Spatial dimensions of the influence of urban green-blue spaces on human health: A systematic review

Exposure to urban green space may both promote and harm mental health in socially vulnerable neighborhoods: A neighborhood-scale analysis in New York City

BACKGROUND

There is growing evidence that exposure to green space can impact mental health, but these effects may be context dependent. We hypothesized that associations between residential green space and mental health can be modified by social vulnerability.

METHOD

We conducted an ecological cross-sectional analysis to evaluate the effects of green space exposure on mental disorder related emergency room (ER) visits in New York City at the level of census tract. To objectively represent green space exposure at the neighborhood scale, we calculated three green space exposure metrics, namely proximity to the nearest park, percentage of green space, and visibility of greenness. Using Bayesian hierarchical spatial Poisson regression models, we evaluated neighborhood social vulnerability as a potential modifier of greenness-mental disorder associations, while accounting for the spatially correlated structures.

RESULTS

We found significant associations between green space exposure (involving both proximity and visibility) and total ER visits for mental disorders in neighborhoods with high social vulnerability, but no significant associations in neighborhoods with low social vulnerability. We also identified specific neighborhoods with particularly high ER utilization for mental disorders.

CONCLUSIONS

Our findings suggest that exposure to green space is associated with ER visits for mental disorders, but that neighborhood social vulnerability can modify this association. Future research is needed to confirm our finding with longitudinal designs at the level of individuals.

Natural and built environments and blood pressure of Alpine schoolchildren

BACKGROUND

Early life environments may influence children's blood pressure (BP), but evidence on the combined effects of natural and built environment exposures is scarce. The present study investigates the associations of natural and built environment indicators, traffic noise, and air pollution with BP in children living in Alpine valleys.

METHODS

In 2004/2005, 1251 school children (8-12 years old) were sampled for a cross-sectional survey in several Austrian and Italian mountain valleys. Children's mothers completed a questionnaire. The outcomes of interest were systolic and diastolic BP measured with a calibrated oscillometric device. Indicators of land cover assigned to the residential and school coordinates within 100 and 1000 m included normalized difference vegetation index (NDVI), tree canopy cover, and a broader naturalness indicator titled distance to nature (D2N). The presence of a home garden was also measured via self-report. Imperviousness density served as a proxy for the built environment. Residential air pollution (NO₂) and noise (L_den) from traffic were calculated using bespoke modeling. NO₂, L_den, physical activity, and body mass index (BMI) were treated as mediating pathways.

RESULTS

Higher NDVI and tree cover levels in residential and school surroundings and home gardens were consistently associated with lower BP. The built environment was associated with higher BP. Counterintuitive inverse associations between NO₂ and L_den and BP were also found. Structural equation modeling showed that higher levels of greenspace and presence of a home garden were weakly associated with more outdoor play spaces, and in turn with lower BMI, and ultimately with lower BP.

CONCLUSIONS

Exposure to natural environments may help maintain normal BP in children, while built environment may increase children's BP. Outdoor play and less adiposity in greener areas may mediate some of these associations. Evidence on air pollution and noise remains controversial and difficult to explain.

Neighborhood environmental exposures and incidence of attention deficit/hyperactivity disorder: A population-based cohort study

BACKGROUND

Emerging studies have associated low greenspace and high air pollution exposure with risk of child attention deficit/hyperactivity disorder (ADHD). Population-based studies are limited, however, and joint effects are rarely evaluated. We investigated associations of ADHD incidence with greenspace, air pollution, and noise in a population-based birth cohort.

METHODS

We assembled a cohort from administrative data of births from 2000 to 2001 (N ∼ 37,000) in Metro Vancouver, Canada. ADHD was identified by hospital records, physician visits, and prescriptions. Cox proportional hazards models were applied to assess associations between environmental exposures and ADHD incidence adjusting for available covariates. Greenspace was estimated using vegetation percentage derived from linear spectral unmixing of Landsat imagery. Fine particulate matter (PM_2.5) and nitrogen dioxide (NO₂) were estimated using land use regression models; noise was estimated using a deterministic model. Exposure period was from birth until the age of three. Joint effects of greenspace and PM_2.5 were analysed in two-exposure models and by categorizing values into quintiles.

RESULTS

During seven-year follow-up, 1217 ADHD cases were diagnosed. Greenspace was associated with lower incidence of ADHD (hazard ratio, HR: 0.90 [0.81-0.99] per interquartile range increment), while PM_2.5 was associated with increased incidence (HR: 1.11 [1.06-1.17] per interquartile range increment). NO₂ (HR: 1.01 [0.96, 1.07]) and noise (HR: 1.00 [0.95, 1.05]) were not associated with ADHD. There was a 50% decrease in the HR for ADHD in locations with the lowest PM_2.5 and highest greenspace exposure, compared to a 62% increase in HR in locations with the highest PM_2.5 and lowest greenspace exposure. Effects of PM_2.5 were attenuated by greenspace in two-exposure models.

CONCLUSIONS

We found evidence suggesting environmental inequalities where children living in greener neighborhoods with low air pollution had substantially lower risk of ADHD compared to those with higher air pollution and lower greenspace exposure.

Using Structural Equation Modeling to Examine Pathways Between Environmental Characteristics and Perceived Restorativeness on Public Rooftop Gardens in China

As a kind of informal green space more closely related to the built environment, public rooftop gardens (PRGs) are novel green open space and important salutogenic resource for urban residents. It is one of the most easily accessible method for urban residents to be in contact with outdoor or natural elements from the context of high-altitude living. Given its potential health benefits to city dwellers, existing empirical studies are heavily focused on immediate recovery through visually accessing PRGs (through windows), neglecting the possibility of using PRGs physically as a place of interaction. This paper hypothesizes usage patterns will mediate the associations between the environmental characteristics of PRG and users' restoration. This is done through inputting data from 12 typical samples of PRG in Chengdu, China into structural equation model (SEM). Combining the concept of Perceived Sensory Dimensions (PSD) and Perceived Restorativeness Scales (PRS) with the usage patterns of the above samples, this study aims to examine the correlation of environmental characteristics, usage pattern and restoration, in which identify their relative importance in the context of PRGs. Through serials of numerical tests on the model, the study shows that out of the 20 theoretical pathways constructed by the environmental characteristics (x)–usage patterns (m)–restorative effect (y), only 14 forms a significant correlation. In addition, out of all PSDs, social, serene, refuge, space and nature dimensions are induced into restorative effects through four patterns of use: retreat, nature touch, interpersonal interaction and family-bonding activities. The findings also show that social and family-bonding are the most influential independent and mediating variables respectively in achieving restorative effects in the PRG. This study reveals important findings about how usage patterns mediate the association between the PSD and PRS of users. And it also has generated practical implications on how we can design public rooftop gardens from the perspective of restoration, which could potentially be the key to the future survival and development of PRGs in urban environments.

Use of the Natural Outdoor Environment in Different Populations in Europe in Relation to Access: Implications for Policy

This cross-cultural study explores the relationship of natural outdoor environment (NOE) use with NOE access. Most urban planning recommendations suggest optimal accessibility to be 300 m-500 m straight distance to spaces with vegetation of at least 1 hectare. Exploring this recommendation, we used data (n = 3947) from four European cities collected in the framework of the PHENOTYPE study: Barcelona (Spain), Doetinchem (The Netherlands), Kaunas (Lithuania) and Stoke-on-Trent (United Kingdom) to obtain residential access to NOE (straight or network distances, using 300 m and 150 m buffers, to NOE larger than 1 hectare or 0.5 hectare) and use of NOE (i.e., self-reported time spent in NOE). Poisson regression models were used to examine the associations between residential access and use of NOE. The models with the strongest association with time spent in NOE in the combined sample were for those living within 300 m straight line distance to either 0.5 ha or 1 ha NOE. Noting that the only indicator that was consistent across all individual cities was living with 150 m network buffer of NOE (of at least 1 ha), this warrants further exploration in reducing recommendations of 300 m straight-line distance to 150 m network distance to 1 ha of NOE for a general indicator for cities within Europe.

Developing an Approach for Assessing Urban Blue-Green Spaces Towards Sustainable Urban Growth Through Retrospective Cyber Metrics Analysis of Operational Estimations Approaches

Urban blue-green spaces provide us abundant social, environmental, and economic benefits, but the disparities often exist in their distribution and accessibility. Traditionally urban blue-green spaces are a consolidation of “blue-green infrastructure” within urban areas. Several urban features like parks, forests, gardens, visible water, such as parks, rivers, canals, reservoirs, ponds, lakes, fountains, etc. are categorized or considered under the blue-green spaces and these are very much crucial for various urban ecosystem services. These play a significant role for all stakeholders of the urban community. Thus, everyone must ensure the equitable number of blue-green spaces for all. Recently, several rules and regulations towards the safeguarding of urban blue-green spaces have been outlined. The work presents a methodological framework to develop an approach towards sustainable urban growth with the help of urban blue-green spaces assessments. The current work has attempted to examine the linkage between issues of the urban blue-green spaces for restoring the required infrastructures. It can be utilised for all sustainable urban development for urban planning and design projects to play a pivotal role. The work emphasizes more to develop a methodological framework to analyze the urban blue-green spaces for augmentation with a theoretical framework. It is expected that the advancement of a problem cum objectives-driven approach will help to design an impact-driven approach for planned and concrete action.

Investigating the association between regeneration of urban blue spaces and risk of incident chronic health conditions stratified by neighbourhood deprivation: A population-based retrospective study, 2000-2018

Chronic non-communicable diseases are leading causes of poor health and mortality worldwide, disproportionately affecting people in highly deprived areas. We undertook a population-based, retrospective study of 137,032 residents in Glasgow, Scotland, to investigate the association between proximity to urban blue spaces and incident chronic health conditions during a canal regeneration programme. Hazard ratios (HRs) were estimated using Cox proportional hazards models adjusted for age and sex, with the incidence of a given health condition as the dependent variable. The analyses were stratified by socioeconomic deprivation tertiles. We found that, in areas in the highest deprivation tertile, proximity to blue space was associated with a lower risk of incident cardiovascular disease (HR 0.85, 95% Confidence Interval (CI) 0.76-0.95), hypertension (HR 0.85, 95% CI 0.79-0.92), diabetes (HR 0.88, 95% CI 0.83-0.94), stroke (HR 0.85, 95% CI 0.77-0.94) and obesity (HR 0.90, 95% CI 0.86-0.94), but not chronic pulmonary disease, after adjusting for age and sex covariates. In middle and low deprivation tertiles, living closer to the canal was associated with a higher risk of incident chronic pulmonary disease (middle: HR 1.56, 95% CI 1.24-1.97, low: HR 1.34, 95% CI 1.05-1.73). Moreover, in the middle deprivation tertile, a higher risk of stroke (HR 1.36, 95% CI 1.02-1.81) and obesity (HR 1.14, 95% CI 1.01-1.29) was observed. We conclude that exposure to blue infrastructure could be leveraged to mitigate some of the health inequalities in cities.

Neighborhood greenspace and risk of type 2 diabetes in a prospective cohort: the Multi-Ethncity Study of Atherosclerosis

BACKGROUND

Neighborhood greenspaces provide opportunities for increased physical activity and social interaction, and thus may reduce the risk of Type 2 diabetes. However, there is little robust research on greenspace and diabetes. In this study, we examine the longitudinal association between neighborhood greenspace and incident diabetes in the Multi-Ethnic Study of Atherosclerosis.

METHODS

A prospective cohort study (N = 6814; 2000-2018) was conducted to examine the association between greenspace, measured as annual and high vegetation season median greenness determined by satellite (Normalized Difference Vegetation Index) within 1000 m of participant homes, and incident diabetes assessed at clinician visits, defined as a fasting glucose level of at least 126 mg/dL, use of insulin or use of hypoglycemic medication, controlling for covariates in stages. Five thousand five hundred seventy-four participants free of prevalent diabetes at baseline were included in our analysis.

RESULTS

Over the study period, 886 (15.9%) participants developed diabetes. Adjusting for individual characteristics, individual and neighborhood-scale SES, additional neighborhood factors, and diabetes risk factors, we found a 21% decrease in the risk of developing diabetes per IQR increase in greenspace (HR: 0.79; 95% CI: 0.63, 0.99).

CONCLUSIONS

Overall, neighborhood greenspace provides a protective influence in the development of diabetes, suggesting that neighborhood-level urban planning that supports access to greenspace--along with healthy behaviors--may aid in diabetes prevention. Additional research is needed to better understand how an area's greenness influences diabetes risk, how to better characterize greenspace exposure and usage, and future studies should focus on robust adjustment for neighborhood-level confounders.

Effects of tree canopy on psychological distress: A repeated cross-sectional study before and during the COVID-19 epidemic

BACKGROUND

During the COVID-19 epidemic period, people showed a stronger connection to the environment within their communities. Although tree canopy in residential areas has been shown to positively affect psychological distress, it is not clear whether the COVID-19 epidemic played a role in this process. Elucidation of the relationship between tree canopy and the impact on psychological distress during the COVID-19 epidemic could provide valuable information as to the best methods to help individuals cope with urban mental stress events.

METHODS

A total of 15 randomly selected residential areas of Beijing were enrolled in this repeated cross-sectional study. A total of 900 residents were included in the two-waves of the investigation (450 residents per wave) before and during the COVID-19 epidemic (i.e., May 2019 and May 2020). Psychological distress was estimated using the 12-question General Health Questionnaire (GHQ-12). Tree canopy coverage (TCC) was measured through visual interpretation based on the 2013 data sources (World View 2 satellite imagery of Beijing urban areas with a resolution of 0.5 m). The demographic characteristics, distance to the nearest surrounding green or blue space, residential area house price, household density, and construction year were also collected in this study. A multivariate logistic regression, relative risk due to interaction (RERI), and synergy index (SI) were used to explore the relationships among tree canopy, COVID-19, and psychological distress.

RESULTS

The negative impact of the COVID-19 epidemic on mental health was significant, with the prevalence of psychological distress increased 7.84 times (aOR = 7.84, 95% CI = 4.67-13.95) during the COVID-19 epidemic period. Tree canopy coverage in the group without psychological distress was significantly higher than that of the psychologically distressed group (31.07 ± 11.38% vs. 27.87 ± 12.97%, P = 0.005). An increase in 1% of TCC, was related to a 5% decrease in the prevalence of psychological distress (aOR = 0.95, 95% CI = 0.93-0.98). An antagonism joint action between tree canopy and the COVID-19 epidemic existed (RERI = 1.09, 95% CI = 0.72-1.47; SI = 0.16, 95% CI = 0.05-0.52), and persisted enhancing only in medium (26.45%-33.21%) and above TCC level. Correlation of GHQ items and TCC significantly differed between the COVID-19 non-epidemic and epidemic periods, with the effects of tree canopy on GHQ-12 items covering topics, such as social function and depression, presumably absent because of epidemic limitations.

CONCLUSIONS

This study indicates that the COVID-19 epidemic harmed mental health and verified the positive effects of residential tree canopy on psychological distress in Beijing. We suggest paying more attention to residents in areas of low TCC and dealing with psychological distress caused by public health stress events based on tree canopy strategies.

New urban models for more sustainable, liveable and healthier cities post covid19; reducing air pollution, noise and heat island effects and increasing green space and physical activity

Cities are centres of innovation and wealth creation, but also hotspots of air pollution and noise, heat island effects and lack of green space, which are all detrimental to human health. They are also hotspots of COVID19. COVID19 has led to a rethink of urban public space. Therefore, is it time to re-think our urban models and reduce the health burden? We provide a narrative meta-review around a number of cutting edge and visionary urban models that that may affect health and that have been reported over the past few years. New urban concepts such as the Superblocks, the low traffic neighbourhood, 15 Minute city, Car free city or a mixture of these that may go some way in reducing the health burden related to current urban and transport practices. They will reduce air pollution and noise, heat island effects and increase green space and physical activity levels. What is still lacking though is a thorough evaluation of the effectiveness and acceptability of the schemes and the impacts on not only health, but also liveability and sustainability, although they are expected to be positive. Finally, the COVID19 pandemic may accelerate these developments and stimulus funding like the EU Next Generation funding should be used to make these changes.

Are greenspace quantity and quality associated with mental health through different mechanisms in Guangzhou, China: A comparison study using street view data

Residential greenspace quality may be more important for people's mental health than the quantity of greenspace. Existing literature mainly focuses on greenspace quantity and is limited to exposure metrics based on an over-head perspective (i.e., remote sensing data). Thus, whether greenspace quantity and quality influence mental health through different mechanisms remains unclear. To compare the mechanisms through which greenspace quantity and quality influence mental health, we used both remote sensing and street view data. Questionnaire data from 1003 participants in Guangzhou, China were analysed cross-sectionally. Mental health was assessed through the World Health Organization Well-Being Index (WHO-5). Greenspace quantity was measured by both remote sensing-based Normalized Difference Vegetation Index (NDVI) and Street View Greenness-quantity (SVG-quantity). Greenspace quality was measured by both Street View Greenness-quality (SVG-quality) and questionnaire-based self-reported greenspace quality. Structural equation models were used to assess mechanisms through which neighbourhood greenspace exposure has an influence on mental health. Stress, social cohesion, physical activity and life satisfaction were found to mediate both SVG-quality - WHO-5 scores and self-reported greenspace quality - WHO-5 scores associations. However, only NO₂ (nitrogen dioxide) mediated the association between NDVI and WHO-5 scores, while NO₂, perceived pollution and social cohesion mediated the association between SVG-quantity and WHO-5 scores. The mechanisms through which neighbourhood greenspace exposure influences mental health may vary across different exposure assessment strategies. Greenspace quantity influences mental health through reducing harm from pollution, while greenspace quality influences mental health through restoring and building capacities.

Ethnic Differences in Environmental Restoration: Arab and Jewish Women in Israel

Throughout the last few decades, plenty of attention has been paid to restorative environments that positively affect human psychological health. These studies show that restorative environments affect human beings emotionally, physiologically, and cognitively. Some studies focus on the cognitive effects of exposure to restorative environments. A widely used index that measures the cognitive response is the Perceived Restoration Potential Scale (PRS). Most studies employing the PRS have examined differences in human cognitive response between types of urban environments mainly urban versus green ones. We use Hartig's questionnaire to expose differences between types of urban environments and ethnic groups. Variances between Arab and Jewish women were calculated in four environments: home; park; residential and central city environments. The effect of intervening variables such as exposure to thermal, noise, social and CO loads and social discomfort were tested. We find that dissimilar to urban typical built-up environments, green areas are highly restorative. Furthermore, differences in the restorativeness of different urban environments are low though significant. These differences depend on their function, aesthetic qualities, and amount of greenery. Ethno-national differences appear to affect the experience of restoration. While both ethnic related groups experienced a tremendous sense of restoration in parks, Jewish women enjoyed slightly higher levels of restoration mainly at home and in residential environments compared to Arab women who experienced higher sense of restorativness in central city environments. Jewish women experienced higher sense of being away and fascination. From the intervening variables, social discomfort explained 68 percent of the experience of restoration, noise explained 49 percent, thermal load explained 43 percent and ethnicity 14 percent of the variance in PRS.

Urban Wetlands: A Review on Ecological and Cultural Values

Wetlands are a critical part of natural environments that offer a wide range of ecosystem services. In urban areas, wetlands contribute to the livability of cities through improving the water quality, carbon sequestration, providing habitats for wildlife species, reducing the effects of urban heat islands, and creating recreation opportunities. However, maintaining wetlands in urban areas faces many challenges, such as the reduction of hydrological functions, changed water regimes due to barriers, contamination by wastewater, habitat loss due to land-use change, and loss of biodiversity due to the entry of alien species. In this article, we review the theoretical background of wetlands in urban areas through the existing studies in the literature. We provide knowledge on urban wetlands and highlight the benefits of these wetlands in urban areas. These benefits include sustainability, biodiversity, urban heat islands, social perception, and recreation values. We also summarize the objectives, methodologies, and findings of the reviewed articles in five tables. In addition, we summarize the critical research gaps addressed in the reviewed articles. Our review study addresses the research gaps by performing a rigorous analysis to identify significant open research challenges, showing the path toward future research in the field. We further discuss and highlight the role of policymakers and stakeholders in preserving wetlands and finally present our conclusions.

Waterscapes for Promoting Mental Health in the General Population

The WHO estimates that, with the development of urbanization, 25% of the population is suffering from psychological and mental distress. Preliminary evidence has suggested that aquatic environments and riparian areas, i.e., waterscapes, can benefit psychological and mental wellbeing. The aim of this study was to identify the processes of waterscape psychological and mental health promotion through aliterature review. We propose a design framework of waterscapes for achieving psychological and mental health in the general population that often visits waterscapes, which has the function of therapeutic landscapes through values of accessibility, versatility, habitats, and biodiversity. According to theories, waterscapes can improve psychological and mental health to divert negative emotions through mitigation (e.g., reduced urban heat island), instoration (e.g., physical activity and state of nature connectedness), and restoration (e.g., reduced anxiety/attentional fatigue). By accessing water (e.g., streams, rivers, lakes, wetlands, and the coast) and riparian areas, people can get in close contact with nature and spend more time in activities (e.g., walking, exploring, talking, and relaxing). Waterscapes with healing effects can enhance psychological resilience to promote people's psychological and mental health. Future research should focus on ensuring an adequate supply of waterscapes and promoting the efficiency of waterscape ecosystem services on mental health. Moreover, fora deep understanding of the complexity of nature-human health associations, it is necessary to explore more consistent evidence for therapeutic waterscapes considering the characteristics and functional mechanisms of waterscape quality, in terms of freshness, luminescence, rippling or fluidity, and cultural value, to benefit public health and biodiversity conservation.

Electroencephalography (EEG)-Based Neural Emotional Response to the Vegetation Density and Integrated Sound Environment in a Green Space

Emotion plays an important role in physical and mental health. Green space is an environment conducive to physical and mental recovery and influences human emotions through visual and auditory stimulation. Both the visual environment and sound environment of a green space are important factors affecting its quality. Most of the previous relevant studies have focused solely on the visual or sound environment of green spaces and its impacts. This study focused on the combination of vegetation density (VD) and integrated sound environment (ISE) based on neural emotional evaluation criteria. VD was used as the visual variable, with three levels: high (H), moderate (M) and low (L). ISE was used as the sound variable, with four levels: low-decibel natural and low-decibel artificial sounds (LL), low-decibel natural and high-decibel artificial sounds (LH), high-decibel natural and low-decibel artificial sounds (HL) and high-decibel natural and high-decibel artificial sounds (HH). These two variables were combined into 12 unique groups. A total of 360 volunteer college students were recruited and randomly assigned to the 12 groups (N = 30). All 12 groups underwent the same 5 min high-pressure learning task (pretest baseline), followed by a 5 min audio-visual recovery (posttest). Six indicators of neural emotion (engagement, excitement, focus, interest, relaxation and stress) were dynamically measured by an Emotiv EPOC X device during the pretest and posttest. Analysis of covariance was used to determine the main and coupled effects of the variables. (1) VD and ISE have significant effects on human neural emotions. In moderate- and high-VD spaces, artificial sound levels may have a positive effect on excitement. (2) A higher VD is more likely to result in excitatory neural emotion expression. (3) Low-VD and high-VD spaces have a higher degree of visual continuity. Both extremely low and extremely high VDs result in a higher expression of stressful emotions than observed for a moderate VD. (4) High-decibel artificial sounds are more likely to attract attention, possibly because artificial sounds are easier to recognize than natural sounds. However, when both the natural and artificial sounds are low, it is difficult to induce higher tones, and the lower the artificial sound decibel level, the easier it is to relax. Additionally, under the influence of an ISE, attention recovery and stress recovery may be negatively correlated. The results show that an appropriate combination of VD and ISE can improve the health benefits of a green space and thus the well-being of visitors.

Estimating multiple greenspace exposure types and their associations with neighbourhood premature mortality: A socioecological study

BACKGROUND

Greenspace exposures are often measured using single exposure metrics, which can lead to conflicting results. Existing methodologies are limited in their ability to estimate greenspace exposure comprehensively. We demonstrate new methods for estimating single and combined greenspace exposure metrics, representing multiple exposure types that combine impacts at various scales. We also investigate the association between those greenspace exposure types and premature mortality.

METHODS

We used geospatial data and spatial analytics to model and map greenspace availability, accessibility and eye-level visibility exposure metrics. These were harmonised and standardised to create a novel composite greenspace exposure index (CGEI). Using these metrics, we investigated associations between greenspace exposures and years of potential life lost (YPLL) for 1673 neighbourhoods applying spatial autoregressive models. We also investigated the variations in these associations in conjunction with levels of socioeconomic deprivation based on the index of multiple deprivations.

RESULTS

Our new CGEI metric provides the opportunity to estimate spatially explicit total greenspace exposure. We found that a 1-unit increase in neighbourhood CGEI was associated with approximately a 10-year reduction in YPLL. Meaning a 0.1 increment or 10% increase in the CGEI is associated with an approximately one year lower premature mortality value. A single 1-unit increase in greenspace availability was associated with a YPLL reduction of 9.8 years, whereas greenness visibility related to a reduction of 6.14 years. We found no significant association between greenspace accessibility and YPLL. Our results further identified divergent trends in the relations between greenspace exposure types (e.g. availability vs. accessibility) and levels of socioeconomic deprivation (e.g. least vs. most).

CONCLUSION

Our methods and metrics provide a novel approach to the assessment of multiple greenspace exposure types, and can be linked to the broader exposome framework. Our results showed that a higher composite greenspace exposure is associated with lower premature mortality.

The Impact of Built and Social Environmental Characteristics on Diagnosed and Estimated Future Risk of Dementia

BACKGROUND

Dementia is a major global health challenge and the impact of built and social environments' characteristics on dementia risk have not yet been fully evaluated.

OBJECTIVE

To investigate associations between built and social environmental characteristics and diagnosed dementia cases and estimated dementia risk.

METHODS

We recruited 25,511 patients aged 65 and older from family physicians' practices. We calculated a dementia risk score based on risk and protective factors for patients not diagnosed with dementia. Our exposure variables were estimated for each statistical area level 1: social fragmentation, nitrogen dioxide, public open spaces, walkability, socio-economic status, and the length of main roads. We performed a multilevel mixed effect linear regression analysis to allow for the hierarchical nature of the data.

RESULTS

We found that a one standard deviation (1-SD) increase in NO2 and walkability score was associated with 10% higher odds of any versus no dementia (95% CI: 1%, 21% for NO2 and 0%, 22% for walkability score). For estimated future risk of dementia, a 1-SD increase in social fragmentation and NO2 was associated with a 1% increase in dementia risk (95% CI: 0, 1%). 1-SD increases in public open space and socioeconomic status were associated with 3% (95% CI: 0.95, 0.98) and 1% decreases (95% CI: 0.98, 0.99) in dementia risk, respectively. There was spatial heterogeneity in the pattern of diagnosed dementia and the estimated future risk of dementia.

CONCLUSION

Associations of neighborhood NO2 level, walkability, public open space, and social fragmentation with diagnosed dementia cases and estimated future risk of dementia were statistically significant, indicating the potential to reduce the risk through changes in built and social environments.

Data for the assessment of vulnerability and resilience in the field of environmental health in the north of France

The integration of multidimensional data is necessary to improve the understanding of environmental and social inequalities in health. The challenge is to define a dataset that provides the most holistic description possible of the territory. This article presents a relevant dataset to characterize the territorial accumulation of health determinants in the second most densely populated region of metropolitan France (Hauts-de-France Region, in the north of France). The multidimensional dataset combines data related to the economic, social, environment, services, health and policy dimensions at fine scale (i.e., each municipality). Data outlining a negative impact on health inequalities (e.g. anthropogenic pressures, socioeconomics factors related to vulnerability, etc.) are considered to be as important as data outlining a positive impact on health inequalities (e.g. natural resources, diversity and economic drive, etc.). The proposed theoretical framework relies on data reuse. Over one hundred variables covering a time frame from 2008 to 2017 were collected from a dozen public and national database providers. The use of official organizations ensured the quality of the collected data. The Geographic Information System, designed to map and catalogue ready-to-use data, was used to generate new data or to deal with missing data. Finally, 50 variables, including mostly quantitative but also qualitative data, were selected after application of inclusion and exclusion criteria. The resulting dataset provides a broad characterisation of the 3,817 municipalities in the Hauts-de-France Region. These data will help to discriminate the distribution pattern of vulnerability and resilience levels in this region. This novel approach is described in the paper “How can we analyse environmental health resilience and vulnerability? A joint analysis with composite indices applied to the north of France”, which provides a detailed description of the methodology used to develop composite indices. This research could therefore be of use to researchers, policy makers and stakeholders in the field of environmental health seeking to identify the weaknesses but also the strengths of municipalities.

Biodiversity and Health in the Urban Environment

PURPOSE OF REVIEW

Biodiversity underpins urban ecosystem functions that are essential for human health and well-being. Understanding how biodiversity relates to human health is a developing frontier for science, policy and practice. This article describes the beneficial, as well as harmful, aspects of biodiversity to human health in urban environments.

RECENT FINDINGS

Recent research shows that contact with biodiversity of natural environments within towns and cities can be both positive and negative to human physical, mental and social health and well-being. For example, while viruses or pollen can be seriously harmful to human health, biodiverse ecosystems can promote positive health and well-being. On balance, these influences are positive. As biodiversity is declining at an unprecedented rate, research suggests that its loss could threaten the quality of life of all humans. A key research gap is to understand-and evidence-the specific causal pathways through which biodiversity affects human health. A mechanistic understanding of pathways linking biodiversity to human health can facilitate the application of nature-based solutions in public health and influence policy. Research integration as well as cross-sector urban policy and planning development should harness opportunities to better identify linkages between biodiversity, climate and human health. Given its importance for human health, urban biodiversity conservation should be considered as public health investment.

An ecosystem service perspective on urban nature, physical activity, and health

Nature underpins human well-being in critical ways, especially in health. Nature provides pollination of nutritious crops, purification of drinking water, protection from floods, and climate security, among other well-studied health benefits. A crucial, yet challenging, research frontier is clarifying how nature promotes physical activity for its many mental and physical health benefits, particularly in densely populated cities with scarce and dwindling access to nature. Here we frame this frontier by conceptually developing a spatial decision-support tool that shows where, how, and for whom urban nature promotes physical activity, to inform urban greening efforts and broader health assessments. We synthesize what is known, present a model framework, and detail the model steps and data needs that can yield generalizable spatial models and an effective tool for assessing the urban nature-physical activity relationship. Current knowledge supports an initial model that can distinguish broad trends and enrich urban planning, spatial policy, and public health decisions. New, iterative research and application will reveal the importance of different types of urban nature, the different subpopulations who will benefit from it, and nature's potential contribution to creating more equitable, green, livable cities with active inhabitants.

Analysis of Spatial and Temporal Changes and Expansion Patterns in Mainland Chinese Urban Land between 1995 and 2015

China has experienced greater and faster urbanization than any other country, and while coordinated regional development has been promoted, urbanization has also introduced various problems, such as an increased scarcity of land resources, uncontrolled demand for urban land, and disorderly development of urban fringes. Based on GIS, remote sensing data, and spatial statistics covering the period 1995–2015, this study identified the patterns, as well as spatial and temporal changes, with respect to urban land expansion in 367 mainland Chinese cities. Over this study period, the area of urban land in mainland China increased from 3.05 to 5.07 million km2, at an average annual growth rate of 2.56%. This urban land expansion typically occurred the fastest in medium-sized cities, followed by large cities, and then small cities, with megacities and megalopolises exhibiting the slowest expansion rates. Nearly 70% of the new urban land came from arable land, 11% from other built land, such as pre-existing rural settlements, and 15% from forests and grasslands. When considering marginal-, enclave-, and infill-type expansion patterns, growth in >80% of the 367 cities surveyed was dominated by marginal expansion patterns. Marginal and enclave expansion patterns were found to be becoming more prevalent, with infill-type expansion being seen less. The results of this study provide a theoretical basis and data support for urban spatial planning, the protection of farmland, and the promotion of urban land use efficiency, and can be used as guidance for regional urbanization planning.

The role of social vs. physical environmental nuisances in affecting stress among Jewish and Muslim women in Israel

We calculate the effects of selected social and physical environmental nuisances on the autonomic nervous system balance among Jewish and Muslim mothers. Seventy-two Jewish and Muslim young healthy mothers from an Arab and Jewish neighboring city were tested in seven urban environments. Three social mediators (social discomfort, participation in household's decision-making and freedom of movement) and three physical mediators (thermal load, carbon monoxide and noise) were considered. Mean differences between Jewish and Muslim heart rate variability (HRV) and the effects of the mediating variables were calculated by ANOVA and stepwise multiple regressions. The results suggest that HRV was predominantly affected by social discomfort. Jewish and Muslim mothers experienced similar levels of social discomfort albeit; their responses differed by type of environment. Jewish mothers experienced stronger social discomfort in outdoor environments while Muslim mothers felt stronger social discomfort at home. Crossing ethnic boundaries was associated with increase in stress in both groups. Social discomfort played a stronger role in predicting stress in inter-ethnic environments. In conclusion, the study shows that social discomfort is a predominant environmental factor in predicting stress and related risk to health as reflected in the ANS balance across ethnicities. In addition ethnic specific factors like women freedom of movement played a minor role in effecting stress. At the same time the physical environmental aspects played essential role in effecting stress.

Proximity to freshwater blue space and type 2 diabetes onset: the importance of historical and economic context

Salutogenic effects of living near aquatic areas (blue space) remain underexplored, particularly in non-coastal and non-urban areas. We evaluated associations of residential proximity to inland freshwater blue space with new onset type 2 diabetes (T2D) in central and northeast Pennsylvania, USA, using medical records to conduct a nested case-control study. T2D cases (n=15,888) were identified from diabetes diagnoses, medication orders, and laboratory test results and frequency-matched on age, sex, and encounter year to diabetes-free controls (n=79,435). We calculated distance from individual residences to the nearest lake, river, tributary, or large stream, and residence within the 100-year floodplain. Logistic regression models adjusted for community socioeconomic deprivation and other confounding variables and stratified by community type (townships [rural/suburban], boroughs [small towns], city census tracts). Compared to individuals living ≥1.25 miles from blue space, those within 0.25 miles had 8% and 17% higher odds of T2D onset in townships and boroughs, respectively. Among city residents, T2D odds were 38-39% higher for those living 0.25 to <0.75 miles from blue space. Residing within the floodplain was associated with 16% and 14% higher T2D odds in townships and boroughs. A post-hoc analysis demonstrated patterns of lower residential property values with nearer distance to the region's predominant waterbody, suggesting unmeasured confounding by socioeconomic disadvantage. This may explain our unexpected findings of higher T2D odds with closer proximity to blue space. Our findings highlight the importance of historic and economic context and interrelated factors such as flood risk and lack of waterfront development in blue space research.

Walkability and Greenness Do Not Walk Together: Investigating Associations between Greenness and Walkability in a Large Metropolitan City Context

BACKGROUND

The existing environment literature separately emphasizes the importance of neighborhood walkability and greenness in enhancing health and wellbeing. Thus, a desirable neighborhood should ideally be green and walkable at the same time. Yet, limited research exists on the prevalence of such "sweet spot" neighborhoods. We sought to investigate this question in the context of a large metropolitan city (i.e., Sydney) in Australia.

METHODS

Using suburb level normalized difference vegetative index (NDVI), percentage urban greenspace, Walk Score^® (Walk Score, Seattle, WA, USA), and other data, we explored the global and local relationships of neighborhood-level greenness, urban green space (percent park area) with walkability applying both non-spatial and spatial modeling.

RESULTS

We found an overall negative relationship between walkability and greenness (measured as NDVI). Most neighborhoods (represented by suburbs) in Sydney are either walkable or green, but not both. Sweet spot neighborhoods that did exist were green but only somewhat walkable. In addition, many neighborhoods were both less green and somewhat walkable. Moreover, we observed a significant positive relationship between percentage park area and walkability. These results indicate walkability and greenness have inverse and, at best, mixed associations in the Sydney metropolitan area.

CONCLUSIONS

Our analysis indicates an overall negative relationship between greenness and walkability, with significant local variability. With ongoing efforts towards greening Sydney and improving walkability, more neighborhoods may eventually be transformed into becoming greener and more walkable.

City-Scale Mapping of Urban Façade Color Using Street-View Imagery

Precise urban façade color is the foundation of urban color planning. Nevertheless, existing research on urban colors usually relies on manual sampling due to technical limitations, which brings challenges for evaluating urban façade color with the co-existence of city-scale and fine-grained resolution. In this study, we propose a deep learning-based approach for mapping the urban façade color using street-view imagery. The dominant color of the urban façade (DCUF) is adopted as an indicator to describe the urban façade color. A case study in Shenzhen was conducted to measure the urban façade color using Baidu Street View (BSV) panoramas, with city-scale mapping of the urban façade color in both irregular geographical units and regular grids. Shenzhen’s urban façade color has a gray tone with low chroma. The results demonstrate that the proposed method has a high level of accuracy for the extraction of the urban façade color. In short, this study contributes to the development of urban color planning by efficiently analyzing the urban façade color with higher levels of validity across city-scale areas. Insights into the mapping of the urban façade color from the humanistic perspective could facilitate higher quality urban space planning and design.

Housing Spaces in Nine European Countries: A Comparison of Dimensional Requirements

Modern housing units must meet new needs and requirements; housing dimensions and functional characteristics are relevant issues, mainly considering population ageing and disability. The housing standards of nine European countries were compared to analyze their ability to satisfy new population need, in terms of size. The regulations were downloaded from the websites of the official channels of each country. A wide variability in room size was observed (e.g., single room: from 9 m2 in Italy to 7 m2 in France, to the absence of any limit in England and Wales, Germany-Hesse, and Denmark). Italian and French legislations define housing dimension considering the room destination and the number of people. The Swedish regulation provides performance requirements and functional indications but does not specify the minimum dimensions of habitable rooms. The rooms' minimum heights vary between 2.70 m in Italy and Portugal and 2.60 m in the Netherlands, but no limits are established in England and Wales. A diverse approach among European countries regulations is observed: from a market-oriented logic one (e.g., England and Wales) in which room minimum dimensions are not defined to a prescriptive one (Italy) and one that is functionality-oriented (the Netherlands). However, considering the health, social, environmental, and economic trends, many of these standards should be revised.

Measuring Nature Contact: A Narrative Review

While many studies suggest evidence for the health benefits of nature, there is currently no standardized method to measure time spent in nature or nature contact, nor agreement on how best to define nature contact in research. The purpose of this review is to summarize how nature contact has been measured in recent health research and provide insight into current metrics of exposure to nature at individual and population scales. The most common methods include surrounding greenness, questionnaires, and global positioning systems (GPS) tracking. Several national-level surveys exist, though these are limited by their cross-sectional design, often measuring only a single component of time spent in nature, and poor links to measures of health. In future research, exposure assessment combining the quantifying (e.g., time spent in nature and frequency of visits to nature) and qualifying (e.g., greenness by the normalized difference of vegetation index (NDVI) and ratings on perception by individuals) aspects of current methods and leveraging innovative methods (e.g., experience sampling methods, ecological momentary assessment) will provide a more comprehensive understanding of the health effects of nature exposure and inform health policy and urban planning.

Exploring Challenges and Opportunities of Biophilic Urban Design: Evidence from Research and Experimentation

Global health emergencies such as Covid-19 have highlighted the importance of access to nature and open spaces in our cities for social, physical, and mental health. However, there continues to be a disconnect between our need for nature and our daily lived experience. Recent research indicates that our connectedness and relationship with nature, and in particular biophilic design, may be key for improving both health and quality of life. Rather than relying on abstract universal ideas of “nature”, using evidence-based biophilic design and policy at a building, neighborhood, and city scale, to link our daily lives with biodiversity, may encourage sense of place and make environmental action more meaningful. Then, improving our natural capital in the urban built environment might help address the current climate and disease crisis, as well as improving our physical and mental health. Drawing from emerging research and innovative practice, the paper describes key research and design paradigms that influence the way we understand the benefits of nature for different environments, including the workplace, neighborhood, and city, and explains where biophilic design theory sits in this field. Examples from recent research carried out in London and Chicago are provided, aiming at demonstrating what kind of research can be functional to what context, followed by a detailed analysis of its application supporting both human and ecological health. The study concludes indicating key policy and design lessons learned around regenerative design and biophilia as well as new directions for action, particularly with regard to climate change, sense of place, and well-being.

Greenspace Interventions, Stress and Cortisol: A Scoping Review

Background: Engaging with nature can profoundly impact psychological and physiological health of persons across the lifespan. Greenspace interventions (GSI) encompass a broad range of strategic, nature-based activities for overall health and wellbeing. Within the past 20 years there has been a growing interest in the access to and management of greenspace to mediate the deleterious impact of acute and chronic stress, particularly, physiologic biomarkers of stress such as cortisol. Objective: This review aims to describe the impact of greenspace interventions on cortisol, to present the current state of the science on GSIs as they impact cortisol, and to uncover any limitations of current research strategies to best inform future research. Methods: A scoping methodology was conducted to systematically study this emerging field and inform future research by mapping the literature based on the GSI category, interventional design, cortisol metrics, and subsequent analysis of cortisol. Conclusion: Considerable heterogeneity in research design, aim(s), interventional strategy, and cortisol metrics were identified from a total of 18 studies on GSIs and cortisol outcomes. While studies demonstrated a potential for the positive association between GSIs and stress relief, more rigorous research is needed to represent GSIs as an intervention to mitigate risks of stress.

Evaluating the literature of therapeutic landscapes with an emphasis on the search for the dimensions of health: A systematic review

Health geography emphasizes landscape capacity as a perspective for examining health dimensions. Much of this emphasis is on the concept of therapeutic landscapes. In the last two decades, changes in the therapeutic landscapes concerning health, as well as why and how the development of the emphasis on the dimensions of the health in the landscape in proportion to the temporal-spatial course of literature in this field can be considered. The framework of the present study is based on a systematic review of therapeutic landscapes in the geography of health in the last two decades. This systematic literature review followed the PRISMA guidelines. Searching for "Therapeutic Landscapes" term at Science Direct and PubMed, screening, 56 eligible articles were selected in the journal Social Science and Medicine, and Health and Place. The results of the systematic review, aiming to search for the health dimensions of the therapeutic landscape, and recognize main gaps, identified three main issues: scale and range of users of therapeutic landscapes, the position importance of experiences in therapeutic landscapes, therapeutic landscapes as the holistic paradigm. The results of the research show that in recent years, attention to multiple dimensions of health, especially non-physical relationships of therapeutic landscapes and multiple dimensions of health, has been considered more and more by researchers. Personal-social perceptions and experiences are also continually evolving, so the concept of therapeutic landscapes and its relationship to health is considered living and dynamic.

Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities

Disadvantaged groups worldwide, such as low-income and racially/ethnically minoritized people, experience worse health outcomes than more privileged groups, including wealthier and white people. Such health disparities are a major public health issue in several countries around the world. In this systematic review, we examine whether green space shows stronger associations with physical health for disadvantaged groups than for privileged groups. We hypothesize that disadvantaged groups have stronger protective effects from green space because of their greater dependency on proximate green space, as they tend to lack access to other health-promoting resources. We use the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method and search five databases (CINAHL, Cochrane, PubMed, Scopus, and Web of Science) to look for articles that examine whether socioeconomic status (SES) or race/ethnicity modify the green space-health associations. Based on this search, we identify 90 articles meeting our inclusion criteria. We find lower-SES people show more beneficial effects than affluent people, particularly when concerning public green spaces/parks rather than green land covers/greenness. Studies in Europe show stronger protective effects for lower-SES people versus higher-SES people than do studies in North America. We find no notable differences in the protective effects of green space between racial/ethnic groups. Collectively, these results suggest green space might be a tool to advance health equity and provide ways forward for urban planners, parks managers, and public health professionals to address health disparities.

Does socioeconomic development lead to more equal distribution of green space? Evidence from Chinese cities

Despite the wide implementation of green spaces to mitigate the negative effects of urbanization, there is little evidence of how cities' socioeconomic development impacts the equality of urban green space (UGS) distribution. This paper addresses this knowledge gap. Employing longitudinal data analysis and the Gini index with various socioeconomic factors, we investigated potential driving factors for UGS equality at the prefectural city level (221 out of 341 cities in total) in China during the rapid urbanization from 2000 to 2015. Results indicated that 72% of Chinese cities (160 of 221) in our sample improved their UGS equality level from 2000 to 2015, whereas 14% of cities studied (31 out of 221) declined in both quantity and equality of green space. Nationwide, economic development levels reflected by gross domestic product per capita exerted a positive and significant impact on the equality of green space distributions. Urban afforestation-related policies in China were successful in promoting the equal distribution of green space. Regional analysis indicated divergent impacts of socioeconomic development and government policies on green space equality. Other institutional development factors, such as adopting a freer land market, might harm efforts toward equal green space distribution without appropriate safeguarding regulations and enforcement powers to ensure the implementation of an equal distribution of green spaces. These findings inform decision-makers about spatial variances in the equality of green space distribution in urban areas, which demand location-oriented interventions to promote inclusive urban afforestation in Chinese cities.

Modelling and mapping eye-level greenness visibility exposure using multi-source data at high spatial resolutions

The visibility of natural greenness is associated with several health benefits along multiple pathways, including stress recovery and attention restoration mechanisms. However, existing methodologies are inadequate for capturing eye-level greenness visibility exposure at high spatial resolutions for observers located on the ground. As a response, we developed an innovative methodological approach to model and map eye-level greenness visibility exposure for 5 m interval locations within a large study area. We used multi-source spatial data and applied viewshed analysis in conjunction with a distance decay model to compute a novel Viewshed Greenness Visibility Index (VGVI) at more than 86 million observer locations. We compared our eye-level visibility exposure map with traditional top-down greenness exposure metrics such as Normalised Differential Vegetation Index (NDVI) and a Street view based Green View Index (SGVI). Furthermore, we compared greenness visibility at street-only locations with total neighbourhood greenness visibility. We found strong to moderate correlations (r = 0.65-0.42, p < 0.05) between greenness visibility and mean NDVI, with a decreasing trend in correlation strength at increasing buffer distances from observer locations. Our findings suggest that top-down and eye-level measurements of greenness are two distinct metrics for assessing greenness exposure. Additionally, VGVI showed a strong correlation (r = 0.481, p < 0.01) with SGVI. Although the new VGVI has good agreement with existing street view based measures, we found that street-only greenness visibility values are not wholly representative of total neighbourhood visibility due to the under-representation of visible greenness in locations such as backyards and community parks. Our new methodology overcomes such underestimations, is easily transferable, and offers a computationally efficient approach to assessing eye-level greenness exposure.

Neighbourhood and path-based greenspace in three European countries: associations with objective physical activity

Background

Greenspace has been associated with health benefits in many contexts. An important pathway may be through outdoor physical activity. We use a novel approach to examine the link between greenspace microenvironments and outdoor physical activity levels in the HEALS study conducted in Edinburgh (UK), the Netherlands, and Athens and Thessaloniki (Greece).

Methods

Using physical activity tracker recordings, 118 HEALS participants with young children were classified with regard to daily minutes of moderate to vigorous physical activity (MVPA); 60 were classified with regard to the metabolic equivalent task (MET)-minutes for each of the 1014 active trips they made. Greenspace indicators were generated for Normalised Difference Vegetation Index (NDVI), tree cover density (TCD), and green land use (GLU). We employed linear mixed-effects models to analyse (1) daily MVPA in relation to greenspace within 300 m and 1000 m of residential addresses and (2) trip MET-minutes in relation to average greenspace within a 50 m buffer of walking/cycling routes. Models were adjusted for activity, walkability, bluespace, age, sex, car ownership, dog ownership, season, weekday/weekend day, and local meteorology.

Results

There was no clear association between MVPA-minutes and any residential greenspace measure. For example, in fully adjusted models, a 10 percentage point increase in NDVI within 300 m of home was associated with a daily increase of 1.14 (95% CI − 0.41 to 2.70) minutes of MVPA. However, we did find evidence to indicate greenspace markers were positively linked to intensity and duration of activity: in fully adjusted models, 10 percentage point increases in trip NDVI, TCD, and GLU were associated with increases of 10.4 (95% CI: 4.43 to 16.4), 10.6 (95% CI: 4.96 to 16.3), and 3.36 (95% CI: 0.00 to 6.72) MET-minutes, respectively. The magnitude of associations with greenspace tended to be greater for cycling.

Conclusions

More strenuous or longer walking and cycling trips occurred in environments with more greenspace, but levels of residential greenspace did not have a clear link with outdoor MVPA. To build on our research, we suggest future work examine larger, more diverse populations and investigate the influence of greenspace for trip purpose and route preference.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10259-0.

Residential Green and Blue Spaces and Type 2 Diabetes Mellitus: A Population-Based Health Study in China

Evidence on the health benefits of green space in residential environments is still limited, and few studies have investigated the potential association between blue space and type 2 diabetes mellitus (T2DM) prevalence. This study included 39,019 participants who had completed the baseline survey from the Henan Rural Cohort Study, 2015-2017. The Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) were employed to characterize the residential green space, and the distance from the participant's residential address to the nearest water body was considered to represent the residential blue space. Mixed effect models were applied to evaluate the associations of the residential environment with T2DM and fasting blood glucose (FBG) levels. An interquartile range (IQR) increase in NDVI and EVI was significantly associated with a 13.4% (odds ratio (OR): 0.866, 95% Confidence interval (CI): 0.830,0.903) and 14.2% (OR: 0.858, 95% CI: 0.817,0.901) decreased risk of T2DM, respectively. The residential green space was associated with lower fasting blood glucose levels in men (%change, -2.060 in men vs. -0.972 in women) and the elderly (%change, -1.696 in elderly vs. -1.268 in young people). Additionally, people who lived more than 5 km from the water body had a 15.7% lower risk of T2DM (OR: 0.843, 95% CI: 0.770,0.923) and 1.829% lower fasting blood glucose levels (95% CI: -2.335%,-1.320%) than those who lived closer to the blue space. Our findings suggest that residential green space was beneficially associated with T2DM and fasting blood glucose levels. However, further research is needed to explore more comprehensively the relationship between residential blue space and public health.

Green and Blue Space Availability and Self-Rated Health among Seniors in China: Evidence from a National Survey

Many empirical studies have shown evidence of multiple health benefits provided by green and blue spaces. Despite the importance of these spaces, investigations are scarce in details for blue spaces rather than green. Moreover, most research has focused on developed regions. A limited number of studies on blue spaces can be found in China with a focus on the city level. Outcomes have been mixed due to varying research scales, methodologies, and definitions. This study relies on a national-level social survey to explore how the self-rated health (SRH) of senior individuals is associated with local green and blue space availability in urban and rural areas. Results indicate that the coverage ratio of overall green spaces and waterbodies around a resident’s home have marginal effects on SRH status in both urban and rural areas. In urban areas, living close to a park can is marginally beneficial for older people’s health. Regarding different types of blue spaces, the presence of a major river (within 0.3–0.5 km) or coastline (within 1 km and 1–5 km) in the vicinity of home negatively affects SRH among the elderly in urban areas. Close proximity to lakes and other types of waterbodies with a water surface larger than 6.25 ha did not significantly influence SRH. These findings not only evaluate general health impacts of green/blue space development on senior populations across the county but inform decision makers concerning the health-promoting qualities and features of different green/blue spaces to better accommodate an aging population in the era of urbanization.

Neighbourhood natural space and the narrowing of socioeconomic inequality in children's social, emotional, and behavioural wellbeing

INTRODUCTION

The natural environment may benefit children's social, emotional and behavioural wellbeing, whilst offering a lever to narrow socioeconomic health inequalities. We investigated whether immediate neighbourhood natural space and private gardens were related to children's wellbeing outcomes and whether these relationships were moderated by household income.

METHODS

A nationally representative sample of 774 children (55% female, 10/11 years old) from the Studying Physical Activity in Children's Environments across Scotland study. Social, emotional and behavioural difficulty scores (Strengths and Difficulties Questionnaire) represented wellbeing outcomes. Percentage of total natural space and private gardens within 100m of the child's residence was quantified using Ordnance Survey's MasterMap Topography Layer®. Linear regression, including interaction terms, explored the two main research questions.

RESULTS

A 10% increase in residential natural space was associated with a 0.08 reduction (-0.15, -0.01; 95%CI) in Emotional Problem scores and a 0.09 improvement (0.02, 0.16; 95%CI) in Prosocial Behaviour scores. Household income moderated the associations between % natural space and private gardens on Prosocial Behaviour scores: for natural space, there was a positive relationship for those in the lowest income quintile (0.25 (0.09, 0.41; 95%CI)) and a null relationship for those in the highest quintile (-0.07 (-0.16, 0.02; 95%CI)). For private garden space, there was a positive relationship for those in the highest quintile (0.15 (0.05, 0.26; 95%CI)) and negative relationship with those in the lowest quintile (-0.30 (-0.50, -0.07, 95%CI)).

CONCLUSION

The natural environment could be a lever to benefit those from less advantaged backgrounds, particularly the development of prosocial behaviours.

Green, Brown, and Gray: Associations between Different Measurements of Land Patterns and Depression among Nursing Students in El Paso, Texas

Background: While greenness has been associated with lower depression, the generalizability of this association in arid landscapes remains undetermined. We assessed the association between depression and residential greenness, but also brownness and grayness among nursing students living in El Paso, Texas (the Chihuahuan desert). Methods: Depression was measured with the Patient Health Questionnaire-9 scale and greenness with the normalized difference vegetation index across three buffer sizes (i.e., 250, 500, and 1000 m). Using data from the National Land Cover Database, two additional measures of land patterns were analyzed: grayness and brownness. Structural equation models were used to assess the relationships of these land patterns to depression and quantify the indirect effects of peer alienation. Results: After adjusting for individual characteristics, at buffers 250 m, greenness was not associated with a decrease in the Incidence Rate Ratios (IRR) of depression (IRR, 0.51; 95% CI, 0.12–2.10); however, grayness and brownness were respectively associated with increases by 64% (IRR, 1.64; 95% CI, 1.07–2.52) and decreases by 35% (IRR, 0.65; 95% CI, 0.42–0.99). At buffer 250 m, peer alienation explained 17.43% (95% CI, −1.79–36.66) of the association between depression and brownness, suggesting a pathway to depression. Conclusions: We did not observe an association between depression and residential greenness in El Paso, Texas. However, we did observe a protective association between brownness and depression and an adverse association with grayness. These results have theoretical implications as they were based on commonly used frameworks in this literature, and adverse association of brownness (and the lack of greenness) and depression was expected.

The Association between Green Space and Adolescents' Mental Well-Being: A Systematic Review

This systematic review summarised and evaluated the evidence for associations between green space and adolescents’ mental well-being. The PRISMA statement guidelines were followed for reporting systematic reviews. Fourteen articles met the inclusion criteria for this review. Synthesis suggests beneficial associations between green space exposure and reduced stress, positive mood, less depressive symptoms, better emotional well-being, improved mental health and behaviour, and decreased psychological distress in adolescents. Several studies found the relationship varied by demographic and socio-economic factors. The limited number of studies and the risk of bias were the main limitations, together with heterogeneity regarding green space and mental well-being assessments. Overall, this review highlights the potential contribution of green space in schoolyards. Improving the availability, accessibility and quality of green space is likely to generate positive impacts on adolescents’ mental well-being. More consistent evidence on the use of different types of green space and perceptions of features are needed in the future.

Tree Canopy Cover Is Best Associated with Perceptions of Greenspace: A Short Communication

A growing literature has supported a relationship between greenspace and health. Various greenspace metrics exist; some are based on subjective measures while others are based on an objective assessment of the landscape. While subjective measures may better reflect individual feelings about surrounding greenspace and the resulting positive benefits thereof, they are expensive and difficult to collect. In contrast, objective measures can be derived with relative ease, in a timely fashion, and for large regions and populations. While there have been some attempts to compare objective and subjective measures of greenspace, what is lacking is a comprehensive assessment of a wide range of greenspace metrics against subjective measures of greenspace. We performed such an assessment using a set of three objective greenspace metrics and a survey of residents in Liverpool, New South Wales, Australia. Our study supported existing findings in that overall, there is very little agreement between perceived and objective greenspace metrics. We also found that tree canopy in 10 min walking buffers around residences was the objective greenspace measure in best agreement with perceived greenspace.

Early life exposure to green space and insulin resistance: An assessment from infancy to early adolescence

BACKGROUND

Recent studies suggest that greater exposure to natural vegetation, or "green space" is associated with lower diabetes risk, possibly through increasing physical activity. However, there is limited research on green space and insulin resistance in youth. We hypothesized greater green space at early-life sensitive time periods would be associated with lower insulin resistance in youth.

METHODS

We used data from Project Viva (N = 460), a pre-birth cohort study that recruited pregnant women in eastern Massachusetts, 1999-2002, and followed offspring into adolescence. We defined residential green space exposure at infancy (median age - 1.1 years), early childhood (3.2 years), mid-childhood (7.7 years), and early adolescence (12.8 years), using 30 m resolution Landsat satellite imagery to estimate the Normalized Difference Vegetation Index [NDVI]. Our main outcome was early adolescence estimated insulin resistance (HOMA-IR). We used multiple imputation to account for missing data and multiple linear regression models adjusted for age, sex, race/ethnicity, parental education, household income, and neighborhood median household income.

RESULTS

The highest green space tertile had the highest percentage of white participants (85%), college-educated mothers (87%) and fathers (85%), and households with income higher than US$70,000 (86%). Unadjusted models showed that participants living in the highest green space tertile at infancy had a 0.15 unit lower HOMA-IR (95% CI: -0.23, -0.06) in early adolescence, than those living in the lowest tertile. However, in adjusted models, we did not observe evidence of associations between green space from infancy to early adolescence and HOMA-IR in early adolescence, although some point estimates were in the hypothesized direction. For example, participants in the highest green space tertile in infancy had 0.03 units lower HOMA-IR (95%CI: -0.14, 0.08) than those living in the lowest tertile.

CONCLUSIONS

Exposure to green space at early life sensitive time periods was not associated with HOMA-IR in youth. Early-life longitudinal studies across diverse populations are needed to confirm or refute our results.

Environmental Justice in The Netherlands: Presence and Quality of Greenspace Differ by Socioeconomic Status of Neighbourhoods

Making our cities more sustainable includes the need to make the transition a just one. This paper focuses on distributive justice with regard to greenspace in cities. Urbanisation and densification will likely result in less greenspace in urban residential areas, especially in deprived neighbourhoods. This is a threat to the aim of healthy and liveable cities, as greenspace has positive effects on human health and well-being. In this study, we show that in The Netherlands, neighbourhoods with a low socioeconomic status already tend to have a lower presence and quality of greenspace than those with a high socioeconomic status. This outcome is independent of the greenness metric that was used. However, depending on the precise greenness metric, socioeconomic differences in greenness between neighbourhoods are smaller in highly urban municipalities than in less urban municipalities, rather than larger. The paper discusses the implications of these outcomes for policy and planning regarding urban greenspace.

COVID-19 and Living space challenge. Well-being and Public Health recommendations for a healthy, safe, and sustainable housing

BACKGROUND AND AIM OF THE WORK

The ongoing pandemic of COVID-19 is a strong reminder that the lockdown period has changed the way that people and communities live, work, and interact, and it's necessary to make resilient the built environment, both outdoor and mainly the indoor spaces: housing, workplaces, public buildings, and entertainment facilities. How can we re-design the concept of Well-being and Public Health in relation to the living places of the future?

METHODS

According to the previous statements and scenario, this paper aims to integrate the building hygiene and well-being, focusing the possible responses, both existing and for the new buildings, taking home a strong message from this "period" of physical distancing.

RESULTS

The Well-being and Public Health recommendations for a healthy, safe, and sustainable housing are framed into the following key points: 1. Visible and accessible green elements and spaces; 2. Flexibility, adaptability, sharing, and crowding of living spaces, and compliant functions located into the buildings; 3. Re-appropriation of the basic principles and archetypes of sustainable architecture, thermal comfort and Indoor Air Quality (IAQ); 4. Water consumption and Wastewater Management; 5. Urban Solid Waste Management; 6. Housing automation and electromagnetic fields; 7. Indoor building and finishing materials.

CONCLUSIONS

The Well-being and Public Health recommendations for a healthy, safe and sustainable housing may provide a useful basis for Designers, Policy Makers (fostering tax incentives for building renewal), Public Health experts and Local Health Agencies, in promoting actions and policies aimed to transform living places in healthier and Salutogenic spaces.

The Impact of Regeneration and Climate Adaptations of Urban Green-Blue Assets on All-Cause Mortality: A 17-Year Longitudinal Study

Urban waterways are underutilised assets, which can provide benefits ranging from climate-change mitigation and adaptation (e.g., reducing flood risks) to promoting health and well-being in urban settings. Indeed, urban waterways provide green and blue spaces, which have increasingly been associated with health benefits. The present observational study used a unique 17-year longitudinal natural experiment of canal regeneration from complete closure and dereliction in North Glasgow in Scotland, U.K. to explore the impact of green and blue canal assets on all-cause mortality as a widely used indicator of general health and health inequalities. Official data on deaths and socioeconomic deprivation for small areas (data zones) for the period 2001–2017 were analysed. Distances between data zone population-weighted centroids to the canal were calculated to create three 500 m distance buffers. Spatiotemporal associations between proximity to the canal and mortality were estimated using linear mixed models, unadjusted and adjusted for small-area measures of deprivation. The results showed an overall decrease in mortality over time (β = −0.032, 95% confidence interval (CI) [−0.046, −0.017]) with a closing of the gap in mortality between less and more affluent areas. The annual rate of decrease in mortality rates was largest in the 0–500 m buffer zone closest to the canal (−3.12%, 95% CI [−4.50, −1.73]), with smaller decreases found in buffer zones further removed from the canal (500–1000 m: −3.01%, 95% CI [−6.52, 0.62]), and 1000–1500 m: −1.23%, 95% CI [−5.01, 2.71]). A similar pattern of results was found following adjustment for deprivation. The findings support the notion that regeneration of disused blue and green assets and climate adaptions can have a positive impact on health and health inequalities. Future studies are now needed using larger samples of individual-level data, including environmental, socioeconomic, and health variables to ascertain which specific elements of regeneration are the most effective in promoting health and health equity.

E. M. Browning M, Rigolon A. Noncommunicable Diseases, Park Prescriptions, and Urban Green Space Use Patterns in a Global South Context: The Case of Dhaka, Bangladesh

Urban green space use is often associated with improved physical and mental health and lower noncommunicable disease (NCDs) burdens. Factors that influence green space visits have been documented in cities of the Global North, but evidence of urban green space use patterns for cities in the Global South is scarce. The aim of this study is to investigate factors influencing urban green space use patterns in Dhaka, Bangladesh, a megacity of the Global South, with a particular focus on how poor health condition and healthcare professionals' prescriptions to exercise outdoors (park prescriptions-ParkRx) impact the green space use of middle-aged adults. We collected green space characteristics and use factors (i.e., availability, accessibility, attractiveness, and attachment), health condition, ParkRx, and urban green space use intensity (i.e., frequency and duration) via a self-reported questionnaire from 169 middle-aged residents of Dhaka. We used multivariate modeling to estimate the association of green space characteristics, health condition, and ParkRx with use intensity. We further applied a mediation analysis to determine the influence of ParkRx on the relationship between residents' poor health conditions and use intensity. We found that green space availability and accessibility did not significantly influence use intensity, but attractiveness was negatively associated with use intensity. Green space use intensity was significantly and positively associated with attachment to the green space, poor health condition (i.e., having noncommunicable diseases), and ParkRx. ParkRx significantly mediated the relationship between health condition and use intensity. We observed limited supply, poor access, and low attractiveness when studying the urban green spaces in Dhaka, but these qualities did not affect use intensity, as found in many case studies in the Global North. In contrast, urban green space use intensity in our case study is mostly dependent on poor health condition and park prescriptions.

Influence of residential greenness on adverse pregnancy outcomes: A systematic review and dose-response meta-analysis

BACKGROUND

With the development of urbanization, there is a decreasing tendency for people contact with natural greenness. Whether maternal exposure to greenness has an impact on pregnancy complications and pregnancy outcomes remains to be confirmed.

OBJECTIVES

To estimate the association and dose-response relationship between residential greenness and pregnancy outcomes.

DATA SOURCES

PubMed, Embase, Ovid, Scopus and Web of Science from inception to 1st December 2019 were searched.

SYNTHESIS METHODS

The summary regression coefficient (β) and odds ratio (OR) with corresponding 95% confidence interval (95%CI) were calculated. The linear dose-response relationship between greenness and adverse pregnancy outcomes was also investigated.

RESULTS

Overall, 36 studies with a total of 11,983,089 participants were included. Birth weight was significantly higher in highest level of greenness exposure group compared to lowest level group (e.g. β:20.22, 95%CI:13.50-26.93 at 100 m buffer). The odds of low birth weight (LBW) decreased in the highest level of group compared to lowest level group (e.g. OR:0.86, 95%CI:0.75-0.99 at 100 m buffer). The odds of small for gestational age (SGA) also decreased in the highest group (OR:0.93, 95%CI:0.88-1.00 at 100 m buffer). In addition, maternal exposure to greenness was associated with increased head circumference and decreased mental disorders. The dose-response models showed a 2% decrease risk of LBW per 0.1 normalized difference vegetation index (NDVI) increase within 300 m buffer (OR:0.98, 95%CI:0.97-0.99, P < 0.001) and a 1% decrease risk of SGA per 0.1 NDVI increase within 300 m buffer (OR:0.99, 95%CI:0.98-1.00, P = 0.037). No significant associations were found on preterm birth, gestational age, gestational diabetes mellitus, gestational hypertension or preeclampsia.

CONCLUSIONS

This review confirms an inverse association between residential greenness and adverse pregnancy outcomes. Findings of our study provide evidences for pregnant women to increase greenness exposure.

Sectoral Analysis of Landscape Interiors (SALI) as One of the Tools for Monitoring Changes in Green Infrastructure Systems

The aim of this article was to present Sectoral Analysis of Landscape Interiors (SALI). This method uses the idea of a landscape interior understood as a fragment of a landscape perceived from the level of a person standing at a given point. The analyses were conducted in two stages: stage I—the quantitative stage, and stage II—the qualitative stage. The first part of the research was the analysis of the percentage share of particular elements of landscape interiors in the images perpetuated in photographs, taking into account their level of transparency. The second part was the assessment of their quality based on expert knowledge. The use of the SALI method in the context of the analysis of greenery changes over time was illustrated on the example of the landscape interior of the main street in the village of Psary in Poland. The research was carried out at a time interval of 10 years—for the years 2009 and 2019. The results of the study indicate very large changes and loss of greenery (especially trees) and the associated deterioration of the landscape. The findings confirm the suitability of the method in landscape research at a human scale.