Green infrastructure through the lens of "One Health": A systematic review and integrative framework uncovering synergies and trade-offs between mental health and wildlife support in cities

Urban park qualities driving visitors mental well-being and wildlife conservation in a Neotropical megacity

Green infrastructure has been widely recognized for the benefits to human health and biodiversity conservation. However, knowledge of the qualities and requirements of such spaces and structures for the effective delivery of the range of ecosystem services expected is still limited, as well as the identification of trade-offs between services. In this study, we apply the One Health approach in the context of green spaces to investigate how urban park characteristics affect human mental health and wildlife support outcomes and identify synergies and trade-offs between these dimensions. Here we show that perceived restorativeness of park users varies significantly across sites and is mainly affected by safety and naturalness perceptions. In turn, these perceptions are driven by objective indicators of quality, such as maintenance of facilities and vegetation structure, and subjective estimations of biodiversity levels. The presence of water bodies benefited both mental health and wildlife. However, high tree canopy coverage provided greater restoration potential whereas a certain level of habitat heterogeneity was important to support a wider range of bird species requirements. To reconcile human and wildlife needs in green spaces, cities should strategically implement a heterogeneous green infrastructure network that considers trade-offs and maximizes synergies between these dimensions.

The mental health impacts of human-ecosystem-animal relationships: A systematic scoping review of Eco-, Planetary, and One Health approaches

The threats to human and animal health, biodiversity conservation, and our living planet's future are ever-present and increasingly more severe due to climate change and environmental degradation. There is an emerging discourse exploring the mental health dimensions contained within these changes. To better understand and respond to these impacts requires novel and creative methodological approaches built on conceptual frameworks that integrate perspectives from the social and natural sciences. Three of the most influential interdisciplinary frameworks at the human-animal-ecosystem interface include: One Health, EcoHealth, and Planetary Health. These frameworks report mental health as an integral component within overall health-related outcomes. However, a comprehensive synthesis of the state of the literature that examines how mental health is explored within these approaches does not currently exist. A systematic scoping review was therefore conducted to obtain clear understandings of patterns, gaps, and broad themes, and to highlight future research needs and considerations. Standardized PRISMA guidelines, including explicitly defined inclusion/exclusion criteria and dual screening/extractions, were used. 13 papers were included: seven using the One Health Framework, with Planetary and EcoHealth each represented by three. Trends observed include a predominate focus on companion animals as interventions, "sense of place" used as a component of mental well-being, and non-physical health-related measurements of animal well-being as an outcome within One Health research. The lack in retrieved studies also highlight the dearth in literature on mental health as a pillar of these three well established frameworks. Compiling what is known in the evidence-base as a launching point for scientific engagement, this review describes guidance for investigators on how to conduct mental health research within these framework parameters so that future studies can elucidate mechanisms underpinning the intersections between the biosphere and human mental-health and data-driven interventions and policy recommendations that simultaneously address mental health and global change can be proposed and enacted.

Toward One Health: a spatial indicator system to model the facilitation of the spread of zoonotic diseases

Recurrent outbreaks of zoonotic infectious diseases highlight the importance of considering the interconnections between human, animal, and environmental health in disease prevention and control. This has given rise to the concept of One Health, which recognizes the interconnectedness of between human and animal health within their ecosystems. As a contribution to the One Health approach, this study aims to develop an indicator system to model the facilitation of the spread of zoonotic diseases. Initially, a literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to identify relevant indicators related to One Health. The selected indicators focused on demographics, socioeconomic aspects, interactions between animal and human populations and water bodies, as well as environmental conditions related to air quality and climate. These indicators were characterized using values obtained from the literature or calculated through distance analysis, geoprocessing tasks, and other methods. Subsequently, Multi-Criteria Decision-Making (MCDM) techniques, specifically the Entropy and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) methods, were utilized to combine the indicators and create a composite metric for assessing the spread of zoonotic diseases. The final indicators selected were then tested against recorded zoonoses in the Valencian Community (Spain) for 2021, and a strong positive correlation was identified. Therefore, the proposed indicator system can be valuable in guiding the development of planning strategies that align with the One Health principles. Based on the results achieved, such strategies may prioritize the preservation of natural landscape features to mitigate habitat encroachment, protect land and water resources, and attenuate extreme atmospheric conditions.

Connecting Biodiversity With Mental Health and Wellbeing — A Review of Methods and Disciplinary Perspectives

Biodiversity conservation and mental health and wellbeing are of increasing global concern, with growing relevance to planning and policy. A growing body of literature exploring the relationships between biodiversity and mental health and wellbeing—based on early research conducted largely from social science perspectives—suggests that particular qualities within natural environments confer particular benefits. Results so far have been inconclusive and inconsistent, contributing to an incohesive body of evidence. While past reviews have focused on reporting variations in results, the present study builds on early reviews by exploring variations from the perspective of author disciplines and the use of different guiding theories, and variables used to measure biodiversity, mental health and wellbeing. This aims to address a research gap in understanding whether research in this topic has become more interdisciplinary or has employed more consistent study designs, which were highlighted as priorities in past reviews, but the progress of which has not yet been explored in depth. We found that research connecting biodiversity and mental health and wellbeing has become only marginally more interdisciplinary in recent years, and there is still a large inconsistency in the use of guiding theories, variables and overall study designs. The variation in disciplinary perspectives and methods reflects a growing interest in this field and the variety of ways researchers are trying to understand and test the complex relationships between biodiversity and mental health and wellbeing. Our study shows that there are unique perspectives that different disciplines can contribute to this body of research and continuing to increase collaboration between disciplines with the use of consistent mixed methods approaches in future may contribute to a more cohesive body of evidence. We provide a framework to conceptualize recommendations for future research, highlighting the importance of interdisciplinary collaboration at multiple scales, and importantly focusing on more specific, mechanistic studies to inform decision-making that provides co-benefits for biodiversity and mental health and wellbeing.

Selected Research Issues of Urban Public Health

Health is created within the urban settings of people’s everyday lives. In this paper we define Urban Public Health and compile existing evidence regarding the spatial component of health and disease in urban environments. Although there is already a substantial body of single evidence on the links between urban environments and human health, focus is mostly on individual health behaviors. We look at Urban Public Health through a structural lens that addresses health conditions beyond individual health behaviors and identify not only health risks but also health resources associated with urban structures. Based on existing conceptual frameworks, we structured evidence in the following categories: (i) build and natural environment, (ii) social environment, (iii) governance and urban development. We focused our search to review articles and reviews of reviews for each of the keywords via database PubMed, Cochrane, and Google Scholar in order to cover the range of issues in urban environments. Our results show that linking findings from different disciplines and developing spatial thinking can overcome existing single evidence and make other correlations visible. Further research should use interdisciplinary approaches and focus on health resources and the transformation of urban structures rather than merely on health risks and behavior.

Urban green spaces and stress during COVID-19 lockdown: A case study for the city of Madrid

Due to the unexpected emergence of COVID-19, different cities improvised responses to prevent the virus from spreading and infecting the population. Madrid, capital of Spain and one of the most affected cities in Europe, confined everyone home and closed most public and private spaces, including public parks. The whole situation was surely to be responsible for stress-levels to peak. We developed an online survey to better understand the relationship between people and Urban Green Spaces prior to the COVID-19 pandemic, and the new bond that may have emerged from this interruption. We recruited participants, without gender or age preference, excluding underage children and teenagers, using a combination of convenience sample and a snowball approach. A total of 132 responses were logged. The study was limited to mental health inferences, specifically related to stress and its most frequent manifestations among the urban population. These indicators included physical, mood or behavioral changes and were studied on those participants who had access to UGS before and during confinement. Among the most important findings, we confirmed that when people are confronted with stressful situations, indoor plant interaction is not a substitute for different outdoor green experiences; those who interacted with green spaces in a daily manner managed stress levels better than people who didn't (but their effects might lose strength over time); and turning to green spaces for comfort during stressful times when you don't usually do so helps overcome difficult situations. This article contributes to the growing study of green spaces as a means towards improved mental well-being in urban areas.

The impact of the COVID-19 pandemic on the importance of urban green spaces to the public

Green spaces provide people with countless intangible benefits, particularly important during crises. Restrictions imposed in many countries due to the COVID-19 pandemic forced people to maintain social distance, limit travels, and even refrain from visiting green spaces and stay at home at a certain point. The survey in one of the largest cities in Poland, Kraków, was intended to help understand the impact of the pandemic on the importance of urban green spaces to the public. The study focused on the first three stages of the pandemic in Poland, from March to November 2020. Nine weeks of the survey yielded over 1250 responses. Responses to spatial questions were analysed with GIS tools and geoprocessing algorithms. The number of visitors to green spaces during the pandemic fell to 78.9% of the population, which is down 13.1% compared to before the pandemic. At the same time, the percentage of people refraining from the visits fell with each phase of the crisis. According to the study, residents believed green spaces to be important for their mental and physical health. Over 75% of the participants considered visits to green spaces as having a very big or big impact on stress level reduction. The work provides empirical proof of the importance of green spaces to residents, particularly during a crisis. The results can affect urban spatial policies and management of green spaces and can potentially be applied in other 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.

Green Space and Health in Mainland China: A Systematic Review

Non-communicable diseases (NCDs) have become a major cause of premature mortality and disabilities in China due to factors concomitant with rapid economic growth and urbanisation over three decades. Promoting green space might be a valuable strategy to help improve population health in China, as well as a range of co-benefits (e.g., increasing resilience to climate change). No systematic review has so far determined the degree of association between green space and health outcomes in China. This review was conducted to address this gap. Five electronic databases were searched using search terms on green space, health, and China. The review of 83 publications that met eligibility criteria reports associations indicative of various health benefits from more green space, including mental health, general health, healthier weight status and anthropometry, and more favorable cardiometabolic and cerebrovascular outcomes. There was insufficient evidence to draw firm conclusions on mortality, birth outcomes, and cognitive function, and findings on respiratory and infectious outcomes were inconsistent and limited. Future work needs to examine the health benefits of particular types and qualities of green spaces, as well as to take advantage of (quasi-)experimental designs to test greening interventions within the context of China's rapid urbanization and economic growth.

A multi-scalar perspective on health and urban housing: an umbrella review

With more than half the world's population living in cities, understanding how the built environment impacts human health at different urban scales is crucial. To be able to shape cities for health, an understanding is needed of planetary health impacts, which encompass the human health impacts of human-caused disruptions on the Earth's natural ecosystems. This umbrella review maps health evidence across the spatial scales of the built environment (building; neighbourhood; and wider system, including city, regional and planetary levels), with a specific focus on urban housing. Systematic reviews published in English between January 2011 and December 2020 were searched across 20 databases, with 1176 articles identified and 124 articles screened for inclusion. Findings suggests that most evidence reports on health determinants at the neighbourhood level, such as greenspace, physical and socio-economic conditions, transport infrastructure and access to local services. Physical health outcomes are also primarily reported, with an emerging interest in mental health outcomes. There is little evidence on planetary health outcomes and significant gaps in the research literature are identified. Based on these findings, three potential directions are identified for future research.

Usage of urban green space and related feelings of deprivation during the COVID-19 lockdown: Lessons learned from an Italian case study

This study investigated perceptions and behavioral patterns related to urban green space (UGS) in Italian cities, during the period of national lockdown imposed due to the outbreak of SARS-CoV-2 in the spring of 2020. A survey was used to examine the responses of population groups in different municipal areas, comparing those in government-defined "red zones", mostly in the northern regions of the country, with "non-red zones" in the rest of the country, where the rate of infection was much lower. A total of 2100 respondents participated in the survey. The majority of respondents declared themselves to be habitual users of UGS, especially of parks or green areas outside the town - mainly visiting for relaxation and physical exercise, but also for observing nature. In the northern regions people more commonly reported the adoption of sustainable practices, in terms of the utilization of tools for "green mobility". During the lockdown, habits changed significantly: only one third of respondents reported visiting UGS, with frequent visits made mainly for the purpose of walking the dog. Other motivations included the need for relaxing, mostly in the red zones, and for physical exercise in non-red zones. The reduction in travel to urban parks was accompanied by increased visitation of gardens and other green spaces in close proximity, as social distancing and other regulations imposed restrictions on movement. In all regions, respondents who could not physically access UGS expressed a feeling of deprivation which was exacerbated by living in towns located in red zones, being a usual visitor of UGS and having no green view from the window. The extent to which these visitors missed UGS depended on the frequency of visitation before the pandemic and the UGS distance, as well as the type of previous activity. In fact, those activities that were most common before the pandemic were missed the most, reinforcing the importance of green areas for social gathering, sports, and observing nature - but simply "spending time outdoors" was also mentioned, even by those who visited UGS during the lockdown, as the time outdoors was not enough or not fully enjoyed. The feeling of missing UGS was only partially alleviated by the green view from the window - only a more open view to a natural landscape or adaptation to a view with little greenery reduced such feeling.

Effects of COVID-19 on the Sustainable Development Goals (SDGs)

Global crises caused by the pandemic of COVID-19, since early 2020, can compromise the world commitment to the 2030 Agenda for Sustainable Development. This study discusses critical aspects of the global pandemic for the achievement of the Sustainable Development Goals (SDGs). More precisely, we analyze how the new circumstances created by the pandemic have affected the interdependencies between SDGs. Following a synopsis of the current literature, we focus on effects regarding SDG3 (Health & Well-Being), SDG4 (Quality Education), SDG8 (Decent Work & Economic Growth), SDG12 (Consumption & Production) and SDG13 (Climate Action). Following a qualitative research approach, we based our analysis on moderated focus group discussions (FGD). Our observations reveal a unique pattern of interconnectedness between SDGs that can be related to COVID-19 consequences. Qualitative interpretations of focus group discussions also depict, that additional spillover effects can be obstacles for achieving SDG 5 (Gender Equality), SDG 9 (Infrastructure & Innovation) and SDG 10 (Reducing Inequalities), SDG 17 (partnerships for the goals), SDG 11 (sustainable cities). Therefore, we consider the interdependent implications and recent trends in international development related to sustainability as a useful framework in the post-pandemic recovery period.