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Grellier J, White MP, de Bell S, Brousse O, Elliott LR, Fleming LE, Heaviside C, Simpson C, Taylor T, Wheeler BW, Lovell R. Valuing the health benefits of nature-based recreational physical activity in England. ENVIRONMENT INTERNATIONAL 2024; 187:108667. [PMID: 38642505 DOI: 10.1016/j.envint.2024.108667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 03/15/2024] [Accepted: 04/15/2024] [Indexed: 04/22/2024]
Abstract
Physical activity (PA) reduces the risk of several non-communicable diseases (NCDs). Natural environments support recreational PA. Using data including a representative cross-sectional survey of the English population, we estimated the annual value of nature-based PA conducted in England in 2019 in terms of avoided healthcare and societal costs of disease. Population-representative data from the Monitor of Engagement with the Natural Environment (MENE) survey (n = 47,580; representing 44,386,756) were used to estimate the weekly volume of nature-based recreational PA by adults in England in 2019. We used epidemiological dose-response data to calculate incident cases of six NCDs (ischaemic heart disease (IHD), ischaemic stroke (IS), type 2 diabetes (T2D), colon cancer (CC), breast cancer (BC) and major depressive disorder (MDD)) prevented through nature-based PA, and estimated associated savings using published costs of healthcare, informal care and productivity losses. We investigated additional savings resulting from hypothetical increases in: (a) visitor PA and (b) visitor numbers. In 2019, 22million adults > 16 years of age in England visited natural environments at least weekly. At reported volumes of nature-based PA, we estimated that 550 cases of IHD, 168 cases of IS, 1,410 cases of T2D, 41 cases of CC, 37 cases of BC and 10,552 cases of MDD were prevented, creating annual savings of £108.7million (95 % uncertainty interval: £70.3million; £150.3million). Nature-based recreational PA in England results in reduced burden of disease and considerable annual savings through prevention of priority NCDs. Strategies that increase nature-based PA could lead to further reductions in the societal burden of NCDs.
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Affiliation(s)
- James Grellier
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK; Institute of Psychology, Jagiellonian University, Krakow, Poland.
| | - Mathew P White
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK; Vienna Cognitive Science Hub, University of Vienna, Kolingasse 14-16, 1090 Vienna, Austria
| | - Siân de Bell
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK; Exeter HS&DR Evidence Synthesis Centre, University of Exeter, Exeter, Devon, UK
| | - Oscar Brousse
- The Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
| | - Lewis R Elliott
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK
| | - Lora E Fleming
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK
| | - Clare Heaviside
- The Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
| | - Charles Simpson
- The Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
| | - Tim Taylor
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK
| | - Benedict W Wheeler
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK
| | - Rebecca Lovell
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK
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2
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Hooyberg A, Roose H, Lonneville B, De Henauw S, Michels N, Everaert G. Survey data linking coastal visit behaviours to socio-demographic and health profiles. Sci Data 2024; 11:315. [PMID: 38538625 PMCID: PMC10973510 DOI: 10.1038/s41597-024-03161-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/19/2024] [Indexed: 04/01/2024] Open
Abstract
Coastal destinations are highly popular for leisure, yet the effects of spending time at the coast on mental and physical health have remained underexplored. To accelerate the research about the effects of the coast on health, we compiled a dataset from a survey on a sample (N = 1939) of the adult Flemish population about their visits to the Belgian coast. The survey queried the number of days spent at the coast in the previous year or before and the following characteristics of their visits: how often they performed specific activities, which of the 14 municipal seaside resorts they visited, who they were with, what they mentally and physically experienced, and what reasons they had for not visiting the coast more often. The respondents' geo-demographic (including residential proximity to the coast), socio-economic, and health profile was also collected. We anticipate that investigations on the data will increase our understanding about the social structuring of coastal visits and give context to the effects of the coast on human health.
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Affiliation(s)
| | - Henk Roose
- Department of Sociology, Ghent University (UGent), Ghent, Belgium
| | | | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University (UGent), Ghent, Belgium
| | - Nathalie Michels
- Department of Developmental, Personality and Social Psychology, Ghent University (UGent), Ghent, Belgium
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3
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Ghosh S, Pal S. Anthropogenic impacts on urban blue space and its reciprocal effect on human and socio-ecological health. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 351:119727. [PMID: 38070422 DOI: 10.1016/j.jenvman.2023.119727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/10/2023] [Accepted: 11/25/2023] [Indexed: 01/14/2024]
Abstract
Quantifying anthropogenic impacts on blue space (BS) and its effect on human and socio-ecological health was least explored. The present study aimed to do this in reference to the urban BS transformation scenario of Eastern India. To measure BS transformation, Landsat image-based water indices were run from 1990 to 2021. Anthropogenic impact score (AIS) and 7 components scores of 78 selected BS on 70 parameters related data driven from the field. Total 345 respondents were taken for human and socio-ecological health assessment. For this, depression (DEP), anxiety (ANX), stress (STR), physical activities (PA), social capital (SC), therapeutic landscape (TL) and environment building (EB) parameters were taken. The result exhibited that BS was reduced. About 50% of urban core BS was reported highly impacted. Human and socio-ecological health was identified as good in proximity to BS, but it was observed better in the cases of larger peripheral BS. AIS on BS was found to be positively associated with mental health (0.47-0.63) and negatively associated with PA, SC, TL and EB (-0.50 to -0.90). Standard residual in ordinary least square was reported low (-1.5 to 1.5) in 95% BS. Therefore, BS health restoration and management is crucial for sustaining the living environment.
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Affiliation(s)
- Susmita Ghosh
- Department of Geography, University of Gour Banga, Malda, India.
| | - Swades Pal
- Department of Geography, University of Gour Banga, Malda, India.
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4
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Dimakopoulou K, Nobile F, de Bont J, Wolf K, Vienneau D, Ibi D, Coloma F, Pickford R, Åström C, Sommar JN, Kasdagli MI, Souliotis K, Tsolakidis A, Tonne C, Melén E, Ljungman P, de Hoogh K, Vermeulen RCH, Vlaanderen JJ, Katsouyanni K, Stafoggia M, Samoli E. Disentangling associations between multiple environmental exposures and all-cause mortality: an analysis of European administrative and traditional cohorts. FRONTIERS IN EPIDEMIOLOGY 2024; 3:1328188. [PMID: 38455945 PMCID: PMC10910955 DOI: 10.3389/fepid.2023.1328188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/20/2023] [Indexed: 03/09/2024]
Abstract
Background We evaluated the independent and joint effects of air pollution, land/built environment characteristics, and ambient temperature on all-cause mortality as part of the EXPANSE project. Methods We collected data from six administrative cohorts covering Catalonia, Greece, the Netherlands, Rome, Sweden, and Switzerland and three traditional cohorts in Sweden, the Netherlands, and Germany. Participants were linked to spatial exposure estimates derived from hybrid land use regression models and satellite data for: air pollution [fine particulate matter (PM2.5), nitrogen dioxide (NO₂), black carbon (BC), warm season ozone (O3)], land/built environment [normalized difference vegetation index (NDVI), distance to water, impervious surfaces], and ambient temperature (the mean and standard deviation of warm and cool season temperature). We applied Cox proportional hazard models accounting for several cohort-specific individual and area-level variables. We evaluated the associations through single and multiexposure models, and interactions between exposures. The joint effects were estimated using the cumulative risk index (CRI). Cohort-specific hazard ratios (HR) were combined using random-effects meta-analyses. Results We observed over 3.1 million deaths out of approximately 204 million person-years. In administrative cohorts, increased exposure to PM2.5, NO2, and BC was significantly associated with all-cause mortality (pooled HRs: 1.054, 1.033, and 1.032, respectively). We observed an adverse effect of increased impervious surface and mean season-specific temperature, and a protective effect of increased O3, NDVI, distance to water, and temperature variation on all-cause mortality. The effects of PM2.5 were higher in areas with lower (10th percentile) compared to higher (90th percentile) NDVI levels [pooled HRs: 1.054 (95% confidence interval (CI) 1.030-1.079) vs. 1.038 (95% CI 0.964-1.118)]. A similar pattern was observed for NO2. The CRI of air pollutants (PM2.5 or NO2) plus NDVI and mean warm season temperature resulted in a stronger effect compared to single-exposure HRs: [PM2.5 pooled HR: 1.061 (95% CI 1.021-1.102); NO2 pooled HR: 1.041 (95% CI 1.025-1.057)]. Non-significant effects of similar patterns were observed in traditional cohorts. Discussion The findings of our study not only support the independent effects of long-term exposure to air pollution and greenness, but also highlight the increased effect when interplaying with other environmental exposures.
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Affiliation(s)
- Konstantina Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Federica Nobile
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Danielle Vienneau
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorina Ibi
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Fabián Coloma
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Regina Pickford
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Johan Nilsson Sommar
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Maria-Iosifina Kasdagli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Kyriakos Souliotis
- Department of Social and Education Policy, University of Peloponnese, Corinth, Greece
- Health Policy Institute, Athens, Greece
| | | | - Cathryn Tonne
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Erik Melén
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachś Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Kees de Hoogh
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Roel C. H. Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Jelle J. Vlaanderen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- MRC Centre for Environment and Health, Environmental Research Group, Imperial College London, United Kingdom NIHR HPRU in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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5
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Fian L, White MP, Arnberger A, Thaler T, Heske A, Pahl S. Nature visits, but not residential greenness, are associated with reduced income-related inequalities in subjective well-being. Health Place 2024; 85:103175. [PMID: 38266374 DOI: 10.1016/j.healthplace.2024.103175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/04/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
Nature exposure can promote human health and well-being. Additionally, there is some, albeit mixed, evidence that this relationship is stronger for socio-economically disadvantaged groups (equigenesis). Using a cross-sectional survey of the Austrian population (N = 2300), we explored the relationships between both residential greenness and recreational nature visits, and affective (WHO-5 Well-Being Index) and evaluative (Personal Well-Being Index-7) subjective well-being. Partially supporting the equigenesis hypothesis, regression analyses controlling for potential confounders found that recreational visit frequency, but not residential greenness, moderated the effect of income-related disparities in both subjective well-being metrics. Results suggest that merely making neighborhoods greener may not itself help reduce inequalities in subjective well-being. Additionally, greater efforts are also needed to support individuals from all sectors of society to access natural settings for recreation as this could significantly improve the well-being of some of the poorest in society.
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Affiliation(s)
- Leonie Fian
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria.
| | - Mathew P White
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria; Cognitive Science HUB, University of Vienna, Vienna, Austria; Environment and Climate Research HUB, University of Vienna, Vienna, Austria
| | - Arne Arnberger
- Institute of Landscape Development, Recreation and Conservation Planning, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Thomas Thaler
- Institute of Landscape Planning (ILAP), University of Natural Resources and Life Sciences, Vienna, Austria
| | - Anja Heske
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Sabine Pahl
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria; Environment and Climate Research HUB, University of Vienna, Vienna, Austria
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6
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Vegaraju A, Amiri S. Urban green and blue spaces and general and mental health among older adults in Washington state: Analysis of BRFSS data between 2011-2019. Health Place 2024; 85:103148. [PMID: 38043153 DOI: 10.1016/j.healthplace.2023.103148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
A growing body of evidence highlights the significant effect of built environment features on mental and general health. This study examined the association between distance to and percentage of green and blue space measures and serious psychological distress, general health, and frequent mental distress among older adults living in urban ZIP codes in Washington state. Percentage of green space, particularly tree canopy and forest space, was significantly associated with better self-rated general health and reduced odds of serious psychological distress. Closer distance to blue space was associated with better self-rated general health. Programs which incentivize exposure to green and blue spaces for urban-dwelling, older adults may improve health outcomes.
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Affiliation(s)
- Adithya Vegaraju
- Elson S. Floyd College of Medicine, Washington State University, USA.
| | - Solmaz Amiri
- Elson S. Floyd College of Medicine, Washington State University, USA; Institute for Research and Education to Advance Community Health, USA
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7
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White MP, Hartig T, Martin L, Pahl S, van den Berg AE, Wells NM, Costongs C, Dzhambov AM, Elliott LR, Godfrey A, Hartl A, Konijnendijk C, Litt JS, Lovell R, Lymeus F, O'Driscoll C, Pichler C, Pouso S, Razani N, Secco L, Steininger MO, Stigsdotter UK, Uyarra M, van den Bosch M. Nature-based biopsychosocial resilience: An integrative theoretical framework for research on nature and health. ENVIRONMENT INTERNATIONAL 2023; 181:108234. [PMID: 37832260 DOI: 10.1016/j.envint.2023.108234] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/09/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023]
Abstract
Nature-based solutions including urban forests and wetlands can help communities cope better with climate change and other environmental stressors by enhancing social-ecological resilience. Natural ecosystems, settings, elements and affordances can also help individuals become more personally resilient to a variety of stressors, although the mechanisms underpinning individual-level nature-based resilience, and their relations to social-ecological resilience, are not well articulated. We propose 'nature-based biopsychosocial resilience theory' (NBRT) to address these gaps. Our framework begins by suggesting that individual-level resilience can refer to both: a) a person's set of adaptive resources; and b) the processes by which these resources are deployed. Drawing on existing nature-health perspectives, we argue that nature contact can support individuals build and maintain biological, psychological, and social (i.e. biopsychosocial) resilience-related resources. Together with nature-based social-ecological resilience, these biopsychosocial resilience resources can: i) reduce the risk of various stressors (preventive resilience); ii) enhance adaptive reactions to stressful circumstances (response resilience), and/or iii) facilitate more rapid and/or complete recovery from stress (recovery resilience). Reference to these three resilience processes supports integration across more familiar pathways involving harm reduction, capacity building, and restoration. Evidence in support of the theory, potential interventions to promote nature-based biopsychosocial resilience, and issues that require further consideration are discussed.
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Affiliation(s)
- Mathew P White
- Cognitive Science HUB, University of Vienna, Austria; European Centre for Environment & Human Health, University of Exeter, UK.
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden
| | - Leanne Martin
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Sabine Pahl
- Urban and Environmental Psychology Group, University of Vienna, Austria
| | | | - Nancy M Wells
- Department of Human Centered Design, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | | | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Lewis R Elliott
- European Centre for Environment & Human Health, University of Exeter, UK
| | | | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | | | - Jill S Litt
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rebecca Lovell
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Freddie Lymeus
- Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden
| | | | - Christina Pichler
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | - Sarai Pouso
- AZTI, Marine Research, Basque Research and Technology Alliance (BRTA), Herrera Kaia, Portualdea z/g, 20110 Pasaia, Gipuzkoa, Spain
| | - Nooshin Razani
- University of California San Francisco, San Francisco, CA, United States
| | - Laura Secco
- Department of Territorio e Sistemi Agro-Forestali (TESAF), University of Padua, Padua, Italy
| | | | - Ulrika K Stigsdotter
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Denmark
| | - Maria Uyarra
- AZTI, Marine Research, Basque Research and Technology Alliance (BRTA), Herrera Kaia, Portualdea z/g, 20110 Pasaia, Gipuzkoa, Spain
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
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8
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Elliott LR, Pasanen T, White MP, Wheeler BW, Grellier J, Cirach M, Bratman GN, van den Bosch M, Roiko A, Ojala A, Nieuwenhuijsen M, Fleming LE. Nature contact and general health: Testing multiple serial mediation pathways with data from adults in 18 countries. ENVIRONMENT INTERNATIONAL 2023; 178:108077. [PMID: 37413929 DOI: 10.1016/j.envint.2023.108077] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/05/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023]
Abstract
The role of neighbourhood nature in promoting good health is increasingly recognised in policy and practice, but consistent evidence for the underlying mechanisms is lacking. Heterogeneity in exposure methods, outcome measures, and population characteristics, little exploration of recreational use or the role of different types of green or blue space, and multiple separate mediation models in previous studies have limited our ability to synthesise findings and draw clear conclusions. We examined multiple pathways linking different types of neighbourhood nature with general health using a harmonised international sample of adults. Using cross-sectional survey data from 18 countries (n = 15,917), we developed a multigroup path model to test theorised pathways, controlling for sociodemographic variables. We tested the possibility that neighbourhood nature (e.g. greenspace, inland bluespace, and coastal bluespace) would be associated with general health through lower air pollution exposure, greater physical activity attainment, more social contact, and higher subjective well-being. However, our central prediction was that associations between different types of neighbourhood nature and general health would largely be serially mediated by recent visit frequency to corresponding environment types, and, subsequently, physical activity, social contact, and subjective well-being associated with these frequencies. Several subsidiary analyses assessed the robustness of the results to alternative model specifications as well as effect modification by sociodemographics. Consistent with this prediction, there was statistical support for eight of nine potential serial mediation pathways via visit frequency which held for a range of alternative model specifications. Effect modification by financial strain, sex, age, and urbanicity altered some associations but did not necessarily support the idea that nature reduced health inequalities. The results demonstrate that across countries, theorised nature-health linkages operate primarily through recreational contact with natural environments. This provides arguments for greater efforts to support use of local green/blue spaces for health promotion and disease prevention.
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Affiliation(s)
- Lewis R Elliott
- European Centre for Environment and Human Health, University of Exeter, Cornwall, United Kingdom.
| | - Tytti Pasanen
- Finnish Institute for Health and Welfare, Tampere, Finland
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter, Cornwall, United Kingdom; Cognitive Science Hub, University of Vienna, Vienna, Austria
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter, Cornwall, United Kingdom
| | - James Grellier
- European Centre for Environment and Human Health, University of Exeter, Cornwall, United Kingdom; Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Marta Cirach
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, USA
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Forest and Conservation Sciences, Faculty of Forestry, University of British Columbia, Canada; School of Population and Public Health, Faculty of Medicine, University of British Columbia
| | - Anne Roiko
- School of Pharmacy & Medical Sciences, Griffith University, Australia
| | - Ann Ojala
- Natural Resources Institute Finland (Luke), Helsinki, Finland
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter, Cornwall, United Kingdom
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9
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Chen Y, Yuan Y, Zhou Y. Exploring the Association between Neighborhood Blue Space and Self-Rated Health among Elderly Adults: Evidence from Guangzhou, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16342. [PMID: 36498412 PMCID: PMC9738962 DOI: 10.3390/ijerph192316342] [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: 09/21/2022] [Revised: 11/26/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Blue spaces is associated with self-rated health (SRH), but little is known about the pathways underlying this association among Chinese urban elderly individuals. Based on neighborhood effect theory, this study examined the relationship between neighborhood blue spaces and SRH among elderly individuals using data from a questionnaire survey conducted in Guangzhou, remote sensing images, street views, and environmental information in the context of a Chinese megacity. In addition, multilevel linear model and mediating effect model empirical analyses were performed. Results showed that first, the SRH of the elderly was associated with individual- and neighborhood-level factors. Second, the multilevel mediation model revealed that multiple biopsychosocial pathways existed between neighborhood blue spaces and the SRH of the elderly, specifically, the blue space characteristics related to the SRH of the elderly via the mediating effect of stress. Third, owing to demographic characteristics and socioeconomic status, the stratified analyses also indicated a strong association between neighborhood blue spaces and SRH outcomes in the older and low-income groups. The mediating effect of stress in the age and income groups was also observed, and the mediation pathways and group differences were confirmed in the context of Chinese cities. This research enriches the empirical literature on blue spaces and elderly health from a multidisciplinary perspective and suggests the need for "healthy neighborhood" and "health-aging" planning in Chinese settings.
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Affiliation(s)
- Yujie Chen
- School of Geographic and Biologic Information, Nanjing University of Posts and Telecommunications, Nanjing 210023, China
| | - Yuan Yuan
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510006, China
- Guangdong Key Laboratory for Urbanization and Geo-Simulation, Guangzhou 510006, China
| | - Yuquan Zhou
- Department of Urban Planning and Spatial Analysis, Sol Price School of Public Policy, University of Southern California, Los Angeles, CA 90089, USA
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10
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Lymeus F, White MP, Lindberg P, Hartig T. Restoration Skills Training in a Natural Setting Compared to Conventional Mindfulness Training: Sustained Advantages at a 6-Month Follow-Up. Front Psychol 2022; 13:763650. [PMID: 35978765 PMCID: PMC9376351 DOI: 10.3389/fpsyg.2022.763650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 06/13/2022] [Indexed: 11/30/2022] Open
Abstract
Restoration skills training (ReST) is a mindfulness-based course in which participants draw support from a natural practice setting while they learn to meditate. Well-established conventional mindfulness training (CMT) can improve psychological functioning but many perceive it as demanding and fail to sustain practice habits. Applying non-inferiority logic, previous research indicated that ReST overcomes compliance problems without compromising the benefits gained over 5 weeks’ training. This article applies similar logic in a 6-month follow-up. Of 97 contacted ReST and CMT course completers, 68 responded and 29 were included with multiple imputation data. The online survey included questions about their psychological functioning in three domains (dispositional mindfulness, cognitive lapses, and perceived stress) and the forms and frequencies with which they had continued to practice mindfulness after the course. Former ReST participants continued, on average, to show higher dispositional mindfulness and fewer cognitive lapses compared to pre-course ratings. Improved psychological functioning in one or more domains was demonstrated by 35%, as determined by a reliable change index. Again, analyses detected no indications of any substantive disadvantages compared to the more demanding, established CMT approach. Compared to the CMT group, more ReST participants had also continued to practice at least occasionally (92 vs. 67%). Continued practice was linked to sustained improvements for ReST but not clearly so for CMT. ReST participants thus continued to use the skills and sustained the improvements in psychological functioning that they had gained in the course, further supporting the utility of ReST as a health intervention.
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Affiliation(s)
- Freddie Lymeus
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
- *Correspondence: Freddie Lymeus,
| | - Mathew P. White
- Vienna Cognitive Science Hub, University of Vienna, Vienna, Austria
| | - Per Lindberg
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
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11
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Yu H, Mulhearn SC, van der Mars H, Griffo JM, Kulinna PH. Off-Hours Facility Use in Public High Schools: Physical Activity Potential vs. Reality. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:341-351. [PMID: 33297864 DOI: 10.1080/02701367.2020.1844128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/27/2020] [Indexed: 06/12/2023]
Abstract
Purpose: Public high school campuses in the United States are generally built with multiple dedicated physical activity facilities from soccer fields to swimming pools. When viewed from a community health standpoint, these campuses hold great potential (if accessible) in providing community members spaces where they can engage in physical activity during non-school hours. Guided by the Social-Ecological Model (SEM) the purpose of this study was to assess access to and use of all physical activity areas on public high school campuses during non-school hours on weekdays and weekend days. Method: Direct observation using the SOPARC instrument was used to assess 19 public high schools across four districts in the Western U.S., by completing 3959 physical activity area sweeps. Results: Facilities were accessible about half of the time (53.4%), but empty 91% of the time. Public high school campuses are an underused resource for community physical activity during non-school hours. Discussion: Increased use of joint-use agreements would enable school districts to increase both the use of campus-based physical activity facilities and physical activity levels of community members who themselves fund the construction and maintenance of schools and school grounds through local taxes. This would help increase the schools' caloric footprint and contribute to improving public health.
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12
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Williams CR, Burnell SM, Rogers M, Flies EJ, Baldock KL. Nature-Based Citizen Science as a Mechanism to Improve Human Health in Urban Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:68. [PMID: 35010326 PMCID: PMC8751081 DOI: 10.3390/ijerph19010068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
The world is becoming increasingly urbanised, impacting human interactions with natural environments (NEs). NEs take a number of forms, ranging from pristine, modified, to built NEs, which are common in many urban areas. NEs may include nature-based solutions, such as introducing nature elements and biological processes into cities that are used to solve problems created by urbanisation. Whilst urbanisation has negative impacts on human health, impacting mental and physical wellbeing through a number of mechanisms, exposure to NEs may improve human health and wellbeing. Here, we review the mechanisms by which health can be improved by exposure to NEs, as explained by Stress Reduction Theory, Attention Restoration Theory, and the 'Old Friends'/biodiversity hypothesis. Such exposures may have physiological and immunological benefits, mediated through endocrine pathways and altered microbiota. Citizen Science, which often causes exposure to NEs and social activity, is being increasingly used to not only collect scientific data but also to engage individuals and communities. Despite being a named component of scientific and environmental strategies of governments, to our knowledge, the intrinsic health benefits of Citizen Science in NEs do not form part of public health policy. We contend that Citizen Science programs that facilitate exposure to NEs in urban areas may represent an important public health policy advance.
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Affiliation(s)
- Craig R. Williams
- UniSA Clinical and Health Science, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; (S.M.B.); (M.R.)
| | - Sophie M. Burnell
- UniSA Clinical and Health Science, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; (S.M.B.); (M.R.)
| | - Michelle Rogers
- UniSA Clinical and Health Science, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; (S.M.B.); (M.R.)
| | - Emily J. Flies
- School of Natural Sciences, University of Tasmania, Private Bag 55, Hobart, TAS 7001, Australia;
| | - Katherine L. Baldock
- UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia;
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13
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Brant BJ, Singleton DA, Noble PJM, Radford AD. Seasonality and risk factors for grass seed foreign bodies in dogs. Prev Vet Med 2021; 197:105499. [PMID: 34583207 DOI: 10.1016/j.prevetmed.2021.105499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 10/20/2022]
Abstract
Grass seed foreign bodies (GSFBs) are a familiar presentation, especially in dogs, associated with a variety of clinical signs depending on site of penetration and extent of migration. Seasonality and risk factors for GSFB occurrence were investigated using electronic health records from a sentinel voluntary network of 245 veterinary practices in the United Kingdom between 17th March 2014 and 18th September 2020. Clinical narrative text mining of 4,580,503 canine consultations produced a final case dataset of 1,037 consultations where GSFBs had been recorded in individual dogs. Cases of GSFBs were recorded in all months, with 940 (90.6 %) recorded between June and September. In particular, the odds of GSFBs in July was almost 176 times more than that of January (Odds ratio, OR, 175.6, 95 % Confidence interval, CI, 43.5-707.7, P < 0.001). Compared to the retriever breed type, spaniel breed types were 7.7 times more likely to present with a GSFB (CI 5.4-11.0, P < 0.001). Other significant risk factors associated with recorded GSFBs for this population included being male (OR = 1.4, CI 1.2-1.6, P < 0.001), and geographical location. When compared to the South East of England, risk was lowest in Wales (OR = 0.1, CI 0.0-0.3, P=<0.001), and highest in the East of England (OR = 1.9, 1.2-2.9, P = 0.003), and overall risk in urban areas was reduced (OR = 0.8, CI 0.7-1.0, P = 0.024). These observations provide a number of areas for temporally targeted health campaigns at specific types of dogs, to reduce the impact of GSFBs on canine welfare.
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Affiliation(s)
- Bethaney J Brant
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, CH64 7TE, UK.
| | - David A Singleton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, CH64 7TE, UK
| | - P J M Noble
- School of Veterinary Science, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, CH64 7TE, UK
| | - Alan D Radford
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, CH64 7TE, UK
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Elliott LR, White MP, Fleming LE, Abraham C, Taylor AH. Redesigning walking brochures using behaviour change theory: implications for walking intentions in natural environments. Health Promot Int 2021; 36:1126-1139. [PMID: 33367651 PMCID: PMC8527999 DOI: 10.1093/heapro/daaa150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Natural environments can be used to promote health through facilitating recreational walking. However, efforts to encourage this often neglect messages identified in psychological research that are effective at influencing intentions to walk. This is despite the National Institute for Health and Care Excellence stating that promotional efforts should utilize theoretical frameworks of behaviour change and be targeted towards less active adults. As an illustrative example, this experiment compared a prototypical recreational walking brochure with an "enhanced" version including such persuasive messages on people's intentions to walk for recreation in natural environments. The enhanced brochure heightened intentions for inexperienced recreational walkers through our hypothesized mechanisms, but appeared to dissuade already-experienced walkers. Optimal messaging strategies in recreational walking brochures require tailoring to more and less active readerships. Guidelines are provided for authors of recreational walking brochures, though the principles and techniques could easily be extended to other means of outdoor walking promotion.
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Affiliation(s)
- Lewis R Elliott
- European Centre for Environment and Human Health,
University of Exeter Medical School, University of Exeter, c/o Knowledge Spa,
RCHT, Truro, Cornwall TR1 3HD, UK
| | - Mathew P White
- European Centre for Environment and Human Health,
University of Exeter Medical School, University of Exeter, c/o Knowledge Spa,
RCHT, Truro, Cornwall TR1 3HD, UK
- Urban & Environmental Psychology Group,
University of Vienna, Austria
| | - Lora E Fleming
- European Centre for Environment and Human Health,
University of Exeter Medical School, University of Exeter, c/o Knowledge Spa,
RCHT, Truro, Cornwall TR1 3HD, UK
| | - Charles Abraham
- School of Psychological Sciences,
Rm. 701, Redmond Barry Building, University
of Melbourne, Parkville, VIC 3010, Australia
| | - Adrian H Taylor
- Faculty of Medicine & Dentistry, University
of Plymouth, N6, ITTC, Tamar Science Park,
Plymouth, Devon PL6 8BX, UK
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15
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Börger T, Campbell D, White MP, Elliott LR, Fleming LE, Garrett JK, Hattam C, Hynes S, Lankia T, Taylor T. The value of blue-space recreation and perceived water quality across Europe: A contingent behaviour study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 771:145597. [PMID: 33663957 DOI: 10.1016/j.scitotenv.2021.145597] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/29/2021] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
This study estimates the value of recreational visits to blue-space sites across 14 EU Member States, representing 78% of the Union's population. Across all countries surveyed, respondents made an average of 47 blue-space visits per person per year. Employing travel cost and contingent behaviour methods, the value of a visit is estimated at €41.32 which adds up to a recreational value of €631bn per year for the total adult population surveyed. Using the Bathing Water Directive's water quality designation, the analysis shows that a one-level improvement in water quality leads to 3.13 more visits (+6.67%), whereas a one-level deterioration leads to 9.77 fewer annual visits (-20.83%). This study provides valuations of benefits of recreation and changes of recreational values due to changes in surface water quality, which can be compared to the implementation and monitoring costs of efforts under the EU's Bathing Water, Water Framework and Marine Strategy Framework Directives.
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Affiliation(s)
- Tobias Börger
- Department of Business and Economics, Berlin School of Economics and Law, Germany; Applied Choice Research Group, University of Stirling Management School, United Kingdom.
| | - Danny Campbell
- Applied Choice Research Group, University of Stirling Management School, United Kingdom.
| | - Mathew P White
- Cognitive Science Hub, University of Vienna, Austria; European Centre for Environment and Human Health, University of Exeter Medical School, United Kingdom.
| | - Lewis R Elliott
- European Centre for Environment and Human Health, University of Exeter Medical School, United Kingdom.
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, United Kingdom.
| | - Joanne K Garrett
- European Centre for Environment and Human Health, University of Exeter Medical School, United Kingdom.
| | | | - Stephen Hynes
- Socio-Economic Marine Research Unit, Whitaker Institute, National University of Ireland, Galway, Ireland.
| | - Tuija Lankia
- Natural Resources Institute Finland (LUKE), Finland.
| | - Tim Taylor
- European Centre for Environment and Human Health, University of Exeter Medical School, United Kingdom.
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16
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Associations between green/blue spaces and mental health across 18 countries. Sci Rep 2021; 11:8903. [PMID: 33903601 PMCID: PMC8076244 DOI: 10.1038/s41598-021-87675-0] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 03/31/2021] [Indexed: 02/02/2023] Open
Abstract
Living near, recreating in, and feeling psychologically connected to, the natural world are all associated with better mental health, but many exposure-related questions remain. Using data from an 18-country survey (n = 16,307) we explored associations between multiple measures of mental health (positive well-being, mental distress, depression/anxiety medication use) and: (a) exposures (residential/recreational visits) to different natural settings (green/inland-blue/coastal-blue spaces); and (b) nature connectedness, across season and country. People who lived in greener/coastal neighbourhoods reported higher positive well-being, but this association largely disappeared when recreational visits were controlled for. Frequency of recreational visits to green, inland-blue, and coastal-blue spaces in the last 4 weeks were all positively associated with positive well-being and negatively associated with mental distress. Associations with green space visits were relatively consistent across seasons and countries but associations with blue space visits showed greater heterogeneity. Nature connectedness was also positively associated with positive well-being and negatively associated with mental distress and was, along with green space visits, associated with a lower likelihood of using medication for depression. By contrast inland-blue space visits were associated with a greater likelihood of using anxiety medication. Results highlight the benefits of multi-exposure, multi-response, multi-country studies in exploring complexity in nature-health associations.
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17
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White MP, Elliott LR, Gascon M, Roberts B, Fleming LE. Blue space, health and well-being: A narrative overview and synthesis of potential benefits. ENVIRONMENTAL RESEARCH 2020; 191:110169. [PMID: 32971082 DOI: 10.1016/j.envres.2020.110169] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 08/28/2020] [Accepted: 09/03/2020] [Indexed: 05/18/2023]
Abstract
Research into the potential health and well-being benefits from exposure to green spaces such as parks and woodlands has led to the development of several frameworks linking the different strands of evidence. The current paper builds on these to provide a model of how exposure to aquatic environments, or blue spaces such as rivers, lakes and the coast, in particular, may benefit health and well-being. Although green and blue spaces share many commonalities, there are also important differences. Given the breadth of the research, spanning multiple disciplines and research methodologies, a narrative review approach was adopted which aimed to highlight key issues and processes rather than provide a definitive balance of evidence summary. Novel aspects of our framework included the inclusion of outcomes that are only indirectly good for health through being good for the environment, the addition of nature connectedness as both a trait and state, and feedback loops where actions/interventions to increase exposure are implemented. Limitations of the review and areas for future work, including the need to integrate potential benefits with potential risks, are discussed.
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Affiliation(s)
- Mathew P White
- European Centre for Environment & Human Health, University of Exeter, UK; Urban & Environmental Psychology Group, University of Vienna, Austria.
| | - Lewis R Elliott
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Mireia Gascon
- Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Bethany Roberts
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Lora E Fleming
- European Centre for Environment & Human Health, University of Exeter, UK
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18
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Garrett JK, White MP, Elliott LR, Wheeler BW, Fleming LE. Urban nature and physical activity: Investigating associations using self-reported and accelerometer data and the role of household income. ENVIRONMENTAL RESEARCH 2020; 190:109899. [PMID: 32750550 DOI: 10.1016/j.envres.2020.109899] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Physical inactivity is a major public health concern. Natural, or semi-natural, environments may encourage physical activity, but the influences of socio-economic factors have been under-researched. METHODS We explored the associations between meeting physical activity (PA) guidelines and both neighbourhood green (area coverage) and blue (freshwater coverage and coastal proximity) environments for urban adults using data from the Health Survey for England [HSE] (2008/2012). We considered different domains of self-reported PA: walking (n = 18,391), sports and other exercise (n = 18,438), non-recreational (domestic/gardening/occupational; n = 18,446) and all three domains combined (n = 18,447); as well as accelerometer-derived PA data using a subsample (n = 1,774). Relationships were stratified by equivalised household income as an indicator of socio-economic status. RESULTS After adjusting for covariates, living <5 km from the coast was associated with significantly higher odds of meeting UK 2010 guidelines through self-reported total, walking and non-recreational PA (e.g. total PA, <5 km vs. >20 km, adjusted odds ratio (ORadj) = 1.26; 95% confidence interval (CI) = 1.15-1.39) but unrelated to sports and exercise. Greater neighbourhood greenspace, however, was only associated with significantly higher odds of meeting guidelines through non-recreational PA alone (e.g. 80-100% vs. <20% ORadj = 1.32; 95% CI = 1.12-1.56). Although associations were most consistent in the lowest income quintile, income-related results were mixed. Relationships were not replicated in the smaller accelerometry subsample. CONCLUSION Our self-report findings for the differing domains of PA as a function of neighbourhood green and blue space broadly replicated previous research, yet the reasons for the observed differences between PA domains and environments remain unclear. We did not observe any associations between environmental variables and accelerometer-measured PA; further research with larger samples is needed.
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Affiliation(s)
- Joanne K Garrett
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK.
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
| | - Lewis R Elliott
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
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19
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Zhai Y, Li D, Wang D, Shi C. Seniors' Physical Activity in Neighborhood Parks and Park Design Characteristics. Front Public Health 2020; 8:322. [PMID: 32850576 PMCID: PMC7403175 DOI: 10.3389/fpubh.2020.00322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 06/12/2020] [Indexed: 11/22/2022] Open
Abstract
Physical activity brings multiple health benefits to seniors. Neighborhood parks provide seniors with accessible spaces and opportunities to engage in physical activity. This study investigated the associations between neighborhood park design characteristics and seniors' total walking step and energy expenditure during the park visit. Seniors' total step was measured by pedometer, and energy expenditure was calculated based on self-reported activities in the park. The study was conducted in 15 neighborhood parks with an area <10 ha, and included 234 senior participants. One-way ANOVA analyses indicated that seniors in parks with larger surface area, longer trail, larger natural area and outdoor fitness equipment had taken more steps. While seniors in parks without water expended more energy. For instance, seniors in parks with surface areas <3 ha walked 507 fewer steps than seniors in parks with areas between 3 and 5 ha, and 691 fewer steps than those in parks larger than 5 ha. When including seniors' demographic attributes, multiple regression analyses suggested that total step was negatively associated with age, but positively associated with total natural area in the park and the presence of outdoor fitness equipment. Seniors energy expenditure was positively associated with BMI and the presence of outdoor fitness equipment. Energy expenditure was also related to income. These findings provide direct implications for neighborhood park design and management. Planners and designers can include more natural areas over paved areas, create longer trails and place more outdoor fitness equipment in parks to encourage seniors to walk and spend more energy.
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Affiliation(s)
- Yujia Zhai
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
| | - Dongying Li
- Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX, United States
| | - De Wang
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
| | - Cheng Shi
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
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20
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The neighborhood effect of exposure to blue space on elderly individuals' mental health: A case study in Guangzhou, China. Health Place 2020; 63:102348. [PMID: 32543435 DOI: 10.1016/j.healthplace.2020.102348] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/09/2020] [Accepted: 04/27/2020] [Indexed: 11/21/2022]
Abstract
Within the urban setting, blue space refers to all visible surface waters, including lakes, rivers, and coastal waters. Exposure to the natural environment, especially blue space, has been consistently linked to better mental health. While previous studies have disentangled the positive relationship between neighborhood blue space and mental health, scant attention has been paid to pathways through which neighborhood blue space affects mental health among Chinese urban elderly individuals. Based on questionnaire data collected from Guangzhou in 2018, remote sensing images, street-scapes, and other such sources, we extracted various blue space indicators. We employed multilevel linear regression modeling, mediating effect modeling to examine bio-psychosocial pathways and mechanisms linking exposure to blue space and elderly individuals' mental health. Propensity score matching method was employed to deal with selection bias. According to this empirical analysis, firstly, neighborhood exposure to blue space was significantly associated with elderly individuals' mental health. Secondly, environmental harm reduction, stress reduction, and social contact facilitation played a separate role in mediating the effect of blue space exposure on elderly individuals' mental health. These findings confirm the mediation pathways in the context of Chinese cities. Our research enriches the empirical research on blue space and public health from the perspective of health geography, and suggests the need for "healthy neighborhood" and "health aging" planning in Chinese settings.
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21
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Hooyberg A, Roose H, Grellier J, Elliott LR, Lonneville B, White MP, Michels N, De Henauw S, Vandegehuchte M, Everaert G. General health and residential proximity to the coast in Belgium: Results from a cross-sectional health survey. ENVIRONMENTAL RESEARCH 2020; 184:109225. [PMID: 32078817 DOI: 10.1016/j.envres.2020.109225] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/27/2020] [Accepted: 02/03/2020] [Indexed: 06/10/2023]
Abstract
The health risks of coastal areas have long been researched, but the potential benefits for health are only recently being explored. The present study compared the general health of Belgian citizens a) according to the EU's definition of coastal (<50 km) vs. inland (>50 km), and b) between eight more refined categories of residential proximity to the coast (<5 km to >250 km). Data was drawn from the Belgian Health Interview Survey (n = 60,939) and investigated using linear regression models and mediation analyses on several hypothesized mechanisms. Results indicated that populations living <5 km of the coast reported better general health than populations living at >50-100 km. Four commonly hypothesized mechanisms were considered but no indirect associations were found: scores for mental health, physical activity levels and social contacts were not higher at 0-5 km from the coast, and air pollution (PM10 concentrations) was lower at 0-5 km from the coast but not statistically associated with better health. Results are controlled for typical variables such as age, sex, income, neighbourhood levels of green and freshwater blue space, etc. The spatial urban-rural-nature mosaic at the Belgian coast and alternative explanations are discussed. The positive associations between the ocean and human health observed in this study encourage policy makers to manage coastal areas sustainably to maintain associated public health benefits into the future.
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Affiliation(s)
| | - Henk Roose
- Department of Sociology, Ghent University (UGent), Ghent, Belgium.
| | - James Grellier
- European Centre for Environment and Human Health (ECEHH), University of Exeter Medical School, University of Exeter, Truro, United Kingdom.
| | - Lewis R Elliott
- European Centre for Environment and Human Health (ECEHH), University of Exeter Medical School, University of Exeter, Truro, United Kingdom.
| | | | - Mathew P White
- European Centre for Environment and Human Health (ECEHH), University of Exeter Medical School, University of Exeter, Truro, United Kingdom.
| | - Nathalie Michels
- Department of Public Health and Primary Care, Ghent University (UGent), Ghent, Belgium.
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University (UGent), Ghent, Belgium.
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22
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Pasanen TP, White MP, Wheeler BW, Garrett JK, Elliott LR. Neighbourhood blue space, health and wellbeing: The mediating role of different types of physical activity. ENVIRONMENT INTERNATIONAL 2019; 131:105016. [PMID: 31352260 DOI: 10.1016/j.envint.2019.105016] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/17/2019] [Accepted: 07/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Evidence suggests that living near blue spaces such as the coast, lakes and rivers may be good for health and wellbeing. Although greater levels of physical activity (PA) may be a potential mechanism, we know little about the types of PA that might account for this. OBJECTIVES To explore the mediating role of: a) 'watersports' (e.g. sailing/canoeing); b) 'on-land outdoor PA' in natural/mixed settings (e.g. walking/running/cycling); and, c) 'indoor/other PA' (e.g. gym/squash) in the relationships between residential blue space availability and health outcomes. METHODS Using data from the Health Survey for England (n = 21,097), we constructed a path model to explore whether weekly volumes of each PA type mediate any of the relationships between residential blue space availability (coastal proximity and presence of freshwater) and self-reported general and mental health, controlling for green space density and a range of socio-economic factors at the individual- and area-level. RESULTS Supporting predictions, living nearer the coast was associated with better self-reported general and mental health and this was partially mediated by on-land outdoor PA (primarily walking). Watersports were more common among those living within 5kms of the coast, but did not mediate associations between coastal proximity and health. Presence of freshwater in the neighbourhood was associated with better mental health, but this effect was not mediated by PA. CONCLUSIONS Although nearby blue spaces offer potentially easier access to watersports, relatively few individuals in England engage in them and thus they do not account for positive population health associations. Rather, the benefits to health from coastal living seem, at least in part, due to participation in land-based outdoor activities (especially walking). Further research is needed to explore the mechanisms behind the relationship between freshwater presence and mental health.
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Affiliation(s)
- Tytti P Pasanen
- Faculty of Social Sciences/Psychology, Tampere University, Kalevantie 5, 33014, Finland.
| | - Mathew P White
- European Centre for Environment and Human Health, College of Medicine and Health, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, College of Medicine and Health, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom
| | - Joanne K Garrett
- European Centre for Environment and Human Health, College of Medicine and Health, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom
| | - Lewis R Elliott
- European Centre for Environment and Human Health, College of Medicine and Health, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom
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Zuccarelli L, Galasso L, Turner R, Coffey EJB, Bessone L, Strapazzon G. Human Physiology During Exposure to the Cave Environment: A Systematic Review With Implications for Aerospace Medicine. Front Physiol 2019; 10:442. [PMID: 31068833 PMCID: PMC6491700 DOI: 10.3389/fphys.2019.00442] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/01/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Successful long-duration missions outside low-Earth orbit will depend on technical and physiological challenges under abnormal environmental conditions. Caves, characterized by absence of light, confinement, three-dimensional human movement and long-duration isolation, are identifiably one of the earliest examples of scientific enquiry into space analogs. However, little is known about the holistic human physiological response during cave exploration or prolonged habitation. Objectives: The aim of our review was to conduct a systematic bibliographic research review of the effects of short and prolonged exposure to a cave environment on human physiology, with a view to extend the results to implications for human planetary exploration missions. Methods: A systematic search was conducted following the structured PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for electronic databases. Results: The search retrieved 1,519 studies. There were 50 articles selected for further consideration, of which 31 met our inclusion criteria. Short-term cave exposure studies have investigated visual dysfunction, cardiovascular, endocrine-metabolic, immunologic-hematological and muscular responses in humans. Augmentations of heart rate, muscular damage, initial anticipatory stress reaction and inflammatory responses were reported during caving activity. Prolonged exposure studies mainly investigated whether biological rhythms persist or desist in the absence of standard environmental conditions. Changes were evident in estimated vs. actual rest-activity cycle periods and external desynchronization, body temperature, performance reaction time and heart rate cycles. All studies have shown a marked methodological heterogeneity and lack reproduction under controlled conditions. Conclusions: This review facilitates a further comparison of the proposed physiological impact of a subterranean space analog environment, with existing knowledge in related disciplines pertaining to human operative preparation under challenging environmental conditions. This comprehensive overview should stimulate more reproducible research on this topic and offer the opportunity to advance study design and focus future human research in the cave environment on noteworthy, reproducible projects.
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Affiliation(s)
- Lucrezia Zuccarelli
- Department of Medicine, University of Udine, Udine, Italy.,Directorate of Human and Robotics, Exploration, European Space Agency, Köln, Germany
| | - Letizia Galasso
- Department of Biomedical Science for Health, University of Milan, Milan, Italy
| | - Rachel Turner
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Emily J B Coffey
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Loredana Bessone
- Directorate of Human and Robotics, Exploration, European Space Agency, Köln, Germany
| | - Giacomo Strapazzon
- Directorate of Human and Robotics, Exploration, European Space Agency, Köln, Germany.,Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
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Garrett JK, White MP, Huang J, Ng S, Hui Z, Leung C, Tse LA, Fung F, Elliott LR, Depledge MH, Wong MC. Urban blue space and health and wellbeing in Hong Kong: Results from a survey of older adults. Health Place 2019; 55:100-110. [DOI: 10.1016/j.healthplace.2018.11.003] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 10/22/2018] [Accepted: 11/06/2018] [Indexed: 12/22/2022]
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Elliott LR, White MP, Taylor AH, Abraham C. How do brochures encourage walking in natural environments in the UK? A content analysis. Health Promot Int 2018; 33:299-310. [PMID: 27794534 PMCID: PMC5892139 DOI: 10.1093/heapro/daw083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Although walking for leisure can support health, there has been little systematic attempt to consider how recreational walking is best promoted. In the UK, local authorities create promotional materials for walking networks, but little is known about whether they effectively encourage walking through persuasive messaging. Many of these materials pertain to walks in natural environments which evidence suggests are generally visited less frequently by physically inactive individuals. Consequently the present study explores whether and how recreational walking brochures use persuasive messages in their promotion of walks in natural environments. A coding taxonomy was developed to classify text in recreational walking brochures according to five behavioural content areas and 87 categories of potentially persuasive messages. Reliability of the taxonomy was ascertained and a quantitative content analysis was applied to 26 brochures collected from Devon, UK. Brochures often provided information about an advertised route, highlighted cultural and aesthetic points of interest, and provided directions. Brochures did not use many potentially effective messages. Text seldom prompted behaviour change or built confidence for walking. Social norm related information was rarely provided and there was a general lack of information on physical activity and its benefits for health and well-being. The limited range of message strategies used in recreational walking brochures may not optimally facilitate walking in natural environments for inactive people. Future research should examine the effects of theory-informed brochures on walking intentions and behaviour. The taxonomy could be adapted to suit different media and practices surrounding physical activity in natural environments.
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Affiliation(s)
- Lewis R Elliott
- Psychology Applied to Health Group, University of Exeter Medical School, Exeter, UK
- European Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK
| | - Mathew P White
- Psychology Applied to Health Group, University of Exeter Medical School, Exeter, UK
- European Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK
| | - Adrian H Taylor
- Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, UK
| | - Charles Abraham
- Psychology Applied to Health Group, University of Exeter Medical School, Exeter, UK
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Gascon M, Zijlema W, Vert C, White MP, Nieuwenhuijsen MJ. Outdoor blue spaces, human health and well-being: A systematic review of quantitative studies. Int J Hyg Environ Health 2017; 220:1207-1221. [DOI: 10.1016/j.ijheh.2017.08.004] [Citation(s) in RCA: 285] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/09/2017] [Accepted: 08/10/2017] [Indexed: 11/25/2022]
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Jansen F, Ettema D, Kamphuis C, Pierik F, Dijst M. How do type and size of natural environments relate to physical activity behavior? Health Place 2017; 46:73-81. [DOI: 10.1016/j.healthplace.2017.05.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 04/10/2017] [Accepted: 05/02/2017] [Indexed: 11/25/2022]
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Why Do People Exercise in Natural Environments? Norwegian Adults' Motives for Nature-, Gym-, and Sports-Based Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040377. [PMID: 28375192 PMCID: PMC5409578 DOI: 10.3390/ijerph14040377] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/13/2017] [Accepted: 04/01/2017] [Indexed: 01/08/2023]
Abstract
Exercise in natural environments (“green exercise”) confers numerous health benefits, but little is known about why people engage in green exercise. This study examined the importance of nature experiences as a motive for physical activity and the motivational profile of people who engage in green exercise compared to gym- and sports-based exercise. Physical activity motives and typical times spent in different domains of physical activity were reported by 2168 Norwegian adults in a survey. Experiencing nature was generally rated as the second-most important physical activity motive, exceeded only by convenience motives, and it was especially important for older adults and those who engage in greater amounts of instrumental physical activity. Green exercisers reported stronger motives concerning convenience and experiencing nature, whereas gym- or sports-based exercisers reported stronger motives for physical health and sociability. The motives associated with different leisure-time exercise domains may assist in understanding optimal promotion of green exercise.
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Antoni G, Marini E, Curreli N, Tuveri V, Comandini O, Cabras S, Gabba S, Madeddu C, Crisafulli A, Rinaldi AC. Energy expenditure in caving. PLoS One 2017; 12:e0170853. [PMID: 28158208 PMCID: PMC5291484 DOI: 10.1371/journal.pone.0170853] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 01/11/2017] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to determine the energy expenditure of a group of cavers of both genders and different ages and experience during a 10 hour subterranean exploration, using portable metabolimeters. The impact of caving activity on body composition and hydration were also assessed through bioelectrical impedance, and nutritional habits of cavers surveyed. During cave activity, measured total energy expenditure (TEE) was in the range 225–287 kcal/h for women-men (MET = 4.1), respectively; subjects had an energy intake from food in the range 1000–1200 kcal, thus inadequate to restore lost calories. Bayesian statistical analysis estimated the effect of predictive variables on TEE, revealing that experienced subjects had a 5% lower TEE than the less skilled ones and that women required a comparatively larger energy expenditure than men to perform the same task. BIVA (bioelectrical impedance vector analysis) showed that subjects were within the range of normal hydration before and after cave activity, but bioelectrical changes indicated a reduction of extracellular water in men, which might result in hypo-osmolal dehydration in the case of prolonged underground exercise. All these facts should be considered when planning cave explorations, preparing training programs for subjects practising caving, and optimizing a diet for cavers. Further, information gathered through this study could be of value to reduce accidents in caves related to increase in fatigue.
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Affiliation(s)
- Giorgia Antoni
- Gruppo Speleo Archeologico Giovanni Spano, Cagliari, Italy
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Elisabetta Marini
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
| | - Nicoletta Curreli
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Valerio Tuveri
- Corpo Nazionale del Soccorso Alpino e Speleologico, Sardinia, Italy
| | - Ornella Comandini
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
| | - Stefano Cabras
- Department of Mathematics and Informatics, University of Cagliari, Cagliari, Italy
- Department of Statistics, Universidad Carlos III de Madrid, Getafe, Spain
| | - Silvia Gabba
- Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - Clelia Madeddu
- Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | | | - Andrea C. Rinaldi
- Gruppo Speleo Archeologico Giovanni Spano, Cagliari, Italy
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- * E-mail:
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Is Green Exercise for All? A Descriptive Study of Green Exercise Habits and Promoting Factors in Adult Norwegians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111165. [PMID: 27886098 PMCID: PMC5129375 DOI: 10.3390/ijerph13111165] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/05/2016] [Accepted: 11/15/2016] [Indexed: 11/17/2022]
Abstract
Background: Physical activity (PA) in natural environments, known as green exercise (GE), can provide health benefits above and beyond PA in other environments, but little is known about the extent to which GE is an accessible form of weekly PA across different social groups. This study aims to examine the “GE phenomenon” in Norway, and evaluate possible differences in GE habits and perceived factors that promote GE across sub-groups of this population. Methods: 2168 adults from all over Norway reported weekly GE and other forms of PA, specific forms of GE, and perceived factors that promote GE. Data were examined in the overall sample and in relation with the respondents’ PA status and sociodemographic characteristics. Results: GE, especially “walking in the forest” and “activities by/on the sea”, was the most popular form of weekly PA, even among those with low PA levels. GE was fairly represented across all social groups, and especially among the elderly, those who live with spouse/partner and those who live in the west regions of Norway, while no associations were found in relation to sex, centrality, education level or household income. “Time flexibility” and “PA-supportive places” were generally perceived as the most important factors that promote GE across all social groups. “Accessibility to nature” was generally perceived relatively little important, though a gradient was observed in relation to age, education level and household income. Conclusions: GE is an important source of weekly PA and health among adult Norwegians, especially in sub-groups of interest for public health such as the elderly, those with lower socio-economic status and those who live in non-urban areas. More should be done to understand and address the inequities relative to the perceived accessibility to nature.
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White MP, Elliott LR, Taylor T, Wheeler BW, Spencer A, Bone A, Depledge MH, Fleming LE. Recreational physical activity in natural environments and implications for health: A population based cross-sectional study in England. Prev Med 2016; 91:383-388. [PMID: 27658650 DOI: 10.1016/j.ypmed.2016.08.023] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/25/2016] [Accepted: 08/15/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Building on evidence that natural environments (e.g. parks, woodlands, beaches) are key locations for physical activity, we estimated the total annual amount of adult recreational physical activity in England's natural environments, and assessed implications for population health. METHODS A cross-sectional analysis of six waves (2009/10-2014/5) of the nationally representative, Monitor of Engagement with the Natural Environment survey (n=280,790). The survey uses a weekly quota sample, and population weights, to estimate nature visit frequency across England, and provides details on a single, randomly selected visit (n=112,422), including: a) duration; b) activity; and c) environment type. RESULTS Approximately 8.23 million (95% CIs: 7.93, 8.54) adults (19.5% of the population) made at least one 'active visit' (i.e. ≥30min, ≥3 METs) to natural environments in the previous week, resulting in 1.23 billion (1.14, 1.32) 'active visits' annually. An estimated 3.20 million (3.05, 3.35) of these also reported meeting recommended physical activity guidelines (i.e. ≥5×30min a week) fully, or in part, through such visits. Active visits by this group were associated with an estimated 109,164 (101,736, 116,592) Quality Adjusted Life Years (QALYs) annually. Assuming the social value of a QALY to be £20,000, the annual value of these visits was approximately £2.18 billion (£2.03, £2.33). Results for walking were replicated using WHO's Health Economic Assessment Tool. CONCLUSIONS Natural environments provide the context for a large proportion of England's recreational physical activity and highlight the need to protect and manage such environments for health purposes.
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Affiliation(s)
- M P White
- European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge, Spa, Royal Cornwall Hospital Treliske, Cornwall, TR1 3HD, United Kingdom.
| | - L R Elliott
- European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge, Spa, Royal Cornwall Hospital Treliske, Cornwall, TR1 3HD, United Kingdom.
| | - T Taylor
- European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge, Spa, Royal Cornwall Hospital Treliske, Cornwall, TR1 3HD, United Kingdom.
| | - B W Wheeler
- European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge, Spa, Royal Cornwall Hospital Treliske, Cornwall, TR1 3HD, United Kingdom.
| | - A Spencer
- Health Economics Group, University of Exeter Medical School, South Cloisters, St Luke's Campus, Exeter EX1 2LU, United Kingdom.
| | - A Bone
- Public Health England, Environmental Change Department, 133-135 Waterloo Road, London SE1 8UG, United Kingdom.
| | - M H Depledge
- European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge, Spa, Royal Cornwall Hospital Treliske, Cornwall, TR1 3HD, United Kingdom.
| | - L E Fleming
- European Centre for Environment & Human Health, University of Exeter Medical School, Knowledge, Spa, Royal Cornwall Hospital Treliske, Cornwall, TR1 3HD, United Kingdom.
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Exploring the relationship between childhood obesity and proximity to the coast: A rural/urban perspective. Health Place 2016; 40:129-36. [DOI: 10.1016/j.healthplace.2016.05.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 05/20/2016] [Accepted: 05/23/2016] [Indexed: 01/27/2023]
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