Population-level linkages between urban greenspace and health inequality: The case for using multiple indicators of neighbourhood greenspace

Spatiotemporal variability of the association between greenspace exposure and depression in older adults in South Korea

BACKGROUND

A number of studies based on young to middle aged adult and child samples have found that exposure to greenspace and bluespace can have a positive impact on mental health and well-being. However, there is limited research among older adults and the extant studies have provided mixed results. The present study was designed to examine how the association between these forms of exposure and depressive symptoms among older adults varies as a function of different spatially and temporally resolved exposure metrics.

METHODS

The sample consisted of 617 individuals (46.19% female) aged ≥ 60 years of age. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Individuals' greenspace exposure was quantified using spatially and temporally resolved metrics, including monthly and annual averaged satellite-derived normalized difference vegetation index (NDVI) across multiple buffer distances (250 m to 2,000 m) centered at participants' home address. We also quantified exposure to blue-greenspace from a highly detailed land use and land cover dataset. A multivariable logistic regression model assessed the association between greenspace and blue-greenspace exposure and depressive symptoms, adjusting for age, sex, income, education, marital status, current smoking, alcohol status, medical conditions, temperature, crime rate, population density, and per capita park area.

RESULTS

We found a significant association between exposures to greenspace and blue-greenspace and depressive symptoms (CES-D cutoff ≥ 4) among older adults. After adjusting for confounding variables, the odds of depressive symptoms were significantly decreased by an IQR increment in residential exposure to greenspace [odds ratio (OR) = 0.67; 95% confidence interval (95% CI), 0.49 ~ 0.91] and blue-greenspace (OR = 0.59; 95% CI, 0.41 ~ 0.84) measured nearby their home address (i.e., as close as 250 m). When stratified by household income level, the association was only significant among low-income individuals. We also found temporal variation in the association between depressive symptoms and monthly NDVI-based greenspace exposure, in which the odds of depressive symptoms were the lowest for greenspace in cold months (i.e., January, February, and March).

CONCLUSIONS

Our findings suggest that neighborhood greenspace may serve as a protective factor against depression among older adults, but the benefits may depend on the spatial and temporal context. More investigation is needed to replicate our findings on the spatial and temporal variations of greenspace exposure metrics and their effects on depressive symptoms.

Exploring the spatial association between the distribution of temperature and urban morphology with green view index

Urban heat islands will occur if city neighborhoods contain insufficient green spaces to create a comfortable environment, and residents' health will be adversely affected. Current satellite imagery can only effectively identify large-scale green spaces and cannot capture street trees or potted plants within three-dimensional building spaces. In this study, we used a deep convolutional neural network semantic segmentation model on Google Street View to extract environmental features at the neighborhood level in Taipei City, Taiwan, including the green vegetation index (GVI), building view factor, and sky view factor. Monthly temperature data from 2018 to 2021 with a 0.01° spatial resolution were used. We applied a linear mixed-effects model and geographically weighted regression to explore the association between pedestrian-level green spaces and ambient temperature, controlling for seasons, land use information, and traffic volume. Their results indicated that a higher GVI was significantly associated with lower ambient temperatures and temperature differences. Locations with higher traffic flows or specific land uses, such as religious or governmental, are associated with higher ambient temperatures. In conclusion, the GVI from street-view imagery at the community level can improve the understanding of urban green spaces and evaluate their effects in association with other social and environmental indicators.

Understanding How Green Space Naturalness Impacts Public Well-Being: Prospects for Designing Healthier Cities

Statement of problem: Urbanization has brought significant advancements in human well-being; however, it poses challenges to urban green spaces (UGSs), affecting environmental quality and public health. Research gap: Previous studies have established the importance of UGSs for urban well-being but have not sufficiently explored how the naturalness of these spaces-ranging from untouched natural areas to human-designed landscapes-affects mental health outcomes in the context of developing countries, particularly Brazil. Purpose: This study aimed to bridge the research gap by investigating the relationship between the degree of naturalness in UGSs and mental health among residents of Brazilian metropolitan areas. Method: Data were collected through an online survey involving 2136 respondents from various Brazilian urban regions. The study used Welch's ANOVA and Games-Howell post hoc tests to analyze the impact of UGS naturalness on mental health, considering depression, anxiety, and stress levels. Results and conclusions: The findings revealed that higher degrees of naturalness in UGSs significantly correlate with lower levels of mental distress. These results underscore the necessity of integrating natural elements into urban planning to enhance public health. Practical implications: Urban planners and policymakers are encouraged to prioritize the preservation and creation of naturalistic UGSs in urban environments to improve mental health outcomes. Future directions: Further research should explore the specific attributes of naturalness that most contribute to well-being and examine the scalability of these findings across different cultural and environmental contexts.

Current methodologies of greenspace exposure and mental health research-a scoping review

Introduction

Greenspaces can provide an important resource for human mental health. A growing body of literature investigates the interaction and the influence of diverse greenspace exposures. In order to gain a comprehensive understanding of the complex connection between greenspace and mental health, a variety of perspectives and methodological combinations are needed. The aim of this review is to assess the current methodologies researching greenspace and mental health.

Methods

A scoping review was conducted. Four electronic databases (Pubmed, Embase, PsycInfo, Web of Science) were searched for relevant studies. A wide range of greenspace and mental health keywords were included to provide a comprehensive representation of the body of research. Relevant information on publication characteristics, types of greenspaces, mental health outcomes, and measurements of greenspace exposure and mental health was extracted and assessed.

Results

338 studies were included. The included studies encompassed a multitude of methods, as well as outcomes for both greenspace and mental health. 28 combinations were found between seven categories each for greenspace and mental health assessment. Some pairings such as geoinformation systems for greenspace assessment and questionnaires investigating mental health were used much more frequently than others, implying possible research gaps. Furthermore, we identified problems and inconsistences in reporting of greenspace types and mental health outcomes.

Discussion

The identified methodological variety is a potential for researching the complex connections between greenspace and mental health. Commonly used combinations can provide important insights. However, future research needs to emphasize other perspectives in order to understand how to create living environments with mental health benefits. For this purpose, interdisciplinary research is necessary.

The impacts of housing conditions on physical and mental health - A mini-review informed by a rapid conversion of evidence from Alidoust and Huang (2021)

This article provides a summary and critical appraisal of the systematic review conducted by Alidoust et al. (1) regarding the various effects of housing on both physical and psychological well-being. We aim to discuss the review's findings against existing published evidence to draw out policy and practical implications. Our mini-review illuminates a wide range of housing-related factors which impact on health around which we draw evidence-based policy initiatives and implications, and outline avenues for future research. This mini-review is part of the wider Rapid Conversion of Evidence Summaries (RaCES) program which aims to critically appraise systematic reviews and highlight evidence-based policy and practice implications.

Association of Redlining and Natural Environment with Depressive Symptoms in Women in the Sister Study

BACKGROUND

Improving mental health is recognized as an important factor for achieving global development goals. Despite strong evidence that neighborhood greenery promotes better mental health, there are environmental justice concerns over the distribution of neighborhood greenery. Underlying these concerns are present-day consequences of historical discriminatory financial investment practices, such as redlining which was established by the U.S. Federal Home Owners' Loan Corporation (HOLC) in the 1930s. The impacts of redlining on environmental and health disparities have been researched extensively. However, the influences of redlining on the associations between neighborhood environment and health outcomes have not been fully assessed.

OBJECTIVES

The aim of this study was to examine whether associations between residential tree cover and depressive symptoms vary across areas subject to HOLC practices.

METHODS

Depressive symptoms were defined by the 10-item Center for Epidemiologic Studies Depression Scale collected during the period 2008-2012 for 3,555 women in the Sister Study cohort residing in cities subject to HOLC practices across the United States. HOLC rating maps were obtained from the Mapping Inequality Project, University of Richmond, with neighborhoods graded as A (best for financial investment, green), B (still desirable, blue), C (declining, yellow), and D (hazardous, red-known as redlined). Tree cover within 500 m and 2,000 m from residences was estimated using 2011 U.S. Forest Service Percent Tree Canopy Cover. Mixed model using climate zone as the random effect was applied to evaluate the associations with adjustments for potential covariates. Analyses were stratified by HOLC grade.

RESULTS

Tree cover was significantly higher in neighborhoods with better HOLC grades. A 10% increase in tree cover was associated with reduced odds of depressive symptoms for the full study population, with adjusted odds ratios (AORs) of 0.93 [95% confidence interval (CI): 0.88, 0.99], and 0.91 (0.85, 0.97) for 500 -m and 2,000 -m buffer, respectively. Across HOLC grades, the strongest associations were observed in redlined neighborhoods, with respective AORs of 0.72 (95% CI: 0.52, 0.99) and 0.63 (95% CI: 0.45, 0.90) for 500 -m and 2,000 -m buffer.

DISCUSSION

Findings support a remediation strategy focused on neighborhood greenery that would address multiple public health priorities, including mental health and environmental justice. https://doi.org/10.1289/EHP12212.

Inequalities and mental health during the Coronavirus pandemic in the UK: a mixed-methods exploration

BACKGROUND

The World Health Organisation declared the novel Coronavirus disease (COVID-19) a global pandemic on 11th March 2020. Since then, the world has been firmly in its grip. At the time of writing, there were more than 767,972,961 million confirmed cases and over 6,950,655 million deaths. While the main policy focus has been on controlling the virus and ensuring vaccine roll-out and uptake, the population mental health impacts of the pandemic are expected to be long-term, with certain population groups affected more than others.

METHODS

The overall objectives of our 'Coronavirus: Mental Health and the Pandemic' study were to explore UK adults' experiences of the Coronavirus pandemic and to gain insights into the mental health impacts, population-level changes over time, current and future mental health needs, and how these can best be addressed. The wider mixed-methods study consisted of repeated cross-sectional surveys and embedded qualitative sub-studies including in-depth interviews and focus group discussions with the wider UK adult population. For this particular inequalities and mental health sub-study, we used mixed methods data from our cross-sectional surveys and we carried out three Focus Group Discussions with a maximum variation sample from across the UK adult population. The discussions covered the broader topic of 'Inequalities and mental health during the Coronavirus pandemic in the UK' and took place online between April and August 2020. Focus Groups transcripts were analysed using thematic analysis in NVIVO. Cross-sectional survey data were analysed using STATA for descriptive statistics.

RESULTS

Three broad main themes emerged, each supporting a number of sub-themes: (1) Impacts of the pandemic; (2) Moving forward: needs and recommendations; (3) Coping mechanisms and resilience. Findings showed that participants described their experiences of the pandemic in relation to its impact on themselves and on different groups of people. Their experiences illustrated how the pandemic and subsequent measures had exacerbated existing inequalities and created new ones, and triggered various emotional responses. Participants also described their coping strategies and what worked and did not work for them, as well as support needs and recommendations for moving forward through, and out of, the pandemic; all of which are valuable learnings to be considered in policy making for improving mental health and for ensuring future preparedness.

CONCLUSIONS

The pandemic is taking a long-term toll on the nations' mental health which will continue to have impacts for years to come. It is therefore crucial to learn the vital lessons learned from this pandemic. Specific as well as whole-government policies need to respond to this, address inequalities and the different needs across the life-course and across society, and take a holistic approach to mental health improvement across the UK.

The Influence of Greenspace Exposure on Affect in People With and Those Without Schizophrenia: Exploratory Study

BACKGROUND

Exposure to natural vegetation (ie, "greenspace") is related to beneficial outcomes, including higher positive and lower negative affect, in individuals with and those without mental health concerns. Researchers have yet to examine dynamic associations between greenspace exposure and affect within individuals over time. Smartphone-based ecological momentary assessment (EMA) and passive sensors (eg, GPS, microphone) allow for frequent sampling of data that may reveal potential moment-to-moment mechanisms through which greenspace exposure impacts mental health.

OBJECTIVE

In this study, we examined associations between greenspace exposure and affect (both self-reported and inferred through speech) in people with and those without schizophrenia spectrum disorder (SSD) at the daily level using smartphones.

METHODS

Twenty people with SSD and 14 healthy controls reported on their current affect 3 times per day over 7 days using smartphone-based EMA. Affect expressed through speech was labeled from ambient audio data collected via the phone's microphone using Linguistic Inquiry and Word Count (LIWC). Greenspace exposure, defined as the normalized difference vegetation index (NDVI), was quantified based on continuous geo-location data collected from the phone's GPS.

RESULTS

Overall, people with SSD used significantly more positive affect words (P=.04) and fewer anger words (P=.04) than controls. Groups did not significantly differ in mean EMA-reported positive or negative affect, LIWC total word count, or NDVI exposure. Greater greenspace exposure showed small to moderate associations with lower EMA-reported negative affect across groups. In controls, greenspace exposure on a given day was associated with significantly lower EMA-reported anxiety on that day (b=-0.40, P=.03, 95% CI -0.76 to -0.04) but significantly higher use of negative affect words (b=0.66, P<.001, 95% CI 0.29-1.04). There were no significant associations between greenspace exposure and affect at the daily level among participants with SSD.

CONCLUSIONS

Our findings speak to the utility of passive and active smartphone assessments for identifying potential mechanisms through which greenspace exposure influences mental health. We identified preliminary evidence that greenspace exposure could be associated with improved mental health by reducing experiences of negative affect. Future directions will focus on furthering our understanding of the relationship between greenspace exposure and affect on individuals with and those without SSD.

Community indicators for mental health in Europe: a scoping review

Background

Community indicators may predict and influence individuals` mental health, and support or impede mental health management. However, there is no consensus on which indicators should be included in predictions, prognostic algorithms, or management strategies for community-based mental health promotion and prevention approaches. Therefore, this scoping review provides an overview of relevant community-level indicators for mental health in the general as well as risk populations in a European context.

Methods

We conducted a scoping review in the following electronic databases: PubMed, Embase, and PsycInfo. Eligible studies focused on context factors such as either the physical or social environment, reporting at least one mental health outcome and referring to a European population. Publications between 2012 and March 8, 2022 are considered.

Results

In total, the search yielded 12,200 identified records. After the removal of duplicates, 10,059 records were screened against the eligibility criteria. In total, 169 studies were included in the final analysis. Out of these included studies, 6% focused on pan-European datasets and 94% on a specific European country. Populations were either general or high-risk populations (56 vs. 44%, respectively) with depressive disorder as the main reported outcome (49%), followed by general mental health (33%) and anxiety (23%). Study designs were cross-sectional studies (59%), longitudinal (27%), and others (14%). The final set of indicators consisted of 53 indicators, which were grouped conceptually into 13 superordinate categories of community indicators. These were divided into the domains of the physical and social environment. The most commonly measured and reported categories of community indicators associated with mental health outcomes were social networks (n = 87), attitudinal factors toward vulnerable groups (n = 76), and the characteristics of the built environment (n = 56).

Conclusion

This review provides an evidence base of existing and novel community-level indicators that are associated with mental health. Community factors related to the physical and social environment should be routinely recorded and considered as influencing factors or potentially underestimated confounders. The relevance should be analyzed and included in clinical outcomes, data, monitoring and surveillance as they may reveal new trends and targets for public mental health interventions.

Multimodal assessment of effects of urban environments on psychological wellbeing

The built environment is a ubiquitous factor of modern human life, which fundamentally affects human wellbeing. Most existing research on the psychological effects of urban environments is predominantly based on subjective self-report measures, which provide valuable insights into subjective experiences, but are also affected by conscious and subconscious bias. In the current study, we evaluate a multimodal approach to capturing wellbeing by employing objective mobile physiological and neurophysiological measurement technologies alongside self-reports to capture the impact of two different urban environments. Moreover, we endeavoured to comprehensively measure and, when possible, control the physical aspects of the environment. Our study specifically aimed to discover differences between psychological wellbeing indicators in adults across low-density vs. moderate-density urban environments. Data collection took place in two urban outdoor locations in Australia. Statistical comparison of the two locations indicated that low urban density led to comparatively higher levels of psychological wellbeing compared to moderate urban density. Self-reports indicated that the low-density environment led to higher levels of subjective feelings of comfort and safety and reduced levels of negative mood. In line with the subjective reports, in the low-density environment compared to the moderate-density environment, individuals showed higher levels of EEG theta activity, while EEG beta and heart rate measures were lower. The research outcome provides insights into how urban density affects people's wellbeing and showcases the benefits of employing ecologically-valid multimodal psychological-environmental measurement approaches to effectively evaluate the psychological impacts of built environments.

How do forms and characteristics of Asian public housing neighbourhoods affect dementia risk among senior population? A cross-sectional study in Hong Kong

BACKGROUND

Public housing estate is a key determinant of community health risk in American/European cities. However, how forms/characteristics of compact/hilly public housing's neighbourhoods affect dementia among Asian seniors was underestimated.

DESIGN

This was a cross-sectional study.

METHODS

A total of 2,077 seniors living in Hong Kong's public housing estates were included. Dementia was measured by a Cantonese version of Montreal - Cognitive Assessment. Built environment was measured based on three dimensions (greenery, walkability, accessibility), including 11 metrics. Circular buffers (without walking paths) and service areas (considering walking paths) with two-dimensional/three-dimensional (terrain) adjustment were applied to quantify forms/characteristics of neighbourhoods. Two spatial buffers were applied: immediate distance (200 m) and walkable distance (500 m). Exposure-by-exposure regressions were applied to evaluate the associations between form/characteristics of neighbourhood and dementia.

RESULTS

Forms/characteristics without considering walking paths may overestimate health benefits from built environment. For circular buffers, higher percentage of building coverage, higher land use mix and more community/transportation/leisure facilities were negatively associated with dementia. All measures of greenery were positively associated with dementia. For service areas, measures of walkability and accessibility became insignificant except more community facilities at the immediate distance. Furthermore, terrain effect was insignificant when it was compared with the impacts of walking paths.

CONCLUSION

Dementia among seniors in hilly public housing estates was negatively associated with neighbourhood's walkability and accessibility and was influenced by walking paths. For healthy ageing, improved forms/characteristics of public housing neighbourhoods should include more accessible spaces and community facilities along walking paths for physical activities and basic daily needs.

The Effects of Urban Living Conditions on Subjective Well-Being: The Case of German Foreign Service Employees

In an increasingly urbanized world, understanding the determinants of urban well-being will continue to grow in importance. Although the effects of different indicators of living conditions on well-being have been widely studied individually, little is known about their relative impact when examined jointly. In this study, we use a unique multi-source dataset that allows us to investigate the effect and relative importance of a variety of subjectively and objectively assessed aspects of urban living conditions on the subjective well-being (SWB) of German Foreign Service expatriates. The study captures living conditions in metropolises around the world at different stages of development, and assesses living conditions in a culturally comparably homogeneous set of participants, thus being potentially less confounded with cultural differences. Using linear regression and dominance analysis, we find that 'quality of and access to nature' (i.e., green space), 'quality of housing', and 'quality of public goods' (i.e., water, air, and sewage systems) have the strongest associations with SWB. Subjectively rated characteristics show stronger associations with SWB than externally assessed characteristics. Additionally, we examine whether the size of a city or the level of development of a country has an effect on SWB. Both living in a megacity (≥ 10 million inhabitants) and a lower development status have negative effects on SWB. However, these effects disappear when the various indicators of living conditions are controlled for. Our findings can inform organisations sending employees abroad as well as urban planners seeking to improve their policies and decision-making.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11482-023-10169-w.

Nonlinear Effects of the Neighborhood Environments on Residents' Mental Health

In the context of rapid urbanization and the "Healthy China" strategy, neighborhood environments play an important role in improving mental health among urban residents. While an increasing number of studies have explored the linear relationships between neighborhood environments and mental health, much remains to be revealed about the nonlinear health effects of neighborhood environments, the thresholds of various environmental factors, and the optimal environmental exposure levels for residents. To fill these gaps, this paper collected survey data from 1003 adult residents in Guangzhou, China, and measured the built and social environments within the neighborhoods. The random forest model was then employed to examine the nonlinear effects of neighborhood environments on mental health, evaluate the importance of each environmental variable, as well as identify the thresholds and optimal levels of various environmental factors. The results indicated that there are differences in the importance of diverse neighborhood environmental factors affecting mental health, and the more critical environmental factors included greenness, neighborhood communication, and fitness facility density. The nonlinear effects were shown to be universal and varied among neighborhood environmental factors, which could be classified into two categories: (i) higher exposure levels of some environmental factors (e.g., greenness, neighborhood communication, and neighborhood safety) were associated with better mental health; (ii) appropriate exposure levels of some environmental factors (e.g., medical, fitness, and entertainment facilities, and public transport stations) had positive effects on mental health, whereas a much higher or lower exposure level exerted a negative impact. Additionally, this study identified the exact thresholds and optimal exposure levels of neighborhood environmental factors, such as the threshold (22.00%) and optimal exposure level (>22.00%) of greenness and the threshold (3.80 number/km²) and optimal exposure level (3.80 number/km²) of fitness facility density.

Restorative Effects from Green Exposure: A Systematic Review and Meta-Analysis of Randomized Control Trials

Despite growing research on green space and health benefits, the body of evidence remains heterogeneous and unclear. A systematic review and meta-analysis of studies of randomized controlled trials (RCTs) with high evidence levels are deemed timely. We searched Scopus, PubMed, Embase, and Web of Science for the literature up to January 2022 and assessed bias using the Cochrane Risk of Bias tool 2.0. We calculated joint impact estimates for each green space exposure assessment technique using random and fixed effects models. Compared to non-green space situations, green space exposure was related to decreased negative feelings, such as fatigue -0.84 (95% CI: -1.15 to -0.54), and increased levels of pleasant emotions, such as vitality 0.85 (95% CI: 0.52 to 1.18). It also lowered physiological indicators, including heart rate levels, by 0.60 (95% CI: -0.90 to -0.31). Effect sizes were large and statistically significant, and the overall quality of the evidence was good. Existing RCTs on greenspace exposure pay insufficient attention to older and adolescent populations, different ethnic groups, different regions, and doses of greenspace exposure interventions. More research is needed to understand how and how much green space investment has the most restorative benefits and guide urban green space planning and renewal.

Association of environmental and socioeconomic indicators with serious mental illness diagnoses identified from general practitioner practice data in England: A spatial Bayesian modelling study

BACKGROUND

The evidence is sparse regarding the associations between serious mental illnesses (SMIs) prevalence and environmental factors in adulthood as well as the geographic distribution and variability of these associations. In this study, we evaluated the association between availability and proximity of green and blue space with SMI prevalence in England as a whole and in its major conurbations (Greater London, Birmingham, Liverpool and Manchester, Leeds, and Newcastle).

METHODS AND FINDINGS

We carried out a retrospective analysis of routinely collected adult population (≥18 years) data at General Practitioner Practice (GPP) level. We used data from the Quality and Outcomes Framework (QOF) on the prevalence of a diagnosis of SMI (schizophrenia, bipolar affective disorder and other psychoses, and other patients on lithium therapy) at the level of GPP over the financial year April 2014 to March 2018. The number of GPPs included ranged between 7,492 (April 2017 to March 2018) to 7,997 (April 2014 to March 2015) and the number of patients ranged from 56,413,719 (April 2014 to March 2015) to 58,270,354 (April 2017 to March 2018). Data at GPP level were converted to the geographic hierarchy unit Lower Layer Super Output Area (LSOA) level for analysis. LSOAs are a geographic unit for reporting small area statistics and have an average population of around 1,500 people. We employed a Bayesian spatial regression model to explore the association of SMI prevalence in England and its major conurbations (greater London, Birmingham, Liverpool and Manchester, Leeds, and Newcastle) with environmental characteristics (green and blue space, flood risk areas, and air and noise pollution) and socioeconomic characteristics (age, ethnicity, and index of multiple deprivation (IMD)). We incorporated spatial random effects in our modelling to account for variation at multiple scales. Across England, the environmental characteristics associated with higher SMI prevalence at LSOA level were distance to public green space with a lake (prevalence ratio [95% credible interval]): 1.002 [1.001 to 1.003]), annual mean concentration of PM2.5 (1.014 [1.01 to 1.019]), and closeness to roads with noise levels above 75 dB (0.993 [0.992 to 0.995]). Higher SMI prevalence was also associated with a higher percentage of people above 24 years old (1.002 [1.002 to 1.003]), a higher percentage of ethnic minorities (1.002 [1.001 to 1.002]), and more deprived areas. Mean SMI prevalence at LSOA level in major conurbations mirrored the national associations with a few exceptions. In Birmingham, higher average SMI prevalence at LSOA level was positively associated with proximity to an urban green space with a lake (0.992 [0.99 to 0.998]). In Liverpool and Manchester, lower SMI prevalence was positively associated with road traffic noise ≥75 dB (1.012 [1.003 to 1.022]). In Birmingham, Liverpool, and Manchester, there was a positive association of SMI prevalence with distance to flood zone 3 (land within flood zone 3 has ≥1% chance of flooding annually from rivers or ≥0.5% chance of flooding annually from the sea, when flood defences are ignored): Birmingham: 1.012 [1.000 to 1.023]; Liverpool and Manchester: 1.016 [1.006 to 1.026]. In contrast, in Leeds, there was a negative association between SMI prevalence and distance to flood zone 3 (0.959 [0.944 to 0.975]). A limitation of this study was because we used a cross-sectional approach, we are unable to make causal inferences about our findings or investigate the temporal relationship between outcome and risk factors. Another limitation was that individuals who are exclusively treated under specialist mental health care and not seen in primary care at all were not included in this analysis.

CONCLUSIONS

Our study provides further evidence on the significance of socioeconomic associations in patterns of SMI but emphasises the additional importance of considering environmental characteristics alongside socioeconomic variables in understanding these patterns. In this study, we did not observe a significant association between green space and SMI prevalence, but we did identify an apparent association between green spaces with a lake and SMI prevalence. Deprivation, higher concentrations of air pollution, and higher proportion of ethnic minorities were associated with higher SMI prevalence, supporting a social-ecological approach to public health prevention. It also provides evidence of the significance of spatial analysis in revealing the importance of place and context in influencing area-based patterns of SMI.

The relationship between greenspace exposure and psychopathology symptoms: A systematic review

Greenspace exposure is associated with psychological benefits. In this systematic review, we summarized and critically evaluated the literature on the relationship between greenspace exposure (i.e., objective and subjective assessments of interactions with nature) and psychopathology incidence and symptom severity in those with and without a clinical diagnosis. A secondary aim of our review was to examine potential interactions between greenspace exposure and urban environmental features (e.g., pollution, population density) associated with poorer mental health. We identified 40 studies published between January 1, 1981, and July 31, 2020, from PubMed and PsycINFO electronic database search. Although heterogeneous in assessments of greenspace exposure and psychopathology symptom domain, the majority of cross-sectional and longitudinal evidence found that objectively assessed greenspace exposure (e.g., satellite measures of greenery) was related to less severe symptoms and lower incidence of psychopathology in children (e.g., attention-deficit/hyperactivity disorder symptoms) and adults (e.g., depression symptoms). In addition, five studies that assessed urban environmental features suggest that greenspace exposure may show a net positive relationship with psychopathology over and above the absence of urban features. We discuss limitations of the literature and future directions, including more mechanistic work to delineate the potential cognitive, affective, and behavioral factors that may contribute to the beneficial relationship between greenspace exposure and psychological health.

Assessing the role of urban green spaces for human well-being: a systematic review

Human has been evolving in a natural environment over a long time; thus, he is habitual to adapt it. Green spaces are obligatory landscapes in an urban structure that provide a natural environment and accelerate other life events. In contrast, unplanned urbanization, and conversion from green to grey structures have damaged natural environmental resources. Studies through different angles have highlighted the importance of urban green spaces for human well-being but now need to identify their role according to the potential. The demands of urban green spaces may differ with the change of population size, types of grey structure, urban expansion, the altitude of the place, and geographical location. Therefore, this systematic review aims to analyse the significance of urban green spaces for human well-being. The study opted for a systematic process during the selection and organization of studies for this review. After analysing, 46 studies were finalized with the consensus of three review authors. Accordingly, literature was analysed under the central theme of "Urban Green Spaces for Human Well-being." Human Well-being was assessed under six sub-themes; physical, psychological, mental, social, subjective, and environmental well-being. The review concluded that urban green spaces are the primary pillar for a sustainable urban place and human well-being due to highly positive and positive correlations. Moreover, the study did not find any demarcation line between green spaces and grey structures according to any specific need. Therefore, the study suggested that the role of urban green spaces for human well-being should be analysed according to their potential and required optimal ratio under different communities' urban specific environments and social behaviour.

Observed inequality in urban greenspace exposure in China

Given the important role of green environments playing in healthy cities, the inequality in urban greenspace exposure has aroused growing attentions. However, few comparative studies are available to quantify this phenomenon for cities with different population sizes across a country, especially for those in the developing world. Besides, commonly used inequality measures are always hindered by the conceptual simplification without accounting for human mobility in greenspace exposure assessments. To fill this knowledge gap, we leverage multi-source geospatial big data and a modified assessment framework to evaluate the inequality in urban greenspace exposure for 303 cities in China. Our findings reveal that the majority of Chinese cities are facing high inequality in greenspace exposure, with 207 cities having a Gini index larger than 0.6. Driven by the spatiotemporal variability of human distribution, the magnitude of inequality varies over different times of the day. We also find that exposure inequality is correlated with low greenspace provision with a statistical significance (p-value < 0.05). The inadequate provision may result from various factors, such as dry cold climate and urbanization patterns. Our study provides evidence and insights for central and local governments in China to implement more effective and sustainable greening programs adjusted to different local circumstances and incorporate the public participatory engagement to achieve a real balance between greenspace supply and demand for developing healthy cities.

Green Space Quality and Health: A Systematic Review

(1) Background: As cities densify, researcher and policy focus is intensifying on which green space types and qualities are important for health. We conducted a systematic review to examine whether particular green space types and qualities have been shown to provide health benefits and if so, which specific types and qualities, and which health outcomes. (2) Methods: We searched five databases from inception up to June 30, 2021. We included all studies examining a wide range of green space characteristics on various health outcomes. (3) Results: 68 articles from 59 studies were found, with a high degree of heterogeneity in study designs, definitions of quality and outcomes. Most studies were cross-sectional, ecological or cohort studies. Environment types, vegetation types, and the size and connectivity of green spaces were associated with improved health outcomes, though with contingencies by age and gender. Health benefits were more consistently observed in areas with greater tree canopy, but not grassland. The main outcomes with evidence of health benefits included allergic respiratory conditions, cardiovascular conditions and psychological wellbeing. Both objectively and subjectively measured qualities demonstrated associations with health outcomes. (4) Conclusion: Experimental studies and longitudinal cohort studies will strengthen current evidence. Evidence was lacking for needs-specific or culturally-appropriate amenities and soundscape characteristics. Qualities that need more in-depth investigation include indices that account for forms, patterns, and networks of objectively and subjectively measured green space qualities.

Mapping urban greenspace use from mobile phone GPS data

Urban greenspace is a valuable component of the urban form that has the potential to improve the health and well-being of residents. Most quantitative studies of relationships between health and greenspace to date have investigated associations only with what greenspace exists in the local environment (i.e. provision of greenspace), rather than to what extent it is used. This is due to the difficulty of obtaining usage data in large amounts. In recent years, GPS functionality integrated into mobile phones has provided a potential solution to this problem by making it possible to track which parts of the environment people experience in their day-to-day lives. In this paper, we demonstrate a method to derive cleaned, trip-level information from raw GPS data collected by a mobile phone app, then use this data to investigate the characteristics of trips to urban greenspace by residents of the city of Sheffield, UK. We find that local users of the app spend an average of an hour per week visiting greenspaces, including around seven trips per week and covering a total distance of just over 2.5 km. This may be enough to provide health benefits, but is insufficient to provide maximal benefits. Trip characteristics vary with user demographics: ethnic minority users and users from more socioeconomically deprived areas tend to make shorter trips than White users and those from less deprived areas, while users aged 34 years and over make longer trips than younger users. Women, on average, make more frequent trips than men, as do those who spent more time outside as a child. Our results suggest that most day-to-day greenspace visits are incidental, i.e. travelling through rather than to greenspace, and highlight the importance of including social and cultural factors when investigating who uses and who benefits from urban greenspace.

"Biophilic Cities": Quantifying the Impact of Google Street View-Derived Greenspace Exposures on Socioeconomic Factors and Self-Reported Health

According to the biophilia hypothesis, humans have evolved to prefer natural environments that are essential to their thriving. With urbanization occurring at an unprecedented rate globally, urban greenspace has gained increased attention due to its environmental, health, and socioeconomic benefits. To unlock its full potential, an increased understanding of greenspace metrics is urgently required. In this first-of-a-kind study, we quantified street-level greenspace using 751 644 Google Street View images and computer vision methods for 125 274 locations in Ireland's major cities. We quantified population-weighted exposure to greenspace and investigated the impact of greenspace on health and socioeconomic determinants. To investigate the association between greenspace and self-reported health, a negative binomial regression analysis was applied. While controlling for other factors, an interquartile range increase in street-level greenspace was associated with a 2.78% increase in self-reported "good or very good" health [95% confidence interval: 2.25-3.31]. Additionally, we observed that populations in upper quartiles of greenspace exposure had higher levels of income and education than those in lower quartiles. This study provides groundbreaking insights into how urban greenspace can be quantified in unprecedented resolution, accuracy, and scale while also having important implications for urban planning and environmental health research and policy.

Measuring Neighborhood Landscapes: Associations between a Neighborhood's Landscape Characteristics and Colon Cancer Survival

Landscape characteristics have been shown to influence health outcomes, but few studies have examined their relationship with cancer survival. We used data from the National Land Cover Database to examine associations between regional-stage colon cancer survival and 27 different landscape metrics. The study population included all adult New Jersey residents diagnosed between 2006 and 2011. Cases were followed until 31 December 2016 (N = 3949). Patient data were derived from the New Jersey State Cancer Registry and were linked to LexisNexis to obtain residential histories. Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI95) for the different landscape metrics. An increasing proportion of high-intensity developed lands with 80–100% impervious surfaces per cell/pixel was significantly associated with the risk of colon cancer death (HR = 1.006; CI95 = 1.002–1.01) after controlling for neighborhood poverty and other individual-level factors. In contrast, an increase in the aggregation and connectivity of vegetation-dominated low-intensity developed lands with 20–<40% impervious surfaces per cell/pixel was significantly associated with the decrease in risk of death from colon cancer (HR = 0.996; CI95 = 0.992–0.999). Reducing impervious surfaces in residential areas may increase the aesthetic value and provide conditions more advantageous to a healthy lifestyle, such as walking. Further research is needed to understand how these landscape characteristics impact survival.

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.

Urban Development and Population Pressure: The Case of Młynówka Królewska Park in Krakow, Poland

Green areas are necessary components of contemporary cities. They have a positive impact on the climate, ecological balance and resilience of the city structure, and provide numerous benefits to inhabitants. However, progressing urbanisation and a rise in urban population leads to increasing pressure on existing green spaces. Since the beginning of the twenty-first century, but especially over the past decade, the number of new developments in Krakow has been successively increasing. New multi- and single-family housing complexes are built not only in peripheral areas, but also as infilling and development of areas closer to the historical city centre. Simultaneously, the number of urban green spaces has increased only insignificantly. This paper analyses the example of Młynówka Królewska Park, located in the western part of Krakow, Poland. It focuses on city expansion processes and their relationship with public greenery. Furthermore, his study examines spatial and demographic issues that may have an impact on accessibility of the park area. The study was based on statistical data, analyses of recent planning documents, procedures and practices, as well as research performed in situ. The results indicate that the population pressure in the area under analysis changed significantly. According to the results, a correlation can be found between the latest urban development and population dynamics.

Green Space Exposure Association with Type 2 Diabetes Mellitus, Physical Activity, and Obesity: A Systematic Review

Type 2 diabetes mellitus (T2DM) is a public health challenge that must be addressed considering the large number of risk factors involved in its appearance. Some environmental risk factors are currently described as predictors of diabetes, with access to green spaces being an element to consider in urban settings. This review aims to study the association between exposure to green spaces and outcomes such as diabetes, obesity, and physical activity in the general population. A systematic review was carried out using the PubMed, Embase, and LILACS databases and other sources. The search strategy was carried out from October 2019 to October 2020. Cross-sectional and cohort studies were included. The article selection was made by a pair of reviewers, and data extraction was carried out using a data extraction sheet. The quality assessment of the included studies was carried out using a validated tool. Finally, 19 scientific articles were included in this review. Evidence supports that people and communities exposed to green spaces, especially in their neighborhood, reduce the risk of T2DM and reduce the risk of being obese and increase the likelihood of physical activity. The onset of T2DM can be moderated by using green spaces, improving physical activity levels, and reducing the risk of being overweight and obese.

Attitude and Perception of Residents towards the Benefits, Challenges and Quality of Neighborhood Parks in a Sub-Saharan Africa City

Urban parks provide various environmental, socio-cultural and economic benefits, also called ecosystem services, as well as challenges. Urban park planning and management needs to consider the perception and attitude of people towards the benefits, challenges and quality of the parks. However, such information is largely lacking for cities of Sub-Saharan Africa. The objectives of this study are to understand the perception and attitude of residents towards the benefits, challenges and qualities of neighborhood parks in a formal settlement area in Addis Ababa, Ethiopia, and to investigate whether these aspects are affected by the socio-demographic characteristics of respondents. Data were collected through a household survey (n = 398) and three focus group discussions. Data were analyzed using descriptive statistics and Chi-square tests. The focus group discussion resulted in the selection of 18 ecosystem services (benefits) and five challenges. Supported by a very high response rate (96.6%), the household survey shows that respondents recognize the environmental, socio-cultural and economic benefits provided by neighborhood parks, but that the socio-cultural and environmental benefits are perceived as more important than the economic benefits. The socio-demographic characteristics of age, gender and education level were found to have no significant effect on perceptions or attitudes. The cost of managing neighborhood parks and the attraction of nuisance insects were the two most important challenges, respectively. The majority of respondents rated the quality of the existing neighborhood parks excellent or good, with the existing safety condition and the presence of high plant diversity receiving the highest number of high scores. The availability of park facilities was the aspect of park quality considered poor by the most respondents. This study highlights the importance of place-based studies for assessing the perceived benefits that attract people to use urban parks, as well as the challenges that deter use. One important lesson that cities in Sub-Saharan Africa could draw from the development and management of neighborhood parks in Addis Ababa is the vital importance of public participation in urban park development and management.

Rurbanization—Making the City Greener: Young Citizen Implication and Future Actions

City life has become the norm for most of the global population and building sustainable cities is a growing trend, together with an increased focus on healthier lifestyles in urban settings. Given this framework, the concept of ‘rurbanization’ is gaining momentum as more and more people are interested in bringing natural green spaces within the urban setting. For this purpose, a research (online survey on a sample of 500 respondents) was developed to discover youths’ perceptions on what a sustainable city means, their perspectives on the urbanization problems, and willingness to take action towards improving the green aspects of their urban life. Results revealed that sustainable life perception vary a lot across the young generation, but opinions on what are the city life issues tend to converge to similar points, such as air quality, disconnection with nature, greenhouse effect, urban heat islands, and water quality. When it comes to rurbanization solutions for a greener urban life, young people lean more towards individual solutions, be it an easy and short-term one, such as endowing their home with more green plants, or a more drastic one, such as moving altogether from the city area towards greener locations. Results were also used in designing a conceptual model for actions towards rurbanization.