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Li Y, Zhang J, Schipperijn J, Tuffier S, Hyman S, Bergmann M, Ketzel M, Backalarz C, Andersen ZJ, Lim YH, Cole-Hunter T. Long-term exposure to green and blue space and incidence of cardiovascular disease: A Danish Nurse Cohort study. Int J Hyg Environ Health 2024; 263:114465. [PMID: 39312815 DOI: 10.1016/j.ijheh.2024.114465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 09/06/2024] [Accepted: 09/18/2024] [Indexed: 09/25/2024]
Abstract
BACKGROUND Few cohort studies have examined the associations of natural surroundings (green and blue space) with cardiovascular disease (CVD) and show mixed findings. We aimed to investigate the associations between long-term exposure to green and blue space and incidence of CVD in the Danish Nurse Cohort. METHODS We followed 19,070 female nurses living in Denmark from 1993/1999 to 2018. The shortest Euclidian distance from a residence to three types of green space (park, woodland, and heathland) and four types of blue space (lake, river, coast, and wetland), along with total count of all types of natural surroundings within a 500 meter (m), 1000 m, and 5000 m radius from a residence, were calculated using GeoDanmark data from 2005. Distance was log-transformed to correct for a right-skewed data distribution. Residential air pollution and road traffic noise data for 2005 were estimated by the Danish air pollution modeling system ('DEHM/UBM/AirGIS') and Nord2000 model, respectively. Cox proportional hazards models were used to estimate associations between green and blue space and the first-ever incidence of total CVD and certain CVD subtypes after adjusting for individual factors, air pollution, and noise. We examined effect modification by age, smoking status, occupational status, household income, and urbanicity level. Hazard ratio (HR) and 95% confidence interval (95% CI) were presented per e unit (equivalent to ∼2.72 fold) increase in distance. RESULTS 8179 new cases of CVD were observed over 344,084 person-years. Living further from woodland was associated with higher stroke incidence (HR: 1.153; 95% CI: 1.029-1.293), while living further from heathland was associated with reduced total CVD incidence (HR: 0.975; 95% CI: 0.955-0.996). No associations were found between distance to park, woodland, lake, river, coast, or wetland and total CVD incidence. Total count of all types of green and blue spaces within a 5000 m radius was linked to a reduced risk of CVD incidence. Adjusting for air pollution or road traffic noise did not alter observed associations. Younger individuals (<50 years old) were observed to have lower HRs when living closer to all types of natural surroundings. CONCLUSION We found that proximity to woodland was associated with a reduced risk of stroke, whilst no significant or even inverse associations were observed between proximity to other types of natural surroundings and CVD incidence. Total count of all types of natural surroundings within a 5000 m radius was negatively associated with CVD incidence, suggesting cumulative benefits of these areas.
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Affiliation(s)
- Yujing Li
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark
| | - Jiawei Zhang
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
| | - Stéphane Tuffier
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark
| | - Samuel Hyman
- Department of Earth and Environmental Science, Centre for Atmospheric Science, School of Natural Sciences, The University of Manchester, Oxford Road, M13 9PL, Manchester, UK
| | - Marie Bergmann
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, GU2 7XH, Guildford, UK
| | | | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark
| | - Thomas Cole-Hunter
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark.
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Satapathy P, Khatib MN, Gaidhane S, Zahiruddin QS, Gaidhane AM, Rustagi S, Serhan HA, Padhi BK. Association of neighborhood deprivation and hypertension: A systematic review and meta-analysis. Curr Probl Cardiol 2024; 49:102438. [PMID: 38301916 DOI: 10.1016/j.cpcardiol.2024.102438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Hypertension impacts nearly one billion individuals and is a primary health challenge. While traditional perspectives have focused on individual behavior and genetics as principal risk factors, recent research underscores the profound influence of socioeconomic factors within neighborhoods on the risk of hypertension. This systematic review and meta-analysis is aimed to elucidate the association between neighborhood deprivation and the risk of hypertension. METHODS A comprehensive literature search was conducted across PubMed, Embase, and Web of Science from inception until December 25, 2023. Observational studies defining neighborhood deprivation and reporting hypertension incidence were included. Nested Knowledge software was used for screening and data extraction, with study quality assessed using the Newcastle-Ottawa Scale. Statistical analysis was performed with R software (V 4.3), using a random-effects model to calculate the pooled relative risk (RR). RESULTS Twenty-six studies were included in the qualitative analysis and 22 in the meta-analysis, covering over 62 million participants. The pooled RR was 1.139 (95% CI: 1.006 - 1.290), p=0.04, indicating a higher hypertension risk in deprived neighborhoods. Subgroup analyses showed variability by country and deprivation assessment methods. RR varied from 1.00 in Japan (95% CI: 0.93-1.08) to 1.60 (95% CI: 1.07-2.39) in France and 1.57 (95% CI: 0.67-3.70) in Germany, with significant heterogeneity observed in measures of neighborhood deprivation. CONCLUSION Our analysis confirms a significant association between neighborhood deprivation and hypertension, underscoring the importance of socioeconomic factors in public health. It highlights the need for targeted local assessments and interventions. Future research should explore the causal mechanisms and effectiveness of interventions addressing neighborhood deprivation.
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Affiliation(s)
- Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India; School of Pharmacy, Graphic Era Hill University, Dehradun, India; Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil 51001, Iraq
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- South Asia Infant Feeding Research Network (SAIFRN), Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Abhay M Gaidhane
- Jawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education, Wardha, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Hashem Abu Serhan
- Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar.
| | - Bijaya K Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Rome M, Happel A, Dahlenburg C, Nicodemus P, Schott E, Mueller S, Lovell K, Beighley RE. Application of floating wetlands for the improvement of degraded urban waters: Findings from three multi-year pilot-scale installations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 877:162669. [PMID: 36907411 DOI: 10.1016/j.scitotenv.2023.162669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 05/06/2023]
Abstract
Floating Treatment Wetlands (FTWs) are an emerging ecological engineering technology being applied the restoration of eutrophic urban water bodies. Documented water-quality benefits of FTW include nutrient removal, transformation of pollutants, and reduction in bacterial contamination. However, translating findings from short-duration lab and mesocosm scale experiments, into sizing criteria that might be applied to field installations is not straightforward. This study presents the results of three well established (>3 years) pilot-scale (40-280 m2) FTW installations in Baltimore, Boston, and Chicago. We quantify annual phosphorus removal through harvesting of above-ground vegetation and find an average removal rate of 2 g-P m-2. In our own study and in a review of literature, we find limited evidence of enhanced sedimentation as a pathway for phosphorus removal. In addition to water-quality benefits, FTW planted with native species, provide valuable wetland habitat; and theoretically improve ecological function. We document efforts to quantify the local effect of FTW installations on benthic and sessile macroinvertebrates, zooplankton, bloom-forming cyanobacteria, and fish. Data from these three projects suggest that, even on a small scale, FTW produce localized changes in biotic structure that reflect improving environmental quality. This study provides a simple and defensible method for sizing FTW for nutrient removal in eutrophic waterbodies. We propose several key research pathways which would advance our understanding of the effects FTW have on the ecosystem they are deployed in.
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Affiliation(s)
- McNamara Rome
- Northeastern University, Civil and Environmental Engineering, 400 Snell Engineering Center, 350 Huntington Ave, Boston, MA 02115, United States of America.
| | - Austin Happel
- Daniel P. Haerther Center for Conservation and Research, John G. Shedd Aquarium, 1200 South DuSable Lake Shore Drive, Chicago, IL, 60605, United States of America
| | - Charmaine Dahlenburg
- National Aquarium, to 501 E Pratt Street, Baltimore, MD 21202, United States of America
| | - Phil Nicodemus
- Urban Rivers, 1550 N Kingsbury St, Chicago, IL 60642, United States of America
| | - Eric Schott
- University of Maryland, Center for Environmental Science, 701 E. Pratt St, IMET, Baltimore, MD 21202, United States of America
| | - Stephanie Mueller
- Urban Rivers, 1550 N Kingsbury St, Chicago, IL 60642, United States of America
| | - Kathryne Lovell
- University of Massachusetts Amherst. College of Engineering, 130 Natural Resources Road Marston Hall, Amherst, MA 01003, United States of America
| | - R Edward Beighley
- Northeastern University, Civil and Environmental Engineering, 400 Snell Engineering Center, 350 Huntington Ave, Boston, MA 02115, United States of America
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Liu Y, Zhao B, Cheng Y, Zhao T, Zhang A, Cheng S, Zhang J. Does the quality of street greenspace matter? Examining the associations between multiple greenspace exposures and chronic health conditions of urban residents in a rapidly urbanising Chinese city. ENVIRONMENTAL RESEARCH 2023; 222:115344. [PMID: 36693460 DOI: 10.1016/j.envres.2023.115344] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/10/2023] [Accepted: 01/19/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Numerous studies have demonstrated that greenspace(GS) exposure is associated with health improvements in individuals with hypertension and diabetes. However, studies examining the associations between multiple GS exposures and chronic health conditions in developing countries are limited. METHODS Geospatial data and spatial analysis were employed to objectively measure the total neighbourhood vegetative cover (mean value of normalised difference vegetation index [NDVI] within specific buffer zone) and proximity to park-based GS (network distance from home to the entrance of park-based GS). Street view imagery and machine learning techniques were used to measure the subjective perceptions of street GS quality. A multiple linear regression model was applied to examine the associations between multiple GS exposures and the prevalence of hypertension and diabetes in neighbourhoods located in Qingdao, China. RESULTS The model explained 29.8% and 28.2% of the prevalence of hypertension and diabetes, respectively. The results suggested that: 1) the total vegetative cover of the neighbourhood was inversely correlated with the prevalence of hypertension (β = -0.272, p = 0.013, 95% confidence interval (CI): [-1.332, -0.162]) and diabetes (β = -0.230, p = 0.037, 95% CI: [-0.720, -0.008]). 2) The street GS quality was negatively correlated with the prevalence of hypertension (β = -0.303, p = 0.007, 95% CI: [-2.981, -0.491]) and diabetes (β = -0.309, p = 0.006, 95% CI: [-1.839, -0.314]). 3) Proximity to park-based GS and the prevalence of hypertension and diabetes mellitus were not significantly correlated. CONCLUSIONS This study used subjective and objective methods to comprehensively assess the greenspace exposure from overhead to eye level, from quantity, proximity to quality. The results demonstrated the beneficial relationships between street GS quality, total vegetative cover, and chronic health in a rapidly urbanising Chinese city. Furthermore. the effect of street GS quality was more pronounced in potentially mitigating chronic health problems, and improving the quality of street GS might be an efficient and effective intervention pathway for addressing chronic health issues in densely populated cities.
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Affiliation(s)
- Yawen Liu
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, 210037, China
| | - Bing Zhao
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, 210037, China.
| | - Yingyi Cheng
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, 210037, China
| | - Tianyi Zhao
- College of Acupuncture and Massage, Health and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Ao Zhang
- College of Acupuncture and Massage, Health and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Siqi Cheng
- College of Horticulture Science, Zhejiang Agriculture & Forestry University, Hangzhou, 310000, China
| | - Jinguang Zhang
- College of Landscape Architecture, Nanjing Forestry University, Nanjing, 210037, China.
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Song J, Wang Y, Zhang Q, Qin W, Pan R, Yi W, Xu Z, Cheng J, Su H. Premature mortality attributable to NO 2 exposure in cities and the role of built environment: A global analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 866:161395. [PMID: 36621501 DOI: 10.1016/j.scitotenv.2023.161395] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/19/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Environmental risks accumulate in cities, including polluted air and health disparities, but these risks can be reduced through scientific city planning. The purpose of this study was to investigate the global burden of premature mortality attributable to NO2 exposure in urban areas and the role of the built environment in this regard. METHODS An approach based on health impact assessment was used to estimate the premature mortality burdens associated with NO2 exposure in 13,169 urban areas around the world using globally gridded NO2 and population estimates, baseline mortality, and epidemiologically derived exposure-response functions. We used the most recent WHO recommended value (i.e.,10 μg/m3) as a counterfactual concentration. Finally, the relationship between the characteristics of the built environment at the city level and the burden of NO2-related mortality was evaluated. RESULTS Worldwide, 549,715(95%CI: 276204-815,023) cases of death attributable to NO2 exposure in urban areas could be prevented if compliance with the latest WHO guideline, accounting for 2.7 % (95%CI:1.4 %-4.0 %) of total mortalities in 2019. Across cities around the world, the age-standardized mortality rate (per 100,000 people) attributable to NO2 exposure ranged from 51.3 (95%CI:25.8-76.0) in Central Asia to 3.4(95%CI: 1.7-5.1) in Oceania. Although there was a significant decrease in premature mortality attributable to NO2 exposure globally, considerable regional heterogeneity exists, with cities in Central Asia and Andean Latin America in particular exhibiting an upward trend. Further, we discovered a positive association between population density and street connectivity with mortality attributable to NO2. While the increase in green and blue space were significantly associated with a lower NO2-associated mortality. CONCLUSION The findings of this study provided a comprehensive understanding of the premature mortality burden due to NO2 in cities throughout the world and the role that urban planning policies can play in reducing the health burden associated with air pollution.
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Affiliation(s)
- Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yuling Wang
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China
| | - Qin Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Wei Qin
- Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, 288 Herston Road, Herston, QLD 4006 Brisbane, Australia
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, Anhui 230031, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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Smith N, Foley R, Georgiou M, Tieges Z, Chastin S. Urban Blue Spaces as Therapeutic Landscapes: "A Slice of Nature in the City". INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15018. [PMID: 36429735 PMCID: PMC9690541 DOI: 10.3390/ijerph192215018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Urban blue spaces are defined as all natural and manmade surface water in urban environments. This paper draws on how the concepts of experienced, symbolic, social, and activity space combine to position urban blue spaces as therapeutic landscapes. We conducted 203 intercept interviews between 12 October 2019 and 10 November 2019. Although safety concerns had health-limiting impacts, interacting with the Glasgow Canal and surrounding landscape was predominantly perceived as health-enhancing. Our findings build on current evidence, which has suggested that urban blue spaces, particularly canals, may foster therapeutic properties, contributing to healthier city environments. Further research is required to understand better the interconnectedness of urban blue spaces and health and how such spaces can be best developed and managed to improve the health outcomes of local populations.
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Affiliation(s)
- Niamh Smith
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK
| | - Ronan Foley
- Department of Geography, Maynooth University, W23 HW31 Kildare, Ireland
| | - Michail Georgiou
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK
| | - Zoë Tieges
- School of Computing, Engineering and Built Environment, Glasgow Caledonian University, Glasgow G4 0BA, UK
| | - Sebastien Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK
- Department of Movement and Sports, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
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A population-based retrospective study of the modifying effect of urban blue space on the impact of socioeconomic deprivation on mental health, 2009-2018. Sci Rep 2022; 12:13040. [PMID: 35906285 PMCID: PMC9338232 DOI: 10.1038/s41598-022-17089-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022] Open
Abstract
The incidence of mental health disorders in urban areas is increasing and there is a growing interest in using urban blue spaces (urban waterways, canals, lakes, ponds, coasts, etc.) as a tool to manage and mitigate mental health inequalities in the population. However, there is a dearth of longitudinal evidence of the mechanisms and impact of blue spaces on clinical markers of mental health to support and inform such interventions. We conducted a 10-year retrospective study, following STROBE guidelines, using routinely collected population primary care health data within the National Health Service (NHS) administrative area of Greater Glasgow and Clyde for the North of Glasgow city area. We explored whether living near blue space modifies the negative effect of socio-economic deprivation on mental health during the regeneration of an urban blue space (canal) from complete dereliction and closure. A total of 132,788 people (65,351 female) fulfilling the inclusion criteria were entered in the analysis. We established a base model estimating the effect of deprivation on the risk of mental health disorders using a Cox proportional hazards model, adjusted for age, sex and pre-existing comorbidities. We then investigated the modifying effect of living near blue space by computing a second model which included distance to blue space as an additional predicting variable and compared the results to the base model. Living near blue space modified the risk of mental health disorders deriving from socio-economic deprivation by 6% (hazard ratio 2.48, 95% confidence interval 2.39–2.57) for those living in the most deprived tertile (T1) and by 4% (hazard ratio 1.66, 95% confidence interval 1.60–1.72) for those in the medium deprivation tertile (T2). Our findings support the notion that living near blue space could play an important role in reducing the burden of mental health inequalities in urban populations.
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