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Urban green spaces and health - a review of evidence

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Publications Partners Contact us Urban green spaces and health - a review of evidence (2016) Download English (PDF, 3.0 MB) Modern urban life style is associated with chronic stress, insufficient physical activity and exposure to anthropogenic environmental hazards. Urban green spaces, such as parks, playgrounds, and residential greenery, can promote mental and physical health, and reduce morbidity and mortality in urban residents by providing psychological relaxation and stress alleviation, stimulating social cohesion, supporting physical activity, and reducing exposure to air pollutants, noise and excessive heat. This report summarizes evidence of health benefits, discusses pathways to health and evaluates health-relevant indicators of urban green space. An example of green space accessibility indicator with a detailed methodological tool kit is provided at the end of the report
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Urban green
spaces
and health
A review of evidence

A
BSTRACT
This report summarizes the available evidence of beneficial effects of urban green spaces, such as
improved mental health, reduced cardiovascular morbidity and mortality, obesity and risk of type 2
diabetes, and improved pregnancy outcomes. Mechanisms leading to these health benefits include
psychological relaxation and stress alleviation, increased physical activity, reduced exposure to air
pollutants, noise and excess heat. Characteristics of urban green spaces that are associated with
specific mechanisms leading to health benefits, and measures or indicators of green space availability,
accessibility and use that have been used in previous surveys are discussed from the perspective of
their public health relevance and applicability for monitoring progress towards goals set in international
commitments, such as the Parma Declaration in the WHO European Region and the global Sustainable
Development Goals. The report also presents a suggested indicator of accessibility of green spaces with
examples of its application in three European cities and a detailed methodological tool kit for GIS
analysis of land use and population data.
Keywords
UrbanHealth
Cities
Environment
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Citation advice:
Urban green spaces and health. Copenhagen: WHO Regional Office for Europe, 2016.
© World Health Organization 2016
Allrightsreserved.TheRegionalOfficeforEuropeoftheWorldHealthOrganizationwelcomesrequestsfor
permissiontoreproduceortranslateitspublications,inpartorinfull.
Thedesignationsemployedandthepresentationofthematerialinthispublicationdonotimplythe
expressionofanyopinionwhatsoeveronthepartoftheWorldHealthOrganizationconcerningthelegal
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orboundaries.Dottedlinesonmapsrepresentapproximateborderlinesforwhichtheremaynotyetbefull
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Thementionofspecificcompaniesorofcertainmanufacturers’productsdoesnotimplythattheyare
endorsedorrecommendedbytheWorldHealthOrganizationinpreferencetoothersofasimilarnaturethat
arenotmentioned.Errorsandomissionsexcepted,thenamesofproprietaryproductsaredistinguishedby
initialcapitalletters.
AllreasonableprecautionshavebeentakenbytheWorldHealthOrganizationtoverifytheinformation
containedinthispublication.However,thepublishedmaterialisbeingdistributedwithoutwarrantyofany
kind,eitherexpressorimplied.Theresponsibilityfortheinterpretationanduseofthemateriallieswiththe
reader.InnoeventshalltheWorldHealthOrganizationbeliablefordamagesarisingfromitsuse.Theviews
expressedbyauthors,editors,orexpertgroupsdonotnecessarilyrepresentthedecisionsorthestatedpolicy
oftheWorldHealthOrganization.
Coverphoto:OPENspaceResearchCentre
iii
Editors
AndreyI.Egorov1,2*,PierpaoloMudu1,MatthiasBraubach1andMarcoMartuzzi1
1WorldHealthOrganization,EuropeanCentreforEnvironmentandHealth,Bonn,Germany
2UnitedStatesEnvironmentalProtectionAgency,NationalHealthandEnvironmentalEffects
ResearchLaboratory,ChapelHill,NorthCarolina,theUnitedStates
*AIEcontributedtothereportworkingatWHOandthenatUSEPA.
Primaryauthors
Section2:
CatharineWardThompsonandEvaSilveirinhadeOliveira
OPENspaceResearchCentre,UniversityofEdinburgh,UnitedKingdom
Section3:
BenedictW.WheelerandMichaelH.Depledge
EuropeanCentreforEnvironmentandHumanHealth,UniversityofExeterMedicalSchool,United
Kingdom
Section4:
MatildaAnnerstedtvandenBosch
SwedishUniversityofAgriculturalSciences,SLU,Alnarp,andLundUniversity,Sweden
Othercontributors
Thefollowingindividualscontributedtheirexpertisetothedevelopmentofrecommendationson
health‐relevantWHOindicatorsofurbangreenspaceandcommentedonthedraftreport:
MarkNieuwenhuijsen,CenterforResearchinEnvironmentalEpidemiology(CREAL),Barcelona,Spain
SjerpDeVries,ResearchInstituteAlterra,WageningenUniversity,Wageningen,TheNetherlands
ThomasClaßen,UniversityofBielefeldSchoolofPublicHealth,Bielefeld,Germany
JennyRoe,UniversityofVirginiaSchoolofArchitecture,Charlottesville,Virginia,theUnitedStates
HannekeKruize,DutchNationalInstituteforPublicHealthandtheEnvironment(RIVM),Bilthoven,
TheNetherlands
FrancescaRacioppi,WHORegionalOfficeforEurope,Copenhagen,Denmark
TanjaWolf,WHORegionalOfficeforEurope,Bonn,Germany
KristenScott,InternattheWHORegionalOfficeforEurope,Bonn,Germany
AnneCleary,InternattheWHORegionalOfficeforEurope,Bonn,Germany.
Acknowledgement
GlennRice,USEnvironmentalProtectionAgency,reviewedthereportandmadevaluablecomments.
iv
Disclaimer
Theviewsexpressedinthisreportarethoseoftheauthorsanddonotnecessarilyreflecttheviews
orpoliciesoftheU.S.EnvironmentalProtectionAgency.Mentionoftradenamesorcommercial
productsdoesnotconstituteendorsementorrecommendationforuse.
v
Listofabbreviations
ADHD AttentionDeficitHyperactivityDisorder
BME(groups) blackandminorityethnic(groups)
CORINE CoordinationofInformationontheEnvironment
EEA EuropeanEnvironmentAgency
EEG Electroencephalography
EU EuropeanUnion
GIS GeographicInformationSystem
GPS GlobalPositioningSystem
NDVI NormalizedDifferenceVegetationIndex
UV(light) ultraviolet(light)
USEPA UnitedStatesEnvironmentalProtectionAgency
WHO WorldHealthOrganization
vi
Tableofcontents
1.INTRODUCTION..................................................................................................................................1
2.EVIDENCEONHEALTHBENEFITSOFURBANGREENSPACES.............................................................3
2.1Definitionsofurbangreenspace.................................................................................................3
2.2Pathwayslinkingurbangreenspacetoimprovedhealthandwell‐being....................................3
2.2.1Overviewofpathwaystohealth...........................................................................................3
2.2.2Improvedrelaxationandrestoration....................................................................................4
2.2.3Improvedsocialcapital.........................................................................................................5
2.2.4Improvedfunctioningoftheimmunesystem.......................................................................5
2.2.5Enhancedphysicalactivity,improvedfitnessandreducedobesity......................................5
2.2.6Anthropogenicnoisebufferingandproductionofnaturalsounds.......................................7
2.2.7Reducedexposuretoairpollution........................................................................................8
2.2.8Reductionoftheurbanheatislandeffect.............................................................................8
2.2.9Enhancedpro‐environmentalbehaviour..............................................................................8
2.2.10Optimizedexposuretosunlightandimprovedsleep..........................................................9
2.3Evidenceofhealthbenefitsofgreenspaces................................................................................9
2.3.1Improvedmentalhealthandcognitivefunction...................................................................9
2.3.2Reducedcardiovascularmorbidity......................................................................................10
2.3.3Reducedprevalenceoftype2diabetes..............................................................................11
2.3.4Improvedpregnancyoutcomes..........................................................................................11
2.3.5Reducedmortality...............................................................................................................11
2.4Mechanismsofpotentialpathogeniceffectsofgreenspaces...................................................12
2.4.1Increasedexposuretoairpollutants...................................................................................12
2.4.2Riskofallergiesandasthma................................................................................................12
2.4.3Exposuretopesticidesandherbicides................................................................................12
2.4.4Exposuretodiseasevectorsandzoonoticinfections..........................................................13
2.4.5Accidentalinjuries...............................................................................................................13
2.4.6ExcessiveexposuretoUVradiation....................................................................................13
2.4.7Vulnerabilitytocrime..........................................................................................................13
2.5Characteristicsofurbangreenspaceassociatedwithspecifichealthbenefitsorhazards........14
2.5.1Perceptionsofgreenspaceaccessibilityandquality..........................................................14
2.5.2Sizeofgreenspace..............................................................................................................15
2.5.3Presenceofspecificfacilitiesforcertainactivities..............................................................15
2.5.4Treecoverandcanopydensity...........................................................................................15
2.6Differentialhealthbenefitsofgreenspacesinspecificpopulationgroups...............................16
2.6.1Women................................................................................................................................16
2.6.2Childrenandadolescents....................................................................................................17
2.6.3Olderadults.........................................................................................................................17
2.6.4Deprivedsubpopulationsandminoritygroups...................................................................18
2.6.5Populationsofvariouscountriesandgeographicregions...................................................19
2.7Co‐benefitsofurbangreenspacesunrelatedtohealtheffects.................................................19
3.INDICATORSOFURBANGREENSPACEAVAILABILITY,ACCESSIBILITYANDUSAGE,.............................
ANDASSESSMENTOFTHEIRHEALTHRELEVANCE...............................................................................21
3.1Classificationofurbangreenspaceindicators...........................................................................21
vii
3.2Greenspacecharacteristicsthatcanbeincorporatedindefinitionsofindicators....................21
3.3Indicatorsofgreenspaceavailability.........................................................................................22
3.3.1Greenness,measuredbyNormalisedDifferenceVegetationIndex(NDVI)........................22
3.3.2Densityorpercentageofgreenspacebyarea....................................................................23
3.3.3Measuresofstreettreesandotherstreetscapegreenery..................................................24
3.4Indicatorsofgreenspaceaccessibility.......................................................................................25
3.4.1Proximitytoanurbanparkorgeographicallydefinedgreenspace....................................25
3.4.2Proportionofgreenspaceorgreennesswithinacertaindistancefromresidence............26
3.4.3Perception‐basedmeasuresofgreenspaceaccessibility...................................................27
3.5Indicatorsofgreenspaceusage.................................................................................................28
3.6Summaryandrecommendationsforahealth‐relevantapproachtoselecting..............................
andusingindicatorsofurbangreenspace......................................................................................29
3.6.1Summaryofconsiderationsforselectingindicators...........................................................29
3.6.2Recommendationsforaprimaryindicator.........................................................................30
3.6.3Recommendationsforsecondaryindicators.......................................................................31
4.PROPOSEDINDICATORANDADATAANALYSISTOOLKIT................................................................32
4.1.Summaryofindicatordevelopmentandevaluation.................................................................32
4.2.DatarequirementsforaWHOUrbanGreenSpaceIndicator...................................................33
4.2.1.LandusedataforEUcountries..........................................................................................33
4.2.2.Landcover/usedatafornon‐EUcountries.........................................................................34
4.2.3Populationdata...................................................................................................................34
4.3.Methodology.............................................................................................................................34
4.3.1Generaloverview................................................................................................................34
4.3.2Basicmethod.......................................................................................................................36
4.3.3.Complexmethod................................................................................................................38
4.4Summaryoftheproposedindicator..........................................................................................39
5.CONCLUSIONS..................................................................................................................................40
6.LITERATURE......................................................................................................................................42
APPENDIX1.Examplesofdefinitionsrelatedtoassessinggreenspaceavailabilityoraccessibility....64
APPENDIX2.TheavailabilityofkeyurbanlandusedatafortheMemberStatesof...............................
theWHOEuropeanRegion..................................................................................................................65
APPENDIX3:Atoolkitforassessinggreenspaceaccessibility–detailedstep‐by‐stepprocedure.....67

viii
1
1.INTRODUCTION
Thereisarecentrevivalofinterestintheimportanceofgreenspacetosupporthealthylivingin
urbanareas.Linksbetweengreenspaceandhealthhavebeenrecognizedthroughouthistory,and
wereoneofthedrivingforcesbehindtheurbanparksmovementofthe19thcenturyinEuropeand
NorthAmerica(Schuyler,1988).
However,manyofthemechanismsbehindsuchlinkswerepoorlyunderstoodorlackedrigorous
scientificevidence.Inthe21stcentury,newresearchtechniquesprovideopportunitiestostudythe
mechanismsbehindassociationsbetweengreenspaceandhealthwithincreasingsophisticationand
helpsatisfycontemporaryscientificstandardsofevidencedemandedtoinformpolicyandpractice.
Thisrefinedunderstandingofthehealthpromotionpotentialofurbangreenspacescancontribute
toaddressingmajorpublichealthissuesrelatedtononcommunicablediseases.AcrossEuropeand
beyond,preventablenoncommunicablediseases,suchasmentalillness,obesity,cardiovascular
diseases,type2diabetesandcancer,remainmajorfactorsnotonlyaffectinghealthandwell‐being,
butalsodrivingupthecostofhealthcareandreducingtheproductivityoftheworkforce.Manysuch
illnessesarelinkedtochronicstressandlifestylefactors,suchasinsufficientphysicalactivity(Shortt
etal.,2014).Urbangreenspaces,aspartofawiderenvironmentalcontext,havethepotentialto
helpaddressproblems‘upstream’,inapreventativeway–consideredamoreefficientapproach
thansimplydealingwiththe‘downstream’consequencesofillhealth(Morrisetal.,2006).
AttheFifthMinisterialConferenceonEnvironmentandHealthinParma,Italy(2010),theMember
StatesoftheWHOEuropeanRegionmadeacommitment“…toprovideeachchildby2020with
accesstohealthyandsafeenvironmentsandsettingsofdailylifeinwhichtheycanwalkandcycleto
kindergartensandschools,andtogreenspacesinwhichtoplayandundertakephysicalactivity”
(WHO,2010b).ImprovingaccesstogreenspacesincitiesisalsoincludedintheUnitedNations
SustainableDevelopmentGoal11.7,whichaimstoachievethefollowing:“By2030,provideuniversal
accesstosafe,inclusiveandaccessible,greenandpublicspaces,inparticularforwomenandchildren,
olderpersonsandpersonswithdisabilities”(UnitedNationsDepartmentofEconomicandSocial
Affairs,2014).Finally,theWHOActionPlanfortheimplementationoftheEuropeanStrategyforthe
PreventionandControlofNoncommunicableDiseasesin2012−2016includesacalltocreatehealth‐
supportingurbanenvironments(WHO,2012).
PreviousWHOreportshavealreadycontributedevidenceandguidanceonaccesstogreenspacein
relationtopublichealthbenefits.AWHOreportonurbanplanning,environmentandhealth
publishedin2010statesthatgreenspacescanpositivelyaffectphysicalactivity,socialand
psychologicalwell‐being,improveairqualityandreduceexposuretonoise;however,theycanalso
beassociatedwithanincreasedriskofinjuryduetoincreasedrecreationalandsport‐relateduse
(WHO,2010d).AnotherWHOreportevaluatedtheeffectsofgreenspacesonphysicalactivityand
theirpotentialtoreducepublichealthinequalities.Itstatesthat“…accesstopublicopenspaceand
greenareaswithappropriaterecreationfacilitiesforallagegroupsisneededtosupportactive
recreation”,butrecognizesthatmultidisciplinaryandintersectoralinterventionsmaybeneededto
supportdisadvantagedgroupswherephysicalactivitylevelsarelowest(WHO,2013).
Recentstudieshaveprovidedevidenceofmultiplebenefitsfromurbangreenspace,throughvarious
mechanisms,andwithpotentiallydifferentialimpactsinvariouspopulations.Epidemiologicalstudies
haveusedamultitudeofapproachestomeasuretheeffectsofurbangreenspaceavailabilityand
accessibilityonthehealthoutcomesofstudyparticipants.Giventhepotentialofurbangreenspaces
toactassettingsforhealthpromotionitisthereforenecessarytosummarizetheexistingevidence
identifying,wherepossible,theunderlyingmechanismscontributingtoboththenegativeand
positivehealthoutcomesofurbangreenspace.Thereisalsoaneedtosummarizeexisting
understandingsofthecharacteristicsofurbangreenspacethatmaydifferentiallybeassociatedwith
2
healthoutcomes,andtounderstandhowdifferentpopulationsmaybeaffectedandbenefitin
differentways.
Thisreportoffersareviewoftheexistingevidenceonthehealtheffectsofgreenspaceinurban
areasalongsideasummaryofhealth‐relevantmeasuresofgreenspaceavailability,accessibilityand
usage.ThereportalsopresentsatoolkitoutlininganexampleofaGeographicInformationSystem
(GIS)‐basedapproachtomeasuringurbangreenspacethatWHOhasrecentlyappliedinthree
Europeancities(AnnerstedtvandenBoschetal.,2016).Thereviewisnotsystematicbut,rather,an
overviewofpreviousWHOreportsandotherpreviouslypublishedreviewsaswellasselectedrecent
researchpublications.Themainobjectivesofthisreportaretoinformpublichealthspecialistsand
policy‐makersonthebenefitsofprovidingurbanresidentswithgreenspaceaccess,andtoprovide
citieswithsystematicapproachestoquantifyingandmonitoringtheirgreenspaceaccess.Indoingso
thisreportadvocatestheimplementationandevaluationoftargeted,evidence‐basedgreenspace
interventionsforthehealthpromotionofurbanresidents.
3
2.EVIDENCEONHEALTHBENEFITSOFURBANGREENSPACES
Thissectionsummarizestheevidenceofpathwaystohealthandhealthbenefitsofurbangreen
spacefocusingparticularlyonresearchpublishedoverthelast10years.Potentialmechanismsby
whichgreenspacemayaffectpublichealtharediscussedfirst,followedbyspecifichealthbenefits
demonstratedbyepidemiologicalstudiesand,finally,potentialdetrimentaleffects.
2.1Definitionsofurbangreenspace
Currently,thereisnouniversallyaccepteddefinitionofurbangreenspace,withregardtoitshealth
andwell‐beingimpacts.Urbangreenspacesmayincludeplaceswith‘naturalsurfaces’or‘natural
settings’,butmayalsoincludespecifictypesofurbangreenery,suchasstreettrees,andmayalso
include‘bluespace’whichrepresentswaterelementsrangingfrompondstocoastalzones.Typical
greenspacesinurbanareasarepublicparks;otherdefinitionsmayalsoincludeprivategardens,
woodlands,children’splayareas,non‐amenityareas(suchasroadsideverges),riversidefootpaths,
beaches,andsoon.Thedefinitionsarenuancedandcontext‐specific.Forexample,theycandepend
onparticularenvironment‐healthpathwaysunderconsideration.Examplesofgreenspacedefinitions
arepresentedinAppendix1.
Thefollowingreviewofhealthbenefitsaswellasdiscussionofgreenspacemeasuresandindicators
inSection3ofthereportsummarizeallavailableevidenceandexperiencebasedonvarious
definitionsofurbangreenspace,reflectingvaryingwaysinwhichitisdescribedanddefinedin
differentstudies.
Considerationofurbangreenspaceindifferentresearchusuallyincludespublicparksandgardens,
butmayormaynotalsoincludearangeofotherareas,suchasotherpublicopenspace,streettrees,
sportspitchesandrecreationalfacilitiessuchasgolfcourses,privateandsemi‐privategardensand
otherresidentialopenspace,roofgardens,urbanagriculture,commercialforests,vegetatedwaste
land,indeedanyplacewherethereisanaturalsurfaceorwheretreesaregrowing.
ThemostcommondefinitionofurbangreenspacethathasbeenusedinstudiesinEuropeisbased
onthedefinitionfromtheEuropeanUrbanAtlas(EuropeanUnion,2011).TheGreenUrbanAreasas
definedbyUrbanAtlascode14100includepublicgreenareasusedpredominantlyforrecreation
suchasgardens,zoos,parks,andsuburbannaturalareasandforests,orgreenareasborderedby
urbanareasthataremanagedorusedforrecreationalpurposes.Inpolicyterms,itisimportantto
focusonurbangreenspacethatisopentothepublicparticularlywhenconsideringuniversalgreen
spaceaccessforallurbanresidents,regardlessofsocioeconomiccircumstances.However,where
relevanttheoverviewincludesstudiesthathaveusedwiderormoreinclusivedefinitionsofurban
greenspace.
WhiletheUrbanAtlasexcludesbodiesofwaterfromthedefinitionofGreenUrbanAreas,we
recognizethatwaterisoftenpartofurbangreenspaceandthatthewateredge,whether,for
example,alongariverorlake,aseabeachoracliff,isoftenanimportantandattractivefeaturefor
peopletouseandenjoy.Forthisreason,wemightconsidertheworkingdefinitionforurbangreen
spaceusedinthisoverviewtoinclude‘green/blue’spacewhichmaybeofbenefitinitsentirety,and
wheretheriparianzoneandaccesstowatermaybeparticularlyvaluedandusedbyurbandwellers.
Thisoverviewdoesnot,however,includestudiesthatareexplicitlyfocusedonthehealthbenefitsof
water‐basedsportsandrecreation.
2.2Pathwayslinkingurbangreenspacetoimprovedhealthandwell‐being
2.2.1Overviewofpathwaystohealth
Themechanismsunderlyinglinksbetweengreenspaceaccessandhealtharelikelytobecomplex
andinteracting.Accesstogreenspacemayproducehealthbenefitsthroughvariouspathways
(mechanismsleadingtohealtheffects),someofwhichmayhaveasynergisticeffect.Variousmodels
4
havebeenproposedtoexplaintheobservedrelationshipbetweengreenspaceandhealth.Hartiget
al.(2014)suggestedfourprincipalandinteractingpathwaysthroughwhichnatureorgreenspace
maycontributetohealth:improvedairquality,enhancedphysicalactivity,stressreductionand
greatersocialcohesion.Lachowycz&Jones(2013)emphasizedphysicalactivity,engagementwith
natureandrelaxation,andsocialactivitiesandinteractionsasmajorpathwaystohealth.Villanueva
etal.(2015)proposedamodelthatemphasizesrespiratoryhealthandresiliencetoheat‐related
illness,socialcapitalandcohesion,andphysicalactivity.Kuo(2015)suggestsacentralrolefor
enhancedimmunefunctioningasapathwaybetweennatureandhealth,recognizingthattheremay
bemultiplepathways,someofwhichmayinteractandofferbothdirectandindirectbenefits.Hartig
etal.(2014)summarizedtheexistingstrongevidenceforrestorativepsychologicaleffectsfrom
interactionwithgreenspaceornaturalenvironments.
2.2.2Improvedrelaxationandrestoration
Ithasbeenrecognizedforcenturiesthatcontactwithnaturecanberestorativeandevidenceof
mentalhealthbenefitsfromhavingcontactwithnatureandgreenspacesiswelldocumented(Hartig,
2007;Hartigetal.,1991).Therearetwomaintheoriesthatattempttoexplainthis:
a)Psycho‐physiologicalstressreductiontheoryproposesthatcontactwithnature(e.g.viewsof
naturalsettings)canhaveapositiveeffectforthosewithhighlevelsofstress,byshiftingthemtoa
morepositiveemotionalstate(Ulrich,1983;Ulrichetal.,1991).Aspeopleareinnatelypredisposed
tofindnon‐threateningnaturalstimulirelaxing,exposuretothesestimulitriggersaparasympathetic
nervoussystemresponseleadingtofeelingsofenhancedwell‐beingandrelaxation.
b)AttentionRestorationTheorysuggeststhatinvoluntaryattentiongiventointerestingandrich
stimuliinnaturalsettingshelpstoimproveperformanceincognitivelydemandingtasks(Kaplanand
Kaplan,1989;Kaplan,1995;Kaplan,2001;KaplanandKaplan,2011).Peoplehavetwotypesof
attention:directedattention,whichrequireseffortand,therefore,isalimitedresource,and
fascinationoreffortlessinvoluntaryattention.Workingonspecifictasksrequiringdirectattention
depletesthislimitedresourcewhileinvoluntaryattention,whichisfacilitatedinnatural
environments,restoresitand,therefore,improvescognitiveperformance.
Botharepsycho‐evolutionarytheories,basedonthebiophiliahypothesis,whichpostulatesthat
humanshaveaninnateneedtoaffiliatewiththenaturalenvironmentwithinwhichtheyhave
evolved(Wilson,1984).Boththeoriessuggestthatinteractionwiththenaturalenvironmentservea
restorativefunctionbutthroughdifferentmechanisms(reviewedbyClatworthyetal.,2013).
Supportforthesetheorieshasbeenprovidedbystudiesthatdemonstraterestorativephysiological
responsesassociatedwithviewingorbeingingreenspace,includingreducedbloodpressure(Hartig
etal.,2003,Ottosson&Grahn,2005,Ulrichetal.,1991),heartrate(Ottosson&Grahn,2005,Ulrich
etal.,1991),skinconductanceandmuscletension(Ulrichetal.,1991).Evidenceof
psychoneuroendocrineresponsestowoodlandenvironmentsarebasedonobservedassociations
withlowerconcentrationsofcortisol,lowerpulserate,lowerbloodpressure,greater
parasympatheticnerveactivityandlowersympatheticnerveactivitywhencomparedtocity
environments(Leeetal.,2011;Parketal.,2007).
Hartigetal.(2014)notedthat“substantialevidencespeakstothepotentialbenefitsofcontactwith
natureforavoidinghealthproblemstraceabletochronicstressandattentionalfatigue”,butalso
pointedoutthatmostpreviouslyconductedstudiesdemonstratedonlyshort‐termrestorative
benefitsofanepisodeofexperiencingnature.Forexample,astudyintheUnitedKingdomused
wearableelectroencephalography(EEG)devicestodemonstratetheeffectsofashortwalkinagreen
spaceonbrainactivitythatmightbeassociatedwithenhancedrelaxationandrestoration(Aspinallet
al.,2015).Itwasalsoshownthatwalkinginnaturalenvironmentsproducesstrongershort‐term
cognitivebenefitsthanwalkingintheresidentialurbanenvironment(Gidlowetal.,2016a).Usingthe
diurnalcortisolpatternasabiomarkerofchronicstressisaninnovativeapproachthatwasappliedin
5
theUnitedKingdomtodemonstratethatexposuretogreenspacereduceschronicstressinadults
livingindeprivedurbanneighbourhoods(Roeetal.,2013,WardThompsonetal.,2012;Beil&Hanes
2013).Similarrelationshipsbetweengreenspaceandstressreductionhavebeenshownusinghair
cortisolasabiomarkerofchronicstress(Honoldetal.,2016;Gidlowetal.,2016b).Cortisolmeasures
havealsodemonstratedthestressreducingeffectsofgardening(vandenBerg&Custer,2011)
suggestingthatsuchactivitiesingreenspacemaybeparticularlyrestorative.Ithasalsobeen
demonstratedthatexposuretogreenspacesreducesneuralactivityinthesubgenualprefrontal
cortexandalleviatesdepressionsymptoms(Bratmanetal.,2015).
2.2.3Improvedsocialcapital
Thereisawell‐knownprotectiveeffectofsocialrelationshipsonhealthandwell‐being,whilesocial
isolationisaknownpredictorofmorbidityandmortality(Nieminenetal.,2010;Pantelletal.,2013;
Yangetal,2016).Greenspacecanplayanimportantroleinfosteringsocialinteractionsand
promotingasenseofcommunity(KimandKaplan,2004).InarecentstudyintheNetherlands,de
Vriesetal.(2013)foundanassociationbetweenthequantityand,evenmorestrongly,thequalityof
streetscapegreeneryandperceivedsocialcohesionattheneighbourhoodscale.Inthatstudy,social
cohesionwasdefinedasasenseofcommunity,withafocusontrust,sharednormsandvalues,
positiveandfriendlyrelationships,andfeelingsofbeingacceptedandbelonging.Theresearchers
developedanindicatorofsocialcohesionbasedonquestionnairedata.Conversely,ashortageof
greenspaceintheenvironmenthasbeenlinkedtofeelingsoflonelinessandlackofsocialsupport
(Maasetal.,2009a,WardThompsonetal.,2016).Varioustypesofurbangreenspacehavebeen
showntofacilitatesocialnetworkingandpromotesocialinclusioninchildrenandadolescents
(Seelandetal.,2009).
Neurosciencehasprovidedevidencethatplaceconstitutesadistinctdimensioninneuronal
processingandso´senseofplace´and´placeidentity´,inwhichthesocialandnaturalenvironment
haveparticularroles,areimportantdimensionsforhumanhealth(Lengen&Kistemann,2012).
Hartigetal.(2014)underlinedthattherelationshipsbetweensocialwell‐beingandgreenspaceare
complexand,whileobservationalresearchmayrevealassociations,theunderlyingmechanismsare
noteasytoexplore.Socialwell‐beingmaynotbebeneficiallyaffectedbygreenandopenspacethat
isperceivedasunsafeorwherepeopleengageinantisocialbehaviour,althoughtheseproblemscan
beaddressedbypropermanagementandmaintenance.Thereisalsosomeevidencethatprovision
ofnewgreenspacesindisadvantagedneighbourhoods(e.g.greeningofvacantlots)canreduce
crime(Branasetal.,2011;Chongetal.,2013).
2.2.4Improvedfunctioningoftheimmunesystem
Japanesestudieshavedemonstratedassociationsbetweenvisitingforestsandbeneficialimmune
responses,includingexpressionofanti‐cancerproteins(Lietal.,2008).Thissuggeststhatimmune
systemsmaybenefitfromrelaxationprovidedbythenaturalenvironmentorthroughcontactwith
certainphysicalorchemicalfactorsinthegreenspace.Ithasbeenshownthatchildrenwiththe
highestexposuretospecificallergensandbacteriaduringtheirfirstyearwereleastlikelytohave
recurrentwheezeandallergicsensitization(Lynchetal.,2014).Anothersuggestedimmunological
pathwayisthroughexposuretodiversemicroorganismsinthenaturalenvironments(Rook,2013),
whichcanplayanimmunoregulatoryrole.Kuo(2015)suggestedacentralroleforenhancedimmune
functioninginthepathwaybetweennatureandhealth.
2.2.5Enhancedphysicalactivity,improvedfitnessandreducedobesity
Physicalinactivityisidentifiedasthefourthleadingriskfactorforglobalmortality(WHO,2010a).
Physicalinactivityisbecomingincreasinglycommoninmanycountrieswithmajorimplicationsfor
theprevalenceofnoncommunicablediseasesandthegeneralhealthofthepopulationworldwide
(WHO,2012).Severalenvironmentalfactorsarerecognizedascontributingtophysicalinactivityin
6
cities,suchashightrafficvolumesandlackofparksandfootpaths.Hartigetal.(2014)foundsome
evidenceforanassociationbetweengreenspaceandlevelsofphysicalactivity,suggestingthatthe
relationshipmayvaryconsiderablybetweenpopulationsubgroups;theyunderlinehowwalkingfor
recreationmaybesupportedbygreenenvironmentsinadifferentwaythanwalkingasameansof
transport.
Severalstudiesinvariouscountrieshavedemonstratedthatrecreationalwalking,increasedphysical
activityandreducedsedentarytimewereassociatedwithaccessto,anduseof,greenspacesin
workingageadults,childrenandseniorcitizens(Wendel‐Vosetal.,2004;Epsteinetal.,2006;
Kaczynski&Henderson,2007;Kaczynskietal.,2008;Sugiyama&WardThompson,2008;Sugiyama
etal.,2009;Cochraneetal.,2009;Astell‐Burtetal.,2013;Schipperijnetal.,2013;Lachowyczand
Jones,2014;Sugiyamaetal.,2014;Gardsjordetal.,2014;Jamesetal.,2015).
Almanzaetal.(2012)usedsatelliteimagescoupledwithGlobalPositioningSystem(GPS)and
accelerometerdatafromchildrenintheUnitedStatestodemonstratethatexposuretogreenspace
measuredbyNormalizedDifferenceVegetationIndex(NDVI),whichreflectsthelight‐absorbing
capacityofvegetationderivedfromsatellitedata,waspositivelyassociatedwithmoderateto
vigorousphysicalactivity(MVPA).
Björketal.(2008)andDeJongetal.(2012)foundapositiveassociationbetweenhighqualitygreen
spacesintheneighbourhoodandhigherlevelsofphysicalactivity,aswellasimprovedself‐assessed
health.Highqualitygreenspacewasdefinedashavingacomparativelyhighnumberofrecreational
attributes,outofatotaloffiveassessedbyexperts,includingqualitiesassociatedwithhistoricaland
culturalassociations,spaciousness,richnessofnaturalspecies,peacefulqualitiesandwildness.Ina
UnitedKingdomstudyofchildrenaged10‐11years,Lachowyczetal.(2012)showedthattimespent
ingreenspacecontributedoverathirdofalloutdoorMVPAoccurringduringweekdayevenings,over
40%onSaturdaysandalmost60%onSundays.Furthermore,linksbetweengreenspaceuseand
MVPAwereconsistentinallseasons.InaSpanishstudy,Dadvandetal.(2014a)foundthatlivingin
greenerresidentialareasandproximitytoforestswasassociatedwithlesssedentarytimeand
reducedrisksofchildrenbeingoverweightorobese.
Onewayinwhichgreenspacemaybelinkedtohealthisthroughtheenhancedbenefitsofphysical
activityingreenornaturalplaces,asopposedtoothercontexts.‘Greenexercise’,definedasphysical
activityundertakeningreenornaturalenvironments(Barton&Pretty,2010),hasbeensuggestedas
beingmorebeneficialthanothertypesofexercise(Marselleetal.,2013).Forexample,runningina
parkisassociatedwithamorerestorativeexperiencewhencomparedtothesameexerciseinan
urbanenvironment(BodinandHartig,2003).Barton&Pretty’s(2010)analysisoftenUnited
Kingdomstudiesshowedmultiplementalhealthbenefitsfromphysicalactivityingreen
environments.Mitchell’s(2013)studyoftheScottishpopulationshowedanassociationbetween
physicalactivityinnaturalenvironmentsandreducedriskofpoormentalhealth,whileactivityin
othertypesofenvironmentwasnotlinkedtothesamehealthbenefit.
Interestinassociationsbetweengreenspaceandphysicalactivityhasalsofocusedonbehaviour
change,withcertaingreenspacespotentiallyencouraginggreaterlevelsofphysicalactivity.Inan
Australiancontext,Sugiyamaetal.(2013)foundthatthepresenceofandproximityto
neighbourhoodgreenspaceshelpstomaintainrecreationalwalkingovertime.
Physicalactivityhasbeenshowntoimprovecardiovascularhealth,mentalhealth,neurocognitive
development,andgeneralwell‐beingandtopreventobesity,cancer,andosteoporosis(Owenetal.,
2010).Providingattractiveurbangreenspacemayencouragepeopletospendmoretimeoutdoors
andfacilitatephysicalactivity(Bedimo‐Rungetal.,2005).Inparticular,manyolderpeoplefinditvery
difficulttomaintainmoderatelevelsofphysicalactivity;therefore,providinggreenspacesthat
encourageolderpeopletobeactive,evenifitisonlyatalightlevel,isimportantforpublichealth.
Thequalityoftheurbangreenspaceanditspropermaintenancemaybeimportantfactorsingreen
spaceusagebyolderadults(Aspinalletal.,2010).Sugiyama&WardThompson(2008)demonstrated
7
anassociationbetweenthequalityofneighbourhoodopenspaceandincreasedwalkinginolder
peopleintheUnitedKingdom.Forpeoplewithmentalillnesslivinginurbanareas,physicalactivityin
greenspacemaybeparticularlybeneficial(RoeandAspinall,2011).Otherpopulationsorsubgroups
maybenefit,inasimilarway,fromgreenspacethatmakesoutdooractivityenjoyableandeasy,
henceencouraginglesssedentarylifestyles.
Asystematicreviewof60studiesfromtheUnitedStates,Canada,Australia,NewZealandand
Europeontherelationshipsbetweengreenspacesandobesityindicatorsfoundthatthemajority
(68%)ofpapersshowedthatgreenspaceisassociatedwithreducedobesity;therelationshipscould
bemodifiedbyageandsocioeconomicstatus(Lachowycz&Jones,2011).
Thereissomeevidencethatusinggreenspaceforgrowingfoodmayinfluencephysicalactivity,
socialwell‐beingandencourageahealthydiet,therebyreducingobesity.Apilotinterventionstudy
usingcommunitygardeningandeducationinnutritionintheUnitedStatesfoundthatobeseand
overweightchildrenhadimprovedtheirBodyMassIndexstatusbytheendoftheseven‐week‐long
programme(Castroetal.,2013).
2.2.6Anthropogenicnoisebufferingandproductionofnaturalsounds
Noisepollutionisamajorandincreasingthreattohumanhealth,duetocontinuingurbanization,
risingtrafficvolumes,industrialactivities,andadecreasingavailabilityofquietplacesincities.The
rangeofdiseaseburdenfromnoisepollutionisestimatedat1.0–1.6millionDisabilityAdjustedLife
YearsintheEuropeanRegion(WHO,2011).Evidencesuggeststhatawell‐designedurbangreen
spacecanbufferthenoise,orthenegativeperceptionofnoise,emanatingfromnon‐naturalsources,
suchastraffic,andproviderelieffromcitynoise(González‐Orejaetal.,2010;Irvineetal.,2009).
Vegetationhasbeenconsideredasameanstoreduceoutdoornoisepollution,mainlyinareaswith
highvolumesoftraffic.AstudyinUttarPradesh,India(Pathaketal.,2008)showedsignificant
reductionsintrafficnoisepollutionfromvegetationbeltsof1.5–3mwidthandasimilarheight
range,withgreaternoisereductionasnoisefrequencyincreased(peakattenuationoccurred
between2.5–5KHz).ThisreinforcesfindingsfromanumberofearlierstudiesinEuropeandNorth
America,indicatingthatacombinationoflandformandvegetationweremosteffectivein
attenuatingtrafficnoise.Forexample,Huddart(1990)intheUnitedKingdomshowedthe
effectivenessof10mwidetreebelts.However,Yangetal.(2011)undertookexperimentsusingEEG
andshowedthatoverhalftheirparticipantsoverratedtheabilityofroadsidevegetationtoattenuate
noise.Theresearcherssuggestthat,becausealmostallparticipantsbelievedthatavegetationbarrier
couldreducenoise,theplantsaffectpeople’semotionalprocessingandthatthereisthereforea
psychologicalmechanismatworkinperceivednoisereduction,andespeciallyinthelevelofnoise
attenuationthatvegetationeffects.InaSwedishstudy,Gidlöf‐Gunnarsson&Öhrström(2010)also
showedthatvegetatedcourtyardsmoderatethenegativeeffectsoftrafficnoise.
Adifferentbutnotunrelatedeffectofgreenandbluespaceinrelationtonoiseperceptionisthe
effectofothernaturalnoisesinmaskingnoisepollutionsuchasfromtraffic.InaBelgianstudy,
Coenseletal.(2011)exploredperceivedloudness,pleasantness,andeventfulnessofstimulithat
combinedroadtrafficnoisewithfountainorbirdsoundatdifferentsoundlevels.Addingafountain
soundreducedtheperceivedloudnessofroadtrafficnoiseonlyifthelatterhadlowtemporal
variability.Conversely,addingbirdsoundsignificantlyenhancedsoundscapepleasantnessand
eventfulness,moresothanforthefountainsound.Theauthorsconcludethatsoundscapequalityis
influencedheavilybythemeaningassociatedwiththedifferentsoundsthatareheard.Galbrun&Ali
(2013)subsequentlyexploredtheperceptionofwatersoundstomitigateroadtrafficnoiseand
foundthat,tobeeffective,watersoundsshouldbesimilarto,ornotlessthan3dBbelow,theroad
trafficnoiselevel(confirmingpreviousresearch),andthatstreamsoundstendtobepreferredto
fountainsounds,whichareinturnpreferredtowaterfallsounds.
8
2.2.7Reducedexposuretoairpollution
Evidenceofmitigatingeffectsofurbangreenspaceonexposuretoanthropogenicairpollutantsin
citieshasbeenreviewedbyBowleretal.(2010a).Vegetation(trees,shrubs,herbsandgrass)can
dampentheimpactsofroadtrafficandindustriesandimproveairqualityinurbanresidentialareas
providingbenefitsforpublichealth.Urbanresidentsindifferentcountries(PortugalandFrance)have
recognizedtheroleofgreenspaceinimprovingperceptionofairquality(Madureiraetal.,2015).
Treesandothervegetationcandecreaselevelsofairpollutantsandreduceatmosphericcarbon
dioxidethroughcarbonstorageandsequestration(LiuandLi,2012,Nowaketal.,2006,Vailsheryet
al.,2013,Baróetal.,2014,Nowaketal.,2013,Calfapietraetal.,2016,Manesetal.,2012).Therefore,
greenspacesprovideindirecthealthbenefitsinadditiontothoseassociatedwithdirectcontacts
withgreenery(Dadvandetal.,2012a).(Potentialdetrimentaleffectsofgreenspacesduetotrapping
airpollutantsarediscussedinSection2.4below.)
2.2.8Reductionoftheurbanheatislandeffect
Heatrelatedmorbidityincitiesisamajorpublichealthconcern(WHOandWMO,2015).TheUrban
HeatIslandeffectcanbeaserioushealthhazardduringheatwavesandextremeheatevents.It
arisesduetoreplacementofvegetationwithimperviousheat‐absorbingsurfacesinurbanareas.
Exposuretoexcessiveheatislinkedtoincreasedmorbidityandmortality,especiallyinvulnerable
subpopulations,suchastheelderly(Smargiassietal.,2009;Basagañaetal.,2011).Asystematic
reviewandmeta‐analysisofliteratureonhowurbanparksaffecttheairtemperatureinurbanareas
showedanaveragecoolingeffectofapproximately1oC(Bowleretal.,2010a).Thestudyalso
suggestedthatparksmaymitigateurbanheatinwidersurroundingurbanareas,withdata
suggestinganeffectupto1kmfromtheparkboundary.Theinclusionofwaterbodieswithinthe
greenspacemayoffergreatercoolingeffects(Völkeretal.,2013).Anotherreviewindicatedthat
urbangreenery,includingparks,streettreesandgreenroofs,mitigateUrbanHeatIslandeffects
(Shisegar2014).IntheUnitedStates,Harlanetal.(2006)showedthatdenselypopulatedareas,
sparsevegetation,andlowlevelsofopenspaceintheneighbourhoodweresignificantlylinkedto
highertemperaturesandurbanheatislandsinPhoenix,Arizona.Duringwarmerweather,treescan
provideshadeandreducethedemandforairconditioningand,especially,inwarmercountries,they
canprovidecomfortableoutdoorsettingsandallowpeopletoavoidheatstress(Lafortezzaetal.,
2009).Jeneretteetal.(2011)emphasizedtherolethatvegetationandgreenspaceplayinreducing
surfacetemperatureinPhoenixandhowmoreequitableaccesstourbangreenareasandvegetation
wouldreduceincome‐associatedinequalityinexposuretoextremeheatandprotectvulnerable
groups,suchaselderlyindividuals.Incoolerclimates,treescanalsoprovideshelterfromwindand
therebyreduceheatingdemandinthecoldseason.
2.2.9Enhancedpro‐environmentalbehaviour
Pro‐environmentalbehaviourcanbedefinedas“behaviourthatconsciouslyseekstominimizethe
negativeimpactofone’sactionsonthenaturalandbuiltworld”(Kollmuss&Agyeman,2002).Inthe
faceofclimatechange,whichisprojectedtohaveseriousdetrimentaleffectsonhealth,anupstream
approachtominimizingandmitigatingitseffectsistopromotepro‐environmentalbehaviour
(AnnerstedtvandenBosch&Depledge,2015).Theauthorssuggestedthat,aswithmanysocial
behaviours,pro‐environmentalbehaviourcanbeinducedbyexternalstimuli,particularlyby
experiencingnaturalenvironments.Recentresearchhassupportedthis,showingthatexposureto
naturemayincreasecooperationand,whenconsideringenvironmentalproblemsassocialdilemmas,
sustainableintentionsandbehaviour(Zelenskietal.,2015).Thereisalsoevidencethatchildhood
experiencesinnatureappeartoenhanceadultenvironmentalism(WellsandLekies,2006).Ifpro‐
environmentalactionsarewidelyadopted,peoplecancontributetosubstantiallyreducingcarbon
emissions(Dietzetal.,2009)therebypotentiallypreventingdetrimentaleffectsofclimatechangeon
health.
9
2.2.10Optimizedexposuretosunlightandimprovedsleep
Ifaccesstogreenspacesupportsgreatertimespentoutdoorsamongthepopulation,itislikelytobe
accompaniedbyincreasedexposuretosunlight,whichcanhavepositiveeffectsaswellasnegative
effects(thelatterarediscussedinsection2.4).HumansgetmostoftheirvitaminDfromexposureto
sunlight,andoptimumlevelsofvitaminDareimportantforoverallhealthandwell‐being,especially
bonedensity,soaccesstogreenspacemaycontributetobetterlevelsofvitaminDandassociated
healthbenefits(Gillie,2005).ThismaybeespeciallyimportantfornorthernEuropeanswhose
environmentlackshighlevelsunlightforsignificantpartsoftheyear,andforolderpeople,sincethe
abilitytosynthesiseVitaminDdecreaseswithage.However,thereislackofstudieslookingatthe
roleofgreenspaceandlevelsofvitaminD.DeRuietal.(2014)exploredhowdifferentpastimes
influencedthelevelsofVitaminDinolderpeople.TheauthorsfoundthatvitaminDlevelswere
significantlyhigherinthosewhoengagedinoutdooractivities,ratherthanforthosewhodidnot.
Thelevelswereparticularlyhighforthosewhocycledorpartookingardening.
Naturallightalsocontainsaspectrumoflightwavelengths,someofwhichmaybebeneficialor
detrimental.Accesstosunlightbringstheriskofexposuretodangerouslevelsofultraviolet(UV)light,
especiallyinsouthernhemispherecountriessuchasAustralia,asreportedinsection2.4.However,
recentresearchalsosuggeststhatUV‐inducedreleaseofnitricoxidefromskinmayhaveunexpected
healthbenefits,includingloweringtheincidenceofhypertensionandcardiovasculardisease(CVD)
thatisparticularlyassociatedwithlowerlatitudesandwintermonths(Liuetal.,2014).
Lightexposure,particularlytobluelight,isalsorecognizedaswaytostimulatealertnessand
cognition,andtopromotehealthysleep.Exposuretobluelightisimplicatedinmetabolismand
circadianrhythms,wherenaturallyoccurringpatternsofdaylightsupporthealthycircadianrhythms
butexposuretobluelightatinappropriatetimes(e.g.atnight)maysuppressthesecretionof
hormonesthatinfluencesuchrhythms.However,thereissomeevidencethatthebeneficialeffectof
naturallightoncognitionmaydiminishwithage(Daneaultetal.,2014).
Adequatesleepiscrucialforgoodhealth,whilesleepdeprivationhasbeenlinkedtoadversehealth
outcomes,suchasmetabolicsyndrome,cardiovascularmorbidityandmortality,andneurocognitive
disorders,suchasdementia(Schmidetal.,2015;Kohansieh&Makaryus,2015;Miller,2015).An
Australianstudyshowedthatthoselivinginagreenerneighbourhoodhadlowerriskofinsufficient
sleep(lessthansixhours)(Astell‐Burtetal.,2013).IntheUnitedStates,Grigsby‐Toussaintetal.
(2015)foundthataccesstonaturalenvironmentsreducedtheprevalenceofself‐reported
insufficientsleepinadults,especiallymen.Therefore,greenspaceaccessmaybenefithealththrough
increasingpeople’sexposuretonaturalpatternsofdaylight,hencehelpingtomaintaincircadian
rhythms.
2.3Evidenceofhealthbenefitsofgreenspaces
2.3.1Improvedmentalhealthandcognitivefunction
Studiesofgreenspacesandhealthhavedemonstratedstrongerevidenceformentalhealthbenefits,
andforstressreduction,comparedwithotherpotentialpathwaystohealth(reviewedbydeVries,
2010;Gasconetal.,2015).AnAustralianstudyhasshownperceivedneighbourhoodgreennesstobe
morestronglyassociatedwithmentalhealththanwithphysicalhealth(Sugiyamaetal.,2008)whilea
studyinSpain(Triguero‐Masetal.,2015)foundthatgreaterexposuretogreenspacewaslinkedto
improvedphysicalandmentalhealthacrossallsocioeconomicstrataandgenders.Theassociations
werestrongerforsurroundinggreenness(measuredbyNDVI)thanfordistancetogreenspace.
Furtheranalysisdemonstratedthatthisassociationwasnotmediatedbyphysicalactivity.Movingto
greenerareashasbeenassociatedwithmentalhealthimprovementsintheUnitedKingdom(Alcock
etal.,2014).Individualslivinginurbanareaswithmoregreenspacehavebeenshowntohavea
reducedlevelofstressandimprovedwell‐beingcomparedtocontrolswithpooreravailabilityof
greenspace(Whiteetal.,2013a).AstudyintheUnitedStatesfoundthathigherlevelsof
10
neighbourhoodgreenerywerelinkedtolowerlevelsofdepression,anxietyandstress(Beyeretal.,
2014),whileaGermanstudyfoundmentalwell‐beingincitydwellerstobeparticularlyassociated
withbluespace(Völker&Kistemann,2015).Inalongitudinalstudy,researchersinSwedenfounda
significantassociationbetweengainedaccessto‘serene’greenspaceandimprovedmentalhealthin
women(vandenBoschetal.,2015).Across‐sectionalstudyinEnglandlinkedthequalityof,and
accessto,greenspacewithreducedpsychologicaldistress(Popeetal.,2015).Anotherrecentcross‐
sectionalstudyinLithuaniademonstratedthat,amongindividualswhoregularlyuseparks,closer
proximityoftheirhometothenearestparkwasassociatedwithreducedoddsofself‐reported
symptomsofdepression(Reklaitieneetal.,2014).InastudyinfourEuropeancities,vandenBerget
al.(2016)demonstratedthatmoretimespentingreenspaceisassociatedwithimprovedmental
healthandvitalityindependentofculturalandclimaticcontexts.Generaltherapeuticbenefitsof
natureengagementamongpeoplewithautismhavealsobeendemonstrated(FaberTaylor&Kuo,
2006).
Thereisaccumulatingevidenceforthebeneficialeffectsofgreenspaceonmentalhealthand
cognitivedevelopmentinchildren,althoughsomestudiesproducedinconsistentresults.Ina
Lithuanianstudy,Balsevicieneetal.(2014)foundthatlivingclosertocityparkswasassociatedwith
improvedmentalhealthinchildrenwhosemothershadalowereducationlevel;however,more
residentialgreennesswasassociatedwithworsementalhealthinchildrenwhosemothershada
highereducationlevel.
Greaterusageofgreenandbluespaces,andgreaterresidentialsurroundinggreenness,havebeen
linkedwithimprovedbehaviouraldevelopment(reduceddifficulties,emotionalsymptomsandpeer
relationshipproblems)andreducedrateofAttentionDeficitHyperactivityDisorder(ADHD)in
children(Amolyetal.,2014).Annualtimespentatthebeachwasnegativelyassociatedwith
behaviouraldifficulties,inparticularpeerrelationshipproblems,butpositivelyassociatedwith
strengthinprosocialbehaviour.Dadvandetal.(2015)demonstratedthatgreatersurrounding
greennessathomeandschoolwasassociatedwithimprovedcognitivedevelopment(betterprogress
inworkingmemoryandreducedinattentiveness)inschoolchildren.Theassociationwaspartly
mediatedbyreducedexposuretoairpollution.Anumberofotherstudieshavedemonstratedthe
positiveimpactofgreenspaceexposureonADHDandrelatedsymptoms(FaberTaylor&Kuo,2011;
vandenBergandvandenBerg,2011;Markevychetal.,2014).
2.3.2Reducedcardiovascularmorbidity
AstudyintheUnitedKingdom(MitchellandPopham,2008)foundanassociationbetweenlow
quantitiesofneighbourhoodgreenspaceandelevatedriskofcirculatorydisease.AstudyinLithuania
foundthatdistancetogreenspaceshaslittleornoinfluenceonlevelsofknowncardiovascularrisk
factorsortheprevalenceofcoronaryheartdiseaseandstroke.However,thereweresignificant
associationsbetweenamoreintenseuseofgreenspaceandreducedriskofcardiovasculardisease
(Tamosiunasetal.,2014).InaLithuanianinterventionstudy,Grazulevicieneetal.(2015b)foundthat
walkingintheparkhadagreatereffectonreducingheartrateanddiastolicbloodpressurethan
walkinginabusyurbanstreet.Theysuggestthatwalkinginagreenspace(suchasapark)couldbe
encouragedasrehabilitationfromcoronaryarterydisease.
Pereiraetal.(2012)alsofoundaninverseassociationbetweenthelevelsandvariabilityof
neighbourhoodgreenness,whichwasassessedusingNDVIdata,andcoronaryheartdiseaseor
strokeinAustralia.Theoddsofhospitalizationandself–reportedheartdiseasewerelowerforthose
livinginneighbourhoodswithhighlyvariablegreenness,comparedtothosewithlowvariabilityin
greenness.Thiseffectwasindependentoftheabsolutelevelsofneighbourhoodgreenness.There
wasweakerevidenceforassociationswiththemeanlevelofneighbourhoodgreenness.Theauthors
hypothesizedthatgreatervariabilityinneighbourhoodgreennessreflectstwopotentialpromotersof
physicalactivity–anaestheticallypleasingnaturalenvironmentandaccesstourbandestinations.
11
2.3.3Reducedprevalenceoftype2diabetes
Itiswell‐knownthattype2diabetesmellituscanbepreventedbylife‐styleinterventionsthat
improvephysicalactivityandreduceobesity.Therefore,itisplausiblethataccesstogreenspaces
canpreventdiabetesbypromotingmoreactivelifestyles.Cross‐sectionalobservationalstudiesin
TheNetherlands,AustraliaandtheUnitedKingdomdemonstratedsignificantassociationsbetween
neighbourhoodgreennessandreducedoddsofhavingtype2diabetesmellitus(Astell‐Burtetal.,
2014a;Maasetal.,2009b;Bodicoatetal.,2014).AstudyinGermanydemonstratedaninverse
associationbetweenneighbourhoodgreenness(measuredbyNDVI)andinsulinresistancein
adolescents(Thieringetal.,2016).Theauthorsconcludedthatthisapparentprotectiveeffectwas
duetovegetationreducingexposuretotraffic‐relatedairpollutants.
2.3.4Improvedpregnancyoutcomes
Asystematicreviewandmeta‐analysis(Dzhambovetal.,2014)showedthataccesstogreenspacein
closeproximitytothehomesofpregnantwomenwaspositivelyassociatedwithbirthweight.Birth
weightisausefulindicatorofhealthinearlylife:lowbirthweightisoneofthemajorpredictorsof
neonatalandinfantmortality,aswellaslong‐termadverseeffectsinchildhoodandbeyond.Recent
studiesinIsrael,GermanyandEngland(Agay‐Shayetal.,2014;Markevychetal.,2014;Dadvandet
al.,2014b)alsofoundapositiveassociationbetweenresidentialgreennessmeasuredbyNDVIand
birthweight.AstudyinLithuaniademonstratedthatalargerdistancetoacityparkfromthehomes
ofpregnantwomenwasassociatedwithincreasedriskofpretermbirthandreducedgestationalage
atbirth(Grazulevicieneetal.,2015a).However,astudyinsouthernCaliforniaintheUnitedStates
showedonlyaweakrelationshipbetweengreenspaceandpretermbirths(Laurentetal.,2013).No
associationwasfoundbetweengreennessandpreeclampsia(Agay‐Shayetal.,2014;Laurentetal.,
2013).
2.3.5Reducedmortality
Evidencethatexposuretourbangreenspaceislinkedtoreducedmortalityratesisaccumulating
(reviewedbyGasconetal.,2016).StudiesinJapanhaveshownthatthefive‐yearsurvivalratein
individualsagedover70waspositivelyassociatedwithhavingaccesstomorespaceforwalkingand
withparksandtree‐linedstreetsneartheresidence(Takanoetal.,2002).Anotherstudyofpre‐
retirementagepopulationinEnglandshowedevidenceoftheinfluenceoftheamountofgreen
spaceintheneighbourhoodonall‐causemortality(MitchellandPopham,2008).Thestudy
reinforcedearlierfindingsbasedonthe2001censuspopulationofEngland,whichfoundthata
higherproportionofgreenspaceinanareawasassociatedwithbetterself‐reportedhealth(Mitchell
&Popham,2007).
Arecentlongitudinalstudyofapproximately575,000adultsinCanadafoundthatincreased
residentialgreenspacewasassociatedwithareductioninmortality(Villeneuveetal.,2012);the
strongesteffectwasonmortalityfromrespiratorydiseases.Itshouldbenotedthatsuchfindings
mayalsoreflectthetypeofurbandevelopmentandavailabilityofpublictransportorwalkable
streets.InSpain,Xuetal.(2013)showedthatperceivedgreennessofneighbourhoodswasassociated
withlowermortalityriskduringheatwaves.
Arecentsystematicreviewdemonstratedthatthemajorityofpreviouslyconductedstudiesshowed
areductionoftheriskofcardiovasculardisease(CVD)mortalityinareaswithhigherresidential
greenness;resultsofmeta‐analysissupportedthehypothesisthatlivinginareaswithhigheramounts
ofgreenspacereducesCVDmortality,whileevidenceofareductionofall‐causemortalityismore
limited(Gasconetal.,2016).IntheUnitedStates,residentialproximitytogreenspacehasbeen
associatedwithareducedriskofstrokemortality(Huetal.,2008)andwithhighersurvivalratesafter
ischemicstroke(Wilkeretal.,2014).Incontrasttotheabovefindings,Richardsonetal.(2012)did
notfindanassociationbetweenavailabilityofgreenspacesandoverallmortalityinthe49largestUS
12
cities.TheauthorssuggestedthismightbeduetothesprawlingnatureofUScitiesandhigherlevels
ofcardependencythaninmostEuropeancities.
2.4Mechanismsofpotentialpathogeniceffectsofgreenspaces
Theevidenceonadverseeffectsofurbangreenspaceorneighbourhoodgreeneryonhealthis
scarcerincomparisontotheevidenceofbeneficialeffects.Anoverviewofsomeofthesedetrimental
effectsandtheirmechanismsisprovidedbelow(Lõhmus&Balbus,2015).
2.4.1Increasedexposuretoairpollutants
Theinteractionbetweentrees,airflowandpollutioniscomplex.Whiletreesandvegetationmaybe
effectiveinbufferingairbornepollutants,insomecases,treesmaytrapandcontainairpollution
nearbusyroadswhenaclosedcanopyimpedesthelocalizeddispersionofvehicularemissions(Jinet
al.,2014).However,itispossibletooptimiseurbangreeneryinordertoavoidairpollutiontrapping
byurbanstreettrees(Jinetal.,2014).
Attractivenearbyparksandopenspacesmaybeassociatedwithincreasedlevelsofphysicalexercise
suchaswalking,asstudiesinEngland(Fosteretal.,2004)andAustralia(Giles‐Corti&Donovan,2003)
haveshown.However,wheregreenspaceisadjacenttosourcesofpollutionsuchasheavily
traffickedroads,physicalactivitycanbeassociatedwithelevatedexposuretoparticulatematter,
ozone,nitrogendioxide,sulphurdioxideandotherpollutants,especiallyundercertainweather
conditions(Carlisle&Sharp,2001).Nonetheless,dependingonurbanairpollutionlevels,the
benefitsofphysicalexercisemaystilloutweighdetrimentaleffectsofexposuretopollutants.Astudy
inmorethan50,000peopleaged50‐65years,livinginDenmark,showedthatexposuretohighlevels
oftraffic‐relatedairpollutiondidnotmodifyassociationsbetweenactivitylevelsandmortality,
demonstratingbeneficialeffectsofphysicalactivityonmortalityeveninthepresenceofairpollution
(Andersenetal.,2015).
2.4.2Riskofallergiesandasthma
Evidenceofassociationsbetweenurbangreenery,allergiesandasthmaisratherinconclusive.Lovasi
etal.(2008)foundthatchildrenlivinginareaswithmorestreettreesinNewYorkCityhadlower
asthmaprevalence.AlatercohortstudyinvolvingminoritychildreninNewYorkCityfailedtoshowa
hypothesizedprotectiveeffectand,infact,demonstratedapositiveassociationbetweentreecover
andallergicsensitizationtotreepollenandasthmainchildren(Lovasietal.,2013).Anotherstudy
conductedintheUnitedStatesreportedthatpollenassociatedwithurbanparksandtreeswaslisted
amongtheself‐reportedtriggersofasthmainPhiladelphia(Keddemetal.,2015).AstudyinSabadell,
Spainhasnotfoundanassociationbetweenresidentialgreennessandasthma;however,thesame
studyshowedthatcloserproximitytoparkswaslinkedwithelevatedprevalenceofasthma(Dadvand
etal.,2014a).Fuertesetal.(2014)usedtwobirthcohorts(followedfrombirthto10years)in
northernandsouthernGermany,andfoundthattherelationshipbetweengreennessandallergies
differedacrosstheirtwostudyareas.Intheurbansoutharea,greennesswaspositivelyassociated
withallergicrhinitisandeyesandnosesymptomswhileintheruralnortharea,greennessappeared
tohaveaprotectiveeffect.
2.4.3Exposuretopesticidesandherbicides
Livingclosetogreenspacesmaybeassociatedwithelevatedexposuretopesticidesandherbicides
especiallyiftheyareusedininappropriatewaysandatexcessivelevels.Theinsecticidesmalathion
anddiazinonandtheherbicideglyphosate,whichisusedtocontrolweedsinurbanparks,maybe
carcinogenicinhumans(Guytonetal.,2015).TheInternationalAgencyforResearchonCancer
classifiedthesecompoundsasprobablycarcinogenictohumans(IARC,2015).
13
2.4.4Exposuretodiseasevectorsandzoonoticinfections
Healthrisksfromgreenspaceincludevector‐bornediseases,whicharetransmittedbyarthropods,
suchasticks(e.g.tick‐borneencephalitis,Lymedisease),mosquitoes(e.g.Chikungunyafever,
Denguefever),orsandflies(e.g.visceralleishmaniasis).Lymediseaseinparticularhasincreasedin
Europeinthe21stcentury,andthishasbeenassociatedwithurbangreenspaceandincreased
animalhostspopulations,suchasdeer,aswellaswithclimatechangeandmilderwintersinnorthern
Europe(MedlockandLeach,2015).
Anotherhealthconcernthatoftengainspublicattentionisthecontaminationofurbangreenspace
withdogorcatfaeces.Ingestionofdogfaecesbyyoungchildrencanleadtotoxocariasis(infections
withToxocaracanis),withseriousillnessandblindnesspossibleinrarecircumstances.Whilewell‐
managedparksandgreenspaceencouragedogwalkerstoremovedogfaeces,limitingdogaccessto
children’splayareasisalsoimportantinordertocontrolthisdisease(Despommier,2003).Usersof
poorlymaintainedgreenspacesandplaygroundsmayalsobeexposedtoToxoplasmagondiiinsoil
contaminatedwithcatfaeces(Duetal.,2012;Afonsoetal.,2008).Thisprotozoanparasiteoffelines
canalsoinfecthumans(asdead‐endintermediatehosts)andcausesevereneurologicaldamagein
childrenborntomotherswhowereinfectedforthefirsttimeduringpregnancy.
2.4.5Accidentalinjuries
Althoughphysicalactivityingreenspacescanhavemanypositivebenefits,ashavebeendescribed
earlier,itcanalsobeassociatedwithanincreasedriskofaccidentsandinjuries,suchasfallsand
drowning(Laoseeetal.,2012).AstudyintheUnitedKingdom(Kendricketal.,2005)showedthat
AccidentandEmergencyhospitaladmissionrateswerehigherinwardswithagreaternumberof
parksandplayareasperchildunderfiveyearsofage.Ball(2004)conductedaretrospectiveanalysis
ofinjuryandfatalitystatisticsassociatedwithplaygroundsintheUnitedKingdom.Mostplayground
equipmentrelatedinjuriesoccurinpublicurbangreenspace,buttheriskofseriousinjuryinUnited
Kingdomplaygroundsissmall,perhapshelpedbytheintroductionofartificial,impact‐absorbing
surfaces.
2.4.6ExcessiveexposuretoUVradiation
Whileoptimallevelsofexposuretosunlightarelinkedtohealthbenefits(seesection2.2.10),
greatertimespentoutdoorsingreenandopenspacesmayresultinexcessiveexposuretosunlight
andelevatedriskofskincancer.Astell‐Burtetal.(2014b)showedthat,inAustralia,theoddsof
havingskincancerwerehigherforthoselivinginagreenerenvironment.Thebalanceofrisksor
benefitsfordifferentlevelsofsunlightexposureisdifficulttoassessforvarioussubpopulations.It
shouldbenotedthatoptimallydesignedgreenspacesandtreecanopiescanalsoprovideprotection
againstexcessiveexposuretoUVradiation(Boldemannetal.,2006;Boldemannetal.,2011).In
addition,thenegativeeffectscanlargelybeavoidedormitigatedbysimplemeanssuchas
appropriateclothing,hatsandsunblockcreams.
2.4.7Vulnerabilitytocrime
Crimeagainstthepersonandanti‐socialbehaviourareperceivedrisksfromgreenspaces,as
reportedinsomestudies.However,thisdoesnotnecessarilyreflectrecordedcrimeincidence(Bogar
&Beyer,2015).Inasystematicreviewoffearofcrimeinurbangreenspaces,Sreetheranandvan
denBosch(2014)foundthatthemajorityofthestudieshighlightedindividualfactors(suchasgender
andpastexperience)asmoreinfluentialthansocialandphysicalfactorsinevokingfearofcrime.
Theystatethatcertaingroupsofpeople,particularlyolderpeople,womenandethnicminorities,
tendtobemorefearfulbecauseoftheirvulnerabilityorpastexperiencesofcrime.
Therearevaryingrelationshipsbetweengreenspaceandrecordedcrimefoundinreportsfromthe
UnitedStates.GroffandMcCord’s(2012)studyinPhiladelphiashowedthatneighbourhoodparks
wereassociatedwithincreasedlevelsofcrime.However,certaincharacteristicsofparks(suchasthe
14
presenceofplayingfieldsandcourts)wereassociatedwithlowercrimelevels.Incontrast,Troyetal.
(2012),inastudyofBaltimore,foundastronginverserelationshipbetweenurbantreecanopyand
violentcrime.
2.5Characteristicsofurbangreenspaceassociatedwithspecifichealth
benefitsorhazards
Despitethegrowingresearchinthisarea,thereiscomparativelylittleevidencedemonstrating
differentialhealthbenefitsassociatedwithspecificcharacteristicsofgreenspace.Varying
configurationsofgreenspace,builtenvironmentandtopographicalfeaturesnearaperson’s
residencemayofferdifferentopportunitiesforphysicalactivitiesandmentalrestoration,depending
ontheperson’sage,genderandindividualpreferences.Anurbangreenspacemayhavevarying
qualitiesthatofferdifferentopportunitiesforquietrelaxation,engagementwiththenatural
environment,children’splay,physicalexerciseandathleticactivitiesorgettingawayfromunpleasant
aspectsoftheurbanenvironment,suchasnoiseorheat.Moreresearchisneededtoidentify
attributesofgreenspacethatareassociatedwithspecifichealthbenefits(Wheeleretal.,2015).
2.5.1Perceptionsofgreenspaceaccessibilityandquality
Researchonthequalityofgreenspaceassociatedwithhealthbenefitshasoftenfocussedonthe
physicalactivitymechanism(Giles‐Cortietal.,2005;Hillsdonetal.,2006).Aqualitativeanalysis
(McCormacketal.,2010)revealedthatattributesofgreenspaces,suchassafety,aesthetics,
amenities,maintenanceandproximitytohome,areimportantforsupportingphysicalactivity
outdoors.Aspectssuchasconcernsoversafety,violence,graffiti,vandalism,litter,noise,pollution,
anddogfoulinghadnegativeassociationswithparkuseandphysicalactivity.
AnAustralianstudysuggestedthathigherlevelsofwalkingwereassociatedwithaccesstoattractive,
largepublicopenspaces(Giles‐Cortietal.,2005).ADutchstudy(VanDillenetal.,2012)assessedthe
quantityandqualityofgreenspaceandtheirlinkstoself‐ratedhealth.Thequality,measuredusing
characteristicssuchasaccessibility,maintenance,absenceoflitterandsafety,waspositively
associatedwithgeneralhealth.Theauthorssuggestedthatthequalityofgreenspacepredicted
healthoutcomesindependentlyofthequantityofthegreenspace.Sugiyamaetal.(2013),inan
Australianstudy,foundnoassociationsbetweeninitiationofwalkingandgreenspacequality
(definedas“pleasantnaturalfeatures”)andproximity.However,proximityofgreenspaces,and
accesstoacomparativelylargesizedgreenspacewithin1.6kmofaperson’shome,wereassociated
withmaintenanceofwalking.Theattractivenessofgreenspacehasalsobeenassociatedwith
increasedrecreationalwalking(Sugiyamaetal.,2010).
AlsoworkinginAustralia,Wangetal.(2015)foundthatpositiveattitudestotheexperienceof
visitinggreenspaceandperceptionsofitsaccessibilityappeartomattermorethanindependently
measuredgeographicattributesinpredictinggreenspaceuse.
InSabadell,Spain,Dadvandetal.(2014a)foundgreenerresidentialareas,asmeasuredbyNDVI,and
proximitytoforestswereassociatedwithlowerprevalenceofbeingoverweightorobeseinchildren.
Asnotedinsection2.3.2,Pereiraetal.(2012),workinginAustralia,foundthatagreatervariabilityin
greennesshasaprotectiveeffectoncoronaryheartdiseaseorstrokeinadults.Peoplelivingin
neighbourhoodswithgreatervariabilityingreennessarelikelytohaveaccesstoaesthetically
pleasingnaturalenvironmentandalsotourbandestinations–bothfactorsstimulatingwalking.
Thequalitiesofgreenspaceintermsofallowingrelaxationandrecreationhavebeendescribedas
importantfactorsinimprovingmentalwell‐being(Popeetal.,2015).Itwasshownthatthequalityof
publicopenspaces(includingparksandgardens)intheneighbourhoodismorerelevanttomental
health,thantheirquantity(Francisetal.,2012).Grahn&Stigsdotter(2010)identifiedeight
perceivedsensorydimensionsofurbanparksorurbanopenspaces:Serene,Space,Nature,Richin
Species,Refuge,Culture,ProspectandSocial.Amongthese,thedimensionsRefugeandNaturewere
15
stronglynegativelycorrelatedwithstress.Refugewasdefinedasaplacesurroundedbybushesand
highervegetationwherepeoplefeelsafe,playandcanobserveotherpeoplebeingactive;Nature
wasdefinedbythefeelingof“beinginnature”.Twolongitudinalstudies(Annerstedtetal.,2012;
VandenBoschetal.,2015)haveshownthataccesstotheSerenedimensionwasassociatedwitha
significantlydecreasedriskofmentalillnessinwomen.SerenehasbeenpreviouslydefinedbyGrahn
&Stigsdotter(2010)as“aholyandsafeplace,whichisacalmenvironment,undisturbedandsilent”
(p.271).
2.5.2Sizeofgreenspace
Thesizeofgreenspaceislikelytoinfluencethelevelsandtypesofactivitypeopleundertakewithinit.
Sugiyamaetal.(2010)suggestedthattheattractivenessofaspaceandtheoptionsforactivitythat
thespaceprovidesmaybemorerelevantforphysicalactivitythanthenumberofopenspaces
available.ThisAustralianstudyconsideredparkswithasizerangeofapproximately1‐10ha.The
authorsproposedthat,whenplanninganddesigninggreenspacetoencouragephysicalactivity,it
mightbebettertoconsiderprovisionofonelargeparkintheneighbourhoodratherthanmany
smallerparks.AstudyofyoungpeopleintheUnitedStates(Epsteinetal.,2006)supportedthisview
andshowedsubstantialincreasesinestimatedtimeinmoderatetovigorousphysicalactivityfor
youthwholivednearlargeparks.
Thereisaneedformoreevidenceontheeffectsofconfigurationandconnectivityofgreenspaceon
healthoutcomes.Whatgreenspaceoffersintermsoffacilities,programmesofevents,formalgame
pitches,healthtrails,cycling,walkingandjoggingroutes,opportunitiestobeusedenroutetodaily
destinationssuchasschool,workorshops,etc.willbeaffectednotonlybydesignandmanagement
ofgreenspacebutalsobyitssize,shape,topographyand/orconfigurationinrelationtobroader
infrastructureandthedistributionofdifferentlandusesintheurbanarea(Robertsonetal.,2012).
2.5.3Presenceofspecificfacilitiesforcertainactivities
Whattheenvironmentofferscanenableordeteroutdooractivities.AstudyinOntario,Canada,
(Kaczynskietal.,2008)foundthatparkfacilitiessuchasapavedtrail,waterarea,andplayground
weremoreimportantforphysicalactivitythanparkamenitiessuchasadrinkingfountain,picnicarea,
andrestroom;pavedtrailsinparticularwerestronglyassociatedwithphysicalactivity.
Schipperijnetal.(2013)reportedthatlevelsofphysicalactivityinthenearesturbangreenspace
werepositivelyrelatedtofeaturessuchaswalking/cyclingroutes,woodedareas,waterfeatures,
lights,pleasantviews,abikerack,andaparkinglot.AstudyintheUS(Oreskovicetal.,2015)
demonstratedthatplaygroundusewasassociatedwithhigherlevelsofphysicalactivityamong
adolescentsaged11‐14years.
Inastudyinvolvingolderwomen,Chastinetal.(2014)foundthatthelackofrestingplacesoutside
thehomestronglylimitedparticipants’motivationorconfidencetobeactive.Mostsaidtheywould
walkmoreiftheycouldfindrestingplacesatstaggeredintervalsinpublicspaces,enablingthemto
restwhenneededandgivingthemincreasedconfidencetoventurefurtheroutside.Thisconfirms
otherresearchthathasidentifiedthevalueoftreesandgreeneryasattractorsforolderpeopleto
usetheoutdoorenvironment,butalsotheimportanceofseatingandfacilitiessuchastoiletsto
enableolderpeople’saccesstoandenjoymentofpublicgreenspace(Aspinalletal.,2010).
2.5.4Treecoverandcanopydensity
Ithasbeenclaimedthaturbangreenerycancontributetoasubstantialreductionintheurbanheat
islandeffect(Tanetal.,2015).However,inastudyofall‐causemortalityduringheatwavesin
Barcelona,Spain,greaterpercentageoftreecoverwasnotassociatedwithreducedmortalityrisk(Xu
etal.,2013),althoughresidents’perceptionoflittlesurroundinggreennesswassignificantly
associatedwithmortality.
16
InalaboratoryenvironmentintheUnitedStates,Jiangetal.(2014b)assessedtheroleoftreecanopy
densityinself‐reportedstressrecoverybyshowingstudyparticipants3‐Dvideoscontainingdifferent
levelsoftreecanopyinanurbanenvironment.Theauthorsfoundapositivelinearassociation,
indicatingthathigherlevelsoftreedensitywereassociatedwithgreaterself‐reportedstress
reduction.Bymeasuringtheparticipants’physiologicalstressreactionbysalivarycortisolandskin
conductance,Jiangetal.(2014a)foundthatmenhadagreaterstressreductionfrommoderatetree
densitycover,ratherthanhighorlowlevels;thesamewasnotfoundforwomen.
Thepresenceofnearbytreesandgrassvisiblefromapartmentbuildingshasbeenshowntolower
levelsofaggressionandmentalfatigueinresidents,incomparisontothoselivinginbuildings
overlookingbarrenvistas(KuoandSullivan,2001).Also,theabsenceofgreenelementsnearhousing
hasbeenshowntoimpactnegativelyonthemanagementofmajorlifeissues(Kuo,2001).However,
somequalitiesofgreenspacesassociatedwithtreecover,especiallywhenovergrownorunmanaged,
mayincreaselevelsofanxietyduetofearofcrime,resultinginanegativeimpactonpeople’swell‐
being(Kuoetal.,1998).InBaltimore,treecanopyhasalsobeenidentifiedashavingapotential
beneficialeffecttowardsincreasedsocialcapital(Holtanetal.,2015).
2.6Differentialhealthbenefitsofgreenspacesinspecificpopulationgroups
Whilethestudiesdescribedabovehaveshownthaturbangreenspacesprovidehealthbenefitsfora
varietyofpopulations,manystudiesalsoshoweddifferinghealthoutcomesdependenton
demographicfactors,includinggender,age,ethnicityandsocioeconomicstatus(Charreireetal.,
2012;Dadvandetal.,2012b;LachowyczandJones,2011;LachowyczandJones,2014;Maasetal.,
2009b;Xuetal.,2013).Thesectionbelowfocusesonstudieswhereparticularsubgroupshavebeen
showntoexperiencedifferentialhealthbenefitsfromgreenspace.
2.6.1Women
Asindicatedinearliersections,thereisevidencethatwomenandmenexperienceandrespondto
urbangreenspaceindifferentways.Asystematicreview(Sreetheran&vandenBosch,2014)
summarizingfindingsfrommanystudiesdemonstratedthatwomen,throughperceivingthemselves
tobemorevulnerable,weremorefearfulinurbangreenspacesthanmen.Conversely,Krenichyn’s
(2006)studyofwomen’suseofalarge,greenparkinNewYorkCityfoundthattheyenjoyedexercise
intheparkcomparedtoexercisinginthestreetbecauseofthebeautifulsceneryanditstherapeutic
orspiritualqualities.Bycontrastwiththeharassment(catcallsandmalecomments)experienced
whenexercisinginthestreet,theparkaffordedatraffic‐freeenvironmentwherewomenfeltfreerto
dresscomfortablyandlesssusceptibletounwelcomeremarks.Thus,appropriatelymanagedgreen
spacemayofferwomenopportunitiestobemorephysicallyactivethaninotherurbancontexts.
Positiveassociationsbetweengreenspaceandmentalhealthhavealsobeenfoundforwomen
differentiallyfrommen.Forexample,vandenBoschetal.(2015)foundasignificantrelationship
betweenaccessto‘serene’greenspaceandimprovedmentalhealthinwomenbutnotmen.Using
measuresofdiurnalsalivarycortisolsecretionasabiomarkerofstress,Roeetal.(2013)foundthat
effectsofgreenspaceexposureonpatternsandlevelsofcortisolweredifferentinmenandwomen.
Moregreenspaceintheresidentialareawasassociatedwithasteeperdeclineinsalivarycortisol
fromthreetoninehourspost‐awakening(healthierdiurnalcortisolpattern)inbothgenders.
However,womenwithlowerexposuretogreenspacewerefoundtohaveahigherrateof
hypocortisolemia(lowcortisollevelatthreehourspost‐awakening),indicatinglong‐term
dysregulationofthepsychoneuroendochrinesystem.Inmen,post‐awakeningcortisollevelswere
notassociatedwithgreenspace;instead,menlivingislessgreenareashadashallowerdeclinein
cortisollevelthroughtheday,resultinginelevatedcortisollevelsatsixandninehourspost‐
awakening,alsoindicatingpsychoneuroendocrinedysregulation.
Thereisconsiderableevidenceofbeneficialeffectsofaccesstogreenspaceforthehealthof
pregnantwomen.Specifically,studiesinEuropeshowedpositiveassociationsbetweenaccessto
17
nearbygreenspaceandbothreducedbloodpressureandreduceddepressioninpregnantwomen,
withastrongereffectforreduceddepressionindisadvantagedgroups(McEachanetal.,2016;
Grazulevicieneetal.,2014).
Suchfindingssuggestitisimportanttotakegenderintoaccountwhenconsideringanyassociations
betweenurbangreenspaceandhealth,sincebothphysiologicalandpsychologicalresponsesto
greenspacemaydiffer.
2.6.2Childrenandadolescents
Ithasbeenshownthatexposuretogreenspacesduringpregnancyhasbeneficialeffectsonin‐utero
development.StudiesinIsrael,GermanyandEngland(Agay‐Shayetal.,2014;Markevychetal.,2014;
Dadvandetal.,2014b)andasystematicreviewandmeta‐analysis(Dzhambovetal.,2014)
demonstratedlinksbetweenbetteraccesstogreenspaceduringpregnancyandincreasedbirth
weight.
Adequateexposuretogreenspaceinchildrenmaynotonlyfacilitatehealthydevelopmentin
childhoodbutalsoprovidelong‐termhealthbenefitsthroughadulthood.Ithasbeenshownthat
socio‐environmentalriskfactorsinprenatallife,infancyandchildhoodalsohaveaneffectoverthe
entirelife‐course(GluckmanandPinal,2001;Gluckman,2012;Gluckmanetal.,2007).Ingeneral
terms,ifaccesstogreenspacecanstimulatethedevelopmentofgrossandfinemotorskillsaswell
ascognitive,emotional,socialandphysicaldevelopmentinchildren(Strife&Downey,2009),then
thesemayleadtobetterhealthandbetterabilitytomaintainhealthylifestylesinadulthood.
Thereissomeevidencethatexposuretogreenspacecaninfluencecognitivedevelopmentin
children.Dadvandetal.(2015)showedabeneficialassociationbetweenexposuretogreenspace
(surroundinggreennessathomeandschoolandduringcommuting)andmeasuresofcognitive
developmentinprimaryschoolchildren.Thisassociationwaspartlymediatedbyreductionin
exposuretoairpollution.Otherstudieshavealsodemonstratedthatgreenspacesarelinkedto
improveddevelopment,reducedproblematicbehaviourandreducedriskofADHD(Amolyetal.,
2014;FaberTaylor&Kuo,2011;vandenBerg&vandenBerg,2011;Markevychetal.,2014).
AccordingtoresearchinSwitzerland,publicurbangreenspacesplayanimportantroleinchildren’s
andyoungpeople’ssocialnetworks,includingfriendshipsacrosscultures,promotingsocialinclusion
(Seelandetal.,2009).
Moregenerally,understandinglinksbetweengreenspaceandchildren’shealthincludes
considerationofrisksandtheimportanceoflearningtomanageriskaschildrendevelopintoadults.
ResearchintheUnitedKingdomhasshownthatthereisagreatattractioninriskyandadventurous
activity,especiallyforadolescentboys.Wildornaturalenvironmentsthatofferchallengewithinan
accessiblecontextcanhelpsatisfythisneedforriskyandadventurousbehaviouramongadolescents
(NaturalEngland,2010b).Opportunitiestodevelopskillsinriskmanagementandcopingwith
uncertainty,importantattributesforadulthood,areoftenunavailabletoteenagersandyoung
peopleunlesstheyareintroducedtowilderareasandriskysituations(NaturalEngland,2010b).
Greenspaceofcertaintypescanofferthiseveninanurbanenvironmentandmaybetheonly
accessibleoptionformany.
2.6.3Olderadults
Apositiverelationshipbetweentheamountofgreenspaceandself‐reportedhealthinsenioradults
wasdemonstratedintheNetherlands(deVriesetal.,2003).Thebeneficialeffectofgreenspacewas
strongerinseniorcitizensandinhousewivesthaninthegeneralpopulation,perhapsduetothese
groups’greaterdependenceonthelocallivingenvironment.
Toussaintetal.(2015)exploredtheroleofgreenspacesinsleepdeficiencyandfoundastronger
protectiveeffectforpeopleaged65andolder,comparedtoyoungeradults.
18
Sedentarybehaviourisanimportanthealthhazardinolderadults,whoareoftenthemostsedentary
segmentofsociety.Arecentsystematicreviewfoundthat,whenmeasuredobjectively,67%of
adultsaged60yearsandoverspentmorethan8.5hoursoftheirwakingdaysedentary(Harveyetal.,
2013).Evidenceofbeneficialeffectsofgreenspacesonphysicalactivityinindividualsaged60years
orolderissummarizedbyBroekhuizenetal.(2013).
Olderadultslivingininner‐cityneighbourhoodsalsobenefitfromthepresenceanduseofgreen
spaces,whichappearstopromotesocialtiesandasenseofcommunity(Kweonetal.,1998).Social
contactisknowntobeimportantforhealthandwell‐being,especiallyforolderpeople,wheresocial
isolationhasbeensignificantlyassociatedwithincreasedmortality(Steptoeetal.,2013).
2.6.4Deprivedsubpopulationsandminoritygroups
Thereisaccumulatingevidenceshowingthaturbangreenspacemaybe‘equigenic’(Mitchelletal.,
2015),i.e.thatthehealthbenefitslinkedwithaccesstogreenspacemaybestrongestamongthe
lowestsocioeconomicgroups,includingminorityethnicgroups.
Mitchell&Popham’s(2008)studyoftheassociationbetweengreenspaceandmortalityratesin
Englandfoundthatpopulationsexposedtothegreenestenvironmentshadthelowestlevelofhealth
inequalityrelatedtoincomedeprivation.
Lachowycz&Jones’s(2014)studyintheUnitedKingdomconfirmedanassociationbetweengreen
spaceaccessandreducedcardiovascularmortalityfoundpreviously(MitchellandPopham,2008;
Villeneuveetal.,2012)butonlyamongstthemostsocioeconomicallydeprivedgroups.Popeetal.
(2015)identifiedsignificantassociationsbetweenreportedaccessto,andbetterqualityof,green
spaceandreducedpsychologicaldistressinadeprivedurbanpopulationintheUS.Inalarge
Europeanepidemiologicalstudy,Mitchelletal.(2015)foundthatsocioeconomicinequalityinmental
well‐beingwas40%narroweramongrespondentsreportinggoodaccesstogreenspace,compared
withthosewithpooreraccess.
Onewayinwhichgoodaccesstogreenspacemaycontributetoreducedhealthinequalitiesin
income‐deprivedcommunitiesisthroughfrequencyofand/ortimespentinoutdooractivities.As
statedearlier,evidencesuggeststhatactivitiesingreenspacemayofferpsychological,physicaland
socialhealthbenefits.Improvementsinaccesstowoodlandgreenspaceneardeprivedurban
communitiesinScotland,UnitedKingdom,positivelyimpactedongreenspaceuseandmayhave
contributedtoimprovementsinactivitylevelsandperceivedqualityoflife(WardThompsonetal.,
2013).
Thereisacommontendencyforthemostdeprivedurbancommunitiestoexperiencethepoorestair
quality,ashasbeenshownfortheUnitedKingdom(Grantetal.,2012)andNorway(Naessetal.,
2007).Thiscancontributetoexcessmortalityindeprivedneighbourhoods.Thus,urbangreenspace
indeprivedareasmayreducehealthdisparitiesbymitigatingairpollution.
IntheUnitedStates,Harlanetal.(2006)showedthatindividualsoflowersocioeconomicstatusand
minoritygroupsinPhoenix,Arizona,weremorelikelytoliveinneighbourhoodswithgreater
exposuretoheatstress.Jeneretteetal.(2011)suggestthatsuchlowerincomepopulationshaveless
meanstocopewithextremetemperatures.Whilewealthierpeoplemayhaveaccesstocooling
systems,thelowincomepopulationreliesmoreonwhatispubliclyavailable.Therefore,theroleof
vegetationincoolingurbanareasmaybeespeciallyimportantfortheurbanpoor.
SreetheranandvandenBosch(2014),inasystematicreviewofEnglishlanguageliterature,found
thatbeinganethnicminorityandlivinginlowincomeneighbourhoodsaffectsfeelingsofsecurityin
urbangreenspaces.Itseemsthatthoseminorityrespondentswhofearedvisitingparksor
playgroundshadexperiencedpreviousdirectorindirectvictimizationintheirlocalurbangreen
spaces.Dadvandetal.(2014b)foundapositiveassociationbetweenlevelsofsurroundinggreenness
duringpregnancyandbabies’birthweightinawhiteBritishpopulationbutnotforthoseofPakistani
19
origin,suggestingadifferencebetweenethnicgroupsthatmayreflectwiderperceptionsanduseof
greenspace.
ManyminorityethnicgroupslivinginEuropeancitiessuffersocioeconomicdeprivationand
comparativelypoorhealth.Onestudyonblackandminorityethnic(BME)groupsinEngland(CABE
2010a)showedthatmanyBMEpeopleliveinthemostdeprivedcensuswardsintheUnitedKingdom
andthatsuchwardshad,onaverage,onlyafifthoftheareaofgreenspacethatisavailabletothe
mostaffluentwards.ThestudyalsoshowedthatinareasmostdenselypopulatedbyBMEgroups(i.e.
comprising40%plusofpopulation),theavailablegreenspaceisofpoorerquality.Asecondstudy
(CABE2010b)foundthatthequalityof,accessto,anduseofurbangreenspacewasasignificant
predictorofgeneralhealthforAfricanCaribbean,Bangladeshi,PakistaniandotherBMEgroups,who
werealsothosewiththepooresthealth(Roeetal.,2016).Thus,provisionandmaintenanceof
appropriategreenspaceinurbanareasmaymakeanimportantcontributiontoreducinghealth
inequalities.
2.6.5Populationsofvariouscountriesandgeographicregions
Somefindings,suchasthestressreductionopportunitiesthaturbangreenspaceaffords,havebeen
replicatedinmultiplestudiesconductedindifferentcountries.However,mostoftheepidemiological
studiescitedabovehavebeenconductedinhighincomecountries(mainlyinwesternandnorthern
Europe,aswellasinNorthAmerica,AustraliaandJapan).Thereisaneedformoreresearchonurban
greenspaceandhealthintheeasternpartsoftheWHOEuropeanRegion.Suchresearchisessential
forassessinghealthbenefitsofurbangreenspacesinmiddleandlowincomecountriesandincities
withdifferenturbandesigncharacteristics.
2.7Co‐benefitsofurbangreenspacesunrelatedtohealtheffects
Therearemanyco‐benefitsthatmayarisefromgoodplanning,designandmanagementofurban
greenspacesinadditiontoimprovedpublichealth.Whilethisreviewfocusesonhealthbenefitsof
urbangreenspaces,potentialadditionalbenefitsarebrieflysummarizedbelow.
TheEuropeanCommission(EuropeanUnion,2015)callsforattentiontoensuringsustainable
urbanizationthroughpromotingnature‐basedsolutionsincludingprovisionofaccessiblegreen
spaces.Theeconomicimportanceof,andreturnon,investmentinurbangreenspaceisabudgetary
issueforurbanplanners,socialservices,andotherprofessionals.Co‐benefitsofinvestmentingreen
spacemayincludeenhancedeconomiccompetitivenessofcities,wherequalityoflifeisimportant
forattractingandretainingaskilledworkforce(KPMG,2012a).Anattractiveandusablegreen
environmentnearresidentialareasislikelytoincreasepropertyvalues(Wachter&Bucchianeri,2008)
andcreate‘liveable’urbanareasthatattractnewresidentsandinvestment,andfacilitateeconomic
sustainability(KPMG,2012b).Equallyurbangreenspacehasbeenshowntobenefiteconomically
deprivedurbancommunitiesmorethanothers,creatingmoreequalsocioeconomicconditions(CABE,
2004).Arecentstudyconcludedthatinvestingingreeninfrastructureincities,mightnotonlybe
ecologicallyandsociallydesirable,butalsoquiteoften,economicallyadvantageous(Elmqvistetal.,
2015).
Agreenurbanenvironmentthatsupportshealthingeneralmayalsoproducehealthierworkforces,
enhancingpeople’squalityoflifeaswellastheirproductivityandearningpotential.Lossesof
productivityduetoobesityanddepressionaremajorcostfactorsaffectingbusinesses.Thus,
improvingaccesstogreenspacecanimprovementalandphysicalhealthandproducemajor
economicbenefitsthroughreducedabsenteeismandimprovedproductivity.Also,investmentin
greenspacemayalsocreategreenjobsandofferthepotentialtoenhancetourism(Cianga&
Popescu,2013).
Arecentreviewshowedthaturbanparksfunctionasbiodiversityhotspots(Busse‐Nielsen,2013).
Well‐designedurbangreenspacecanalsobenefithydrologicalsystemsandenhancesustainable
20
urbandrainage,helppreventandmitigatefloodingandcreateandextendnewhabitatsforplantand
animalspecies(Gilletal.,2007).Greenspacemayalsoofferopportunitiesforenvironmental
educationandengagementwithnatureateveryagecategory,fromyoungchildrentosenioradults
(Dadvandetal.,2015;NaturalEngland,2010b;Sugiyamaetal.,2009).
Greenspacescanalsoimproveurbanecosystemhealthbyreducingtheeffectsofweatherextremes
andairpollution(LRTAPWorkingGrouponEffects,2013).Similarly,noisereductionbygreenspace
maybenefitspeciesotherthanhuman(Francisetal.,2009).
Theuseofurbangreenspaceforlow‐carboncommuting,e.g.bywalkingorcyclingtoschoolorto
work,canreducegreenhousegasemissionsandcontributetomitigatingglobalclimatechange.
Urbangreenspacecanmakeactivetravelattractiveandtherebyencourageandsupportnew,
environmentallyfriendlybehaviours(ScottishGovernment,2016).
Inadditiontogeneralopportunitiesforsocialcohesion,urbangreenspacemayalsoofferthechance
todevelopindividualandcommunitycapital.Publicgreenplaces,forexample,offeropportunities
forbiggergroupstogatherthanispossibleinthehome.Urbangreenspacesthatcanalsobe
adaptedfordifferenttemporaryuses,suchasfestivalsandculturalevents.Finally,urbangreenspace
mayplayanimportantroleinenhancingcommunityresilienceandhelpingcommunitiescopewith
naturaldisastersandextremeweatherevents(Tidball&Krasny,2014).
21
3.INDICATORSOFURBANGREENSPACEAVAILABILITY,
ACCESSIBILITYANDUSAGE,ANDASSESSMENTOFTHEIRHEALTH
RELEVANCE
3.1Classificationofurbangreenspaceindicators
Akeyaspectofunderstandinglinksbetweengreenspaceandhealthisunderstandinghowpeople’s
exposuretogreenspaceisconceptualisedandmeasured.Aswithconsiderationofanyhealth
outcomesassociatedwithanenvironmentalexposure,howtheexposureismeasuredisimportantin
determiningwhatrelationshipsareapparent,andwhatcausalpathwaysandmechanismscanbe
inferred(Nieuwenhuijsen,2015).Studiesofgreenspaceandhealthtodatehaveusedavarietyof
measuresandindicators.Thissectionofthereportsummarizesinbriefkeymeasureswhichhave
beenreportedintheliterature,andusedinsomeexemplarnationalgovernmentalpolicies.It
describesanddiscussespossibledatasourcesforahealth‐relatedgreenspaceindicatorfortheWHO
EuropeanRegion,anddiscusseschallengesaroundtheapplicationofsuchanindicator.
Akeydefiningfeatureofgreenspacemeasuresusedinhealthresearchandpolicyiswhetherthey
considertheavailability,accessibilityorusageofgreenspaces.Thesetypesofmeasuresarenot
alwaysmutuallyexclusive;forexample,somemeasurescouldbedescribedasindicatingavailability
oraccessibility,andusageisalwaysrelatedtothequantity,qualityandcharacteristicsofgreenspace.
Definitionsofindicatorsofavailabilityandaccessibilitycanalsoincorporatespecificcharacteristicsof
greenspaces(e.g.accessibilityofgreenspaceofatleast1hasize).Availabilitymeasuresquantify
neighbourhoodgreenspacewithoutdistinguishingbetweenthatwhichispubliclyaccessibleandthat
whichisnot,andwithoutanyconsiderationoftheproximityofspecificareasofgreenspaceto
individualresidencesorcommunities.
Measuresofaccessibilitymayconsideranyorallof:
a) theproximityofspecificgreenspacestoresidencesorcommunities(usingeitherlinear
distanceorwalkingdistance);
b) greenspacesthatarepubliclyaccessible(withorwithoutentryfee);and
c) specificpointsofaccesstogreenspaces(e.g.gateways,paths,carparks).
Usagemeasuresgobeyondtheseconsiderationstoreflectactualuseofgreenspacebyindividualsor
communities.Measuresofusagemightbeobjective(e.g.observedparkuse,orlocationtrackingof
individuals)orself‐reported(e.g.basedonvisitsurveys).
Examplesofthesedifferenttypesofmeasuresandhowtheyarerelevanttopublichealthandwell‐
beingarepresentedinSection3.3to3.5.
3.2Greenspacecharacteristicsthatcanbeincorporatedindefinitionsof
indicators
Greenspacecharacteristicsrefertotype,sizeandqualityofgreenspacesandtheusefunctionsthat
theyallow.Ithasbeendemonstratedthatdifferenthealtheffectscanbelinkedtodifferent
characteristicsofgreenspaces,andthatspecificcharacteristicscanbelinkedwithhealthbenefitsin
specificpopulationgroups(Wheeleretal.,2015,deVriesetal.,2003,Annerstedtetal.,2012;White
etal.,2013b;Whiteetal.,2014;Elliottetal.,2015).Keygreenspacecharacteristicsthathavebeen
consideredintheliteratureinclude:
• sizeofgreenspace(Giles‐Cortietal.,2005;Nordhetal.,2009);
• landcovertypee.g.grassorwoodland(Wheeleretal.,2015;Alcocketal.,2015;Votsietal.,
2013);
• presenceofwaterorcoastline(bluespace)(Whiteetal.,2010;VölkerandKistemann,2011);
22
• recreationaltypese.g.opensportsarea,children’splayareas,‘natural’,formalgardens
(Lachowyczetal.,2012;Mitchell,2013);and
• environmentalqualitiese.g.biodiversity,‘wildness’(Annerstedtetal.,2012;Dallimeretal.,
2012;Lovelletal.,2014).
Thereisalsoevidenceontheroleof‘socialqualities’ofpublicgreenspacesuchasamenities(e.g.the
presenceofbenches,carparks,publiclavatories)andenvironmentalincivilities(e.g.thepresenceof
litter,graffiti,dogwaste).Dataonthesecharacteristicsareingeneralnotreadilyavailable,buthave
tobecollectedthroughspeciallydesignedenvironmentalauditsusingarangeoftools(Gidlowetal.,
2012;Rosenbergetal.,2009).
Astudyofgreenspace‘quantityandquality’andhealthintheNetherlandsusedagreenspaceaudit
tooltomeasurevariousfacetsofgreenspacequality,suchaslitter,naturalness,maintenanceand
safety.Thisstudyfoundpositiveassociationsbetweenbothquantitymeasuresofgreenspaceand
thecompositequalityindicator,withgeneralself‐reportedhealth,amentalhealthinventoryand
selectedacutehealthcomplaints(vanDillenetal.,2012).
Whilstitisincreasinglyrecognizedthatqualitiesandcharacteristicsofgreenspaceareimportant,the
majorityoftheexistingevidenceongreenspaceandhealthdoesnotconsidertheseaspects(Hartig
etal.,2014;Bowleretal.,2010b;Jorgensen&Gobster,2010).Giventhelackofasubstantive,
consistentevidencebase,thefocushereisthereforeonamoregenericconceptualizationofgreen
space;thepotentialvalueofmorenuancedconsiderationofnaturalenvironmentsinurbanareasis
discussedinSection3.6..
Asdescribedabove,thisreportisnotbasedonanexhaustive,systematicreviewoftheliterature,but
onexpertknowledgeandassessmentoftheevidencebase.Thissectionoutlinesthekeymeasuresor
indicatorsofurbangreenspacethathavebeenusedtoassessassociationofgreenspaceexposure
withhealthandwell‐being.Foreachindicatorweconsiderthepotentialmechanismsatplay;
examplesofstudiesthathaveimplementedtheindicator;andthedatarequirementsand
applicabilityasaWHOindicator.
3.3Indicatorsofgreenspaceavailability
3.3.1Greenness,measuredbyNormalisedDifferenceVegetationIndex(NDVI)
Description
TheNormalisedDifferenceVegetationIndex(NDVI)isameasureofhowmuchlive,greenvegetation
ispresentinanarea–anindicatorofanarea’s‘greenness’.Itisderivedthroughremotesensing,
usuallyfromsatelliteimagery,andisbasedonestimatingtheproportionofphotosyntheticallyactive
wavelengthsoflight(i.e.thatareabsorbedbychlorophyllinplants)thatisabsorbedbytheground
cover(Pettorellietal.,2005;Myneni&Hall,1995).TheNDVIisaratioofadifferenceandasumof
thespectralreflectancemeasurementsacquiredinthevisibleredandnear‐infraredregions.These
measurementsarethemselvesratiosofthereflectedradiationovertheincomingradiationineach
spectralbandwhichcanvarybetween0and1.Thus,theNDVIcanrangefrom‐1to+1.Valuesof
approximatelyzeroindicatebarrenareaswithverysparseornovegetation;morepositivevalues
indicatemorelivingvegetation;morenegativevaluesgenerallyindicatethepresenceoffree‐
standingwater,cloudsorsnow.Asameasureoflivinggreenvegetation,NDVIisverysensitivetothe
timeofyearandweatherconditionsatthetimeofimagery,whichmustbetakenintoaccountwhen
usingsatellitedatatocalculateNDVI.
Examplesofapplicationinresearchandsurveillance
AnumberofstudieshaveinvestigatedrelationshipsbetweenmeasuresofNDVIandhealthandwell‐
beingoutcomes.TypicallythemeanNDVIforanareaiscalculatedbasedonhighresolutionimagery,
andisusedasanindicatoroftheaverage‘greenness’.Theareamaybeeitherastatisticalor
23
administrativearea,orthe“buffer”zoneofsetdistancefromanindividual’sresidencelocation,or
thecentroidofageographicalarea.
StudieshavelinkedNDVIwithawiderangeofotherhealthandwell‐beingoutcomesincluding:
increasedwalking(Sarkaretal.,2015);lowerBodyMassIndexinchildren(Belletal.,2008);lower
ratesofdepression,anxietyandstresssymptomology(Beyeretal.,2014);andlowermortalitydueto
causessuchasrespiratorydiseasesandcardiovasculardisease(Villeneuveetal.,2012).
DatarequirementsandapplicabilityasaWHOindicator
SatelliteimageryenablingcalculationofNDVIatarelativelyhighresolutionisreadilyavailableona
globalbasisfromvarioussources.AkeysourcethathasbeenusedinpreviousresearchisLandsat7
EnhancedThematicMapperPlus1availablefromNASA/USGeologicalSurvey2.Thesedataareat30m
x30mresolution,sufficientformostapplicationsinthisarea,andareavailableforrelatively
frequenttimeseries,permittingselectionofmostrelevanttimesofyear(e.g.the‘greenest’period
(Dadvandetal.,2012b)).Akeyadvantageofthesedataistheirglobalavailabilityandfrequencyof
update,permittinggeographicallyconsistentindicatorsandmonitoringofchangeovertime.NDVI
maybemostrelevanttoconsideringthegreenspaceandhealthpathwaysthatarerelatedto
psychologicalprocesses(stressreduction,attentionrestoration),andwiderecosystemservicessuch
asurbanheatislandmitigation(Bowleretal.,2010a).
3.3.2Densityorpercentageofgreenspacebyarea
Description
Indicatorsofgreenspacebasedonareadensityhavealsobeenwidelyusedinepidemiological
studies.AswithNDVI,theseindicatorsarealsousuallycalculatedforstatisticalareas(e.g.census
outputareas),orwithinbuffersaroundresidentiallocationsorcentroidsofpostalareas.Various
geographicaldatasourceshavebeenusedtodefinegreenspacedensity.Indicatorvaluescanbe
basedonremotely‐sensedsatelliteimageryoraerialphotographyclassifiedtoindicatelandcover
types,ormaybederivedfromcartographicdatabasesoflandparcels,classifiedbylanduseorland
cover.Thelanduseorlandcoverdataareoverlaidwiththestatisticalboundariesorbufferzones,
andtheproportionoftheareacoveredwithgreenspace(howeverdefined)iscalculated.
Examplesofapplicationinresearchandsurveillance
Arangeofhealthandwell‐beingoutcomeshavebeenstudiedusinggreenspacedensitymeasures.
Forexample,Mitchell&Popham(2007)usedasmallareagreenspaceindicatorbasedontheEnglish
GeneralisedLandUseDatabase(ahighresolutioncartographiclandparcelclassification)to
investigatetheassociationbetweengreenspacedensityandmortality.Thisstudyindicatedthat
areaswithahigherpercentageofgreenspacelandusetendedtohavelowermortalityrates,and
alsosuggestedthatthesocioeconomicdisparitiesinmortalitywereloweringreenerareas,
suggestingapotentially‘equigenic’effect(Mitchelletal.,2015).Thissamelandusebasedgreen
spaceindicatorforEnglandhasbeenusedinstudiesofmentalhealth(Alcocketal.,2014),physical
activity(Myttonetal.,2012),generalself‐reportedhealth(Mitchell&Popham,2007)andchildhood
obesity(Cetateanu&Jones,2014).
Inrepresentingthegeneralquantityofavailablegreenspace,availabilityindicatorsmayberelevant
tohealtheffectpathwaysincludingprovisionofopportunityandmotivationforphysicalactivity;
opportunityforstressrecoveryandattentionrestoration;andprovisionofotherecosystemservices
suchasairpollutionamelioration.

1http://landsat.gsfc.nasa.gov/?p=3225
2http://landsatlook.usgs.gov/
24
DatarequirementsandapplicabilityasaWHOindicator
Manystudiesusingindicatorsofgreenspacedensityhavedonesousingnationalorlocalland
use/landcoverdatasets,whicharenotapplicableforuseasaconsistentWHOindicator.However,
somehaveusedinternationaldata,suchastheCoordinationofInformationontheEnvironment
(CORINE)LandCoverdata,whichclassifieslandcoverusingsatelliteimagery,andisavailableacross
Europe(seeAppendix2forcoverageacrosstheWHOEuropeanRegion),atresolutiondownto100m
gridcells3.CORINEhassomelimitationsinthatitonlyincludeslargergreenspaces(thoseatleast25
hectares),somissesmanyofthesmallergreenspacesinurbanareas.However,someresearchhas
indicatedthatagreenspacemeasurebasedonCORINEdataisfairlystronglycorrelatedwitha
measurebasedonamoredetailednationalcartographicdatabase(Mitchelletal.,2011).
Otherinternationaldatasourcesthatcouldbeusedtodevelopindicatorsofurbangreenspace
densityinclude:
• GlobalLandCoverdataset:30mresolutionlandcovermapdataforyears2000and2010
releasedbytheChinesegovernment4.
• UrbanAtlas:Europeanurbanlandcovermapdata,forurbanzoneswithpopulationgreater
than100,0005(seeAppendix2forcoverageacrosstheWHOEuropeanRegion).
• Cartographicaldatasources:OpenStreetMap6isaglobal,opencartographicdatabase
derivedfromcitizencontributorsandopenlicencedatasources.Itcouldbeusedtoextract
greenspacegeographicaldata,withtheprovisothatdataqualityanddefinitionispotentially
geographicallyvariableduetothenatureofthedata.
Animportantaspectofusinganyofthesedatasetstoderiveagreenspaceindicatoristhatitis
necessarytoconsideradefinitionofwhatisincluded(andexcluded)as‘greenspace’inorderto
selecttherelevantlanduse/landcoverclasses.Forexample,UrbanAtlasincludesaclassnamed
“greenurbanareas”,aswellasseveralotherpotentiallyrelevantcategories,suchas“sportand
leisurefacilities”,“agriculturalareas,semi‐naturalareasandwetlands”and“forests”(theseare
furtherdiscussedinSection4).Anotherconsiderationisthestatisticalunittowhichthedataare
allocatedforintegrationwithpopulationandhealthdata.Ideallytheseunitsshouldbeatafairlyhigh
resolution(i.e.smallarea),butmaybedefinedaccordingtosomecriteria.
3.3.3Measuresofstreettreesandotherstreetscapegreenery
Theindicatorsofgreenspaceavailabilitydescribedabovegenerallyreflectalltypesofgreeneryina
specificarea.Specifically,NDVIisameasureoftotalgreeneryincludingisolatedelementsof
vegetation.Atthesametime,thereismeritinconsideringotherspecificaspectsofurbannature,
suchasstreettrees,greenwallsandroofsandothertypesofstreetscapegreenery.Treesplanted
alongstreetsandroadsmaydampennoiseandairpollutionlevelsinresidentialhouses,andmitigate
adversehealtheffectsofproximitytobusyroads.Theseaspectsmayformanimportantpartof
urbanecosystems,andthereissomeevidenceofhealthandwell‐beingbenefit.Forexample,one
ecologicalstudyofLondonBoroughsfoundthatthosewithhigherstreettreedensityhadlowerrates
ofantidepressantprescriptions(Tayloretal.,2015).Experimental,laboratorystudiesusing3D
imageryofstreetsceneshavesuggestedthaturbantreesmaypromotestress‐recovery(self‐
reported)andpositiveimpactsonstressasmeasuredbysalivarycortisol(Jiangetal.,2014a;Jianget
al.,2014b).AnotherstudyintheNetherlandshasinvestigatedthequantityandqualityofstreetscape
greenerybasedonastreetaudit,andfoundassociationswithperceivedgeneralhealth,mental
health,andacutehealthcomplaints(deVriesetal.,2013).

3http://www.eea.europa.eu/data‐and‐maps/data/corine‐land‐cover‐2006‐raster‐3
4http://www.globallandcover.com
5http://www.eea.europa.eu/data‐and‐maps/data/urban‐atlas
6http://www.openstreetmap.org
25
3.4Indicatorsofgreenspaceaccessibility
Indicatorsofgreenspaceaccessibilitytakeintoaccountthedistributionofthepopulation
(individuals,householdsorcommunities)intermsoftheirproximitytogreenspace.Theymayalso
includeconsiderationofwhetherthegreenspaceispubliclyaccessible,andifso,whereaccess
pointsandroutesarelocated.
3.4.1Proximitytoanurbanparkorgeographicallydefinedgreenspace
Description
Akeyindicatorofaccessibilityisproximitytogreenspacefromaresidenceorneighbourhoodtothe
nearestgreenspace.Thedistancemaybeexpressedassimplelinear(straightline)distance,travel
distance(byroad/pathnetwork)orconvertedintoestimatedtraveltime.Atthepopulationlevel,
thesetypesofindicatorscanbesummarized,forexampletoassessthepercentageofapopulation
livingwithinacertaindistanceofagreenspace(ofsomeminimumsizeorotherselectioncriteria).
Theseindicatorsmaystillincludeproximitytogreenspacethatisnotpubliclyaccessible,depending
onthenatureofthedataavailable.Anarrayofdistanceshasbeenusedintheliteratureconsidering
accesstourbangreenspaces,andthereisnouniversallyacceptedguidanceonadistancethreshold
thatdefines‘accessible’.Anotherconsiderationisusingdistancetoaboundaryofgreenspacevs.
distancetoadefinedentranceortrailhead.
Thesetypesofindicatorscanbeusedtoestablishnationalorsubnationalgreenspaceaccessibility
standards.Forexample,NaturalEnglandsetanAccessibleNaturalGreenspaceStandardforEngland
(NaturalEngland,2010a).Thisrecommendsthateveryone,wherevertheylive,shouldhavean
accessiblegreenspace:
• ofatleast2hectaresinsize,nomorethan300mlineardistance(5minutes’walk)from
home;
• atleastoneaccessible20hectare(ha)sitewithintwokilometresofhome;
• oneaccessible100hasitewithinfivekilometresofhome;
• oneaccessible500hasitewithintenkilometresofhome;and
• aminimumofonehaofstatutoryLocalNatureReservesperthousandpopulation.
TheEuropeanCommonIndicatoroflocalpublicopenareasdoesnotsetatargetandisnot
specificallyfocusedongreenspace,butisbasedonasimilarmetric–thepercentageofcitizensliving
within300mfromapublicopenareaofminimumsize0.5hectares(AmbienteItaliaResearch
Institute,2003).Thereisnoclearagreementontheuseofadistancethatrepresentsaccessibility–
whiletheNaturalEnglandstandardsuggests300mtobea5minutewalk,theEuropeanCommon
Indicatorssuggestthisdistancetoapproximatea15minutewalk.7TheNaturalEnglandand
EuropeanCommonIndicatordefinitionsofaccessiblegreenspacearegiveninAppendix1for
reference.
TheonlinetoolEnviroAtlas8providedbytheUSEnvironmentalProtectionAgency(USEPA)includes
variousindicatorsofgreenspaceavailabilityandaccessibility,suchasgreenspacepercapita,total
residentialpopulationwithin500mwalkingdistancealongwalkableroadsandpathwaysofapark
entranceandpercentageofresidentialpopulationwithin500mwalkingdistanceofaparkentrance
atacensusblocklevel(Pickardetal.,2015).

7“TheEuropeanEnvironmentAgency,DGRegionalPolicyandISTAT(ItalianIstitutoNazionalediStatistica)all
usetheconcept‘within15minutes’walk’todefineaccessibility.Itmayreasonablybeassumedthatthis
correspondstoaround500mwalkingdistancealongroadsorpathwaysonfootforanelderlyperson,whichin
turnmaybeequivalentto300mlineardistanceusedintheEuropeanCommonIndicators(AmbienteItalia
ResearchInstitute,2003.Pages79and185.).
8https://www.epa.gov/enviroatlas
26
Examplesofapplicationinresearchandsurveillance
Manystudiesofgreenspaceandhealthhaveusedproximitymetricstoestimateaccessibilityof
greenspaces.Forexample,astudyinTelAviv,Israelusedresidencewithin300moftheboundaryof
agreenspaceofatleast0.5haasanindicatorofproximitytodemonstratebeneficialeffectofgreen
spacesonbirthoutcomes(Agay‐Shayetal.,2014).ThesamestudyalsousedNDVIasa
neighbourhoodgreennessorgreenspaceavailabilitymeasure.Theauthorshypothesisedthat
greennesswouldbemoreindicativeofmechanismsinvolvingreductionofpsychophysiologicalstress,
andmodifyingtheimpactofairpollution,noiseandtemperature,whileproximitytoamajorgreen
spacewouldbemoreindicativeofmechanismsinvolvingphysicalactivity.
OnestudyofphysicalactivityandproximitytogreenspaceinBristol,UnitedKingdomuseda
minimumgreenspaceareaof2ha,definedbytheauthorsasaminimumtosupportphysicalactivity.
Thestudysuggestedthatpeoplelivingclosertogreenspacesweremorelikelytoengageinlevelsof
physicalactivitythatmetgovernmentrecommendations(Coombesetal.,2010).Anecologicalstudy
ofmortalityinFloridaintheUnitedStatescalculatedacounty‐levelmeasureofgreenspace
accessibilitybasedonaverageconstituentcensustractproximitytonearestgreenspace(without
apparentsizethreshold).Thisstudysuggestednoassociationbetweenasimpleaveragedistanceto
greenspaceandmortality,butdidfindanassociationwithamorecomplexproximity‐basedmeasure
ofaccessibilitybasedon“cumulativeopportunity”(Couttsetal.,2010).
DatarequirementsandapplicabilityasaWHOindicator
Atpopulationscale,anindicatorofgreenspaceaccessibilityrequiresbothageographicalgreen
spacedataset(withtheinclusioncriteriaforgreenspacesclearlydefined),andapopulationdataset
withappropriategeographicalresolution.Mostcommonly,populationdataareavailableforsmall
geographicalareas,suchaspostaldistrictsorcensusdatareportingareas.Thetwodatasetsshould
beapproximatelycomparableintermsoftimeperiodcovered.Therearesomesuggestionsthatsize
ofgreenspacemayinfluencethetypeofusageandhealthandwell‐beingoutcomesafforded.Whilst
thereisnoconclusiveevidenceonacriticalsizethresholdforspecifichealthandwell‐being
outcomes,itissuggestedherethatinternationalindicatorsshouldmeasuresmallsizegreenspaces,
asthesemaybemoreamenabletolocalandnationalpolicyinterventions.
Anumberofgreenspacedatasetsareavailablethatcouldtheoreticallybeusedforthistypeof
indicatorintheregion,asdescribedinSection3.3.2.2.NDVI,GlobalLandCoverandCORINEdatasets
donotincludedelineationofspecificparcelsofland,butcouldtheoreticallybeconfiguredand
analysedtoapproximatedefined‘greenspaces’.However,CORINEonlyincludeslandparcelsgreater
than25ha,makingitunsuitabletouseforahealth‐relatedindicatorwhichshouldincludesmaller
neighbourhoodgreenspaces.UrbanAtlascoversurbanareasintheEuropeanUnionbutdoesnot
includecountriesintheeasternpartoftheWHOEuropeanRegion.Itdoesdelineatespecificgreen
spaces,andidentifypubliclyaccessiblespaces.ThisisdescribedfurtherinSection4.
3.4.2Proportionofgreenspaceorgreennesswithinacertaindistancefromresidence
Description
Theproportionofoverallgreennessorgreenspacewithinacertainradiusaroundaresidencecanbe
ausefulmeasureinresearchprojectsaddressingspecifichealthoutcomepathways.Theseindicators
havebeenwidelyusedinepidemiologicalstudies.Indicatorvaluescanbeestimatedforarangeof
bufferzonestoexplorethestrengthofassociationswithspecifichealtheffects.
Examplesofapplicationinresearchandsurveillance
AlongitudinalstudyofgreenspaceandchildhoodobesityinCaliforniausedmunicipalitydataon
landusetocalculateanindicatorofparkacreagewithina500mbufferofstudyparticipants’homes
(Wolchetal.,2011).Higheravailabilityofgreenspaceaccordingtothisdensitymeasurewas
27
associatedwithreducedriskofobesityandbeingoverweightbythetimethestudyparticipants
reachedtheageof18.
Remotelysensedlandcoverdatahavebeenusedinsimilarstudies.AnexampleintheNetherlands
usedtheNationalLandCoverClassificationdatabase,whichclassifiesthelanduseof25mgridcells
acrossthecountry(Maasetal.,2009b).Thesedatawereusedtocalculategreenspaceareadensity
within1kmand3kmbuffersofhomepostalcodelocationsofindividualsincludedonprimarycare
databases.Thestudydemonstratedastrongprotectiveeffectofgreenspaceondepressionand
anxiety.
Severalrecentstudieshavealsoinvestigatedtherelationshipbetweenbirthoutcomesand
neighbourhoodgreennessusingNDVI.Dadvandetal.(2012b)useddatafromfourSpanishcohorts,
andcalculatedaverageNDVIforthreebufferzonesat100m,250mand500mfromtheresidence
addresslocationofmothersattimeofdelivery.Thefindingssuggestedthatthoselivingingreener
areasweremorelikelytohaveheavierbabies(lowerlikelihoodofLowBirthWeight).Studiesusing
similarmethodshavebeencarriedoutintheUnitedStatesandIsrael(Hystadetal.,2014;Agay‐Shay
etal.,2014)andhaveshownlinksbetweensurroundinggreennessandpositivepregnancyoutcomes.
DatarequirementsandapplicabilityasaWHOindicator
NDVIisusefulindetermininggeneralgreennesswithinadefineddistancefromhome,andhasthe
advantageofglobalavailabilityandfrequentupdate.GlobalLandCoverisanotherpotentiallyuseful
database.EuropeanUrbanAtlascanalsobeusedtocalculatetheproportionofgeographically
definedgreenspacewithinabufferzonearoundeachresidence.Nationalormunicipalhigh
resolutionlandusedatabasescanalsobeusedincombinationwithgeocodedpopulationdata.The
applicationofthistypeofindicatorusuallyrequireshighresolutiongeocodeddataonindividual
residences.InthecontextofaWHOindicator,dataanalysiscanbecomputationallyintensivewhile
requirementsforhighresolutiondatawouldlimittheapplicabilityoftheseindicators.
3.4.3Perception‐basedmeasuresofgreenspaceaccessibility
Description
Perceivedaccessibilitycanalsobeausefulmeasuresupplementingdistance‐basedaccessibility.One
issueforconsiderationisthepotentialmismatchbetweenperceivedandobjectivelymeasured
accessibility.Itispossiblethatperceivedproximitymaybeanimportantdriverofuseespeciallyif
objectivelymeasuredproximityisnotconsistentlyrelatedtoperceivedproximityacrosspopulation
subgroups.Thereislimitedevidenceofthis,butonestudyinGlasgow,UnitedKingdomcompared
participants’perceptionofthedistancetotheirnearestparkandtheactualdistancemeasuredvia
botharoadnetworkandasstraightlinedistance(Macintyreetal.,2008).Thestudyfoundlimited
agreementbetweenperceivedandobjectivemeasures,andimportantlysuggestedthatthis
agreementwaspooreramongstpeopleoflowersocialclassandinmoredeprivedareas.
Examplesofapplicationinresearchandsurveillance
OnestudyuseddatafromtheEuropeanQualityofLifeSurveytoinvestigateassociationsbetween
self‐reportedgreenspaceaccessibilityandmentalhealthinequalities.Thequestionusedtoassess
perceivedaccessibilitywas“Thinkingofphysicalaccess,distance,openinghoursandthelike,how
wouldyoudescribeyouraccesstothefollowingservice?[recreational/greenareas]”(Mitchelletal.,
2015).Thestudyfoundsocioeconomicinequalitiesinmentalhealthtobesubstantiallylower
amongstpeoplereportinggoodaccesstorecreational/greenareascomparedtothosewithpoorer
access.
DatarequirementsandapplicabilityasaWHOindicator
Perception‐basedgreenspaceaccessibilityindicatorscanbeusefulasbroadmeasuresofqualityof
lifeorinlocalinvestigationsinsupportoftargetedpolicymeasures.TheEuropeanQualityofLife
SurveyisconductedeveryfouryearsintheEuropeanUnioncountries(otherEuropeancountriesmay
28
alsoparticipate)9.Thedataarecollectedfromrandomlyselectedindividualsacrosseachparticipating
countryandmaynotbesufficientforcharacterizinggreenspaceaccessibilityatmunicipallevel.Local
dataarenotreadilyavailableandneedstobecollectedusingspeciallydesignedsurveytools.This
wouldmakeabroadandsustainedinternationalapplicationofanindicatorbasedonperception‐
basedmeasuresintheWHOEuropeanRegionratherproblematic.
3.5Indicatorsofgreenspaceusage
Description
Healthandwell‐beingbenefitmaybegainedwithoutactualphysicaluseofgreenspace;forexample,
theremaybepsychologicaleffectsofsimplyviewinggreenspace,evenifitisnotpubliclyaccessible
(e.g.privategardens).However,severalofthepathwaysfromgreenspacetohealthandwell‐being
requirethatindividualsactuallyspendtimeinthegreenspaceinordertogainbenefit(e.g.through
physicalactivity).Indicatorsofgreenspaceusageareusefulintermsofa)understanding
relationshipswithhealthandwell‐beingoutcomesandb)understandinghowandtowhatextent
greenspacesareactuallyusedbylocalresidentandvisitingpopulations.Theseindicatorsmayhelp
toprovideinformationon,forexample,greenspacesthatareunderutilizedorthathavepotentialfor
diversificationofuseandusers.Thereareseveralwaysinwhichusagemightbemeasured.
• Fromthepopulationperspective,surveyscanestablishhowoftenindividualsvisittheirlocal
greenspaces,whichonestheyvisitandwhichcharacteristicsattractvisits,onaself‐reported
basis.
• Fromanindividualperspective,mobilitytrackingusingGlobalPositioningSystemtechnology
canbeusedtoassessexactlywhichgreenspacesareused,durationofvisits,andsoon.
• Fromthegreenspacepointofview,observation,gatecountandsurveydatacanbeusedto
establishhowmuchaspecificspaceisused,andwhatitisusedfor.Thismethodfocuseson
thecontributionofasinglearea.Therefore,itisdifficulttolinkitwithhealthbenefits.
However,thisapproachcanbehelpfulforassessingeffectsofpolicymeasuresaimedat
improvinggreenspaceuse.
Thesemethodscanpotentiallybeusedincombinationtobuildunderstandingofhow,whenandby
whomgreenspacesareused,andtoassesshealthandwell‐beingoutcomesrelatedtousage.
Examplesofapplicationinresearchandsurveillance
Greenspaceusagemaybephysicallyactiveorpassive,andcouldleadtohealthandwell‐being
benefitsthroughvariousmechanismsdescribedabove,dependingonthetypeofspaceandthe
activitiesafforded.Forexample,onestudyintheNetherlandsestablishedusageextentand
characteristicsthroughapostalquestionnairesurvey.The‘VitaminG’studydevelopedaseriesof
questionstoestablishpatternsandexperienceofgreenspaceuse.Thesesurveyquestionsaskabout
variousaspectsofuseoflocalgreenareas:“distancefromhome,frequencyofvisitation,durationof
visits,activitiesperformedduringvisits,accompanyingpersons,interactionswithotherpeople
duringvisits”(Groenewegenetal.,2006;Groenewegenetal.,2012).Otherstudieshaveuseddataon
self‐reportedvisitstonaturalenvironments(includingurbangreenspace),relatingthecharacteristics
oftheindividuals,theenvironmentvisitedandthenatureofthevisittoperceivedstressreduction,
mentalrestorationandphysicalactivity(Whiteetal.,2013b;Whiteetal.,2014;Elliottetal.,2015).
AnumberofstudieshaveusedGPSreceiverstotrackindividuals’movementsandtomapand
analysetheiruseofgreenspaces.Forexample,astudyofaround1,300schoolchildreninBristol,
UnitedKingdomusedGPSdataincombinationwithaccelerometry(measuringphysicalactivity).The
studyfoundthatchildren(especiallyboys)weremorelikelytobephysicallyactiveatthelevelabove
theModerate‐VigorousPhysicalActivitythresholdsingreenspacescomparedtoothertypesof
urbanenvironments(Wheeleretal.,2010).

9https://www.eurofound.europa.eu/surveys/european‐quality‐of‐life‐surveys
29
AstudyintheUnitedStatesusedastandardisedobservationtool(theSystemforObservingPlayand
RecreationinCommunities)toobservephysicalactivitybehaviourineightparks;theauthors
concludedthatvisitorstoruralparkstendedtobelessphysicallyactivethanvisitorstourbanparks
(ShoresandWest,2010).
DatarequirementsandapplicabilityasaWHOindicator
Greenspaceusagedataarenotcollectedonaninternationalbasis,withtheexceptionofself‐
reportedmeasuresincludedintheEuropeanQualityofLifeSurvey,mentionedabove,andsome
Eurobarometersurveys.Forexample,Eurobarometerdatawereusedtocomparethequalityoflife
in79cities,includinganindicatorof“satisfactionwithgreenspacessuchasparksandgardens”
(EuropeanCommission,2013).Thesedatamayhelptoinformnationsorlocalitiesaboutpublic
perceptionsandusageoftheirgreenspaces,butaredependentonthegeographicalareascovered
bythesurveys.
3.6Summaryandrecommendationsforahealth‐relevantapproachto
selectingandusingindicatorsofurbangreenspace
3.6.1Summaryofconsiderationsforselectingindicators
Littleresearchhasdirectlycompareddifferentindicatorsofgreenspace.Someresearch(Mitchellet
al.,2011)hascomparedgreenspacemeasuresbasedondetailedcartographicdatabasesandcoarser
datafromCORINE,andsuggestedthattheyarebroadlycomparable,butwithsomeimportant
differences(especiallydueCORINE’sexclusionofsmallergreenspaces).Arecentsystematicreview
ofthementalhealthbenefitsoflong‐termexposuretogreenandbluespacessuggestedsome
differentialsbetweenrelationshipswithmeasuresof:surroundinggreenness;accesstogreenspaces;
qualityofgreenspaces;andbluespaces(Gasconetal.,2015).However,theevidencebasewas
highlightedasbeinglimitedorinadequate,andfurtherresearchisrequiredtoestablishwhether
therearetruedifferencesbetweentheseconceptualizationsoflocalurbangreenspace.Various
studieshavehighlightedtheimportanceof:
• nuancedconsiderationofdifferenttypesandqualitiesofgreenspace;
• thevariousmechanismsthroughwhichawiderangeofhealthandwell‐beingoutcomes
couldarise;and
• thelikelihoodthattherewillbevariationinresponsetoanyparticulargreenspace‘exposure’
accordingtopopulationandindividualcharacteristicsincludingage,sex,socioeconomic
status,local/regionalculturalnorms,lifecourseexperienceandsoon(Belletal.,2014;
MitchellandPopham,2008;Gasconetal.,2015;Hartigetal.,2014;Annerstedtetal.,2012).
Itisthereforeworthsummarizingsomeofkeyquestionsanduncertainties.Thesecouldbe
consideredbythoseimplementingandusingtheindicatorstogivecontext,andtopromote
opportunitiestodevelopmorebespokeindicatorsbasedonlocallyavailabledatasources:
• Whatarethemostimportant/relevantpotentialexposurepathwaysandhealthoutcomes
(seeSection1)?
• Doessizeofgreenspacematter?Differentsizedpatchesofgreenspacemaybeimportant
forpathwaysleadingtodifferenthealthbenefits.
• Doeslandcovertypeofthegreenspacematter?Whataboutwater(bluespace)orother
locallyrelevantlandcovertypes?
• Whatisthedegreeof‘wild’or‘tamed’natureinthegreenspace?Whatistheactualand
perceivedbiodiversityvalueofthegreenspace?Cultureandcontext–Isurbangreenspace
differentindifferentcitiesandregions,doesitmeandifferentthingsindifferentcultures,
anddoesithaveconnectionswithhealthviadifferentpathways?
• Areanyofthefollowingcharacteristicsparticularlyrelevanttothelocality/region?
- perceptionsofenvironmentalquality
30
- safetyissues(suchaslighting)
- attractiveness
- maintenance
- cleanliness
- diversityofenvironments
- diversityofusergroupsandpotentialconflictsofuse
- biodiversity,wildlife,vegetation
- facilitiese.g.catering,lavatories,carparking
- dogownership/restrictionsonaccessfordogs
- identity,cultureandcommunitysignificance
- landownership
- pesticideuseandotherpotentialhazards
- treespecies,especiallywithregardtoallergenlevels.
Inconclusion,whilethereisarapidlygrowingevidencebaseregardingthepotentialhealthandwell‐
beingbenefitsofurbangreenspace,theeffectsareheterogeneousand,therefore,theycannotbe
summarizedinasimplefashionasastraightforwardexposure‐outcomerelationship.Asinglegreen
spacemeasureisunlikelytobeabletocaptureandsummarizeallofthesecomplexities.However,
thereisconsiderablemeritindevelopingcomparable,generalindicatorsofhealth‐relevanturban
greenspaceacrosstheEuropeanRegionforavarietyofpurposes,withutilityatlocal,nationaland
internationalscales.
Alongsidereasonableevidencethattheindicatorrepresentsahealth‐relevantmeasureofurban
greenspace,anumberofotherfactorsneedtobetakenintoconsiderationforpragmatic
implementationanduse:
• Arethedatareadilyavailable?;
• Howfrequentlywillthedatabeupdated?Itshouldbenotedthatanyfuturechangesinthe
waythegreenspaceorpopulationdataareproducedorappliedcouldinfluencethe
indicator,andthereforeimpactoncapacitytomonitorchangeovertime;
• Atwhatspatialscaleandresolutionaredataavailable?;and
• IstherecomparabledatacoverageinternationallyacrosstheEuropeanRegion?
Abalanced,health‐relevantapproachtoaWHOurbangreenspaceindicatorfortheEuropeanRegion
shouldbebasedonconsiderationofthesefactorsandtheevidenceandapproachesdescribedabove.
Itshouldutilizeexistingdatathatarereadilyavailableandshouldnotrequirenewdatacollection.
3.6.2Recommendationsforaprimaryindicator
Aproximity‐basedindicatorofgreenspaceaccessibility,usingtheEuropeanUrbanAtlasasthemost
appropriateandfeasibleinternationalsourceofurbangreenspacedataintheEUMemberStates(all
EUMemberStatescontributedataforcitieswithmorethan100000inhabitants)orcomparable
sourcesoflandusedatainothercountriesoftheWHOEuropeanRegionisarealisticapproachwhich
wouldproducedatapertinenttotheParmaDeclarationcommitment“…toprovideeachchildwith…
greenspacestoplayandundertakephysicalactivity”(WHO,2010b).Thefocusonphysicalactivity
callsforanindicatorreflectingaccessibilitytogreenspacessuitableforthispurpose.
Basedontheexistingevidenceandtherationalepresentedabove,thefollowingapproachis
suggested:
1. Typeofindicator:Accessibilityindicatorbasedonresidentialproximitytogreenspaces
(definedgreenspacescombinedwithpopulationdistributiondata).
2. Greenspacedatasource:EuropeanUrbanAtlasbecauseofitslevelofspatialdetail,its
availabilityinamajorityofEuropeanMemberStatesandappropriatespatialresolution.
Comparablenationalormunicipaldatasourceswouldneedtobeidentifiedoutsidethe
UrbanAtlascoveragearea.
31
3. Greenspacedefinition:AsperUrbanAtlasClass1.4.1GreenUrbanAreas(seeBox2.1),with
twominimumsizesof0.5ha(coreindicator)or1.0ha(additionalindicatortoallow
flexibility).Recommendreportingresultsforbothminimumsizes.Testingofevenlarger
minimumgreenspacesizescanberecommendedtofacilitatemorein‐depthpolicyanalysis
andprovidedatainsupportofinterventions.
4. Populationdata:Tobeobtainedatthefinestspatialresolutionpossible(variablesource
accordingtolocation).Europeanpopulationestimatesareavailablefor100mgrid,whichis
anappropriateintra‐cityscale(e.g.theEurostat2006grid10isappropriateforcombination
withthe2006UrbanAtlasdata).Futureupdatescoulduseupdatedpopulationgrids,orlocal
censussmallareadata.
5. Tomeasureproximity,populationunit(e.g.censusarea)centroidlineardistancefromgreen
spaceedgeisareasonableproxyforthewalkingdistancetotheparkentrance.Network
distancemaybemoreaccurateandreflectvariationinlocalaccessroutesbutisalsomore
complextocalculate;lineardistanceisanappropriateproxy.
6. Alineardistanceof300misreasonableasitcorrespondstoapproximately5minwalking
distancealongwalkableroadsorpathways.Testingofdifferentlineardistancesmaybe
recommendedtofacilitatemorein‐depthpolicyanalysisandprovidedatainsupportof
interventions.However,meaningfulanalysisatsmalldistancesrequireshighresolutionland
useandpopulationdata.
7. Dependingontheavailabilityofdataatacitylevel,localpublichealthauthoritiesmaybe
advisedtoconductfurtheranalysesbasedontheproposedproximity‐basedindicator–for
examplecalculatingaccessibilitymeasuresforspecificpopulationsubgroups.
Section4ofthisreportpresentsadetailedmethodologicalapproachtoaproximitybasedindicator
andananalysistoolkit.
3.6.3Recommendationsforsecondaryindicators
Otherindicatorsaddressingavailabilityofoverallgreennessshouldalsobeconsideredinorderto
addressotherpathwaystohealth,suchaspsychologicalrelaxation.Furtherindicatorswouldalso
provideadditionalcontextandinformationforinformedpolicyanalysis.Keyindicatorsconsideredto
beofmeritare:
• GreenspaceavailabilityindicatorbasedonNDVI–meanvaluetoindicateaverage
‘greenness’atcityscale,orforsmallareaswithinacitytoindicatedistributionacrossthe
population.Toenableinter‐cityandtemporalcomparisons,theseasonalnatureofthis
measurehastobetakeninaccount(e.g.timingofmeasurementsstandardized).
• Perception‐basedindicatorbasedonlocal/nationalsurveystoestablishgreenspaceusage
andperceptions.Suchsurveyscouldimplementquestionssuchasthoseusedinthe
EuropeanQualityofLifeSurveys11andintheregularEuropeanUnion’spublicopinionsurvey
EuroBarometer(EuropeanCommission,2013)forconsistencyandcomparability.


10http://ec.europa.eu/eurostat/statistics‐explained/index.php/Population_grids
11https://www.eurofound.europa.eu/surveys/european‐quality‐of‐life‐surveys
32
4.PROPOSEDINDICATORANDADATAANALYSISTOOLKIT
4.1.Summaryofindicatordevelopmentandevaluation
Inordertomonitorprogresstowardsthecommitment“…toprovideeachchildby2020withaccess
tohealthyandsafeenvironmentsandsettingsofdailylifeinwhichtheycanwalkandcycleto
kindergartensandschools,andgreenspacesinwhichtoplayandundertakephysicalactivity”(WHO,
2010b)whichtheMemberStatesoftheWHOEuropeanRegionmadeatthe5thMinisterial
ConferenceonEnvironmentandHealthinParma,Italy(2010),anindicatortool,whichcanbeapplied
onamunicipallevelintheEuropeanRegion,isrequired.AtaWHOtechnicalmeetingin2010a
preliminaryindicatordefinitionandmethodwassuggested(WHO,2010c).Therecommendationwas
todevelopanindicatorbasedonanalysisofGISdataonlanduseandpopulationreflectingproximity
ofpopulationtourbangreenspaces.Thelineardistanceof300mwassuggestedascorrespondingto
approximately5minwalkalongwalkablepathways.Itshouldbenotedthatwhile300misa
commonlyuseddistancecut‐off,currentlythereisnoconsensusontheresidentialproximityto
greenspacethatislinkedwithphysicalactivityandrelaxation‐relatedhealthbenefits(reviewedby
Ekkel&deVries,2017).Futureepidemiologicalstudiesareexpectedtoprovidenewinsightsonthe
spatialshapesofassociationsbetweenproximitytogreenspaceandspecifichealtheffectsincertain
populationgroups.
Inordertotestthesuggestedindicatorandfurtherdevelopitsmethodology,threecasestudieshave
beenconductedinUtrecht(theNetherlands),Kaunas(Lithuania),andMalmö(Sweden).Aninitial
outlineofindicatormethodologywasdevelopedbyTheNationalInstituteforPublicHealthandthe
Environment(RIVM),theNetherlands,includingtwoalternativemethodsforestimatingtheindicator
value.ThecasestudiesusedEuropeanUrbanAtlasdataonlanduse,aswellaslocaldataonlanduse
andpopulation(AnnerstedtvandenBoschetal.,2016).Thecasestudiesinvolvedtestingvarious
definitionsofgreenspacesbasedonUrbanAtlasclassifications,minimumsizesofgreenspaces
rangingfrom0.25hato5ha,andbufferzonesfrom100mto500m.Thecasestudiesalsocompared
resultsproducedusingspatiallyaggregatedpopulationdataandhighresolutionpopulationdataon
individualhouses.
Thelessonslearnedhighlightedpotentialchallengeswithacquiringhouse‐levelpopulationdatain
thecontextofaninternationalstudy.Theresultsalsoshowedthatusingabufferzone(linear
distancetoapark)whichiscomparabletothegridsizeoflanduseorpopulationdataresultedin
statisticalinstabilityofindicatorvalues.Ontheotherhand,usinggreaterdistancesproduced
estimatesofpopulationproportionresidingwithinthebufferzonecloseto100%andlowerinter‐city
variabilityoftheindicatorvalues.
Thissectionpresentsarevisedindicatordefinitionandfullydevelopedmethodologyforestimating
theindicatorvaluebasedonresultsofthepilotsurveysandaddressesrecommendationsfrom
internationalexpertswhoattendedtheWHOmeetingongreenspacesandhealthinBonn,Germany
inMay2015.ItstartswithdescribingthedatarequirementsforaWHOUrbanGreenSpaceIndicator
insection4.2beforeandthenoutlinestwomethodsforestimatingtheindicatorvalue.These
methods,hereaftercalled“basic”and“complex”method,havebeentestedinthreecasestudies
(AnnerstedtvandenBoschetal.,2016).Bothmethodsusethesamekindoflandusedata.Thebasic
methodusespopulationdataaggregatedatthecensusblocklevelandisdiscussedfurtherinSection
4.3.2.Thecomplex(andmoreprecise)methodrequiresgeocodeddataonindividualresidencesand
isdiscussedfurtherinSection4.3.3.Adetailed,step‐to‐stepguidewithinstructionsonhowto
conducttheanalysisisprovidedinAppendix3.
33
4.2.DatarequirementsforaWHOUrbanGreenSpaceIndicator
4.2.1.LandusedataforEUcountries
TheapplicationofanUrbanGreenSpaceIndicatorrequiresharmonisedandcomparablelanduse
dataavailableataninternationallevel.UrbanAtlasiscurrentlythemostup‐to‐datelanduse
databaseforcitiesintheMemberStatesoftheEU(EuropeanUnion,2011).Itisthebiggest
internationaldatabaseintheWHOEuropeanRegioncurrentlycovering27EUcountriesrepresenting
overhalfofthe53regionalMemberStates.UrbanAtlasdataarefreelyavailablethroughthe
EuropeanEnvironmentAgency(EEA)12andaredeliveredinvectorformatintopologicallycorrect
GIS‐files.Theupdatefrequencyistobedetermined.
UrbanAtlashasahighthematicresolutionwithaclassificationsystemfocusingoninterurbanareas.
Intotal,theclassificationsystemcontainsfourmajorunits:(1)Artificialsurfaces,(2)Agricultural
areas,semi‐naturalareasandwetlands,(3)Forests,and(4)Water.Theminimumoverallthematic
accuracyforunit1is85%andthegeometricresolutionis0.25ha.Fortheremainingunitsthe
thematicaccuracyis80%,whilethegeometricresolutionis1ha.Thepositionpixelaccuracyisless
than5mforallunits.
Unit1,artificialsurfaces,isfurthersubdividedintosubunits,definingspecificartificialurbanlanduse
types,suchasroads,greenurbanareas,sportsandleisurefacilitiesandresidentialareasofvarious
density.Fortheindicator,thesubunits“greenurbanareas”(UrbanAtlascode14100)and“sports
andleisurefacilities”(code14200)couldbeconsidered,aswellasthenon‐artificialunits
“agriculturalareas,semi‐naturalareasandwetlands”(code20000)and“forests”(code30000).The
conclusionaftercasestudiesandconsultationswithWHOtechnicalexpertswastousethesubunit
“greenurbanareas”fortheindicator’sdefinitionofurbangreenspaces.Moredetailedinformation
onthedefinitionisprovidedinBox4.1.
Box4.1EuropeanUrbanAtlasClass1.4.1(vectordatacode14100):GreenUrbanAreas(European
Commission,2011)
Minimummappingresolution0.25ha,Minimumwidth:10m
Included:
• Publicgreenareasforpredominantlyrecreationalusesuchasgardens,zoos,parks,castleparks.
• Suburbannaturalareasthathavebecomeandaremanagedasurbanparks.
• Forestsorgreenareasextendingfromthesurroundingsintourbanareasaremappedasgreen
urbanareaswhenatleasttwosidesareborderedbyurbanareasandstructures,andtraces
ofrecreationalusearevisible.
Notincluded:
• Privategardenswithinhousingareas
• Cemeteries
• Buildingswithinparks,suchascastlesormuseums
• Patchesofnaturalvegetationoragriculturalareasenclosedbybuilt‐upareaswithoutbeing
managedasgreenurbanareas

12http://www.eea.europa.eu/data‐and‐maps/data/urban‐atlas;
http://dataservice.eea.europa.eu/map/UrbanAtlasbeta/
34
4.2.2.Landcover/usedatafornon‐EUcountries
Detailedurbanlandusedatafornon‐EUcountriesarecurrentlynotsystematicallymappedandnot
freelyavailableinternationally.However,variedglobalmapservicesaredevelopedorunder
developmentforopenaccess,suchasGlobalLandCoverdatasetandOpenStreetMap.Thesedata,
orlocalorregionalequivalents,arerecommendedtobeusedwhereUrbanAtlasdataarenot
available.Thesamemethodology,asoutlinedinthissection,shouldbeapplicable.Inadditionthe
urbangreenspacedefinitionusedshouldaimtobeassimilaraspossibletothatoftheUrbanAtlas
definition.
VariouslandusedatasourcesaredescribedanddiscussedinSection3ofthisreport.
4.2.3Populationdata
LocalscalepopulationdataaboutplaceofresidenceinGISlayersareneeded.Populationdistribution
dataareusuallyfreelyavailablefromlocalsources,suchasmunicipalities.Thesedatamaybeon
individualor,forexample,censusblocklevel.Thefinestspatialresolutionpossibleshouldbe
obtained.Whiletheproposedindicatorisdesignedtomeasuretheoverallaccessibilityofgreen
spaces,additionalinformationonsocioeconomicanddemographiccharacteristicsofcensusblocksor
otherspatialunitscanbeusedtostratifythepopulation,toestimateindicatorvaluesforspecific
populationstrata,andassesspotentialinequalityinaccesstogreenspace.
ComparableEuropeanpopulationestimatesareavailablefor100mgrids,whichisanappropriate
intra‐cityscale.Forexample,theEurostat2006grid13isappropriateforcombinationwiththe2006
UrbanAtlasdata.
ForEUcountries,anotherpossibleoptionisthePopulationdensitydisaggregateddataset,provided
byEEA14(Gallego,2010).ThesearerasterdataonpopulationdensityusingCORINElandcoverdata
from2000,andisavailablefreeofchargeEU‐wide.Fornon‐EUcountries,inputdatafromlocal
sourceswouldbeanoption.
Duetofactorslikedataprotection,non‐synchroniseddatacollection,orfinancialcosts,itisnot
expectedthatharmonised,individualresidentialdatawillbeeasilyandfreelyavailableacrossthe
membercountriesoftheWHOEuropeanRegion.
Forthebasicversionoftheindicatormethod,censusblockpopulationdistributiondataorsimilar
spatialresolutionscaleareadequate.EUcountriesshoulduselocaldataorEU‐synchronised
populationdatafrom,forexample,EurostatorEEA.Non‐EUcountrieswillhavetorelyondatafrom
localsources.
Toconductthecomplexversion,individualpopulationdataarerequired.Therefore,thebasicversion
isthegeneralrecommendationtouseforreportingtheUrbanGreenSpaceIndicator,butwhen
individualpopulationdataareavailablethecomplexversionmaybetested.
4.3.Methodology
4.3.1Generaloverview
Aspatialanalysistoolisrequiredforestimatingvaluesoftheindicator.Severalalternativemethods
arepossible,allrelyingonGISdata.AcommonGISsoftware(ArcGISforDesktop15)wasusedfor
analysisofdatafromcasestudies.ArcMap,theprimarycomponentofArcGIS,wasappliedto
estimatevaluesoftheindicator.ThisreportdescribestheapplicationofArcGISsoftwareversion10.1.

13http://ec.europa.eu/eurostat/statistics‐explained/index.php/Population_grids
14http://www.eea.europa.eu/data‐and‐maps/data/population‐density‐disaggregated‐with‐corine‐land‐cover‐
2000‐2
15http://www.esri.com/software/arcgis/arcgis‐for‐desktop/index.html
It
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(Fig.4.3).Thecompletelywithinoptionprovidesunderestimations,asresidentsinthepolygonsthat
arenotentirelywithinthebufferwillbeomitted,althoughpartsofthepolygon’spopulationmay,in
fact,bewithinthebuffer(Fig.4.4).
Thecentroidoptionshouldalsogiveanapproximation.However,theoreticallyitmaybeclosertothe
individualdataresultandtherealsituation,sinceitwillincludethepopulationofpolygonswiththe
centroidwithinthebufferzone,whilestillnotincludingeverypolygon,andcorrespondingpopulation,
touchingthebufferborder(Fig.4.5).
Thecentroidoption,orequivalent,shouldbeappliedfortheindicator.
Fig.4.3.Inclusiveoption(“intersectthesourcelayerfeature”intheGIS‐selection)
Fig.4.4.Exclusiveoption(“completelywiththesourcelayerfeature”intheGIS‐selection)
38
Fig.4.5.Centroidoption(“centroidinthesourcelayerfeature”inGIS‐selection)
Step4Estimatingtotalpopulationwithinthebufferzone
InArcGIS,the‘Statistic’toolcanbeusedtosumthepopulationwithinthebuffer.
Step5Calculatingtheindicatorvalue
Applytheformulafromsection4.3.1toestimatetheUrbanGreenSpaceIndicatorvalueastheratio
ofthenumberofpeoplewholivewithin300mfromthenearestgreenspacetothetotalnumberof
residentsofthecityorareaofinterest,multipliedby100%.
4.3.3.Complexmethod
Step1Selectinggreenspaces
Theselectionofgreenspacesismadebythesameprocedureasinthebasicmethod.Theselection
shouldthenbeexportedtoanewlayerbytheselectionoptionCreateLayerofSelectedFeaturein
ArcGIS.TheDissolvetoolisusedtodissolvetheboundariesinbetweenthepolygons.Equivalent
toolsshallbeselectedinalternativeGISsoftware.
Step2Selectingpopulationinstudyarea
Populationdataatindividuallevelareselectedasinputdata.
Step3Calculatingindividualdistancetonearestgreenarea
Toestimatethenumberofinhabitantslivingatacertaindistancetonearesturbangreenspace,the
proximitytoolNear,orequivalent,canbeused.Thetoolcanmeasurethedistancebetweeneach
featureanditsnearestneighbourhoods’location,intheUrbanAtlascasetheselected“GreenUrban
Areas”.Adistancemeasurementattribute(300m)isaddedtotheinputfeaturesattributetable.
Step4Estimatingthetotalpopulationwithinthebufferzone
The‘Statistic’toolcanbeusedtosumthepopulationwithinthebuffer.
Step5CalculatingtheUrbanGreenSpaceIndicator
Applytheformulafromsection4.3.1toestimatetheUrbanGreenSpaceIndicatorvalueastheratio
ofthenumberofpeoplewholivewithin300mfromthenearestgreenspacetothetotalnumberof
residentsofthecityorareaofinterest,multipliedby100%.
39
Step6Processingoutputinstatisticalprogramme
Thedistancemeasurementfieldsthatareaddedtotheattributetablecanbeexportedtoageneral
statisticalprogramme,suchasSPSS,SAS,orthefreelyavailableR.Thisallowsfordeepenedstatistical
explorations,forexamplerelatingacity’sgreenspaceaccessibilitytosocioeconomicconditionsor
othersocialindicatorsandpotentialrelationtohealthoutcomes.
4.4Summaryoftheproposedindicator
TheindicatorapproachoutlinedabovewasdevelopedincollaborationbetweenWHOandseveral
researchinstitutes.Casestudiestotesttheinitiallysuggesteddefinitionsandanalysismethodswere
performedinthreemiddle‐sizedEuropeancitiesintheNetherlands,Lithuania,andSweden.Based
onthesecasestudiesanddiscussionsandagreementsbyparticipantsataWHOexpertmeeting,the
methoddescribedinthissectionandinAppendix3wasestablishedfordefiningpublicgreenspace
accessibilityinthecitiesoftheMemberStatesoftheWHOEuropeanRegion.
Specificrequirementsandrecommendationsforthecoreindicatorareasfollows.
• LandusedataarederivedfromUrbanAtlasorequivalentdatabasewithclassifiedGIS‐
dataofurbanareas,includingdelineationofgreenspaces.
• Populationdatashallbeobtainedfromlocalsourcesatfinestspatialresolutionpossible,
orfromEU‐wideaggregatedpopulationdensitydatasets.
• UrbangreenspacesaredefinedinaccordancewiththeUrbanAtlasdefinitionofgreen
urbanareasandwithaminimumsizeof0.5ha.Itisrecommendedtoperformadditional
analysisforaminimumgreenspacesizeof1.0ha.TheUrbanAtlasdefinitionwillserveas
atemplatefordefiningurbangreenspacesinotherlandusedatabases
• Themaximumdistancetotheborderofgreenspacesis300m,measuredaslinear
distance.
• TheGIS‐methodisbasedonaproximity‐analysis,wherethesizeofacity’spopulation
livingwithinabufferzoneof300maroundgreenspacesofatleast0.5haiscalculated.
Thisprovidesanumberforestimatingtheproportionofacity’stotalpopulationwith
recommendedaccesstogreenspaces.
40
5.CONCLUSIONS
Urbanplanners,managersandpolicy‐makersfaceconflictingdemandstopromotemorecompact
citieswithgreaterpopulationdensityinordertocreatecriticalmasstosupportandjustifypublicand
privateserviceprovision,and,ontheotherhand,toprovidegreenspaceandtoimproveurban
ecosystemservices.Builtformmaycreatedifficultenvironments,withpoororturbulentairflows,
heatislandeffectsandincreasedsurfacewaterrunoff.Increasingdensificationofcitiesmayalso
resultinremovalordegradationofexistinggreenspaceinwaysthatwillbedifficulttoreverse.Loss
anddegradationofurbangreenspacecancontributetotheburdenofdiseaseexacerbatingthe
effectsofotheradversefactorsintheurbanenvironment,suchasinequalities,airpollution,noise,
chronicstressandinsufficientphysicalactivity.Reducingthehealthrisksaswellaspromotinghealth
benefitsofurbanlivingrequiresstrongerinteractionsandcollaborationsbetweenurbanplanners
andpublichealthworkers.
Theinformedworkoflandscapearchitects,plannersandurbandesignersisimportantincontributing
professionalexpertisetoensurethathealthbenefitsaswellasenvironmentalandeconomicco‐
benefitsofgreenspacesaremaximizedandfutureopportunitiesarenotlostthroughshort‐sighted
urbandevelopmentdecisions.
Theevidenceshowsthaturbangreenspacehashealthbenefits,particularlyforeconomically
deprivedcommunities,children,pregnantwomenandseniorcitizens.Itisthereforeessentialthatall
populationshaveadequateaccesstogreenspace,withparticularpriorityplacedonprovisionfor
disadvantagedcommunities.Whiledetailsofurbangreenspacedesignandmanagementhavetobe
sensitivetolocalgeographicalandculturalconditions,theneedforgreenspaceanditsvaluefor
healthandwell‐beingisuniversal.
TheimportanceofgreenspacesforhealthisrecognizedintheParmaDeclaration(WHO2010b)with
acommitment“…toprovideeachchildby2020withaccesstohealthyandsafeenvironmentsand
settingsofdailylifeinwhichtheycanwalkandcycletokindergartensandschools,andtogreen
spacesinwhichtoplayandundertakephysicalactivity”.SimilarvisionsareexpressedintheUnited
NationsSustainableDevelopmentGoal11.7andtheWHOActionPlanfortheimplementationofthe
EuropeanStrategyforthePreventionandControlofNoncommunicableDiseasesin2012−2016
(WHO,2012).
Toputthesevisionsintopracticeandmakeagreenurbanenvironmentanassetforallpopulations,
policy‐makersneedtorelyonobjectiveandcomparablemeasuresandindicatorsreflectingurban
greenspaceprovisionacrossmultiplecommunitiesandcountries,andhelpingtoidentifyareas
wheretargetedinterventionsarenecessary.Theapplicationofharmonizedindicatorstomeasure
greenspaceprovisionmayalsohelptoevaluatetheeffectsoftargetedpolicyinterventions.Such
indicatorsshallbeevidence‐based,unanimouslydefined,anduniversallyapplicableacrossvarious
populationsandenvironmentalconditions.Theimplementationofsuchindicatorsrequiresthe
developmentofharmonizeddefinitions,datacollectionmethodsandanalyticaltoolkits,whichare
suitableforlocalpublichealthspecialistsandmunicipalagencieswithlimitedexperienceinGISdata
analysis.
Thisreportsummarizedtheexistingevidenceofhealtheffectsofurbangreenspacestoconclude
thattherearemanypublichealthbenefitsthroughdiversepathways,suchaspsychological
relaxationandstressreduction,enhancedphysicalactivity,andmitigationofexposuretoair
pollution,excessiveheat,andnoiseaswellasotherharmfulfactorsintheurbanenvironment.These
numerousbenefitsstronglyoutweighpotentialdetrimentaleffectsofgreenspacessuchasexposure
toallergenicpollenandtoinfectionscarriedbyinsectvectors.Inaddition,mostdetrimentaleffects
areassociatedwithpoorlymaintainedgreenspaces;theycanbereducedorpreventedthrough
properplanning,organizationandmaintenanceofgreenurbanareas.
41
Thereportalsoevaluatedandcomparedpreviouslydevelopedindicatorsofgreenspaceavailability,
accessibilityandusagefromthepointofviewoftheirpublichealthrelevanceandpractical
applicability.Thereportidentifiesurbangreenspaceindicatorswhicharesuitableforwide‐scale
applicationintheEuropeanRegionandproposesanindicatordefinitionanddataanalysistoolkitfor
universaluse.TheproposedindicatorisbasedonpreviousworkconductedbyWHOinselected
countries.Itinvolvesmeasuringtheproportionofcitypopulationlivingwithin300mofagreen
spacewithadefinedminimumsize.Theindicatorisintendedformonitoringtheimplementationof
Parmacommitment“toprovideeachchild…withaccessto…greenspacestoplayandundertake
physicalactivity.”
Theproposedindicatormeasuresaccessibilityofgreenspacesofdefinedminimumsizessuitablefor
physicalactivityaswellasmentalrelaxation.Theavailableevidencesuggeststhatthereisalsoa
needforsmall,localgreenspacesveryclosetowherepeopleliveandspendtheirday,aswellas
largegreenspaces,offeringformalprovisionssuchasplayingfields,andopportunitiestoexperience
contactwithnatureandrelativesolitude.
Furtherdevelopmentandapplicationofurbangreenspaceindicatorsthatreflectvariousknown
mechanismsofbeneficialhealtheffects,suchasviewinggreenery,iswarrantedinordertoprovide
cityplannerswithbroaderinformationthatcansupportthedevelopmentoftargetedinterventions
aimedatspecificpopulationsubgroups.
Acityofwell‐connected,attractivegreenspacesthatoffersafeopportunitiesforurbanresidentsfor
activemobilityandsportsaswellasforstressrecovery,recreationandsocialcontact,islikelytobe
moreresilienttoextremeenvironmentalevents,suchasheatwaves(duetothemitigationofurban
heatislandeffect)andextremerainfall(duetoreducedsurfacerun‐off).Suchacityisalsolikelyto
havehealthiercitizens,reducingdemandsonhealthservicesandcontributingtoastrongereconomy.
42
6.LITERATURE
AFONSO,E.,LEMOINE,M.,POULLE,M.,RAVAT,M.,ROMAND,S.,THULLIEZ,P.,VILLENA,I.,AUBERT,
D.,RABILLOUD,M.,RICHE,B.&GILOT‐FROMONT,E.2008.Spatialdistributionofsoilcontamination
byToxoplasmagondiiinrelationtocatdefecationbehaviourinanurbanarea.InternationalJournal
forParasitology,38,1017‐1023.
AGAY‐SHAY,K.,PELED,A.,CRESPO,A.V.,PERETZ,C.,AMITAI,Y.,LINN,S.,FRIGER,M.&
NIEUWENHUIJSEN,M.J.2014.Greenspacesandadversepregnancyoutcomes.Occupational&
EnvironmentalMedicine,71,562‐569.
ALCOCK,I.,WHITE,M.P.,WHEELER,B.W.,FLEMING,L.E.&DEPLEDGE,M.H.2014.Longitudinal
effectsonmentalhealthofmovingtogreenerandlessgreenurbanareas.EnvironmentalScience&
Technology,48,1247‐1255.
ALCOCK,I.,WHITE,M.P.,LOVELL,R.,HIGGINS,S.L.,OSBORNE,N.J.,HUSK,K.&WHEELER,B.W.
2015.Whataccountsfor‘England’sgreenandpleasantland’?Apaneldataanalysisofmentalhealth
andlandcovertypesinruralEngland.LandscapeandUrbanPlanning,142,38‐46.
ALMANZA,E.,JERRETT,M.,DUNTON,G.,SETO,E.&ANNPENTZ,M.2012.Astudyofcommunity
design,greenness,andphysicalactivityinchildrenusingsatellite,GPSandaccelerometerdata.
Health&Place,18,46–54.
AMBIENTEITALIARESEARCHINSTITUTE.2003.EuropeanCommonIndicators:TowardsaLocal
SustainabilityProfile.FinalReport.Milano,Italy.Availableat:
http://www.cityindicators.org/Deliverables/eci_final_report_12‐4‐2007‐1024955.pdf(accessedon
19May2016).
AMOLY,E.,DADVAND,P.,FORNS,J.,LOPEZ‐VICENTE,M.,BASAGANA,X.,JULVEZ,J.,ALVAREZ‐
PEDREROL,M.,NIEUWENHUIJSEN,M.J.&SUNYER,J.2014.Greenandbluespacesandbehavioral
developmentinBarcelonaschoolchildren:theBREATHEproject.EnvironmentalHealthPerspectives,
122,1351‐1358.
ANDERSEN,Z.J.,DENAZELLE,A.,MENDEZ,M.A.,GARCIA‐AYMERICH,J.,HERTEL,O.,TJØNNELAND,
A.,OVERVAD,K.,RAASCHOU‐NIELSEN,O.&NIEUWENHUIJSEN,M.J.2015.Astudyofthecombined
effectsofphysicalactivityandairpollutiononmortalityinelderlyurbanresidents:theDanishdiet,
cancer,andhealthcohort.EnvironmentalHealthPerspectives,123,557‐563.
ANNERSTEDT,M.,ÖSTERGREN,P.‐O.,BJORK,J.,GRAHN,P.,SKÄRBÄCK,E.&WÄHRBORG,P.2012.
Greenqualitiesintheneighbourhoodandmentalhealth–resultsfromalongitudinalcohortstudyin
SouthernSweden.BMCPublicHealth,12,337.
ANNERSTEDTVANDENBOSCH,M.&DEPLEDGE,M.2015.Healthypeoplewithnatureinmind.BMC
PublicHealth,15,1232.
ANNERSTEDTVANDENBOSCH,M.,MUDU,P.,USCILA,V.,BARRDAHL,M.,KULINKINA,A.,STAATSEN,
B.,SWART,W.,KRUIZE,H.,ZURLYTE,I.&EGOROV,A.I.2016.Developmentofanurbangreenspace
indicatorandthepublichealthrationale.ScandinavianJournalofPublicHealth,44,159‐167.
ASPINALL,P.,MAVROS,P.,COYNE,R.&ROE,J.2015.Theurbanbrain:analysingoutdoorphysical
activitywithmobileEEG.BritishJournalofSportsMedicine,49,272‐276.
43
ASPINALL,P.A.,THOMPSON,C.W.,ALVES,S.,SUGIYAMA,T.,BRICE,R.&VICKERS,A.2010.
Preferenceandrelativeimportanceforenvironmentalattributesofneighbourhoodopenspacein
olderpeople.EnvironmentandPlanningB:PlanningandDesign,37,1022‐1039.
ASTELL‐BURT,T.,FENG,X.&KOLT,G.S.2013.Doesaccesstoneighbourhoodgreenspacepromotea
healthydurationofsleep?Novelfindingsfromacross‐sectionalstudyof259319Australians.British
MedicalJournalOpen,3.
ASTELL‐BURT,T.,FENG,X.&KOLT,G.S.2014a.Isneighborhoodgreenspaceassociatedwithalower
riskoftype2diabetes?Evidencefrom267,072Australians.DiabetesCare,37,197‐201.
ASTELL‐BURT,T.,FENG,X.&KOLT,G.S.2014b.Neighbourhoodgreenspaceandtheoddsofhaving
skincancer:multilevelevidenceofsurveydatafrom267072Australians.JournalofEpidemiology&
CommunityHealth,68,370‐374.
BALL,D.J.2004.Policyissuesandrisk‐benefittrade‐offsof‘safersurfacing’forchildren’s
playgrounds.AccidentAnalysis&Prevention,36,661‐670.
BALSEVICIENE,B.,SINKARIOVA,L.,GRAZULEVICIENE,R.,ANDRUSAITYTE,S.,UZDANAVICIUTE,I.,
DEDELE,A.&NIEUWENHUIJSEN,M.2014.Impactofresidentialgreennessonpreschoolchildren’s
emotionalandbehavioralproblems.InternationalJournalofEnvironmentalResearchandPublic
Health,11,6757.
BARÓ,F.,CHAPARRO,L.,GÓMEZ‐BAGGETHUN,E.,LANGEMEYER,J.,NOWAK,D.J.&TERRADAS,J.
2014.Contributionofecosystemservicestoairqualityandclimatechangemitigationpolicies:the
caseofurbanforestsinBarcelona,Spain.AMBIO,43,466‐479.
BARTON,J.&PRETTY,J.2010.Whatisthebestdoseofnatureandgreenexerciseforimproving
mentalhealth?AMulti‐StudyAnalysis.EnvironmentalScience&Technology,44,3947‐3955.
BASAGAÑA,X.,SARTINI,C.,BARRERA‐GÓMEZ,J.,DADVAND,P.,CUNILLERA,J.,OSTRO,B.,SUNYER,J.
&MEDINA‐RAMÒN,M.2011.Heatwavesandcause‐specificmortalityatallages.Epidemiology,2,
765‐772.
BEDIMO‐RUNG,A.L.,MOWEN,A.J.&COHEN,D.A.2005.Thesignificanceofparkstophysical
activityandpublichealth:aconceptualmodel.AmericanJournalofPreventiveMedicine,28,159‐
168.
BEIL,K.&HANES,D.2013.Theinfluenceofurbannaturalandbuiltenvironmentsonphysiological
andpsychologicalmeasuresofstress—apilotstudy.InternationalJournalofEnvironmentalResearch
&PublicHealth,10,1250‐1267.
BELL,J.F.,WILSON,J.S.&LIU,G.C.2008.Neighborhoodgreennessand2‐yearchangesinbodymass
indexofchildrenandyouth.AmericanJournalofPreventiveMedicine,35,547‐553.
BELL,S.L.,PHOENIX,C.,LOVELL,R.&WHEELER,B.W.2014.Greenspace,healthandwellbeing:
makingspaceforindividualagency.Health&Place,30,287‐292.
44
BEYER,K.M.,KALTENBACH,A.,SZABO,A.,BOGAR,S.,NIETO,F.J.&MALECKI,K.M.2014.Exposure
toneighborhoodgreenspaceandmentalhealth:evidencefromthesurveyofthehealthof
Wisconsin.InternationalJournalofEnvironmentalResearch&PublicHealth,11,3453‐72.
BJORK,J.,ALBIN,M.,GRAHN,P.,JACOBSSON,H.,ARDO,J.,WADBRO,J.,OSTERGREN,P.‐O.&
SKARBACK,E.2008.Recreationalvaluesofthenaturalenvironmentinrelationtoneighbourhood
satisfaction,physicalactivity,obesityandwellbeing.JournalofEpidemiology&CommunityHealth,
62(4),e2‐e2.
BODICOAT,D.H.,O’DONOVAN,G.,DALTON,A.M.,GRAY,L.J.,YATES,T.,EDWARDSON,C.,HILL,S.,
WEBB,D.R.,KHUNTI,K.,DAVIES,M.J.&JONES,A.P.2014.Theassociationbetweenneighbourhood
greenspaceandtype2diabetesinalargecross‐sectionalstudy.BritishMedicalJournalOpen,4,
e006076.
BODIN,M.&HARTIG,T.2003.Doestheoutdoorenvironmentmatterforpsychologicalrestoration
gainedthroughrunning?PsychologyofSportandExercise,4,141‐153.
BOGAR,S.&BEYER,K.M.2015.Greenspace,violence,andcrime:Asystematicreview.Trauma,
Violence&Abuse,17,160‐171.
BOLDEMANN,C.,BLENNOW,M.,DAL,H.,MÅRTENSSON,F.,RAUSTORP,A.,YUEN,K.&WESTER,U.
2006.Impactofpreschoolenvironmentuponchildren’sphysicalactivityandsunexposure.
PreventiveMedicine,42,301‐308.
BOLDEMANN,C.,DAL,H.,MÅRTENSSON,F.,COSCO,N.,MOORE,R.,BLENNOW,M.,PAGELS,P.,
RAUSTORP,A.,WESTER,U.&SÖDERSTRÖM,M.2011.Preschooloutdoorplayenvironmentmay
combinepromotionofchildren´sphysicalactivityandsunprotection:Furtherevidencefrom
SouthernSwedenandNorthCarolina.Science&Sports26,72‐82.
BOWLER,D.E.,BUYUNG‐ALI,L.,KNIGHT,T.M.&PULLIN,A.S.2010a.Urbangreeningtocooltowns
andcities:Asystematicreviewoftheempiricalevidence.LandscapeandUrbanPlanning,97,147‐
155.
BOWLER,D.E.,BUYUNG‐ALI,L.M.,KNIGHT,T.M.&PULLIN,A.S.2010b.Asystematicreviewof
evidencefortheaddedbenefitstohealthofexposuretonaturalenvironments.BMCPublicHealth,
10,456.
BRANAS,C.C.,CHENEY,R.A.,MACDONALD,J.M.,TAM,V.W.,JACKSON,T.D.&TENHAVE,T.R.
2011.Adifference‐in‐differencesanalysisofhealth,safety,andgreeningvacanturbanspace.
AmericanJournalofEpidemiology,174,1296‐1306.
BRATMAN,G.N.,HAMILTON,J.P.,HAHN,K.S.,DAILY,G.C.&GROSS,J.J.2015.Natureexperience
reducesruminationandsubgenualprefrontalcortexactivation.ProceedingsoftheNationalAcademy
ofSciencesUSA,112,8567‐8572.
BROEKHUIZEN,K.,DEVRIES,S.&PIERIK,F.2013.Healthyaginginagreenlivingenvironment:a
systematicreviewoftheliterature.TNOLeiden.Availableat:https://www.tno.nl/media/1647/2013‐
tno‐r10154‐healthy‐aging‐in‐a‐green‐living‐environment‐def‐samenvatting‐2.pdf(accessedon19
May2016).
45
BUSSE‐NIELSEN,A.,ANNERSTEDT,M.,MARUTHAVEERAN,S.&KONIJNENDIJKVANDENBOSCH,C.
2013.Speciesrichnessinurbanparksanditsdrivers:Areviewofempiricalevidence.Urban
Ecosystems,16.
CABE.2010a.Urbangreennation:Buildingtheevidencebase.London:CommissionforArchitecture
andtheBuiltEnvironment(CABE).
CABE.2010b.CommunityGreen:UsingLocalSpacestoTackleInequalityandImproveHealth.London:
CommissionforArchitectureandtheBuiltEnvironment(CABE).
CABE.2004.Thevalueofpublicspace:howhighqualityparksandpublicspacescreateeconomic,
socialandenvironmentalvalue.London:CommissionforArchitectureandtheBuiltEnvironment
(CABE).
CALFAPIETRA,C.,MORANI,A.,SGRIGNA,G.,DIGIOVANNI,S.,MUZZINI,V.,PALLOZZI,E.,GUIDOLOTTI,
G.,NOWAK,D.&FARES,S.2016.Removalofozonebyurbanandperi‐urbanforests:evidencefrom
laboratory,field,andmodelingapproaches.JournalofEnvironmentalQuality,45,224–233.
CARLISLE,A.J.&SHARP,N.C.C.2001.Exerciseandoutdoorambientairpollution.BritishJournalof
Sports,35,214‐222.
CASTRO,D.C.,SAMUELS,M.&HARMAN,A.E.2013.Growinghealthykids:acommunitygarden‐
basedobesitypreventionprogram.AmericanJournalofPreventiveMedicine,44,S193‐9.
CETATEANU,A.&JONES,A.2014.Understandingtherelationshipbetweenfoodenvironments,
deprivationandchildhoodoverweightandobesity:EvidencefromacrosssectionalEngland‐wide
study.Health&Place,27,68‐76.
CHARREIRE,H.,WEBER,C.,CHAIX,B.,SALZE,P.,CASEY,R.,BANOS,A.,BADARIOTTI,D.,KESSE‐GUYOT,
E.,HERCBERG,S.&SIMON,C.2012.Identifyingbuiltenvironmentalpatternsusingclusteranalysis
andGIS:Relationshipswithwalking,cyclingandbodymassindexinFrenchadults.International
JournalofBehavioralNutritionandPhysicalActivity,9,59.
CHASTIN,S.F.M.,FITZPATRICK,N.,ANDREWS,M.&DICROCE,N.2014.Determinantsofsedentary
behavior,motivation,barriersandstrategiestoreducesittingtimeinolderwomen:aqualitative
investigation.InternationalJournalofEnvironmentalResearch&PublicHealth,11,773‐791.
CHONG,S.,LOBB,E.,KHAN,R.,ABU‐RAYYA,H.,BYUN,R.&JALALUDIN,B.2013.Neighbourhood
safetyandareadeprivationmodifytheassociationsbetweenparklandandpsychologicaldistressin
Sydney,Australia.BMCPublicHealth,13,422.
CIANGA,N.&POPESCU,A.C.2013.GreenspacesandurbantourismdevelopmentinCraiova
municipalityinRomania.EuropeanJournalofGeography,4,34‐45.
CLATWORTHY,J.,HINDSJ.M.&CAMIC,P.M.2013.Gardeningasamentalhealthintervention:a
review.MentalHealthReviewJournal,18,214‐225.
COCHRANE,T.,DAVEY,R.C.,GIDLOW,C.,SMITH,G.R.,FAIRBURN,J.,ARMITAGE,C.J.,STEPHANSEN,
H.&SPEIGHT,S.2009.Smallareaandindividuallevelpredictorsofphysicalactivityinurban
communities:Amulti‐levelstudyinStoke‐on‐Trent,England.InternationalJournalofEnvironmental
ResearchandPublicHealth,6,654‐677.
46
COENSEL,B.D.,VANWETSWINKEL,S.&BOTTELDOOREN,D.2011.Effectsofnaturalsoundsonthe
perceptionofroadtrafficnoise.TheJournaloftheAcousticalSocietyofAmerica,129,EL148‐EL153.
COOMBES,E.,JONES,A.P.&HILLSDON,M.2010.Therelationshipofphysicalactivityandoverweight
toobjectivelymeasuredgreenspaceaccessibilityanduse.SocialScience&Medicine,70,816‐822.
COUTTS,C.,HORNER,M.&CHAPIN,T.2010.Usinggeographicalinformationsystemtomodelthe
effectsofgreenspaceaccessibilityonmortalityinFlorida.GeocartoInternational,25,471‐484.
DADVAND,P.,DENAZELLE,A.,TRIGUERO‐MAS,M.,SCHEMBARI,A.,CIRACH,M.,AMOLY,E.,
FIGUERAS,F.,BASAGANA,X.,OSTRO,B.&NIEUWENHUIJSEN,M.2012a.Surroundinggreennessand
exposuretoairpollutionduringpregnancy:ananalysisofpersonalmonitoringdata.Environmental
HealthPerspectives,120,1286‐1290.
DADVAND,P.,SUNYER,J.,BASAGANA,X.,BALLESTER,F.,LERTXUNDI,A.,FERNANDEZ‐SOMOANO,A.,
ESTARLICH,M.,GARCIA‐ESTEBAN,R.,MENDEZ,M.A.&NIEUWENHUIJSEN,M.J.2012b.Surrounding
greennessandpregnancyoutcomesinfourSpanishbirthcohorts.EnvironmentalHealthPerspectives,
120,1481‐1487.
DADVAND,P.,VILLANUEVA,C.M.,FONT‐RIBERA,L.,MARTINEZ,D.,BASAGANA,X.,BELMONTE,J.,
VRIJHEID,M.,GRAZULEVICIENE,R.,KOGEVINAS,M.&NIEUWENHUIJSEN,M.J.2014a.Risksand
benefitsofgreenspacesforchildren:across‐sectionalstudyofassociationswithsedentarybehavior,
obesity,asthma,andallergy.EnvironmentalHealthPerspectives,122,1329‐1335.
DADVAND,P.,WRIGHT,J.,MARTINEZ,D.,BASAGAÑA,X.,MCEACHAN,R.R.C.,CIRACH,M.,GIDLOW,
C.J.,DEHOOGH,K.,GRAŽULEVIČIENĖ,R.&NIEUWENHUIJSEN,M.J.2014b.Inequality,greenspaces,
andpregnantwomen:Rolesofethnicityandindividualandneighbourhoodsocioeconomicstatus.
EnvironmentInternational,71,101‐108.
DADVAND,P.,NIEUWENHUIJSEN,M.J.,ESNAOLA,M.,FORNS,J.,BASAGANA,X.,ALVAREZ‐
PEDREROL,M.,RIVAS,I.,LOPEZ‐VICENTE,M.,DECASTROPASCUAL,M.,SU,J.,JERRETT,M.,QUEROL,
X.&SUNYER,J.2015.Greenspacesandcognitivedevelopmentinprimaryschoolchildren.
ProceedingsoftheNationalAcademyofSciencesUSA,112,7937‐7942.
DALLIMER,M.,IRVINE,K.N.,SKINNER,A.M.J.,DAVIES,Z.G.,ROUQUETTE,J.R.,MALTBY,L.L.,
WARREN,P.H.,ARMSWORTH,P.R.&GASTON,K.J.2012.BiodiversityandtheFeel‐GoodFactor:
UnderstandingAssociationsbetweenSelf‐ReportedHumanWell‐beingandSpeciesRichness.
Bioscience,62,47‐55.
DANEAULT,V.,HÉBERT,M.,ALBOUY,G.,DOYON,J.,DUMONT,M.,CARRIER,J.&VANDEWALLE,G.
2014.Agingreducesthestimulatingeffectofbluelightoncognitivebrainfunctions.Sleep,37,85‐96.
DEJONG,K.,ALBIN,M.,SKÄRBÄCK,E.,GRAHN,P.&BJÖRK,J.2012.Perceivedgreenqualitieswere
associatedwithneighborhoodsatisfaction,physicalactivity,andgeneralhealth:Resultsfromacross‐
sectionalstudyinsuburbanandruralScania,southernSweden.Health&Place,18:1374‐1380.
DERUI,M.,TOFFANELLO,E.D.,VERONESE,N.,ZAMBON,S.,BOLZETTA,F.,SARTORI,L.,MUSACCHIO,
E.,CORTI,M.C.,BAGGIO,G.,CREPALDI,G.,PERISSINOTTO,E.,MANZATO,E.&SERGI,G.2014.
47
VitaminDdeficiencyandleisuretimeactivitiesintheelderly:areallpastimesthesame?PLoSOne,9,
e94805.
DEVRIES,S.2010.Nearbynatureandhumanhealth:Lookingatthemechanismsandtheir
implications.In:WARDTHOMPSON,C.,ASPINALL,P.&BELL,S.(eds.)InnovativeApproachesto
ResearchingLandscapeandHealth.Abingdon:Routledge.
DEVRIES,S.,VERHEIJ,R.A.,GROENEWEGEN,P.P.&SPREEUWENBERG,P.2003.Natural
environments–healthyenvironments?Anexploratoryanalysisoftherelationshipbetween
greenspaceandhealth.EnvironmentandPlanningA,35,1717‐1731.
DEVRIES,S.,VANDILLEN,S.M.E.,GROENEWEGEN,P.P.&SPREEUWENBERG,P.2013.Streetscape
greeneryandhealth:Stress,socialcohesionandphysicalactivityasmediators.SocialScienceand
Medicine,94,26‐33.
DESPOMMIER,D.2003.Toxocariasis:clinicalaspects,epidemiology,medicalecology,andmolecular
aspects.ClinicalMicrobiologyReviews,16,265‐272.
DIETZ,T.,GARDNER,G.T.,GILLIGAN,J.,STERN,P.C.&VANDENBERGH,M.P.2009.Household
actionscanprovideabehavioralwedgetorapidlyreduceUScarbonemissions.Proceedingsofthe
NationalAcademyofSciences,106,18452‐18456.
DU,F.,FENG,H.L.,NIE,H.,TU,P.,ZHANG,Q.L.,HU,M.,ZHOU,Y.Q.&ZHAO,J.L.2012.Surveyon
thecontaminationofToxoplasmagondiioocystsinthesoilofpublicparksofWuhan,China.
VeterinaryParasitology,184,2–4,141–146.
DZHAMBOVA.M.,DIMITROVA,D.D.&DIMITRAKOVA,E.D.2014.Associationbetweenresidential
greennessandbirthweight:Systematicreviewandmeta‐analysis.UrbanForestry&UrbanGreening
13,621‐629.
EDWARDS,B.,GRAY,M.&HUNTER,B.2015.TheImpactofDroughtonMentalHealthinRuraland
RegionalAustralia.SocialIndicatorsResearch,121,177‐194.
EKKEL,E.D.&DEVRIES,S.2017.Nearbygreenspaceandhumanhealth:Evaluatingaccessibility
metrics.LandscapeandUrbanPlanning,157,214‐220.
ELLIOTT,L.R.,WHITE,M.P.,TAYLOR,A.H.&HERBERT,S.2015.Energyexpenditureonrecreational
visitstodifferentnaturalenvironments.SocialScience&Medicine,139,53‐60.
ELMQVIST,T.,SETÄLÄ,H.,HANDEL,S.N.,VANDERPLOEG,S.,ARONSON,J.,BLIGNAUT,J.N.,GÓMEZ‐
BAGGETHUN,E.,NOWAK,D.J.,KRONENBERG,J.&DEGROOT,R.2015.Benefitsofrestoring
ecosystemservicesinurbanareas.CurrentOpinioninEnvironmentalSustainability,14,101‐108.
EPSTEIN,L.H.,RAJA,S.,GOLD,S.S.,PALUCH,R.A.,PAK,Y.&ROEMMICH,J.N.2006.Reducing
SedentaryBehavior:Therelationshipbetweenparkareaandthephysicalactivityofyouth.
PsychologicalScience,17,654‐659
EUROPEANCENTREFORDISEASEPREVENTIONANDCONTROL.Nodate.Climatechange[Online].
Availableat:http://ecdc.europa.eu/en/healthtopics/climate_change/pages/index.aspx(accessedon
19May2016).EUROPEANCOMMISSION.2011.MappingguideforaEuropeanUrbanAtlas.Available
at:http://www.eea.europa.eu/data‐and‐maps/data/urban‐atlas(accessedon19May2016).
48
EUROPEANCOMMISSION.2013.FlashEurobarometer366:“QualityoflifeinCities:Perception
surveyin79Europeancities”.Luxembourg:PublicationsOfficeoftheEuropeanUnion.Availableat:
http://ec.europa.eu/regional_policy/sources/docgener/studies/pdf/urban/survey2013_en.pdf
(accessedon19May2016).
EUROPEANUNION.2011.MappingGuideforaEuropeanUrbanAtlas.EuropeanEnvironment
Agency,EEA,Copenhagen,Denmark.
EUROPEANUNION.2015.TowardsanEUResearchandInnovationpolicyagendaforNature‐Based
Solutions&Re‐NaturingCities.FinalReportoftheHorizon2020ExpertGroupon‘Nature‐Based
SolutionsandRe‐NaturingCities’.Luxembourg:Directorate‐GeneralforResearchandInnovation.
FABERTAYLOR,A.F.&KUO,F.E.M.2011.CouldexposuretoeverydaygreenspaceshelptreatADHD?
Evidencefromchildren’splaysettings.AppliedPsychology:HealthandWell‐Bring,3,281‐303.
FABERTAYLOR,A.&KUO,F.E.2006.“Iscontactwithnatureimportantforhealthychilddevelopment?
Stateoftheevidence”.InChildrenandtheirenvironments:learning,usinganddesigningspaces,
Editedby:Spencer,C.andBlades,M.124–140.Cambridge:CambridgeUniversityPress.
FERNANDEZ,A.,BLACK,J.,JONES,M.,WILSON,L.,SALVADOR‐CARULLA,L.,ASTELL‐BURT,T.&BLACK,
D.2015.Floodingandmentalhealth:asystematicmappingreview.PLoSONE,10,e0119929.
doi:10.1371/journal.pone.0119929.
FLOYD,M.F.,SPENGLER,J.O.,MADDOCK,J.E.,GOBSTER,P.H.&SUAU,L.J.2008.Park‐based
physicalactivityindiversecommunitiesoftwoU.S.cities.Anobservationalstudy.AmericanJournal
ofPreventiveMedicine,34,299‐305.
FOSTER,C.,HILLSDON,M.&THOROGOOD,M.2004.Environmentalperceptionsandwalkingin
Englishadults.JournalofEpidemiology&CommunityHealth,58,924‐928.
FRANCIS,J.,WOOD,L.J.,KNUIMAN,M.&GILES‐CORTI,B.2012.Qualityorquantity?Exploringthe
relationshipbetweenPublicOpenSpaceattributesandmentalhealthinPerth,WesternAustralia.
SocialScience&Medicine,74,1570‐1577.
FRANCIS,C.D.,ORTEGA,C.P.&CRUZ,A.2009.Noisepollutionchangesaviancommunitiesand
speciesinteractions.CurrentBiology,19,1415–1419.
FUERTES,E.,MARKEVYCH,I.,VONBERG,A.,BAUER,C.P.,BERDEL,D.,KOLETZKO,S.,SUGIRI,D.&
HEINRICH,J.2014.Greennessandallergies:evidenceofdifferentialassociationsintwoareasin
Germany.JournalofEpidemiologyandCommunityHealth,68,787‐790.
GALBRUN,L.&ALI,T.T.2013.Acousticalandperceptualassessmentofwatersoundsandtheiruse
overroadtrafficnoise).TheJournaloftheAcousticalSocietyofAmerica,133,227‐237.
GALLEGO,F.J.2010.ApopulationdensitygridoftheEuropeanUnion.PopulationandEnvironment,
31,460‐473.
GARDSJORD,H.S.,TVEIT,M.S.&NORDH,H.2014.PromotingYouth’sPhysicalActivitythroughPark
Design:LinkingTheoryandPracticeinaPublicHealthPerspective.LandscapeResearch,39,70‐81.
49
GASCON,M.,TRIGUERO‐MAS,M.,MARTÍNEZ,D.,DADVAND,P.,ROJAS‐RUEDA,D.,PLASÈNCIA,A.&
NIEUWENHUIJSEN,M.J.2016.Residentialgreenspacesandmortality:asystematicreview.
EnvironmentInternational,86,60‐67.
GASCON,M.,TRIGUERO‐MAS,M.,MARTINEZ,D.,DADVAND,P.,FORNS,J.,PLASENCIA,A.&
NIEUWENHUIJSEN,M.J.2015.Mentalhealthbenefitsoflong‐termexposuretoresidentialgreenand
bluespaces:asystematicreview.InternationalJournalofEnvironmentalResearchandPublicHealth,
12,4354‐4379.
GIDLÖF‐GUNNARSSON,A.&ÖHRSTRÖM,E.(2010).Attractive“Quiet”Courtyards:APotential
ModifierofUrbanResidents’ResponsestoRoadTrafficNoise?InternationalJournalof
EnvironmentalResearchandPublicHealth,7,3359–3375.
GIDLOW,C.J.,JONES,M.V.,HURST,G.,MASTERSON,D.,CLARK‐CARTER,D.,TARVAINEN,M.P.,
SMITH,G.&NIEUWENHUIJSEN,M.2016a.Wheretoputyourbestfootforward:Psycho‐physiological
responsestowalkinginnaturalandurbanenvironments.JournalofEnvironmentalPsychology,45,
22–29.
GIDLOW,C.J.,RANDALL,J.,GILLMAN,J.,SMITH,G.R.&JONES,M.V.2016b.Naturalenvironments
andchronicstressmeasuredbyhaircortisol.LandscapeandUrbanPlanning,148,61‐67.
GIDLOW,C.J.,ELLIS,N.J.&BOSTOCK,S.2012.DevelopmentoftheNeighbourhoodGreenSpace
Tool(NGST).LandscapeandUrbanPlanning,106,347‐358.
GILES‐CORTI,B.,BROOMHALL,M.H.,KNUIMAN,M.,COLLINS,C.,DOUGLAS,K.,NG,K.,LANGE,A.&
DONOVAN,R.J.2005.Increasingwalking:howimportantisdistanceto,attractiveness,andsizeof
publicopenspace?AmericanJournalofPreventiveMedicine,28,169‐76.
GILES‐CORTI,B.&DONOVAN,R.J.2003.Relativeinfluencesofindividual,socialenvironmental,and
physicalenvironmentalcorrelatesofwalking.AmericanJournalofPublicHealth,93,1583‐1589.
GILLS.E.,HANDLEYJ.F.,ENNOSA.R.&PAULEITS.2007.Adaptingcitiesforclimatechange:theroleof
thegreeninfrastructure.BuiltEnvironment33,115‐133.
GILLIE,O.(Editor).2005.Sunlight,VitaminDandHealth.HealthResearchForumoccasionalreports
no.2,London,UK.Availableat:http://www.stjornusol.is/hfj/images/stories/greinar/sunbook.pdf
(accessedon19May2016).
GONZÁLEZ‐OREJA,J.A.,BONACHE‐REGIDOR,C.&DELAFUENTE‐DÍAZ‐ORDAZ,A.A.2010.Farfrom
thenoisyworld?Modellingtherelationshipsbetweenparksize,treecoverandnoiselevelsinurban
greenspacesofthecityofPuebla,Mexico.Interciencia,35,486‐492
GRAHN,P.&STIGSDOTTER,U.K.2010.Therelationbetweenperceivedsensorydimensionsofurban
greenspaceandstressrestoration.LandscapeandUrbanPlanning,94,264‐275.
GRANT,M.,BIRD,C.&MARNO,P.2012.Healthinequalitiesanddeterminantsinthephysicalurban
environment:Evidencebriefing.Bristol:WHOCollaboratingCentreforHealthyUrbanEnvironments,
UniversityoftheWestofEngland.
50
GRAZULEVICIENE,R.,DANILEVICIUTE,A.,DEDELE,A.,VENCLOVIENE,J.,ANDRUSAITYTE,S.,
UZDANAVICIUTE,I.&NIEUWENHUIJSEN,M.J.2015a.Surroundinggreenness,proximitytocityparks
andpregnancyoutcomesinKaunascohortstudy.InternationalJournalofHygieneandEnvironmental
Health,218,358‐365.
GRAZULEVICIENE,R.,VENCLOVIENE,J.,KUBILIUS,R.,GRIZAS,V.,DEDELE,A.,GRAZULEVICIUS,T.,
CEPONIENE,I.,TAMULEVICIUTE‐PRASCIENE,E.,NIEUWENHUIJSEN,M.J.,JONES,M.&GIDLOW,C.
2015b.TheEffectofParkandUrbanEnvironmentsonCoronaryArteryDiseasePatients:A
RandomizedTrial.BioMedResearchInternational,2015,9.
GRAZULEVICIENE,R.,DEDELE,A.,DANILEVICIUTE,A.,VENCLOVIENE,J.,GRAZULEVICIUS,T.,
ANDRUSAITYTE,S.,UZDANAVICIUTE,I.&NIEUWENHUIJSEN,M.J.2014.TheInfluenceofProximityto
CityParksonBloodPressureinEarlyPregnancy.InternationalJournalofEnvironmentalResearchand
PublicHealth,11,2958‐2972
GRIGSBY‐TOUSSAINT,D.S.,TURI,K.N.,KRUPA,M.,WILLIAMS,N.J.,PANDI‐PERUMAL,S.K.&JEAN‐
LOUIS,G.2015.Sleepinsufficiencyandthenaturalenvironment:ResultsfromtheUSBehavioralRisk
FactorSurveillanceSystemSurvey.PreventiveMedicine,78,78‐84.
GROENEWEGEN,P.P.,VANDENBERG,A.E.,DEVRIES,S.&VERHEIJ,R.A.2006.VitaminG:effectsof
greenspaceonhealth,well‐being,andsocialsafety.BMCPublicHealth,6,149.
GROENEWEGEN,P.P.,VANDENBERG,A.E.,MAAS,J.,VERHEIJ,R.A.&DEVRIES,S.2012.IsaGreen
ResidentialEnvironmentBetterforHealth?IfSo,Why?AnnalsoftheAssociationofAmerican
Geographers,102,996‐1003.
GROFF,E.&MCCORD,E.S.2012.Theroleofneighborhoodparksascrimegenerators.Security
Journal,25,1‐24.
GUYTON,K.Z.,LOOMIS,D.,GROSSE,Y.,ELGHISSASSI,F.,BENBRAHIM‐TALLAA,L.,GUHA,N.,
SCOCCIANTI,C.,MATTOCK,H.&STRAIF,K.2015.Carcinogenicityoftetrachlorvinphos,parathion,
malathion,diazinon,andglyphosate.TheLancetOncology,16,490‐491.
HARLAN,S.L.,BRAZEL,A.J.,PRASHAD,L.,STEFANOV,W.L.&LARSEN,L.2006.Neighborhood
microclimatesandvulnerabilitytoheatstress.SocialScience&Medicine,63,2847‐63.
HARTIG,T.2007.Threestepstounderstandingrestorativeenvironmentsashealthresources.In:
THOMPSON,C.W.&TRAVLOU,P.(eds.)OpenSpace:PeopleSpace.Abingdon:Taylor&Francis.
HARTIG,T.,EVANS,G.W.,JAMNER,L.D.,DAVIS,D.S.&GÄRLING,T.2003.Trackingrestorationin
naturalandurbanfieldsettings.JournalofEnvironmentalPsychology,23,109‐123.
HARTIG,T.,MANG,M.&EVANS,G.W.1991.RestorativeEffectsofNaturalEnvironmentExperiences.
EnvironmentandBehavior,23,3‐26.
HARTIG,T.,MITCHELL,R.,DEVRIES,S.&FRUMKIN,H.2014.NatureandHealth.AnnualReviewof
PublicHealth,35,207‐228.
51
HARVEY,J.A.,CHASTIN,S.F.M.&SKELTON,D.A.2013.Prevalenceofsedentarybehaviorinolder
adults:Asystematicreview.InternationalJournalofEnvironmentalResearchandPublicHealth,10,
6645‐6661.
HILLSDON,M.,PANTER,J.,FOSTER,C.&JONES,A.2006.Therelationshipbetweenaccessandquality
ofurbangreenspacewithpopulationphysicalactivity.PublicHealth,120,1127‐1132.
HOLTAN,M.T.,DIETERLEN,S.L.&SULLIVAN,W.C.2015.Sociallifeundercover:Treecanopyand
socialcapitalinBaltimore,Maryland.EnvironmentandBehavior,47,502‐525.
HONOLD,J.,LAKES,T.,BEYER,R.&VANDERMEER,E.2016.Restorationinurbanspaces:Nature
viewsfromhome,greenways,andpublicparks.EnvironmentandBehavior,48:796‐825.
HU,Z.,LIEBENS,J.&RAO,K.R.2008.Linkingstrokemortalitywithairpollution,income,and
greennessinnorthwestFlorida:anecologicalgeographicalstudy.InternationalJournalofHealth
Geographics,7,20.
HUDDART,L.1990.Theuseofvegetationfortrafficnoisescreening.DepartmentofTransport,
VehiclesandEnvironmentDivision,VehicleGroup,TransportandRoadResearchLaboratory.
Crowthorne,UnitedKingdom.
HYSTAD,P.,DAVIES,H.W.,FRANK,L.,VANLOON,J.,GEHRING,U.,TAMBURIC,L.&BRAUER,M.2014.
Residentialgreennessandbirthoutcomes:evaluatingtheinfluenceofspatiallycorrelatedbuilt‐
environmentfactors.EnvironmentalHealthPerspectives,122,1095‐102.
IARC.2015.SomeOrganophosphateInsecticidesandHerbicides:Diazinon,Glyphosate,Malathion,
Parathion,andTetrachlorvinphos.IARCMonographVol.112.InternationalAgencyforResearchon
Cancer.Lyon,France.Availableat:http://monographs.iarc.fr/ENG/Monographs/vol112/index.php
(accessedon19May2016).
IRVINE,K.N.,DEVINE‐WRIGHT,P.,PAYNE,S.R.,FULLER,R.A.,PAINTER,B.&GASTON,K.J.2009.
Greenspace,soundscapeandurbansustainability:Aninterdisciplinary,empiricalstudy.Local
Environment,14,155‐172
JAMES,P.,BANAY,R.F.,HART,J.E.&LADEN,F.2015.Areviewofthehealthbenefitsofgreenness.
CurrentEpidemiologyReports,2,131‐142.
JENERETTE,G.D.,HARLAN,S.L.,STEFANOV,W.L.&MARTIN,C.A.2011.Ecosystemservicesand
urbanheatriskscapemoderation:water,greenspaces,andsocialinequalityinPhoenix,USA.
EcologicalApplications,21,2637‐2651.
JIANG,B.,CHANG,C.‐Y.&SULLIVAN,W.C.2014a.Adoseofnature:Treecover,stressreduction,and
genderdifferences.LandscapeandUrbanPlanning,132,26‐36.
JIANG,B.,LI,D.,LARSEN,L.&SULLIVAN,W.C.2014b.Adose‐responsecurvedescribingthe
relationshipbetweenurbantreecoverdensityandself‐reportedstressrecovery.Environmentand
Behavior,48,607‐629.
JIN,S.J.,GUO,J.K.,WHEELER,S.,KAN,L.Y.&CHES.Q.2014.EvaluationofimpactsoftreesonPM2.5
52
dispersioninurbanstreets.AtmosphericEnvironment,99,277–287.
JORGENSEN,A.&GOBSTER,P.H.2010.ShadesofGreen:Measuringtheecologyofurbangreen
spaceinthecontextofhumanhealthandwell‐being.Nature+Culture,5,338‐363.
KACZYNSKI,A.T.&HENDERSON,K.A.2007.Environmentalcorrelatesofphysicalactivity:Areviewof
evidenceaboutparksandrecreation.LeisureSciences,29,315‐354.
KACZYNSKI,A.T.&HENDERSON,K.A.2008.Parksandrecreationsettingsandactiveliving:areview
ofassociationswithphysicalactivityfunctionandintensity.JournalofPhysicalActivity&Health,5,
619.
KACZYNSKI,A.T.,POTWARKA,L.R.&SAELENS,B.E.2008.Associationofparksize,distance,and
featureswithphysicalactivityinneighborhoodparks.AmericanJournalofPublicHealth,98,1451‐
1456.
KAPLAN,R.&KAPLAN,S.1989.Theexperienceofnature:Apsychologicalperspective,Cambridge
UniversityPress.
KAPLAN,R.&KAPLAN,S.2011.Well‐being,Reasonableness,andtheNaturalEnvironment.Applied
Psychology:HealthandWell
‐
Being,3,304‐321.
KAPLAN,S.1995.Therestorativebenefitsofnature:Towardanintegrativeframework.Journalof
environmentalpsychology,15,169‐182.
KAPLANS.2001.Meditation,Restoration,andtheManagementofMentalFatigue.Environmentand
Behavior,33,480‐506.
KEDDEM,S.,BARG,F.K.,GLANZ,K.,JACKSON,T.,GREEN,S.&GEORGE,M.2015.Mappingtheurban
asthmaexperience:UsingqualitativeGIStounderstandcontextualfactorsaffectingasthmacontrol.
SocialScience&Medicine,140,9‐17.
KENDRICK,D.,MULVANEY,C.,BURTON,P.&WATSON,M.2005.Relationshipsbetweenchild,family
andneighbourhoodcharacteristicsandchildhoodinjury:acohortstudy.SocialScience&Medicine,
61,1905‐15.
KIM,J.&KAPLAN,R.2004.Physicalandpsychologicalfactorsinsenseofcommunity:newurbanist
kentlandsandnearbyorchardvillage.EnvironmentandBehavior,36,313‐340.
KOHANSIEH,M.&MAKARYUS,A.N.2015.Sleepdeficiencyanddeprivationleadingtocardiovascular
disease.InternationalJournalofHypertension,ArticleID615681,5pp.
KOLLMUSS,A.&AGYEMAN,J.2002.MindtheGap:Whydopeopleactenvironmentallyandwhatare
thebarrierstopro‐environmentalbehavior?EnvironmentalEducationResearch,8,239‐260.
KPMG.2012a.TheEconomicsofEcosystemsandBiodiversityforBusiness–TheNetherlands.Ministry
ofEconomicAffairs,AgricultureandInnovation,TheNetherlands.
KPMG.2012b.Green,healthyandproductive,TheEconomicsofEcosystemsandBiodiversity(TEEB
NL),Greenspaceandhealth.MinistryofEconomicAffairs,AgricultureandInnovation,The
Netherlands.
53
KRENICHYN,K.2006.“Theonlyplacetogoandbeinthecity”:womentalkaboutexercise,being
outdoorsandthemeaningsofalargeurbanpark.Health&Place,12,631–643.
KUO,F.E.2001.CopingwithPoverty:ImpactsofEnvironmentandAttentionintheInnerCity.
EnvironmentandBehavior,33,5‐34.
KUOM.2015.Howmightcontactwithnaturepromotehumanhealth?Promisingmechanismsanda
possiblecentralpathway.FrontiersofPsychology,25,1093.
KUO,F.E.,BACAICOA,M.&SULLIVAN,W.C.1998.TransformingInner‐CityLandscapes:Trees,Sense
ofSafety,andPreference.EnvironmentandBehavior,30,28‐59.
KUO,F.E.&SULLIVAN,W.C.2001.AggressionandViolenceintheInnerCity:EffectsofEnvironment
viaMentalFatigue.EnvironmentandBehavior,33,543‐571.
KWEON,B.‐S.,SULLIVAN,W.C.&WILEY,A.R.1998.Greencommonspacesandthesocialintegration
ofinner‐cityolderadults.EnvironmentandBehavior,30,832‐858.
LACHOWYCZ,K.&JONES,A.P.2011.Greenspaceandobesity:asystematicreviewoftheevidence.
ObesityReviews,12,e183‐e189.
LACHOWYCZ,K.&JONES,A.P.2013.Towardsabetterunderstandingoftherelationshipbetween
greenspaceandhealth:Developmentofatheoreticalframework.LandscapeandUrbanPlanning,
118,62‐69.
LACHOWYCZ,K.&JONES,A.P.2014.Doeswalkingexplainassociationsbetweenaccessto
greenspaceandlowermortality?SocialScience&Medicine,107,9‐17.
LACHOWYCZ,K.,JONES,A.P.,PAGE,A.S.,WHEELER,B.W.&COOPER,A.R.2012.Whatcanglobal
positioningsystemstellusaboutthecontributionofdifferenttypesofurbangreenspaceto
children’sphysicalactivity?Health&Place,18,586‐594.
LAFORTEZZA,R.,CARRUS,G.,SANESI,G.&DAVIES,C.2009.Benefitsandwell‐beingperceivedby
peoplevisitinggreenspacesinperiodsofheatstress.UrbanForestry&UrbanGreening,8,97‐108.
LAOSEE,O.C.,GILCHRIST,J.&RUDD,R.2012.Drowning–UnitesStates,2005‐2009.Morbidityand
MortalityWeeklyReport,61,344‐347.Availableat:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6119a4.htm(accessedon19May2016).
LAURENT,O.,WU,J.,LI,L.&MILESI,C.2013.GreenspacesandpregnancyoutcomesinSouthern
California.Health&Place,24,190‐195.
LEE,J.,PARK,B.‐J.,TSUNETSUGU,Y.,OHIRA,T.,KAGAWA,T.&MIYAZAKI,Y.2011.Effectofforest
bathingonphysiologicalandpsychologicalresponsesinyoungJapanesemalesubjects.PublicHealth,
125,93‐100.
LENGEN,C.&KISTEMANN,T.2012.Senseofplaceandplaceidentity:reviewofneuroscientific
evidence.Health&Place,18,1162‐1171.
LIU,D.,FERNANDEZ,B.O.,HAMILTON,A.,LANG,N.N.,GALLAGHER,J.M.,NEWBY,D.E.,FEELISCH,M.
&WELLER,R.B.2014.UVAirradiationofhumanskinvasodilatesarterialvasculatureandlowers
54
bloodpressureindependentlyofnitricoxidesynthase.JournalofInvestigativeDermatology,134,
1839‐1846.
LI,Q.,MORIMOTO,K.,KOBAYASHI,M.,INAGAKI,H.,KATSUMATA,M.,HIRATA,Y.,HIRATA,K.,
SUZUKI,H.,LI,Y.&WAKAYAMA,Y.2008.Visitingaforest,butnotacity,increaseshumannatural
killeractivityandexpressionofanti‐cancerproteins.InternationalJournalofImmunopathologyand
Pharmacology,21,117‐127.
LIU,C.&LI,X.2012.CarbonstorageandsequestrationbyurbanforestsinShenyang,China.Urban
Forestry&UrbanGreening,11,121‐128.
LOHMUSM&BALBUSJ.2015.Makinggreeninfrastructurehealthierinfrastructure.InfectionEcology
andEpidemiology5:30082
LOVASI,G.S.,O’NEIL‐DUNNE,J.P.,LU,J.W.,SHEEHAN,D.,PERZANOWSKI,M.S.,MACFADEN,S.W.,
KING,K.L.,MATTE,T.,MILLER,R.L.,HOEPNER,L.A.,PERERA,F.P.&RUNDLE,A.2013.Urbantree
canopyandasthma,wheeze,rhinitis,andallergicsensitizationtotreepolleninaNewYorkCitybirth
cohort.EnvironmentalHealthPerspectives,121,494‐500.
LOVASI,G.S.,QUINN,J.W.,NECKERMAN,K.M.,PERZANOWSKI,M.S.&RUNDLE,A.2008.Children
livinginareaswithmorestreettreeshavelowerasthmaprevalence.JournalofEpidemiologyand
CommunityHealth,62,647‐649.
LOVELL,R.,WHEELER,B.W.,HIGGINS,S.L.,IRVINE,K.N.&DEPLEDGE,M.H.2014.ASystematic
ReviewoftheHealthandWell‐BeingBenefitsofBiodiverseEnvironments.JournalofToxicologyand
EnvironmentalHealth,PartB,17,1‐20.
LRTAPWorkingGrouponEffects(2013).Benefitsofairpollutioncontrolforbiodiversityand
ecosystemservices.Long‐rangeTransboundaryAirPollution(LRTAP)WorkingGrouponEffects.
Availableat:http://www.syke.fi/download/noname/%7B62B1FBA0‐3047‐4985‐8353‐
ACD85678A617%7D/75996(accessedon19May2016).
LYNCH,S.V.,WOOD,R.A.,BOUSHEY,H.,BACHARIER,L.B.,BLOOMBERG,G.R.,KATTAN,M.,
O’CONNOR,G.T.,SANDEL,M.T.,CALATRONI,A.,MATSUI,E.,JOHNSON,C.C.,LYNN,H.,VISNESS,C.
M.,JAFFEE,K.F.,GERGEN,P.J.,GOLD,D.R.,WRIGHT,R.J.,FUJIMURA,K.,RAUCH,M.,BUSSE,W.W.
&GERN,J.E.2014.Effectsofearly‐lifeexposuretoallergensandbacteriaonrecurrentwheezeand
atopyinurbanchildren.JournalofAllergyandClinicalImmunology,134,593‐601.e12.
MAAS,J.,VANDILLEN,S.M.E.,VERHEIJ,R.A.&GROENEWEGEN,P.P.2009a.Socialcontactsasa
possiblemechanismbehindtherelationbetweengreenspaceandhealth.Health&Place,15,586‐
595.
MAAS,J.,VERHEIJ,R.A.,DEVRIES,S.,SPREEUWENBERG,P.,SCHELLEVIS,F.G.&GROENEWEGEN,P.
P.2009b.Morbidityisrelatedtoagreenlivingenvironment.JournalofEpidemiologyandCommunity
Health,63,967‐973.
55
MACINTYRE,S.,MACDONALD,L.&ELLAWAY,A.2008.Lackofagreementbetweenmeasuredand
self‐reporteddistancefrompublicgreenparksinGlasgow,Scotland.InternationalJournalof
BehavioralNutritionandPhysicalActivity,5,26.
MADUREIRA,H.,NUNES,F.,OLIVEIRA,J.V.,CORMIER,L.&MADUREIRA,T.2015.Urbanresidents’
beliefsconcerninggreenspacebenefitsinfourcitiesinFranceandPortugal.UrbanForestry&Urban
Greening,14,56‐64.
MANES,F.,INCERTI,G.,SALVATORI,E.,VITALE,M.,RICOTTA,C.&COSTANZA,R.2012.Urban
ecosystemservices:treediversityandstabilityoftroposphericozoneremoval.Ecological
Applications,22,349–360.
MARKEVYCH,I.,FUERTES,E.,TIESLER,C.M.,BIRK,M.,BAUER,C.P.,KOLETZKO,S.,VONBERG,A.,
BERDEL,D.&HEINRICH,J.2014.Surroundinggreennessandbirthweight:resultsfromtheGINIplus
andLISAplusbirthcohortsinMunich.Health&Place,26,39‐46.
MARSELLE,M.R.,IRVINE,K.N.&WARBER,S.L.2013.Walkingforwell‐being:aregroupwalksin
certaintypesofnaturalenvironmentsbetterforwell‐beingthangroupwalksinurbanenvironments?
InternationalJournalofEnvironmentalResearchandPublicHealth,10,5603‐5628.
MCCORMACK,G.R.,ROCK,M.,TOOHEY,A.M.&HIGNELL,D.2010.Characteristicsofurbanparks
associatedwithparkuseandphysicalactivity:areviewofqualitativeresearch.Health&Place,16,
712‐726.
MCEACHAN,R.R.,PRADY,S.L.,SMITH,G.,FAIRLEY,L.,CABIESES,B.,GIDLOW,C.,WRIGHT,J.,
DADVAND,P.,VANGENT,D.&NIEUWENHUIJSEN,M.J.2016.Theassociationbetweengreenspace
anddepressivesymptomsinpregnantwomen:moderatingrolesofsocioeconomicstatusand
physicalactivity.JournalofEpidemiologyandCommunityHealth,70,253‐259.
MEDLOCK,J.M.&LEACH,S.A.2015.Effectofclimatechangeonvector‐bornediseaseriskinthe
UnitedKingdom.TheLancetInfectiousDiseases,15,721‐730.
MILLER,M.A.2015.TheRoleofSleepandSleepDisordersintheDevelopment,Diagnosis,and
ManagementofNeurocognitiveDisorders.FrontiersinNeurology,6,224.
MITCHELL,R.2013.Isphysicalactivityinnaturalenvironmentsbetterformentalhealththanphysical
activityinotherenvironments?SocialScienceandMedicine,91,130‐134.
MITCHELL,R.,ASTELL‐BURT,T.&RICHARDSON,E.A.2011.Acomparisonofgreenspaceindicators
forepidemiologicalresearch.JournalofEpidemiologyandCommunityHealth,65,853‐858.
MITCHELL,R.&POPHAM,F.2007.Greenspace,urbanityandhealth:relationshipsinEngland.Journal
ofEpidemiologyandCommunityHealth,61,681‐683.
MITCHELL,R.&POPHAM,F.2008.Effectofexposuretonaturalenvironmentonhealthinequalities:
anobservationalpopulationstudy.Lancet,372,1655‐1560.
MITCHELL,R.J.,RICHARDSON,E.A.,SHORTT,N.K.&PEARCE,J.R.2015.Neighborhood
EnvironmentsandSocioeconomicInequalitiesinMentalWell‐Being.AmericanJournalofPreventive
Medicine,49,80‐84.
56
SHORTT,N.K.,RIND,E.,PEARCE,J.&MITCHELL,R.2014.Integratingenvironmentaljusticeand
socioecologicalmodelsofhealthtounderstandpopulation‐levelphysicalactivity.Environmentand
PlanningA,46,1479–1495.
MYNENI,R.B.&HALL,F.G.1995.Theinterpretationofspectralvegetationindexes.Geoscienceand
RemoteSensing,IEEETransactionson,33,481‐486.
MYTTON,O.T.,TOWNSEND,N.,RUTTER,H.&FOSTER,C.2012.Greenspaceandphysicalactivity:An
observationalstudyusingHealthSurveyforEnglanddata.Health&Place,18,1034‐1041.
NAESS,O.,PIRO,F.N.,NAFSTAD,P.,SMITH,G.D.&LEYLAND,A.H.2007.Airpollution,social
deprivation,andmortality:amultilevelcohortstudy.Epidemiology,18,686‐94.
NATIONALCAPITALPOISONCENTRE.Nodate.PoisonStatistics,NationalData2013[Online].
Availableat:http://www.poison.org/poison‐statistics‐national(accessedon19May2016).
NATURALENGLAND2010a.Naturenearby:AccessibleNaturalGreenspaceGuidance.Sheffield:
NaturalEngland.
NATURALENGLAND2010b.WildAdventureSpace:ItsRoleinTeenagers’Lives.NaturalEngland
CommissionedReportNECR025.
NIEMINEN,T.,MARTELIN,T.,KOSKINEN,S.,ARO,H.,ALANEN,E.&HYYPPÄ,M.2010.Socialcapitalas
adeterminantofself‐ratedhealthandpsychologicalwell‐being.InternationalJournalofPublic
Health,55,531‐542.
NIEUWENHUIJSEN,M.J.2015.Exposureassessmentinenvironmentalepidemiology,Oxford;New
York,OxfordUniversityPress.
NORDH,H.,HARTIG,T.,HAGERHALL,C.M.&FRY,G.2009.Componentsofsmallurbanparksthat
predictthepossibilityforrestoration.UrbanForestryandUrbanGreening,8,225‐235.
NOWAK,D.J.,CRANE,D.E.&STEVENS,J.C.2006.Airpollutionremovalbyurbantreesandshrubsin
theUnitedStates.UrbanForestryandUrbanGreening,4,115‐123.
NOWAK,D.J.,GREENFIELD,E.J.,HOEHN,R.E.&LAPOINT,E.2013.Carbonstorageandsequestration
bytreesinurbanandcommunityareasoftheUnitedStates.EnvironmentalPollution,178,229–236.
ORESKOVIC,N.M.,PERRIN,J.M.,ROBINSON,A.I.,LOCASCIO,J.J.,BLOSSOM,J.,CHEN,M.L.,
WINICKOFF,J.P.,FIELD,A.E.,GREEN,C.&GOODMAN,E.2015.Adolescents’useofthebuilt
environmentforphysicalactivity.BMCPublicHealth,15,251.
OTTOSSON,J.&GRAHN,P.2005.Acomparisonofleisuretimespentinagardenwithleisuretime
spentindoors:onmeasuresofrestorationinresidentsingeriatriccare.LandscapeResearch,30,23‐
55.
OWEN,N.,HEALY,G.N.,MATTHEWS,C.E.&DUNSTAN,D.W.2010.Toomuchsitting:the
population‐healthscienceofsedentarybehavior.ExerciseandSportSciencesReviews,38,105‐113.
57
PANTELL,M.,REHKOPF,D.,JUTTE,D.,SYME,S.L.,BALMES,J.&ADLER,N.2013.SocialIsolation:A
PredictorofMortalityComparabletoTraditionalClinicalRiskFactors.AmericanJournalofPublic
Health,103,2056–2062.
PARK,B.‐J.,TSUNETSUGU,Y.,KASETANI,T.,HIRANO,H.,KAGAWA,T.,SATO,M.&MIYAZAKI,Y.2007.
PhysiologicaleffectsofShinrin‐yoku(takingintheatmosphereoftheforest)‐usingsalivarycortisol
andcerebralactivityasindicators.JournalofPhysiologicalAnthropology,26,123‐128.
PATHAK,V.,TRIPATHI,B.D.&MISHRA,V.K.2008.DynamicsoftrafficnoiseinatropicalcityVaranasi
anditsabatementthroughvegetation.EnvironmentalMonitoringandAssessment,146,67‐75.
PEREIRA,G.,FOSTER,S.,MARTIN,K.,CHRISTIAN,H.,BORUFF,B.J.,KNUIMAN,M.&GILES‐CORTI,B.
2012.Theassociationbetweenneighborhoodgreennessandcardiovasculardisease:an
observationalstudy.BMCPublicHealth,12,466‐466.
PETTORELLI,N.,VIK,J.O.,MYSTERUD,A.,GAILLARD,J.‐M.,TUCKER,C.J.&STENSETH,N.C.2005.
Usingthesatellite‐derivedNDVItoassessecologicalresponsestoenvironmentalchange.Trendsin
Ecology&Evolution,20,503‐510.
PICKARD,B.R.,DANIEL,J.,MEHAFFEY,M.,JACKSON,L.E.&NEALE,A.2015.EnviroAtlas:Anew
geospatialtooltofosterecosystemservicesscienceandresourcemanagement.EcosystemServices,
14,45–55.
POPE,D.,TISDALL,R.,MIDDLETON,J.,VERMA,A.,VANAMEIJDEN,E.,BIRT,C.&BRUCE,N.G.2015.
Qualityofandaccesstogreenspaceinrelationtopsychologicaldistress:resultsfromapopulation‐
basedcross‐sectionalstudyaspartoftheEURO‐URHIS2project.EuropeanJournalofPublicHealth
pii:ckv094[Epubaheadofprint].
REKLAITIENE,R.,GRAZULEVICIENE,R.,DEDELE,A.,VIRVICIUTE,D.,VENSLOVIENE,J.,TAMOSIUNAS,
A.,BACEVICIENE,M.,LUKSIENE,D.,SAPRANAVICIUTE‐ZABAZLAJEVA,L.,RADISAUSKAS,R.,
BERNOTIENE,G.,BOBAK,M.&NIEUWENHUIJSEN,M.J.2014.Therelationshipofgreenspace,
depressivesymptomsandperceivedgeneralhealthinurbanpopulation.ScandinavianJournalof
PublicHealth,42,669‐676.
RICHARDSON,E.A.,MITCHELL,R.,HARTIG,T.,DEVRIES,S.,ASTELL‐BURT,T.&FRUMKIN,H.2012.
Greencitiesandhealth:aquestionofscale?JournalofEpidemiologyandCommunityHealth,66,160‐
165.
ROBERTSON,L.B.,WARDTHOMPSON,C.,ASPINALL,P.,MILLINGTON,C.,MCADAM,C.&MUTRIE,N.
2012.Theinfluenceofthelocalneighbourhoodenvironmentonwalkinglevelsduringthewalkingfor
wellbeingintheWest:Pedometer‐basedcommunityintervention.JournalofEnvironmentaland
PublicHealth,2012,974786.
ROE,J.&ASPINALL,P.2011.Therestorativebenefitsofwalkinginurbanandruralsettingsinadults
withgoodandpoormentalhealth.Health&Place17,103‐113.
ROE,J.J.,ASPINALL,P.A.,WARDTHOMPSON,C.2016.UnderstandingRelationshipsbetweenHealth,
Ethnicity,PlaceandtheRoleofUrbanGreenSpaceinDeprivedUrbanCommunities.Int.J.Environ.
Res.PublicHealth,13,681.
58
ROE,J.J.,THOMPSON,C.W.,ASPINALL,P.A.,BREWER,M.J.,DUFF,E.I.,MILLER,D.,MITCHELL,R.&
CLOW,A.2013.Greenspaceandstress:Evidencefromcortisolmeasuresindeprivedurban
communities.InternationalJournalofEnvironmentalResearchandPublicHealth,10,4086‐4103.
ROOK,G.2013.Regulationoftheimmunesystembybiodiversityfromthenaturalenvironment:An
ecosystemserviceessentialtohealth.ProceedingsoftheNationalAcademyofSciencesUSA,110,
18360‐18367.
ROSENBERG,D.,DING,D.,SALLIS,J.F.,KERR,J.,NORMAN,G.J.,DURANT,N.,HARRIS,S.K.&
SAELENS,B.E.2009.NeighborhoodEnvironmentWalkabilityScaleforYouth(NEWS‐Y):reliabilityand
relationshipwithphysicalactivity.PreventiveMedicine,49,213‐218.
SARKAR,C.,WEBSTER,C.,PRYOR,M.,TANG,D.,MELBOURNE,S.,ZHANG,X.&JIANZHENG,L.2015.
Exploringassociationsbetweenurbangreen,streetdesignandwalking:ResultsfromtheGreater
Londonboroughs.LandscapeandUrbanPlanning,143,112‐125.
SCHIPPERIJN,J.,BENTSEN,P.,TROELSEN,J.,TOFTAGER,M.&STIGSDOTTER,U.K.2013.Associations
betweenphysicalactivityandcharacteristicsofurbangreenspace.UrbanForestry&Urban
Greening,12,109‐116.
SCHMID,S.M.,HALLSCHMID,M.&SCHULTES,B.2015.Themetabolicburdenofsleeploss.The
LancetDiabetesandEndocrinology,3,52‐62.
SCHUYLER,D.1988.TheNewUrbanLandscape:TheRedefinitionofCityForminNineteenth‐Century
America.JohnsHopkinsUniversityPress,Baltimore,MD,UnitedStates.
SCOTTISHGOVERNMENT2016.NationalWalkingStrategyOverview.PathsforAllonbehalfofthe
NationalWalkingStrategyDeliveryForum,Edinburgh:ScottishGovernment.
SEELAND,K.,DÜBENDORFER,S.&HANSMANN,R.2009.MakingfriendsinZurich’surbanforestsand
parks:Theroleofpublicgreenspaceforsocialinclusionofyouthsfromdifferentcultures.Forest
PolicyandEconomics,11,10‐17.
SHISEGAR,N.2014.Theimpactofgreenareasonmitigatingurbanheatislandeffect:Areview.
InternationalJournalofEnvironmentalSustainability,9,119‐130.
SHORES,K.A.&WEST,S.T.2010.Ruralandurbanparkvisitsandpark‐basedphysicalactivity.
PreventiveMedicine,50Suppl1,S13‐S17.
SHORTT,N.K.,RIND,E.,PEARCE,J.&MITCHELL,R.2014.Integratingenvironmentaljusticeand
socioecologicalmodelsofhealthtounderstandpopulation‐levelphysicalactivity.Environmentand
PlanningA,46,1479–1495.
SMARGIASSI,A.,GOLDBERG,M.S.,PLANTE,C.,FOURNIER,M.,BAUDOUIN,Y.&KOSATSKY,T.2009.
Variationofdailywarmseasonmortalityasafunctionofmicro‐urbanheatislands.Journalof
EpidemiologyandCommunityHealth,63,659‐664.
SREETHERAN,M.&VANDENBOSCH,C.C.K.2014.Asocio‐ecologicalexplorationoffearofcrimein
urbangreenspaces–Asystematicreview.UrbanForestry&UrbanGreening,13,1‐18.
59
STEPTOE,A.,SHANKAR,A.,DEMAKAKOS,P.&WARDLE,J.2013.Socialisolation,loneliness,andall‐
causemortalityinoldermenandwomen.ProceedingsoftheNationalAcademyofSciencesUSA,110,
5797‐5801.
STRIFE,S.&DOWNEY,L.2009.ChildhoodDevelopmentandAccesstoNature:ANewDirectionfor
EnvironmentalInequalityResearch.Organization&Environment,22(1),99–122
SUGIYAMA,T.,CERIN,E.,OWEN,N.,OYEYEMI,A.L.,CONWAY,T.L.,VANDYCK,D.,SCHIPPERIJN,J.,
MACFARLANE,D.J.,SALVO,D.,REIS,R.S.,MITÁŠ,J.,SARMIENTO,O.L.,DAVEY,R.,SCHOFIELD,G.,
ORZANCO‐GARRALDA,R.&SALLIS,J.F.2014.Perceivedneighbourhoodenvironmentalattributes
associatedwithadults[U+05F3]recreationalwalking:IPENAdultstudyin12countries.Healthand
Place,28,22‐30
SUGIYAMA,T.,FRANCIS,J.,MIDDLETON,N.J.,OWEN,N.&GILES‐CORTI,B.2010.Associations
betweenrecreationalwalkingandattractiveness,size,andproximityofneighborhoodopenspaces.
AmericanJournalofPublicHealth,100,1752‐1757.
SUGIYAMA,T.,GILES‐CORTI,B.,SUMMERS,J.,DUTOIT,L.,LESLIE,E.&OWEN,N.2013.Initiatingand
maintainingrecreationalwalking:Alongitudinalstudyontheinfluenceofneighborhoodgreenspace.
PreventiveMedicine,57,178‐182.
SUGIYAMA,T.,LESLIE,E.,GILES‐CORTI,B.&OWEN,N.2008.Associationsofneighbourhood
greennesswithphysicalandmentalhealth:dowalking,socialcoherenceandlocalsocialinteraction
explaintherelationships?JournalofEpidemiologyandCommunityHealth,62,e9.
SUGIYAMA,T.,THOMPSON,C.W.&ALVES,S.2009.Associationsbetweenneighborhoodopenspace
attributesandqualityoflifeforolderpeopleinBritain.EnvironmentandBehavior,41,3‐21.
SUGIYAMA,T.&WARDTHOMPSON,C.2008.Associationsbetweencharacteristicsofneighbourhood
openspaceandolderpeople’swalking.UrbanForestry&UrbanGreening,7,41‐51.
TAKANO,T.,NAKAMURA,K.&WATANABE,M.2002.Urbanresidentialenvironmentsandsenior
citizens’longevityinmegacityareas:theimportanceofwalkablegreenspaces.Journalof
EpidemiologyandCommunityHealth,56,913‐918.
TAMOSIUNAS,A.,GRAZULEVICIENE,R.,LUKSIENE,D.,DEDELE,A.,REKLAITIENE,R.,BACEVICIENE,M.,
VENCLOVIENE,J.,BERNOTIENE,G.,RADISAUSKAS,R.,MALINAUSKIENE,V.,MILINAVICIENE,E.,
BOBAK,M.,PEASEY,A.&NIEUWENHUIJSEN,M.J.2014.Accessibilityanduseofurbangreenspaces,
andcardiovascularhealth:findingsfromaKaunascohortstudy.EnvironmentalHealth,13,20.
TAN,Z.,LAU,K.K.‐L.&NG,E.2015.Urbantreedesignapproachesformitigatingdaytimeurbanheat
islandeffectsinahigh‐densityurbanenvironment.EnergyandBuildings,114,265‐274.
TAYLOR,M.S.,WHEELER,B.W.,WHITE,M.P.,ECONOMOU,T.&OSBORNE,N.J.2015.Research
note:Urbanstreettreedensityandantidepressantprescriptionrates—across‐sectionalstudyin
London,UK.LandscapeandUrbanPlanning,136,174‐179.
THIERING,E.,MARKEVYCH,I.,BRÜSKE,I.,FUERTES,E.,KRATZSCH,J.,SUGIRI,D.,HOFFMANN,B.,VON
BERG,A.,BAUER,C.P.,KOLETZKO,S.,BERDEL,D.&HEINRICH,J.2016.Associationsofresidential
60
long‐termairpollutionexposuresandsatellite‐derivedgreennesswithinsulinresistanceinGerman
adolescents.EnvironmentalHealthPerspectives,[Epubaheadofprint].
TIDBALL,K.G.&KRASNY,M.E.2014.GreeningintheRedZone:Disaster,ResilienceandCommunity
Greening.SpringerNetherlands.
TRIGUERO‐MASM.,DADVANDP.,CIRACHM.,MARTÍNEZD.,MEDINAA.,MOMPARTA.,BASAGAÑA
X.,GRAŽULEVIČIENĖR.&NIEUWENHUIJSENM.J.2015.Naturaloutdoorenvironmentsandmental
andphysicalhealth:relationshipsandmechanisms.EnvironmentInternational,77,35‐41.
TROY,A.,GROVE,J.M.&O’NEIL‐DUNNE,J.2012.Therelationshipbetweentreecanopyandcrime
ratesacrossanurban–ruralgradientinthegreaterBaltimoreregion.Landscape&UrbanPlanning,
106,262‐270.
ULRICH,R.S.1983.AestheticandAffectiveResponsetoNaturalEnvironment.In:ALTMAN,I.&
WOHLWILL,J.F.(eds.)HumanBehavior&Environment:AdvancesinTheory&Research.NewYork:
Plenum.
ULRICH,R.S.,SIMONS,R.F.,LOSITO,B.D.,FIORITO,E.,MILES,M.A.&ZELSON,M.1991.Stress
recoveryduringexposuretonaturalandurbanenvironments.JournalofEnvironmentalPsychology,
11,201‐230.
UNITEDNATIONSDEPARTMENTOFECONOMICANDSOCIALAFFAIRS.2014.OpenWorkingGroup
proposalforSustainableDevelopmentGoals[Online].Availableat:
https://sustainabledevelopment.un.org/sdgsproposal.html(accessedon19May2016).
VAILSHERY,L.S.,JAGANMOHAN,M.&NAGENDRA,H.2013.Effectofstreettreesonmicroclimate
andairpollutioninatropicalcity.UrbanForestry&UrbanGreening,12,408–415.
VANDENBERG,A.E.&CUSTERS,M.H.G.2011.GardeningPromotesNeuroendocrineandAffective
RestorationfromStress.JournalofHealthPsychology,16,3‐11.
VANDENBERG,A.E.&VANDENBERG,C.G.2011.AcomparisonofchildrenwithADHDinanatural
andbuiltsetting.ChildCareHealthandDevelopment,37,430‐439.
VANDENBERG,M.,VANPOPPEL,M.,VANKAMP,I.,ANDRUSAITYTE,S.,BALSEVICIENE,B.,CIRACHM.,
DANILEVICIUTEA.,ELLISN.,HURSTG.,MASTERSOND.,SMITHG.,TRIGUERO‐MASM.,
UZDANAVICIUTEI.,WITP.D.,MECHELENW.V.,GIDLOWC.,GRAZULEVICIENER.,NIEUWENHUIJSEN
M.J.,KRUIZEH.&MAASJ.2016.Visitinggreenspaceisassociatedwithmentalhealthandvitality:A
cross‐sectionalstudyinfourEuropeancities.HealthPlace,38,8‐15.
VANDENBOSCH,M.A.,ÖSTERGREN,P.O.,GRAHN,P.,SKÄRBÄCK,E.&WÄHRBORG,P.2015.Moving
toserenenaturemaypreventpoormentalhealth–resultsfromaSwedishlongitudinalcohortstudy.
InternationalJournalofEnvironmentalResearchandPublicHealth,12,7974‐7989.
VANDILLEN,S.M.,DEVRIES,S.,GROENEWEGEN,P.P.&SPREEUWENBERG,P.2012.Greenspacein
urbanneighbourhoodsandresidents’health:addingqualitytoquantity.JournalofEpidemiologyand
CommunityHealth,66,e8.
61
VILLANUEVA,K.,BADLAND,H.,HOOPER,P.,KOOHSARI,M.J.,MAVOA,S.,DAVERN,M.,ROBERTS,R.,
GOLDFELD,S.&GILES‐CORTI,B.2015.Developingindicatorsofpublicopenspacetopromotehealth
andwellbeingincommunities.AppliedGeography,57,112‐119.
VILLENEUVE,P.J.,JERRETT,M.,G.SU,J.,BURNETT,R.T.,CHEN,H.,WHEELER,A.J.&GOLDBERG,M.
S.2012.AcohortstudyrelatingurbangreenspacewithmortalityinOntario,Canada.Environmental
Research,115,51‐58.
VÖLKER,S.&KISTEMANN,T.2011.Theimpactofbluespaceonhumanhealthandwell‐being–
Salutogenetichealtheffectsofinlandsurfacewaters:areview.InternationalJournalofHygieneand
EnvironmentalHealth,214,449‐60.
VÖLKER,S.&KISTEMANN,T.2015.Developingtheurbanblue:Comparativehealthresponsestoblue
andgreenurbanopenspacesinGermany.Health&Place,35,196–205.
VÖLKER,S.,BAUMEISTER,H.,CLASSEN,T.,HORNBERG,C.&KISTEMANN,T.2013.Evidenceforthe
temperature‐mitigatingcapacityofurbanbluespace–ahealthgeographicperspective.Erdkunde,67,
355–371.
VOTSI,N.‐E.P.,MAZARIS,A.D.,KALLIMANIS,A.S.,DRAKOU,E.G.&PANTIS,J.D.2013.Landscape
structureanddiseasesprofile:associatinglandusetypecompositionwithdiseasedistribution.
InternationalJournalofEnvironmentalHealthResearch,24,176‐187.
WACHTER,S.M.&BUCCHIANERI,G.W.2008.WhatisaTreeWorth?Green‐CityStrategies,Signaling
andHousingPrices.RealEstateEconomics,36,213‐239.
WANG,D.,BROWN,G.,LIU,Y.&MATEO‐BABIANO,I.2015.Acomparisonofperceivedand
geographicaccesstopredicturbanparkuse.Cities,42,PartA,85‐96.
WARDTHOMPSON,C.,ROE,J.,ASPINALL,P.,MITCHELL,R.,CLOW,A.&MILLER,D.2012.Moregreen
spaceislinkedtolessstressindeprivedcommunities:Evidencefromsalivarycortisolpatterns.
LandscapeandUrbanPlanning,105,221‐229.
WARDTHOMPSON,C.,ROE,J.&ASPINALL,P.2013.Woodlandimprovementsindeprivedurban
communities:Whatimpactdotheyhaveonpeople’sactivitiesandqualityoflife?Landscapeand
UrbanPlanning,118,79‐89.
WARDTHOMPSON,C.,ASPINALL,P.,ROE,J.,ROBERTSONL.&MILLER,D.2016.MitigatingStressand
SupportingHealthinDeprivedUrbanCommunities:TheImportanceofGreenSpaceandtheSocial
Environment.InternationalJournalofEnvironmentalResearchandPublicHealth,13,440.
WELLS,N.M.&LEKIES,K.S.2006.NatureandtheLifeCourse:PathwaysfromChildhoodNature
ExperiencestoAdultEnvironmentalism.Children,YouthandEnvironments,16,1‐24.
WENDEL‐VOS,G.C.,SCHUIT,A.J.,DENIET,R.,BOSHUIZEN,H.C.,SARIS,W.H.&KROMHOUT,D.
2004.Factorsofthephysicalenvironmentassociatedwithwalkingandbicycling.Medicine&Science
inSports&Exercise,36,725‐730.
WHEELER,B.,LOVELL,R.,HIGGINS,S.,WHITE,M.,ALCOCK,I.,OSBORNE,N.,HUSK,K.,SABEL,C.&
DEPLEDGE,M.2015.Beyondgreenspace:anecologicalstudyofpopulationgeneralhealthand
62
indicatorsofnaturalenvironmenttypeandquality.InternationalJournalofHealthGeographics,14,
17.
WHEELER,B.W.,COOPER,A.R.,PAGE,A.S.&JAGO,R.2010.Greenspaceandchildren’sphysical
activity:aGPS/GISanalysisofthePEACHproject.PreventiveMedicine,51,148‐52.
WHITE,M.,SMITH,A.,HUMPHRYES,K.,PAHL,S.,SNELLING,D.&DEPLEDGE,M.2010.Bluespace:
Theimportanceofwaterforpreference,affect,andrestorativenessratingsofnaturalandbuilt
scenes.JournalofEnvironmentalPsychology,30,482‐493.
WHITE,M.P.,ALCOCK,I.,WHEELER,B.W.&DEPLEDGE,M.H.2013a.Wouldyoubehappierlivingin
agreenerurbanarea?Afixed‐effectsanalysisofpaneldata.PsychologyScience,24,920‐928.
WHITE,M.P.,PAHL,S.,ASHBULLBY,K.,HERBERT,S.&DEPLEDGE,M.H.2013b.Feelingsof
restorationfromrecentnaturevisits.JournalofEnvironmentalPsychology,35,40‐51.
WHITE,M.P.,WHEELER,B.W.,HERBERT,S.,ALCOCK,I.&DEPLEDGE,M.H.2014.Coastalproximity
andphysicalactivity:Isthecoastanunder‐appreciatedpublichealthresource?PreventiveMedicine,
69,135‐140.
WILSON,E.O.1984.Biophilia.HarvardUniversityPress,Cambridge,MA.
WHO.2010a.GlobalRecommendationsonPhysicalActivityforHealth.Geneva,Switzerland:World
HealthOrganization.Availableat:
http://apps.who.int/iris/bitstream/10665/44399/1/9789241599979_eng.pdf(accessedon19May
2016).
WHO.2010b.ParmadeclarationonEnvironmentandHealth.FifthMinisterialConferenceon
EnvironmentandHealth“Protectingchildren’shealthinachangingenvironment”.Copenhagen:
WHORegionalOfficeforEurope.
WHO.2010c.ToolsforthemonitoringofParmaConferencecommitments.Reportofthemeeting25‐
26November2010,Bonn,Germany.Copenhagen,Denmark:WHORegionalOfficeforEurope.
WHO.2010d.UrbanPlanning,EnvironmentandHealth:FromEvidencetoPolicyAction.Meeting
Report.Copenhagen,Denmark:WHORegionalOfficeforEurope.
WHO.2011.Burdenofdiseasefromenvironmentalnoise.Quantificationofhealthylifeyearslostin
Europe.Copenhagen:WHORegionalOfficeforEurope.
WHO.2012.ActionplanforimplementationoftheEuropeanstrategyforthepreventionandcontrol
ofnoncommunicablediseases2012−2016.Copenhagen:WHORegionalOfficeforEurope.
WHO.2013.Physicalactivitypromotioninsociallydisadvantagedgroups:principlesforaction(PHAN
WorkPackage4FinalReport).Copenhagen:WHORegionalOfficeforEurope.Availableat:
http://www.euro.who.int/__data/assets/pdf_file/0005/185954/E96817eng.pdf?ua=1(accessedon
19May2016).
WHO&WorldMeteorologicalOrganization(WMO).2015.HeatwavesandHealth:Guidanceon
Warning‐SystemDevelopment.Geneva:WorldMeteorologicalOrganizationandWorldHealth
Organization.
63
WILKER,E.H.,WU,C.‐D.,MCNEELY,E.,MOSTOFSKY,E.,SPENGLER,J.,WELLENIUS,G.A.&
MITTLEMAN,M.A.2014.Greenspaceandmortalityfollowingischemicstroke.Environmental
Research,133,42‐48.
WOLCH,J.,JERRETT,M.,REYNOLDS,K.,MCCONNELL,R.,CHANG,R.,DAHMANN,N.,BRADY,K.,
GILLILAND,F.,SU,J.G.&BERHANE,K.2011.Childhoodobesityandproximitytourbanparksand
recreationalresources:Alongitudinalcohortstudy.Health&Place,17,207‐214.
XU,Y.,DADVAND,P.,BARRERA‐GÓMEZ,J.,SARTINI,C.,MARÍ‐DELL’OLMO,M.,BORRELL,C.,MEDINA‐
RAMÓN,M.,SUNYER,J.&BASAGAÑA,X.2013.Differencesontheeffectofheatwavesonmortality
bysociodemographicandurbanlandscapecharacteristics.JournalofEpidemiologyandCommunity
Health,67,519‐525.
YANG,F.,BAO,Z.Y.&ZHU,Z.J.2011.Anassessmentofpsychologicalnoisereductionbylandscape
plants.InternationalJournalofEnvironmentalResearch&PublicHealth,8,1032‐48.
YANG,C.Y.,BOEN,C.,GERKEN,K.,LI,T.,SCHORPP,K.&HARRIS,K.M.2016.Socialrelationshipsand
physiologicaldeterminantsoflongevityacrossthehumanlifespan.ProceedingsoftheNational
AcademyofSciencesUSA,113,578–583.
ZELENSKI,J.M.,DOPKO,R.L.&CAPALDI,C.A.2015.Cooperationisinournature:Natureexposure
maypromotecooperativeandenvironmentallysustainablebehavior.JournalofEnvironmental
Psychology,42,24‐31.

64
APPENDIX1.Examplesofdefinitionsrelatedtoassessinggreenspace
availabilityoraccessibility
EuropeanCommonIndicators–Availabilityoflocalpublicopenareasandservices
Publicopenareasaredefinedas:
• publicparks,gardensoropenspaces,fortheexclusiveuseofpedestriansandcyclists,except
greentrafficislandsordividers,graveyards(unlessthelocalauthorityrecognizestheir
recreationalfunctionornatural,historicalorculturalimportance);
• open‐airsportsfacilities,accessibletothepublicfreeofcharge;
• privateareas(agriculturalareas,privateparks),accessibletothepublicfreeofcharge.
Toallowamorecompletedataanalysis,theindicatormustbecalculatedtwice:first,relatingto
areasgreaterthan5,000m2,andsecondforallareasusedbythepublicforleisureandopenair
activities,regardlessoftheirdimension(AmbienteItaliaResearchInstitute,2003).
UrbanAtlasintheEuropeanUnion
TheGreenUrbanAreasasdefinedbyUrbanAtlas(code14100)includepublicgreenareasused
predominantlyforrecreationsuchasgardens,zoos,parks,andsuburbannaturalareasandforests,
orgreenareasborderedbyurbanareasthataremanagedorusedforrecreationalpurposes
(EuropeanUnion,2011).FormoredetailedinformationonthedefinitionofgreenspaceintheUrban
AtlasseeBox4.1inSection4.2.1.
NaturalEngland’sAccessibleNaturalGreenSpaceStandard16
Accessiblegreenspace–placesthatareavailableforthegeneralpublictousefreeofchargeand
withouttimerestrictions(althoughsomesitesmaybeclosedtothepublicovernightandtheremay
befeesforparkingavehicle).Theplacesareavailabletoall,meaningthateveryreasonableeffortis
madetocomplywiththerequirementsundertheDisabilityDiscriminationAct(DDA1995).An
accessibleplacewillalsobeknowntothetargetusers,includingpotentialuserswholivewithinthe
sitecatchmentarea.
Naturalgreenspace–Placeswherehumancontrolandactivitiesarenotintensivesothatafeelingof
naturalnessisallowedtopredominate.Naturalandsemi‐naturalgreenspaceexistsasadistinct
typologybutalsoasdiscreteareaswithinthemajorityofothergreenspacetypologies.
EuropeanEnvironmentAgency17
Greenspaceisdefinedasaplotofvegetatedlandseparatingorsurroundingareasofintensive
residentialorindustrialuseanddevotedtorecreationorparkuses.
UnitedStatesEnvironmentalProtectionAgency’s(USEPA)EnviroAtlas18
USEPA’sEnviroAtlas(Pickardetal.,2015)definesgreenspaceasallvegetatedland,including
agriculture,lawns,forests,wetlands,andgardens.Barrenlandandimpervioussurfacessuchas
concreteandasphaltareexcluded.

16http://webarchive.nationalarchives.gov.uk/20160714000001/http://publications.naturalengland.org.uk/
publication/40004
17http://glossary.eea.europa.eu/terminology/concept_html?term=green%20space
18https://www.epa.gov/enviroatlas
65
APPENDIX2.Theavailabilityofkeyurbanlandusedataforthe
MemberStatesoftheWHOEuropeanRegion
WHOEuropeanMemberEuropeanUrbanAtlas
(2006)*
CORINELandCover
(2006)**
AlbaniaAvailable
Andorra
Armenia
AustriaAvailable Available
Azerbaijan
Belarus
BelgiumAvailable Available
BosniaandHerzegovina Available
BulgariaAvailable Available
CroatiaAvailable
CyprusAvailable Available
CzechRepublicAvailable Available
DenmarkAvailable Available
EstoniaAvailable Available
FinlandAvailable Available
FranceAvailable Available
Georgia
GermanyAvailable Available
GreeceAvailable
HungaryAvailable Available
IcelandAvailable
IrelandAvailable Available
Israel
ItalyAvailable Available
Kazakhstan
Kyrgyzstan
LatviaAvailable Available
LithuaniaAvailable Available
LuxembourgAvailable Available
MaltaAvailable Available
66
Monaco
MontenegroAvailable
NetherlandsAvailable Available
NorwayAvailable
PolandAvailable Available
PortugalAvailable Available
RepublicofMoldova
RomaniaAvailable Available
RussianFederation
SanMarino
SerbiaAvailable
SlovakiaAvailable Available
SloveniaAvailable Available
SpainAvailable Available
SwedenAvailable Available
SwitzerlandAvailable
Tajikistan
TheformerYugoslavRepublicofMacedonia Available
TurkeyAvailable
Turkmenistan
Ukraine
UnitedKingdomAvailable Available
Uzbekistan
*Coveringmostcitieswithpopulation>100,000
**CORINE2006includesLiechtenstein
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75
10000toselecttheminimumgreenspacesizeof1ha(or5000toselectthesizeof0.5ha),and
completetheformula(Fig.A.3.13).ClickOK.
Fig.A.3.13.
Youhavenowselectedtheurbangreenspaceswithanareaof1haorlarger.Toexportthemasa
layer,followthesameprocedureasprevious;gobacktothetableofcontents,rightclickontheLand
uselayer,gotoSelectionÆCreatelayerfromselectedfeatures(Fig.A.3.10).Youcanthenrename
thelayertosomethinglike“Greenspaces_1ha”andselectacolourofyourchoiceforthelayer,as
describedearlier.
Creatingbufferaroundgreenspaces
The300meterbuffersizearoundgreenspacesbeing1haorlargerispresentedasanexample.Same
stepscanbeperformedforanybufferdistancedesiredandaroundanysizelimit.
Tocreatethebuffer,gotoGeoprocessingÆBuffer.Selectyourpreviouslycreatedlayer“Green
spaces_1ha”fromthedropdownmenuastheinputfeature.Intheoutputfeatureclass,clickonthe
openfoldericonontherightandnavigatetothefolderwhereallyourshapefilesarestored.Give
thislayeranamesuchas“greenspaces1ha_300mbuffer”.Next,specify300Metersasthelinear
distance.Lastly,clickOK(Fig.A.3.14).
76
Fig.A.3.14.
Theprogrammewillrunforacoupleofminutesandcreateabufferlayerthatwillappearinthe
TableofContents.Youcanrenameithereandeditthesymbolaspreviouslydescribed.Itisoften
nicetosetthelayertobetransparentsothatyoucanseethefeaturesunderneath.Youcansetthe
transparencybyrightclickingonthelayer,goingtoPropertiesÆDisplayÆTransparency40%.
FortheMalmöexample,theresultofthiscouldlooklikethefollowing(Fig.A.3.15):
Fig.A.3.15.
77
Tochangethedisplay,youcanmovethelayersupanddown.Theylayerintheordertheyappearin
thetableofcontents.Youcanalsode‐selectsomeofthelayerssotheyarenotalldisplayed
simultaneously.
Determiningpercentofpopulationhavingaccesstogreenspaces
Thenextstepistodeterminewhatpercentageofthepopulationiswithinthe300mbufferofgreen
spaceswithaminimumsizeof1ha(thesearethecriteriaforthecurrentanalysis.Thesame
procedurecanbeappliedtoanybufferdistanceandgreenspacesize.).
Makesurethepreviousselectionhasbeencleared.ThengotoSelectionÆSelectbylocation.The
selectionmethodshouldsay“selectfeaturesfrom”.Ifthepreviousselectionhasnotbeencleared,
thenyouhavetheoptionto“addtocurrentselection”or“selectfromcurrentlyselected”,etc.The
targetlayershouldbethepopulationdatalayer.Thesourcelayeristhe300mbufferaroundgreen
spacesof1haormore(namede.g.“greenspaces1ha_300mbuffer).Inthelaststepyoudecidethe
“spatialselectionmethodfortargetlayerfeatures”.Select“havetheircentroidinthesourcelayer
feature”(Fig.A.3.16).
Fig.A.3.16.
Aftertheselectionhasbeenmade,youcaneitherexportitasanewlayer(aspreviouslydescribed)
orsummarizetheselectionbyrightclickingonthePopulationdatalayerandopeningtheattribute
table(Fig.A.3.17).
78
Fig.A.3.17.
Hereyouhavetheoptionofviewingjusttheselectedfeaturesbyclickingon“showselectedrecords”
atthebottomofthescreen(Fig.A.3.18).
Fig.A.3.18.
IntheMalmöexample,thedataaredividedbygender.Eachcellispopulatedwiththenumberof
peopleindicated.Thelastcolumntotherightisthesummationofbothgenders(i.e.totalpopulation
ofthecensustract).Byrightclickingonthetitleofthe“SUMMA”columnandgoingtoStatistics,you
willgetthesummaryoftheselection(Fig.A.3.19).
79
Fig.A.3.19.
Theresultswillbedemonstratedasafrequencydistribution(Fig.A.3.20).
Fig.A.3.20.
Thesumof237,936indicatesthenumberofpeoplelivingwithinthe300mbufferzoneofgreen
spaceswithaminimumsizeof1ha.Thepercentagecanbecalculatedbyobtainingthetotalnumber
ofpeoplelivinginMalmö.Youcandothisbyclearingtheselection(Fig.A.3.21),rightclickingonthe
populationlayerandopeningtheattributetableagain.
Fig.A.3.21
80
Makesurethatallrecordsaredisplayedbymakingtheproperselectioninthebottomleftcornerof
thescreen.Rightclickonthe“SUMMA”columnoftheattributetableagainandselectit.Theresult
indicatesthatthetotalpopulationofMalmois297 616 people.
Thelaststepistocalculatethe%ofpeoplelivingwithinthe300mbufferaroundgreenspaceswitha
minimumsizeof1hausingthefollowingformula:
population living within 300 m buffer (1 ha)
total population = 237936
297616 *100=79.9% 
TheurbangreenspaceindicatorinMalmöforalineardistanceof300mtotheborderofgreen
spaceswithanareaofatleast1hais79.9%.
The WHO Regional
Office for Europe
The World Health Organization (WHO) is a
specialized agency of the United Nations
created in 1948 with the primary responsibility
for international health matters and public
health. The WHO Regional Office for Europe is
one of six regional offices throughout the world,
each with its own programme geared to the
particular health conditions of the countries it
serves.
Member States
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Andorra
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Ireland
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Original: English
WHO European Centre for Environment and Health, Bonn, Germany
T
his report summarizes the available evidence of beneficial
effects of urban green spaces, such as improved mental
health, reduced cardiovascular morbidity and mortality,
obesity and risk of type 2 diabetes, and improved
pregnancy outcomes.
Mechanisms leading to these health benefits include
psychological relaxation and stress alleviation, increased
physical activity, reduced exposure to air pollutants, noise
and excess heat.
Characteristics of urban green spaces that are associated
with specific mechanisms leading to health benefits, and
measures or indicators of green space availability,
accessibility and use that have been used in previous
surveys are discussed from the perspective of their public
health relevance and applicability for monitoring progress
towards goals set in international commitments, such as the
Parma Declaration in the WHO European Region and the
global Sustainable Development Goals.
The report also presents a suggested indicator of
accessibility of green spaces with examples of its
application in three European cities and a detailed
methodological tool kit for GIS analysis of land use and
population data.
World Health Organization
Regional Office for Europe
UN City, Marmorvej 51 DK-2100 Copenhagen Ø, Denmark
Tel.: +45 45 33 70 00 | Fax: +45 45 33 70 01
E-mail: postmaster@euro.who.int
Web site: www.euro.who.int
... Promote physical health perception [3], Reduce the risk of cardiovascular and diabetes [7], Reduce the incidence rate of respiratory diseases [8], Reduce the risk of cancer [8], Improve infant birth weight [9], Reduce the risk of overweight or obesity [10] Social Health Reduce crime rate [9], Improve social cohesion [10], Improve community satisfaction [10], Enhance social security [11], Promote overall social health [11] Overall General Health Reduce number of health-related complaints [7], Reduce all-cause mortality [9], Promote general mental health [10], Improve happiness and life satisfaction [10] Existing related researches are mainly based on the demographic and geographic background in North America and Northern Europe, and there are few related studies on the Chinese background. Therefore, in order to verify the specific characteristics of the urban park health effect on the Chinese demographic and geographic background, this study research the physical and mental health status of residents living around the park, the way of residents using the park, and the residents' satisfaction of the characteristics of the park, to explore the effects of urban park on the physical and mental health of surrounding residents. ...
The effects of urban park on residents’ health: an empirical study based on Tangxi River Park in Hefei
Article
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  • Sep 2020
As an important way for urban residents to access nature environment, urban park has a certain degree of impact on the health of the population. In this study, Tangxihe Park in Hefei City was used as the research site, and the impact of urban parks on population health was quantitatively studied by analyzing the demographic characteristics, physical and mental health of park users, and park satisfaction. The results show that the quality of overall environment, green space and activity facilities of the park have a positive effect on improving the physical and mental health of the residents, the time of residents spending in the park have a positive effect on their physical and mental health, the longer of the residents spending in the park, the higher of the health benefits they received. Physical health regression analysis showed that residents received better physical health benefits by using the park between 6am to 9am compared to those entering the park between 12pm to 14pm and 14pm to 18pm. Mental health regression analysis showed that residents entering the park between 14pm to 18pm received better mental health benefits than those entering the park between 6am to 9am. The research results verify the specific health effects of urban parks in the context of Chinese demographic and geographic background, and enrich the theoretical content on the health benefits of urban parks in different regional contexts.
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Unraveling nonlinear effects of environment features on green view index using multiple data sources and explainable machine learning
Article
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  • Dec 2024
Urban greening plays a crucial role in maintaining environmental sustainability and enhancing people’s well-being. However, limited by the shortcomings of traditional methods, studying the heterogeneity and nonlinearity between environmental factors and green view index (GVI) still faces many challenges. To address the concerns of nonlinearity, spatial heterogeneity, and interpretability, an interpretable spatial machine learning framework incorporating the Geographically Weighted Random Forest (GWRF) model and the SHapley Additive exPlanation (Shap) model is proposed in this paper. In this paper, we combine multi-source big data, such as Baidu Street View data and remote sensing images, and utilize semantic segmentation models and geographic data processing techniques to study the global and local interpretation of the Beijing region with GVI as the key indicator. Our research results show that: (1) Within the Sixth Ring Road of Beijing, GVI shows significant spatial clustering phenomenon and positive correlation linkage, and at the same time exhibits significant spatial differences; (2) Among many environmental variables, the increase of green coverage rate has the most significant positive effect on GVI, while the increase of building density shows a strong negative correlation with GVI; (3) The performance of the GWRF model in predicting GVI is excellent and far exceeds that of comparison models.; (4) Whether it is the green coverage rate, urban built environment or socioeconomic factors, their influence on GVI shows non-linear characteristics and a certain threshold effect. With the help of these non-linear influences and explicit threshold effects, quantitative analyses of greening are provided, which can help to assist urban planners in making more scientific and rational decisions when allocating greening resources.
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Unraveling nonlinear effects of environment features on green view index using multiple data sources and explainable machine learning
Preprint
Full-text available
  • Jul 2024
Urban greening plays a crucial role in maintaining environmental sustainability and enhancing people's well-being. However, limited by the shortcomings of traditional methods, studying the heterogeneity and nonlinearity between environmental factors and green view index (GVI) still faces many challenges. To address the concerns of nonlinearity, spatial heterogeneity, and interpretability, an interpretable spatial machine learning framework incorporating the Geographically Weighted Random Forest (GWRF) model and the SHapley Additive exPlanation (Shap) model is proposed in this paper. In this paper, we combine multi-source big data, such as Google Street View data and remote sensing images, and utilize semantic segmentation models and geographic data processing techniques to study the global and local interpretation of the Beijing region with GVI as the key indicator. Our research results show that: (1) Within the Sixth Ring Road of Beijing, GVI shows significant spatial clustering phenomenon and positive correlation linkage, and at the same time exhibits significant spatial differences; (2) Among many environmental variables, the increase of vegetation coverage has the most significant positive effect on GVI, while the increase of building density shows a strong negative correlation with GVI; (3) Whether it is the vegetation cover rate, urban built environment or socio-economic factors, their influence on GVI shows non-linear characteristics and a certain threshold effect; (4) The performance of the GWRF model in simulating and predicting GVI is excellent and far exceeds that of existing models. Based on these findings, this study can provide an important reference for urban planners to enhance urban greening.
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Healthy aging in a green living environment: a systematic review of the literature
Technical Report
Full-text available
  • Mar 2013
Deze studie geeft een overzicht van de literatuur naar het verband tussen een groene leefomgeving en de psychosociale status, het beweeggedrag en de gezondheid bij mensen van 60 jaar en ouder. Door middel van een gestructureerde zoekstrategie is naar relevante publicaties gezocht binnen de databases PubMed, PsycInfo en EMBASE. In totaal zijn 16 publicaties over 11 studies geselecteerd met een methodologische kwaliteit van 5,5 tot 10,5 punten op een 11-puntsschaal. De resultaten van deze studie laten een positief verband zien tussen een groene leefomgeving en beweeggedrag, ervaren gezondheid en morbiditeit, mortaliteit en overleving bij ouderen. Verdere identificatie van barrières voor een optimaal gebruik van de groene leefomgeving door ouderen is gewenst.
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Understanding Relationships between Health, Ethnicity, Place and the Role of Urban Green Space in Deprived Urban Communities
Article
Full-text available
Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME) groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523) to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID) segmentation analyses identified three distinct general health segments in our sample ranging from "very good" health (people of Indian origin), to "good" health (white British), and "poor" health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups), labelled "Mixed BME" in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness) ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in "Mixed BME". Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME communities since this can play an important role in helping address the health inequalities experienced by these groups.
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Nearby green space and human health: Evaluating accessibility metrics
Article
  • Oct 2016
  • LANDSCAPE URBAN PLAN
There is growing scientific recognition that contact with nature in general, and contact with urban green more specific, have the potential to positively contribute to human health. For the purpose of developing healthy urban neighbourhoods, this raises the question how to take scientific evidence about these health benefits into account. Accessibility metrics that are well substantiated by empirical evidence are needed. This paper reviews the quantitative and qualitative aspects relevant for accessibility metrics and empirical studies addressing these aspects in relation to health. Studies comparing different types of green space indicators suggest that cumulative opportunities indicators are more consistently positively related to health than residential proximity ones. In contrast to residential proximity indicators, cumulative opportunities indicators take all the green space within a certain distance into account. Comparing results across studies proved to be hard. Green space accessibility was measured in a variety of ways and the green space indicator that was chosen was often not problematized. We feel that it is time for a more function-oriented approach. How precisely does contact with nature impact health and what type and qualities are relevant in this regard? We think this will lead to a new generation of more evidence-based accessibility metrics that will help to advance the field.
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