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Garrett JK, Clitherow TJ, White MP, Wheeler BW, Fleming LE. Coastal proximity and mental health among urban adults in England: The moderating effect of household income. Health Place 2019; 59:102200. [PMID: 31582294 DOI: 10.1016/j.healthplace.2019.102200] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 07/16/2019] [Accepted: 08/22/2019] [Indexed: 12/23/2022]
Abstract
After adjusting for covariates, self-reported general health in England is higher among populations living closer to the coast, and the association is strongest amongst more deprived groups. We explored whether similar findings were present for mental health using cross-sectional data for urban adults in the Health Survey for England (2008-2012, N ≥25,963). For urban adults, living ≤1 km from the coast, in comparison to >50 km, was associated with better mental health as measured by the GHQ12. Stratification by household income revealed this was only amongst the lowest-earning households, and extended to ≤5 km. Our findings support the contention that, for urban adults, coastal settings may help to reduce health inequalities in England.
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Affiliation(s)
- Joanne K Garrett
- European Centre for Environment and Human Health, European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital Treliske, Truro, Cornwall, TR1 3HD, UK.
| | - Theodore J Clitherow
- European Centre for Environment and Human Health, European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital Treliske, Truro, Cornwall, TR1 3HD, UK
| | - Mathew P White
- European Centre for Environment and Human Health, European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital Treliske, Truro, Cornwall, TR1 3HD, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital Treliske, Truro, Cornwall, TR1 3HD, UK
| | - Lora E Fleming
- European Centre for Environment and Human Health, European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital Treliske, Truro, Cornwall, TR1 3HD, UK
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Does the Mode of Exercise Influence the Benefits Obtained by Green Exercise? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16163004. [PMID: 31434352 PMCID: PMC6720300 DOI: 10.3390/ijerph16163004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/07/2019] [Accepted: 08/15/2019] [Indexed: 11/17/2022]
Abstract
Green exercise studies have tended to use walking as a modality of exercise to establish benefits to mental health. Whether green exercise benefits translate into different forms of green exercise has been deemed an important research gap. A mixed-methods study design was used to compare psychological responses between two forms of green exercise; golf and walking. A total of 20 participants (10 in each group), with a range of ages and experience were recruited to take part in the study. Participants in the walking condition exhibited significantly greater levels of dissociative cognitions than golf condition participants. Consequently, only the walking condition significantly improved in a directed attention test. Results from the Exercise-Induced Feeling Inventory questionnaire found the walking condition demonstrated increases in all four subscales, whereas the golf condition showed no significant improvements. Based on the findings from the qualitative analysis, distinct differences were seen with regards to the perception of the environment. Participants in the golf condition noted natural elements as obstacles to effective performance, whereas the walking group noted natural stimuli as evoking positive feelings. In agreement with the Attention Restoration Theory, the current study demonstrates that the benefits of green exercise are somewhat reduced when greater levels of directed attention towards the activity are exhibited during green exercise.
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What Motivates Participants to Adhere to Green Exercise? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101832. [PMID: 31126095 PMCID: PMC6571838 DOI: 10.3390/ijerph16101832] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/15/2019] [Accepted: 05/21/2019] [Indexed: 11/30/2022]
Abstract
There is a lack of research into green exercise which investigates and compares motivational drivers between the different types of outdoor activities. The current paper addressed this gap by classifying and comparing three types of green exercise: (i) Recreational physical activity, (ii) competitive sport, and (iii) outdoor adventure sport. Using a mixed methodological approach, the present study investigated the motivations for adhering to green exercise and directly compared the differences between these three forms of green exercise. Online questionnaires and face-to-face interviews were used to collect data. The results demonstrated that within all types of green exercise, enjoyment was the greatest motivator. Based on analysis of the qualitative materials, extrinsic motivators such as the environment, family, and friends were highlighted as key factors in beginning and continuing their activity. However, intrinsic motivators were also emphasised as more important in adherence to green exercise. Furthermore, as seen in other research, numerous psychological benefits were reported over time. The results of the study may act as a starting point in understanding how we may increase public engagement in green exercise by prompting participants to select a form of green exercise that best suits them based on their motivational profile.
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Ward Thompson C, Silveirinha de Oliveira E, Tilley S, Elizalde A, Botha W, Briggs A, Cummins S, Leyland AH, Roe JJ, Aspinall P, Brookfield K, Mitchell R. Health impacts of environmental and social interventions designed to increase deprived communities’ access to urban woodlands: a mixed-methods study. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundContact with natural environments can bring health benefits, but research is lacking on how changes in access to natural environments might improve health, especially for deprived populations.ObjectiveTo evaluate the health impacts of woodland environment interventions intended to increase communities’ engagement with these woodlands.DesignA prospective study of Forestry Commission Scotland’s Woods In and Around Towns (WIAT) programme in deprived communities to enhance public access to natural environments. The study investigated the impact that WIAT had on community-level mental health over time.SettingThree intervention and three control woodland sites, and associated communities within 1.5 km of the woodlands, located in central Scotland and eligible for WIAT support.ParticipantsA core community survey was administered at each site in three waves, at baseline and after each phase of intervention (n = 5460, panel A). The completed survey contained a nested longitudinal cohort (n = 609, panel B). Community members also undertook 6-monthly environmental audits at all sites (n = 256) and participated in post-intervention focus groups (n = 34).InterventionsPhase 1 involved physical changes to the woodlands, including footpaths, entrances and vegetation. Phase 2 involved community engagement events promoting woodland use.Main outcome measuresThe primary outcome was the Perceived Stress Scale (PSS). Other health measures included health-related quality of life (HRQoL) EuroQol-5 Dimensions (EQ-5D), physical activity (PA) [International Physical Activity Questionnaire (IPAQ)], connectedness to nature [Inclusion of Nature in Self (INS) scale] and social cohesion.ResultsThe PSS scores significantly increased in the intervention group and marginally decreased in the control group. Multilevel regression models showed a differential impact between the intervention and the control at survey wave 3 in panel A [B(unstandardised coefficient) 3.58, 95% confidence interval (CI) 2.85 to 4.31;p < 0.001] and in panel B [B3.03, 95% CI 1.54 to 4.52;p < 0.001]. Using the same analytical approach, no significant change in HRQoL was associated with the intervention. Economic assessment included an illustrative cost–utility analysis and a cost–consequences analysis. The differential in stress between the intervention group and the control group was lower or non-significant in those who visited ‘nature’ in the previous year [panel A,B1.9, 95% CI 0.8 to 3.0;p < 0.001; panel B,B0.64, 95% CI –1.60 to 2.88;p = 0.57]. The IPAQ score showed a positive association with the intervention for moderate levels of PA [panel B,B559.3, 95% CI 211.3 to 907.2;p = 0.002] and overall PA [panel B,B861.5, 95% CI 106.5 to 1616.4;p = 0.025]. The intervention was also associated with increased nature connectedness and social cohesion by wave 3 – significant for panel A only. Qualitative and quantitative evidence showed that interventions increased the perceived quality of the woodland environment and enhanced its enjoyment for different activities, but the increase in use of natural environments post intervention was only 6% (panel B).LimitationsThis study was limited to three intervention sites. External factors may be the primary influence on health outcomes.ConclusionsThe WIAT interventions did not improve community-level health within 6 months of completion, and hence there was no basis for demonstrating cost-effectiveness. However, the WIAT interventions are low cost (average £11.80 per person in the eligible population) and have potential for cost-effectiveness, if health benefits were found in the longer term.Future workUsing routinely collected data to consider a whole-programme evaluation is recommended.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
| | | | - Sara Tilley
- OPENspace Research Centre, Edinburgh College of Art, University of Edinburgh, Edinburgh, UK
| | - Aldo Elizalde
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- Adam Smith Business School, University of Glasgow, Glasgow, UK
| | - Willings Botha
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health, School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
| | - Andrew Briggs
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Steven Cummins
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Alastair H Leyland
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jenny J Roe
- School of Energy, Geoscience, Infrastructure and Society, Heriot-Watt University, Edinburgh, UK
- Stockholm Environment Institute, University of York, York, UK
- Center for Design and Health, University of Virginia, Charlottesville, VA, USA
| | - Peter Aspinall
- School of Energy, Geoscience, Infrastructure and Society, Heriot-Watt University, Edinburgh, UK
| | - Katherine Brookfield
- OPENspace Research Centre, Edinburgh College of Art, University of Edinburgh, Edinburgh, UK
| | - Richard Mitchell
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Ihlebæk C, Aamodt G, Aradi R, Claussen B, Thorén KH. Association between urban green space and self-reported lifestyle-related disorders in Oslo, Norway. Scand J Public Health 2017; 46:589-596. [PMID: 28976295 DOI: 10.1177/1403494817730998] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
AIMS The need for studies from more countries on the relationship between urban green space and health has been emphasized. The aim of this study was to investigate the association between two types of measurement of urban green space and self-reported lifestyle-related disorders in Oslo, Norway. METHODS Self-reported measures on mental disorders, asthma, type 2 diabetes and musculoskeletal pain of 8638 participants in the Oslo Health Study (HUBRO) were linked to two types of green space variables: the vegetation cover greenness derived from satellite data, which shows the city's vegetation cover regardless of property boundaries, and the land use greenness derived from municipal plans showing information about publicly accessible vegetation-covered areas. Associations between greenness and health measures were analysed by logistic regression models controlling for possible individual and contextual confounders. RESULTS Increasing vegetation cover greenness was associated with fewer self-reported mental disorders for both men and women after controlling for possible confounders. The proportion of women who reported high levels of musculoskeletal pain increased with increasing degrees of both of the greenness measurements, but no significant association was observed for men. No association was found for asthma and diabetes type 2 for either men or women. CONCLUSIONS Although there was a positive association between vegetation cover greenness and self-reported mental disorders, the main findings showed mixed results. The lack of clear associations between urban green space and lifestyle-related health disorders in Oslo might have been influenced by a large proportion of the inhabitants having easy access to green areas.
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Affiliation(s)
- Camilla Ihlebæk
- 1 Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Norway.,2 Faculty of Health and Social Work Studies, Østfold University College, Norway
| | - Geir Aamodt
- 1 Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Norway
| | - Renata Aradi
- 3 Department of Landscape Architecture, Faculty of Landscape and Society, Norwegian University of Life Sciences, Norway
| | - Bjørgulf Claussen
- 4 Institute of Health and Society, Department of Community Medicine, Faculty of Medicine, University of Oslo, Norway
| | - Kine Halvorsen Thorén
- 3 Department of Landscape Architecture, Faculty of Landscape and Society, Norwegian University of Life Sciences, Norway
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Patrick R, Kingsley J. Health promotion and sustainability programmes in Australia: barriers and enablers to evaluation. Glob Health Promot 2017; 26:82-92. [DOI: 10.1177/1757975917715038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In an era characterised by the adverse impacts of climate change and environmental degradation, health promotion programmes are beginning to actively link human health with environmental sustainability imperatives. This paper draws on a study of health promotion and sustainability programmes in Australia, providing insights to evaluation approaches being used and barriers and enablers to these evaluations. The study was based on a multi-strategy research involving both quantitative and qualitative methods. Health promotion practitioners explained through surveys and semi-structured interviews that they focused on five overarching health and sustainability programme types (healthy and sustainable food, active transport, energy efficiency, contact with nature, and capacity building). Various evaluation methods and indicators (health, social, environmental, economic and demographic) were identified as being valuable for monitoring and evaluating health and sustainability programmes. Findings identified several evaluation enablers such as successful community engagement, knowledge of health and sustainability issues and programme champions, whereas barriers included resource constraints and competing interests. This paper highlights the need for ecological models and evaluation tools to support the design and monitoring of health promotion and sustainability programmes.
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Affiliation(s)
- Rebecca Patrick
- Health, Nature & Sustainability Research Group, School of Health & Social Development, Deakin University, Burwood, Victoria, Australia
| | - Jonathan Kingsley
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
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Exploring the relationship between childhood obesity and proximity to the coast: A rural/urban perspective. Health Place 2016; 40:129-36. [DOI: 10.1016/j.healthplace.2016.05.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 05/20/2016] [Accepted: 05/23/2016] [Indexed: 01/27/2023]
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Public Opinions and Use of Various Types of Recreational Infrastructure in Boreal Forest Settings. FORESTS 2016. [DOI: 10.3390/f7060113] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Clark NE, Lovell R, Wheeler BW, Higgins SL, Depledge MH, Norris K. Biodiversity, cultural pathways, and human health: a framework. Trends Ecol Evol 2014; 29:198-204. [DOI: 10.1016/j.tree.2014.01.009] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 12/15/2013] [Accepted: 01/23/2014] [Indexed: 10/25/2022]
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Alcock I, White MP, Wheeler BW, Fleming LE, Depledge MH. Longitudinal effects on mental health of moving to greener and less green urban areas. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2014; 48:1247-55. [PMID: 24320055 DOI: 10.1021/es403688w] [Citation(s) in RCA: 246] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Despite growing evidence of public health benefits from urban green space there has been little longitudinal analysis. This study used panel data to explore three different hypotheses about how moving to greener or less green areas may affect mental health over time. The samples were participants in the British Household Panel Survey with mental health data (General Health Questionnaire scores) for five consecutive years, and who relocated to a different residential area between the second and third years (n = 1064; observations = 5320). Fixed-effects analyses controlled for time-invariant individual level heterogeneity and other area and individual level effects. Compared to premove mental health scores, individuals who moved to greener areas (n = 594) had significantly better mental health in all three postmove years (P = .015; P = .016; P = .008), supporting a "shifting baseline" hypothesis. Individuals who moved to less green areas (n = 470) showed significantly worse mental health in the year preceding the move (P = .031) but returned to baseline in the postmove years. Moving to greener urban areas was associated with sustained mental health improvements, suggesting that environmental policies to increase urban green space may have sustainable public health benefits.
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Affiliation(s)
- Ian Alcock
- European Centre for Environment and Human Health, University of Exeter Medical School , Knowledge Spa, Royal Cornwall Hospital, Truro TR1 3HD, U.K
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Silveirinha de Oliveira E, Aspinall P, Briggs A, Cummins S, Leyland AH, Mitchell R, Roe J, Ward Thompson C. How effective is the Forestry Commission Scotland's woodland improvement programme--'Woods In and Around Towns' (WIAT)--at improving psychological well-being in deprived urban communities? A quasi-experimental study. BMJ Open 2013; 3:e003648. [PMID: 23996826 PMCID: PMC3758971 DOI: 10.1136/bmjopen-2013-003648] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION There is a growing body of evidence that suggests that green spaces may positively influence psychological well-being. This project is designed to take advantage of a natural experiment where planned physical and social interventions to enhance access to natural environments in deprived communities provide an opportunity to prospectively assess impacts on perceived stress and mental well-being. STUDY DESIGN AND METHODS A controlled, prospective study comprising a repeat cross-sectional survey of residents living within 1.5 km of intervention and comparison sites. Three waves of data will be collected: prephysical environment intervention (2013); postphysical environment intervention (2014) and postwoodland promotion social intervention (2015). The primary outcome will be a measure of perceived stress (Perceived Stress Scale) preintervention and postintervention. Secondary, self-report outcomes include: mental well-being (Short Warwick-Edinburgh Mental Well-being Scale), changes in physical activity (IPAQ-short form), health (EuroQoL EQ-5D), perception and use of the woodlands, connectedness to nature (Inclusion of Nature in Self Scale), social cohesion and social capital. An environmental audit will complement the study by evaluating the physical changes in the environment over time and recording any other contextual changes over time. A process evaluation will assess the implementation of the programme. A health economics analysis will assess the cost consequences of each stage of the intervention in relation to the primary and secondary outcomes of the study. ETHICS AND DISSEMINATION Ethical approval has been given by the University of Edinburgh, Edinburgh College of Art Research, Ethics and Knowledge Exchange Committee (ref. 19/06/2012). Findings will be disseminated through peer-reviewed publications, national and international conferences and, at the final stage of the project, through a workshop for those interested in implementing environmental interventions.
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Affiliation(s)
| | - Peter Aspinall
- School of Built Environment, Heriot-Watt University, Edinburgh, UK
| | - Andrew Briggs
- Health Economics & Health Technology Assessment Institute of Health & Wellbeing University of Glasgow, Glasgow, UK
| | - Steven Cummins
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Alastair H Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Richard Mitchell
- Centre For Research on Environment, Society and Health Institute of Health and Wellbeing University of Glasgow, Glasgow, UK
| | - Jenny Roe
- School of Built Environment, Heriot-Watt University, Edinburgh, UK
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White MP, Alcock I, Wheeler BW, Depledge MH. Would you be happier living in a greener urban area? A fixed-effects analysis of panel data. Psychol Sci 2013; 24:920-8. [PMID: 23613211 DOI: 10.1177/0956797612464659] [Citation(s) in RCA: 301] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Urbanization is a potential threat to mental health and well-being. Cross-sectional evidence suggests that living closer to urban green spaces, such as parks, is associated with lower mental distress. However, earlier research was unable to control for time-invariant heterogeneity (e.g., personality) and focused on indicators of poor psychological health. The current research advances the field by using panel data from over 10,000 individuals to explore the relation between urban green space and well-being (indexed by ratings of life satisfaction) and between urban green space and mental distress (indexed by General Health Questionnaire scores) for the same people over time. Controlling for individual and regional covariates, we found that, on average, individuals have both lower mental distress and higher well-being when living in urban areas with more green space. Although effects at the individual level were small, the potential cumulative benefit at the community level highlights the importance of policies to protect and promote urban green spaces for well-being.
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Affiliation(s)
- Mathew P White
- European Centre for Environment & Human Health, University of Exeter, Truro, United Kingdom.
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Stack K, Shultis J. Implications of attention restoration theory for leisure planners and managers. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/14927713.2013.776747] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Does living by the coast improve health and wellbeing? Health Place 2012; 18:1198-201. [DOI: 10.1016/j.healthplace.2012.06.015] [Citation(s) in RCA: 240] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 06/22/2012] [Accepted: 06/25/2012] [Indexed: 11/20/2022]
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