Ev2 and Ev2/Ev1 and their reflection degree on the construction quality of railway subgrade, 422 sets of tested data are selected to make statistical analyses. The sampled 93 sets of graded broken stone Ev2 are analyzed and compared with K30. Such conclusions can be made that, firstly, there is close pertinence between the value of Ev2/Ev1 and the sub-grade compaction quality. Secondly, for the graded broken stone without mixing cement, the parallel tested data of K30 and Evd is easy to be unqualified if Ev2/Ev1 is larger. For the graded broken stone mixing 3%-5% cement, the distribution of Ev2 and Ev2/Ev1 is discrete. But the tested data of K30 is small when the value of Ev2/Ev1 is larger. Finally, from Ev2 multiple loading curve and the test results of unqualified points in field tests, it is found more effective to control the subgrade compaction quality by adopting double-index Ev2 and Ev2/Ev1.
IntroductionIndividual studiesThe summary effectHeterogeneity of effect sizesSummary points
Background:
Several epidemiological studies have investigated the effect of the quantity of green space on health outcomes such as self-rated health, morbidity and mortality ratios. These studies have consistently found positive associations between the quantity of green and health. However, the impact of other aspects, such as the perceived quality and average distance to public green, and the effect of urban green on population health are still largely unknown.
Methods:
Linear regression models were used to investigate the impact of three different measures of urban green on small-area life expectancy (LE) and healthy life expectancy (HLE) in The Netherlands. All regressions corrected for average neighbourhood household income, accommodated spatial autocorrelation, and took measurement uncertainty of LE, HLE as well as the quality of urban green into account.
Results:
Both the quantity and the perceived quality of urban green are modestly related to small-area LE and HLE: an increase of 1 SD in the percentage of urban green space is associated with a 0.1-year higher LE, and, in the case of quality of green, with an approximately 0.3-year higher LE and HLE. The average distance to the nearest public green is unrelated to population health.
Conclusions:
The quantity and particularly quality of urban green are positively associated with small-area LE and HLE. This concurs with a growing body of evidence that urban green reduces stress, stimulates physical activity, improves the microclimate and reduces ambient air pollution. Accordingly, urban green development deserves a more prominent place in urban regeneration and neighbourhood renewal programmes.