The health benefits of urban green spaces: a review of the evidence

Unravelling the dynamics of mental health inequalities in England: A 12-year nationwide longitudinal spatial analysis of recorded depression prevalence

Background

Depression is one of the most significant public health issues, but evidence of geographic patterns and trends of depression is limited. We aimed to examine the spatio-temporal patterns and trends of depression prevalence among adults in a nationwide longitudinal spatial study in England and evaluate the influence of neighbourhood socioeconomic deprivation in explaining patterns.

Methods

Information on recorded depression prevalence was obtained from the indicator Quality and Outcomes Framework: Depression prevalence that measured the annual percentage of adults diagnosed with depression for Lower Super Output Areas (LSOA) from 2011 to 2022. We applied Cluster and Outlier Analysis using the Local Moran's I algorithm. Local effects of deprivation on depression in 2020 examined with Geographically Weighted Regression (GWR). Inequalities in recorded prevalence were presented using Prevalence Rate Ratios (PRR).

Results

The North West Region of England had the highest concentration of High-High clusters of depression, with 17.4% of the area having high values surrounded by high values in both space and time and the greatest percentage of areas with a high rate of increase (43.1%). Inequalities widened among areas with a high rate of increase in prevalence compared to those with a lower rate of increase, with the PRR increasing from 1.66 (99% CI 1.61-1.70) in 2011 to 1.81 (99% CI 1.76-1.85) by 2022. Deprivation explained 3%-39% of the variance in depression in 2020 across the country.

Conclusions

It is crucial to monitor depression's spatial patterns and trends and investigate mechanisms of mental health inequalities. Our findings can help identify priority areas and target prevention and intervention strategies in England. Evaluating mental health interventions in different geographic contexts can provide valuable insights to policymakers on the most effective and context-sensitive strategies, enabling them to allocate resources towards preventing the worsening of mental health inequalities.

Greenness and Hospitalization for Cardiorespiratory Diseases in Brazil

BACKGROUND

The potential health benefits of exposure to vegetation, or greenness, are well documented, but there are few nationwide studies in Brazil, a country facing challenges related to land-use planning, deforestation, and environmental health risks.

OBJECTIVES

In this study, we investigated the association between greenness and hospitalizations for cardiorespiratory diseases in Brazil.

METHODS

We accessed hospital admissions data from 967,771 postal codes (a total of 26,724,624 admissions) covering Brazil for the period between 2008 and 2018. We used Normalized Difference Vegetation Index (NDVI) data from the Moderate Resolution Imaging Spectroradiometer (MODIS) to measure greenness at the postal-code level. First, we applied a quasi-Poisson regression model to estimate the association between greenness and hospitalizations for circulatory and respiratory diseases, adjusted for air pollution, weather variables, and area-level socioeconomic status. We stratified the analyzes by sex, age group, health outcome, and Brazilian regions. In the second stage, we performed a meta-analysis to estimate pooled effects across the Brazilian regions.

RESULTS

The national meta-analysis for the whole population, incorporating both urban and nonurban areas, showed that higher levels of greenness were associated with a lower risk of hospitalizations for circulatory diseases. An interquartile range (IQR = 0.18 ) increase in average NDVI was associated with a 17% (95% confidence interval: 8%, 27%) lower risk of cardiovascular admissions. In contrast, there was no association found between greenness and respiratory admissions. When specifically examining urban areas, the results remained consistent with the overall findings. However, the analyses of nonurban areas revealed divergent results, suggesting that higher levels of greenness in rural regions are associated with a lower risk of hospital admissions for both circulatory and respiratory diseases.

DISCUSSION

The findings emphasize the importance of prioritizing the preservation and creation of green spaces in urban areas as a means of promoting cardiovascular health in Brazil. https://doi.org/10.1289/EHP13442.

The effects of urban green space and road proximity to indoor traffic-related PM2.5, NO2, and BC exposure in inner-city schools

BACKGROUND

Since there are known adverse health impacts of traffic-related air pollution, while at the same time there are potential health benefits from greenness, it is important to examine more closely the impacts of these factors on indoor air quality in urban schools.

OBJECTIVE

This study investigates the association of road proximity and urban greenness to indoor traffic-related fine particulate matter (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) in inner-city schools.

METHODS

PM2.5, NO2, and BC were measured indoors at 74 schools and outdoors at a central urban over a 10-year period. Seasonal urban greenness was estimated using the Normalized Difference Vegetation Index (NDVI) with 270 and 1230 m buffers. The associations between indoor traffic-related air pollution and road proximity and greenness were investigated with mixed-effects models.

RESULTS

The analysis showed linear decays of indoor traffic-related PM2.5, NO2, and BC by 60%, 35%, and 22%, respectively for schools located at a greater distance from major roads. The results further showed that surrounding school greenness at 270 m buffer was significantly associated (p < 0.05) with lower indoor traffic-related PM2.5: -0.068 (95% CI: -0.124, -0.013), NO2: -0.139 (95% CI: -0.185, -0.092), and BC: -0.060 (95% CI: -0.115, -0.005). These associations were stronger for surrounding greenness at a greater distance from the schools (buffer 1230 m) PM2.5: -0.101 (95% CI: -0.156, -0.046) NO2: -0.122 (95% CI: -0.169, -0.075) BC: -0.080 (95% CI: -0.136, -0.026). These inverse associations were stronger after fully adjusting for regional pollution and meteorological conditions.

IMPACT STATEMENT

More than 90% of children under the age of 15 worldwide are exposed to elevated air pollution levels exceeding the WHO's guidelines. The study investigates the impact that urban infrastructure and greenness, in particular green areas and road proximity, have on indoor exposures to traffic-related PM2.5, NO2, and BC in inner-city schools. By examining a 10-year period the study provides insights for air quality management, into how road proximity and greenness at different buffers from the school locations can affect indoor exposure.

Urban professionals' restorative tourism: exploring the role of perceived environmental restorativeness, push and pull motivations and destination attributes on tourism expectations

Introduction

Urban professionals often seek respite from their daily routines through restorative tourism, driven by a complex interplay of motivations that include both internal "push" factors and external "pull" factors. This study investigates the intricate relationship between the perceived environmental restorativeness of tourist destinations and the expectations of urban professionals engaging in restorative tourism. Furthermore, it examines how push and pull motivations mediate this relationship while also considering the moderating effect of destination attributes.

Methods

The multiple regression analyses on the survey data collected from 221 urban professionals with restorative tourism experiences provided quantitative evidence regarding the hypothesized relationships among perceived environmental restorativeness, push and pull motivations, destination attributes, and tourism expectations.

Results

The results showed that perceived environmental restorativeness has a positive effect on urban professionals' tourism expectations; urban professionals' pull motivation and push motivation each play a mediating role between perceived environmental restorativeness and tourist expectations; and restorative tourism destination attributes have a moderating effect between perceived environmental restorativeness and push motivation, as well as the relationship between perceived environmental restorativeness and pull motivation.

Discussion

This study provides essential theoretical contributions to restorative tourism and practical implications when designing restorative tourism destinations that target urban professionals.

Tourist Trampling on a Peripheral Plant Population Restricted to an Urban Natural Area in the Capo Sant'Elia Promontory (Sardinia, W-Mediterranean Basin)

Urban natural areas provide important ecological services such as biodiversity conservation, as well as opportunities for people to connect with nature and preserve cultural heritage. However, the increasing demand for access to natural areas and the expansion of human recreational activities, such as hiking and biking, pose threats to these ecosystems, especially for animal and plant species, finally resulting in biodiversity loss. This study explores the intricate link between human trampling, plant density, and the morphological and reproductive characteristics of Globularia alypum L., a plant with a peripheral population in Sardinia restricted to a natural area within an urban context. The study examined trampling effects on 75 plots along a frequently used path crossing the plant's core population. Similar environmental conditions were assumed, with differences attributed to human trampling intensity and plant density, and morphological and reproductive traits were measured within each plot. Our results showed that human trampling caused differences in the morphological traits of plants, whereas, in contrast, reproductive traits are less vulnerable to human trampling than morphological ones. As a result, trampled areas may experience decreased plant recruitment, which can have long-term implications for plant population dynamics. Understanding the relationship between trampling effects and the sensitivity of peripheral plant populations is crucial for effective conservation and management strategies.

Exploring non-linear effects of walking accessibility on well-being in rural older adults of Jintang County: a random forest analysis

Objective

The global concern surrounding the aging population has brought the well-being of older individuals to the forefront of societal attention. Unfortunately, studies focusing on the well-being of older people residing in rural areas are frequently overshadowed by the developmental disparities between rural and urban regions. Thus, this study aims to delve into the non-linear impact of walking accessibility on the subjective well-being of rural older adults. The goal is to gain a comprehensive understanding of this relationship, ultimately contributing to an improved quality of life and health for older adults in rural areas.

Methods

In this study, the Random Forest algorithm was employed to explore the non-linear effects of demographic variables, perceived safety, subjective built environment (including perceptions and preferences of the built environment), and walking accessibility on the subjective well-being of older adults.

Results

The findings of this study underscore the pivotal role of walking accessibility in influencing the well-being of older adults, particularly in terms of access to bazaars and health centers, where non-linear and threshold effects are evident. Furthermore, community safety, road conditions, and walking preferences were identified as positive influencers on the well-being of older adults. Well-being trends varied with age, revealing noteworthy non-linear relationships for certain variables.

Conclusion

The insights gained from this study provide crucial theoretical guidance for the development of policies tailored to the unique context of rural aging. By taking into account factors such as walking accessibility, community safety, health support, and social interaction, we can create an improved living environment for rural older adults, ultimately enhancing their happiness and overall quality of life.

Unearthing Inequities in the Relationship between Multiple Sociodemographic Factors and Diverse Elements of Park Availability and Quality in a Major Southern Metropolitan Region

Parks are critical components of healthy communities. This study explored neighborhood socioeconomic and racial/ethnic inequalities in park access and quality in a large U.S. southeastern metropolitan region. A total of 241 block groups were examined, including 77 parks. For each block group, we obtained multiple sociodemographic indicators, including unemployment rate, education level, renter-occupied housing, poverty rate, and racial/ethnic minority composition. All parks were mapped using geographical information systems and audited via the Community Park Audit Tool to evaluate their features and quality. We analyzed seven diverse elements of park quality (transportation access, facility availability, facility quality, amenity availability, park aesthetics, park quality concerns, and neighborhood quality concerns), as well as an overall park quality score by calculating the mean for all parks within each block group. The mean percent of residents below 125% of the poverty level and the percentage of renter-occupied housing units were significantly higher among block groups with any parks in comparison to block groups with no parks. In addition, there were significant positive associations between park transportation access scores and both the percentage of residents with less than high school education and the percent identifying as non-Hispanic white. Moreover, there was a significant negative association between park amenity availability and the block group's unemployed population. Further, a significant negative association between park aesthetics and the population with a lower than high school education percentage was observed. Revealed differences in park availability, park acreage, and park quality dimensions emphasized the need for targeted policy, programmatic, and infrastructure interventions to improve park access and quality and address health disparities.

Reassessing the role of urban green space in air pollution control

The assumption that vegetation improves air quality is prevalent in scientific, popular, and political discourse. However, experimental and modeling studies show the effect of green space on air pollutant concentrations in urban settings is highly variable and context specific. We revisited the link between vegetation and air quality using satellite-derived changes of urban green space and air pollutant concentrations from 2,615 established monitoring stations over Europe and the United States. Between 2010 and 2019, stations recorded declines in ambient NO2, (particulate matter) PM10, and PM2.5 (average of -3.14% y-1), but not O3 (+0.5% y-1), pointing to the general success of recent policy interventions to restrict anthropogenic emissions. The effect size of total green space on air pollution was weak and highly variable, particularly at the street scale (15 to 60 m radius) where vegetation can restrict ventilation. However, when isolating changes in tree cover, we found a negative association with air pollution at borough to city scales (120 to 16,000 m) particularly for O3 and PM. The effect of green space was smaller than the pollutant deposition and dispersion effects of meteorological drivers including precipitation, humidity, and wind speed. When averaged across spatial scales, a one SD increase in green space resulted in a 0.8% (95% CI: -3.5 to 2%) decline in air pollution. Our findings suggest that while urban greening may improve air quality at the borough-to-city scale, the impact is moderate and may have detrimental street-level effects depending on aerodynamic factors like vegetation type and urban form.

Mental health and natural land cover: a global analysis based on random forest with geographical consideration

Natural features in living environments can help to reduce stress and improve mental health. Different land types have disproportionate impacts on mental health. However, the relationships between mental health and land cover are inconclusive. In this study, we aim to accurately fit the relationships, estimate the impacts of land cover change on mental health, and demonstrate the global spatial variability of impacts. In the analysis, we show the complex relationships between mental health and eight land types based on the random forest method and Shapley additive explanations. The accuracy of our model is 67.59%, while the accuracy of the models used in previous studies is usually no more than 20%. According to the analysis results, we estimate the average effects of eight land types. Due to their scarcity in living environments, shrubland, wetland, and bare land have larger impacts on mental health. Cropland, forest, and water could improve mental health in high-population-density areas. The impacts of urban land and grassland are mainly negative. The current land cover composition influences people's attitudes toward a specific land type. Our research is the first study that analyzes data with geographical information by random forest and explains the results geographically. This paper provides a novel machine learning explanation method and insights to formulate better land-use policies to improve mental health.

Revealing disparities in different types of park visits based on cellphone signaling data in Guangzhou, China

Urban parks play a crucial role in promoting the urban ecological environment and the health and well-being of dwellers. However, existing research on park visits and drivers has largely ignored the classification of parks. Using the four-level park system in Guangzhou as a case, this study first measured park visits based on cellphone signaling data. Then, the independent and interactive influences of driving factors on the visits of four types of parks were investigated and compared comprehensively based on the geographical detector model. The factor detector model preliminarily distinguished the functional and role differences of various park types. Nature and urban parks are more functional, and community and pocket parks mainly provide nearby residents with convenient relaxation spaces. The interaction detector further revealed the disparities in park visit drivers between four types of parks. The most significant finding is that nearby recreational facility is the key to the use of natural and urban parks, while the determining factor for the visits of community and pocket parks is the surrounding population. Based on these findings, the study recommends tailored strategies for each type of park, to promote effective management and increased utilization. In particular, the study highlights the importance of understanding the differences between park types and developing customized strategies to maximize the benefits of urban parks and foster a healthy and sustainable urban environment.

Patterns and Correlates of Participation in a Weekly Mass Participation Physical Activity Event, parkrun, in Australia, 2011-2020

BACKGROUND

Studying effective interventions already operating at scale is critical to improving physical activity intervention research translation. The free, weekly, timed 5-km run or walk parkrun represents a unique opportunity to examine successful organic dissemination. We conducted an ecological analysis to identify patterns of growth in Australian parkrun participation and their correlates from 2011 to 2020.

METHOD

Outcome variables were (1) weekly counts of walkers/runners and (2) monthly number of new parkrun registrants. We used latent class analysis to characterize growth trajectories followed by logistic regression on class membership. Covariates included parkrun course characteristics (eg, surface type and route), site-level aggregate participant profile (eg, proportion women and mean age), and surrounding area characteristics (eg, population density and physical activity norm).

RESULTS

Three hundred and sixty-three parkruns were included (n = 8,388,695 participation instances). Sixty-nine percent followed a low-growth and 31% a high-growth participation pattern. High growth was associated with greater participation by women, concrete/bitumen surface type, lower area socioeconomic status, and greater volunteer heterogeneity. Odds of being in the slow-growth class were higher if the course contained >1 km of repetition, higher average age of participants, better average parkrun performance, and higher running group membership. Two patterns of new registration were identified: high start followed by steep decline; and low start, slow decline with similar correlates to participation.

CONCLUSIONS

Parkruns with a less competitive social milieu may have more rapid dissemination. As a free and regular event, parkruns in low socioeconomic areas have the potential to improve the activity levels of those with fewer resources.

Parenthood, spatial temporal environmental exposure, and leisure-time physical activity participation: Evidence from a micro-timescale retrospective longitudinal study

Parents with dependent children are at a high risk of physical inactivity. While previous studies have mostly focused on how parents' time constraints and changing social network may inhibit leisure time physical activity (LTPA) over the long-term, less is known about the integrated effects of parenting and spatial-temporal environmental exposure on the execution of LTPA during certain episodes of a day. By adopting an integrated social-spatiotemporal-environmental model (ST-ISEM) based on micro-timescale retrospective longitudinal analysis, we examine the association between LTPA participation and spatial-temporal environmental exposure at a micro-timescale, i.e., at the episode-level in working adults' workday, and specifically how parenting integrated with spatial-temporal environmental exposure can jointly influence episode-level LTPA participation. Using data from the day reconstruction method from 701 individuals in Shenzhen, China, we find that parenting may affect the participation of LTPA on workdays not only by shaping temporal environmental factors (time constraint path and social network path), but also by interacting with built environmental exposures (spatial path), both at the episode-level. This study contributes to the theorizing of an integrated social-environmental model for health and wellbeing by extending the ISEM from the life span to the micro-timescale and also by highlighting the importance of temporality in environmental exposure and health studies. It also contributes to the spatial temporal behavioral perspective of time geography literature by clarifying multiple pathways through which social and spatiotemporal environmental factors could interact and jointly affect health behaviors at a micro-timescale. This study contributes to the literature on parenting and LTPA decline by enriching and deepening the understanding of the time constraint and social network pathways through which parenting leads to LTPA change at the micro-timescale. While time constraints may decrease parents' LTPA at long-term, increasing physical activities related to childcare after work may strongly obstruct moderate-to-vigorous LTPA at a micro-timescale. This study also identifies a spatial pathway by which parenting hinders LTPA due to changing understanding and usage of urban spaces. This pathway warrants attention from social epidemiologists, health geographers, and urban planners since existing interventions promoting physical activity in urban spaces may be ineffective for parents.

Efficacy of green infrastructure in reducing exposure to local, traffic-related sources of airborne particulate matter (PM)

One aim of roadside green infrastructure (GI) is to mitigate exposure to local, traffic-generated pollutants. Here, we determine the efficacy of roadside GI in improving local air quality through the deposition and/or dispersion of airborne particulate matter (PM). PM was collected on both pumped air filters and on the leaves of a recently installed 'tredge' (trees managed as a head-high hedge) at an open road environment next to a primary school in Manchester, U.K. The magnetic properties of PM deposited on leaves and filters (size fractions PM10 and PM2.5) were deduced from hysteresis loops, first-order reversal curves (FORCs), and low-temperature remanence measurements. These were complemented with electron microscopy to identify changes in magnetic PM concentration downwind of the tredge/GI. We show that the tredge is permeable to airflow using a simple CO2 tracer experiment; hence, it allows interception and subsequent deposition of PM on its leaves. Magnetic loadings per m3 of air from filters (PM10 saturation magnetisation, Ms, at 5 K) were reduced by 40 % behind the tredge and a further 63 % in the playground; a total reduction of 78 % compared to roadside air. For the PM2.5 fraction, the reduction in magnetic loading behind the tredge was remarkable (82 %), reflecting efficient diffusional capture of sub-5 nm Fe-oxide particles by the tredge. Some direct mixing of roadside and playground air occurs at the back of the playground, caused by air flow over, and/or through gaps in, the slowly-permeable tredge. The magnetic loading on tredge leaves increased over successive days, capturing ~23 % of local, traffic-derived PM10. Using a heuristic two-dimensional turbulent mixing model, we assess the limited dispersion of PM < 22.5 μm induced by eddies in the tredge wake. This study demonstrates that PM deposition on leaves reduces exposure significantly in this school playground setting; hence, providing a cost-effective mitigation strategy.

Understanding the pathways between the use of urban green spaces and self-rated health: A case study in Mexico City

In recent decades, extensive research has demonstrated the positive impact of urban green spaces (UGS) on public health through several pathways. However, in the context of Latin America, particularly Mexico City, there remains a notable scarcity of evidence linking UGS use to health outcomes and an insufficient understanding of the pathways or factors underlying these associations. Therefore, this study employs Structural Equation Modeling (SEM) to investigate the intricate pathways between UGS use and residents' perceived health in Mexico City, a densely populated urban center. The SEM integrates three key mediators: sentiments towards UGS, UGS quality, and time spent within these spaces. Survey data was collected through an online survey distributed via social media in May 2020 (n = 1,707). The findings indicate a minor yet significant direct link between UGS use and self-reported health (0.0427, p < 0.1). Conversely, the indirect pathways through sentiments towards UGS, UGS quality, and time spent in UGS were highly significant (0.1950, p < 0.01), underscoring their substantial role as mediators in the UGS use-health association. While a comprehensive understanding of the mechanisms linking perceived health to UGS use in Mexico City requires further research, this study proposes that fostering positive sentiments towards UGS, enhancing UGS quality, and encouraging extended visits to green areas could potentially amplify the perceived health benefits associated with UGS use among residents. These insights offer valuable inputs for policymaking, emphasizing the importance of integrating public perspectives to optimize nature-based solutions and broaden their positive impact within Mexico City.

Associations of PM2.5 composition and green space with metabolic syndrome in a Chinese essential hypertensive population

BACKGROUND

Metabolic syndrome (MetS) has emerged as a significant global public health concern. While environmental factors, including PM2.5, have been identified as important risk factors for MetS in the general population, limited studies have investigated their impact on individuals with essential hypertension. Therefore, our study aims to explore the relationship between PM2.5 composition, green space, and their combined effects on MetS among a Chinese essential hypertensive population.

METHOD

A total of 20,131 participants diagnosed with essential hypertension from 10 provinces in China were included in this study. Individual level exposure to various environmental factors (including PM2.5, PM2.5 composition, green space and temperature) were evaluated using spatiotemporal models based on satellites data. Participants were defined as MetS according to the definition issued by the International Diabetes Federation. Generalized additive mixed models were used to analyze the individual air pollutants, green space and their interaction on MetS.

RESULT

The prevalence of MetS in this population was 44.33%. The adjusted odd ratio (OR) of MetS, with each one unit increase in SO42-, BC and NO3- were 1.077 (1.049, 1.106), 1.126 (1.077, 1.177) and 0.977 (0.958, 0.996) respectively. Additionally, each unit increase of the Normalized Difference Vegetation Index (NDVI) was associated with a decreased risk of MetS (OR: 0.988, 95% CI: 0.984-0.993). In particular, green space was found to mitigate the adverse impacts of PM2.5 on MetS (OR: 0.988, 95% CI: 0.984-0.993).

CONCLUSION

Our results suggested that there was a positive association between PM2.5 and its composition (SO42-, BC) with MetS in the essential hypertensive population, while green space might play a protective role. Moreover, green space could effectively weaken the positive relationship between air pollutants and MetS, especially in males and participants younger than 60 years old.

The impact of urban green space on the health of middle-aged and older adults

Introduction

Urban green space is one of the most closely related ecosystem services to residents' lives, and it can be regarded as a preventive public health measure. Residents living in parks and other green environments can help improve their physical and mental health, reduce stress and even prevent crime and violence. Therefore, based on the actual situation in China, this paper analyzes the relationship between urban green space and the health of middle-aged and older adults and its mechanisms.

Methods

This study used multiple linear regression, based the data from the China Health and Retirement Longitudinal Study (CHARLS) in 2013, 2015, and 2018, to explore the relationship between urban green space and the health of middle-aged and older adults. At the same time, group regression was conducted to identify the heterogeneity of health effects of urban green space.

Results

The research shows that the increase of urban green space areas can significantly improve the health status of middle-aged and older adults. After a series of robustness tests, the results are still valid. In addition, the health effects of urban green space are different because of gender, age, education level, marital status residence, geographical location of the respondents and park quantity distribution. Further research found that reducing hot weather and optimizing air quality are the potential mechanisms of urban green space affecting the health of middle-aged and older adults, providing new evidence for the causal mechanism between urban green space and the health of middle-aged and older adults.

Discussion

This study expanded the research scope of the impact of urban green space on the health of middle-aged and older adults, covering a representative sample in China. The results show that urban green space has an important impact on the health of middle-aged and older adults. Policy suggestions are made to help cities optimize the landscape and residents to enjoy ecology.

Differences in the influence of daily behavior on health among older adults in urban and rural areas: evidence from China

Background

As the population of older adult in China keeps growing, the degree of aging is becoming increasingly serious and the health of older adults is a growing concern. Comparing the personal characteristics and health levels of urban and rural older adults and determining the relationship between these factors are of great significance in maintaining their health. In addition, exploring how these relationships differ between urban and rural areas is important.

Method

This study conducted a literature review to examine the impact of various factors on the physical and mental health of older adults in urban and rural areas in China. Moreover, based on cross-sectional data from the 2017 Chinese General Social Survey (CGSS), urban-rural differences in the factors' degree of influence on the perceived health of older adults were studied using multiple logistic regression.

Results

Regular physical exercise had a powerful protective effect on urban older adults' physical and mental health, whereas regular participation in social activities had a positive impact on rural older adults' health. Low income, low educational level, low social trust, lack of a partner, and having more than one child negatively affected the physical health of rural older people. Low socioeconomic status had a negative impact on rural people's health both in mind and body. Overall, the rural adults' health status was found to be relatively low and deserves more attention.

Conclusion

This study demonstrated that older people's physical and mental health levels can be significantly affected by the frequency of daily activities and individual and family characteristics. Furthermore, urban-rural differences were observed. These findings could provide feasible suggestions for governments, communities, and older adults' family members to help alleviate health inequality.

Neighborhood park access and park characteristics are associated with weight status in youth

This study investigated park access and park quality in the context of childhood obesity. Participants were 20,638 children ages 6-17y from a large primary care health system. Analyses tested associations of park access and park characteristics with children's weight status, and sociodemographic interactions. Both park access and the quality of nearest park were associated with a lower odds of having obesity. Park quality interacted with age, sex, and income. Findings suggest park access is important for supporting a healthy weight in children. Park quality may be most important among 12-14-year-olds, girls, and higher income groups.

The impact of place-based contextual social and environmental determinants on preterm birth: A systematic review of the empirical evidence

The objective of this study was to systematically review the available empirical evidence examining associations between preterm birth (PTB) and five domains of place-based contextual social and environmental determinants, including (1) physical environment, (2) residential greenness, (3) neighborhood violence/crime, (4) food accessibility and availability, and (5) health services accessibility, among adult mothers in high-income countries. The evidence in this review suggests an adverse association between damaged physical environment, neighborhood violence/crime, lack of health services accessibility, and PTB. The existing evidence also suggests a beneficial effect of residential greenness on PTB. Further studies are needed to investigate these associations for more understanding of the direction and magnitude of these association and for potential heterogeneity by factors such as race/ethnicity, urban vs rural residence, immigration status, and social class.

Association between greenspace and cancer: evidence from a systematic review and meta-analysis of multiple large cohort studies

Cancer is a chronic disease that seriously endangers human health, and studies on its association with greenspace have been published. We aimed to systematically review the epidemiological evidence and obtain the best available evidence. PubMed, Web of Science, Embase, and Cochrane Library were used as search databases, the time limit was September 12, 2022, and the cited articles were manually supplemented. Two researchers independently performed literature screening and data extraction. We performed a meta-analysis of data using a normalized difference vegetation index (NDVI) as the greenspace measure, providing hazard ratio (HR) and corresponding 95% CI. After standardization of the data, we used a random effects model for pooling. We also assessed the risk of bias for each study and the quality of each evidence body. We identified 10,108 items and included 14 studies from 11 institutions in eight countries. All studies had a low risk of bias. Quantitative analysis of 13 studies found a beneficial association of greenspace with the mortality of lung cancer (pooled HR [95% CI]=0.965 [0.947, 0.983]) and prostate cancer (HR [95% CI]=0.939 [0.898, 0.980]) based on 0.1-unit NDVI increment and a potential beneficial association with the incidence of prostate, lung, and breast cancer. Greenspace had opposite associations with cancer mortality for urban and rural populations. Indirect comparisons did not find statistically significant differences in the effects of greenspace on different cancer outcomes. The evidence body assessment was considered to be "very low." This review indicated potential beneficial associations between greenspace for lung, prostate, and breast cancer outcomes. However, there was a lack of mediation analysis to explore the underlying mechanism of a causal association. Meanwhile, the interstudy heterogeneity was large. Therefore, future studies should consider more accurate exposure assessment and more comprehensive covariate coverage, while focusing on mediating analysis. PROSPERO: CRD42022361068.

In situ psycho-cognitive assessments support self-determined urban green exercise time

Prescribed nature walks frequently yield improvements to mood and cognition as observed in experimental studies. Research that uses real life settings such as self-determined time exercising outdoors for restorative health benefits may more accurately elicit effects than time-specified study protocols. This study examined in situ psycho-cognitive outcomes of routine walks in urban greenspace to test the concept that self-set exposure duration and not context alone is related to magnitude of psycho-cognitive benefit. Pre-post measurements taken on a diverse participant pool of individuals walking in urban parks and recruited on random days over a two-week period found significant associations between outdoor activity duration and cognitive and mood improvements. Greater outdoor walking duration linearly predicted stronger processing speeds but non-linearly in tests of other cognitive domains. Results of fixed effects model for mean mood change following green exercise show outdoor walking influenced mood change at highest levels of significance, even after accounting for individual level variability in duration. Mood improved for all durations of outdoor walking under a random effects model with high significance. Untethering fixed intervals of outdoor exercise from formal study design revealed briefer but more frequent nature engagement aligned with nature affinity. The influence of unmeasured factors, e.g., nature affinity or restorative conditioning, for prescriptive durations of urban green exercise merits further investigation toward designing wellbeing interventions directed at specific urban populations.

Impact of individual and environmental factors on academic performance of pregnant adolescent

BACKGROUND

Teenage pregnancies continue to disrupt teenage girls' academic development. As a result, teenage mothers are at risk of unemployment, maternal death, and poverty. Previous research, however, has shown that both individual and environmental factors can have a significant impact on the prevalence of adolescent pregnancy. However, there has been little rigorous research on the impact of these factors on pregnant students' academic performance.

OBJECTIVES

The purpose of this study was to determine the relationship between environmental (neighbourhood) and individuals (sexual attitudes, peer attachment) factors. It also examined the influence of individual factors on the academic performance of pregnant teens.

METHODS

The study included a cross-sectional study of 400 pregnant adolescent students aged 15-19 years. The target groups were drawn from three major cities in Nigeria. Respondents were identified through targeted snowballing. Pregnant participants were a combination of married and unmarried girls attending school from home. Data were collected using a structured and self-completed questionnaire. Thus, frequency, mean and standard deviation were used for descriptive analysis. Pearson correlation analysis was applied to show the relationship between variables.

RESULTS

The study found that neighbourhood (r=-.125, p = .12) had a negative and significant relationship with peer attachment. However, there was no significant evidence of a relationship between sexual attitudes and neighbourhood (r=-.040, p = .422). There was, however, a significant relationship between sexual attitudes and academic performance (r = .236, p = .000). There was also a relationship between peer attachment and academic performance (r=-.401, p = < 0.001).

CONCLUSION

This study suggests that the academic performance of pregnant teenagers necessitates a combination of approaches, which includes changes in personal and prosocial behaviour, and environmental reforms. This can be achieved through, peer education, school day-care, subsidised or free contraceptives, free or subsidized education, and community programmes that positively influence young adults in the neighbourhood. These approaches can indirectly boost self-efficacy, motivation, and confidence to achieve higher academic feat, while reducing school dropout rate among the target groups.

Non-response bias in the analysis of the association between mental health and the urban environment: a cross-sectional study in Brussels, Belgium

BACKGROUND

This paper aims at analysing the impact of partial non-response in the association between urban environment and mental health in Brussels. The potential threats of the partial non-response are biases in survey estimates and statistics. The effect of non-response on statistical associations is often overlooked and evidence in the research literature is lacking.

METHODS

Data from the Belgian Health Interview Survey 2008 and 2013 were used. The association between non-response and potential determinants was explored through logistic regressions.

RESULTS

Participants with low income, low educational levels, lower or higher age or in households with children were less likely to respond. When adjusting for socio-economic variables, non-response was higher in areas which are less vegetated, more polluted or more urbanised. Because the determinants of non-response and depressive disorders were similar, it is reasonable to assume that there will be more people with mental health problems among the non-respondents. And because more non-responses were found in low vegetation areas, the protective association between green spaces and mental health may be underestimated.

CONCLUSION

Our capacity to measure the association between the urban environment and health is affected by non-response in surveys. The non-random spatial and socio-economic distribution of this bias affects the research findings.

Neighborhood Socioeconomic Status, Green Space, and Walkability and Risk for Falls Among Postmenopausal Women: The Women's Health Initiative

PURPOSE

This study estimated associations between neighborhood socioeconomic status (NSES), walkability, green space, and incident falls among postmenopausal women and evaluated modifiers of these associations, including study arm, race and ethnicity, baseline household income, baseline walking, age at enrollment, baseline low physical functioning, baseline fall history, climate region, and urban-rural residence.

METHODS

The Women's Health Initiative recruited a national sample of postmenopausal women (50-79 years) across 40 U.S. clinical centers and conducted yearly assessments from 1993 to 2005 (n = 161,808). Women reporting a history of hip fracture or walking limitations were excluded, yielding a final sample of 157,583 participants. Falling was reported annually. NSES (income/wealth, education, occupation), walkability (population density, diversity of land cover, nearby high-traffic roadways), and green space (exposure to vegetation) were calculated annually and categorized into tertiles (low, intermediate, high). Generalized estimating equations assessed longitudinal relationships.

RESULTS

NSES was associated with falling before adjustment (high vs. low, odds ratio, 1.01; 95% confidence interval, 1.00-1.01). Walkability was significantly associated with falls after adjustment (high vs. low, odds ratio, 0.99; 95% confidence interval, 0.98-0.99). Green space was not associated with falling before or after adjustment. Study arm, race and ethnicity, household income, age, low physical functioning, fall history, and climate region modified the relationship between NSES and falling. Race and ethnicity, age, fall history, and climate region modified relationships between walkability and green space and falling.

CONCLUSIONS

Our results did not show strong associations of NSES, walkability, or green space with falling. Future research should incorporate granular environmental measures that may directly relate to physical activity and outdoor engagement.

Effects of major urban redesign on sedentary behavior, physical activity, active transport and health-related quality of life in adults

BACKGROUND

The built environment is increasingly recognized as a determinant for health and health behaviors. Existing evidence regarding the relationship between environment and health (behaviors) is varying in significance and magnitude, and more high-quality longitudinal studies are needed. The aim of this study was to evaluate the effects of a major urban redesign project on physical activity (PA), sedentary behavior (SB), active transport (AT), health-related quality of life (HRQOL), social activities (SA) and meaningfulness, at 29-39 months after opening of the reconstructed area.

METHODS

PA and AT were measured using accelerometers and GPS loggers. HRQOL and sociodemographic characteristics were assessed using questionnaires. In total, 241 participants provided valid data at baseline and follow-up. We distinguished three groups, based on proximity to the intervention area: maximal exposure group, minimal exposure group and no exposure group.

RESULTS

Both the maximal and minimal exposure groups showed significantly different trends regarding transport-based PA levels compared to the no exposure group. In the exposure groups SB decreased, while it increased in the no exposure group. Also, transport-based light intensity PA remained stable in the exposure groups, while it significantly decreased in the no exposure group. No intervention effects were found for total daily PA levels. Scores on SA and meaningfulness increased in the maximal exposure group and decreased in the minimal and no exposure group, but changes were not statistically significant.

CONCLUSION

The results of this study emphasize the potential of the built environment in changing SB and highlights the relevance of longer-term follow-up measurements to explore the full potential of urban redesign projects.

TRIAL REGISTRATION

This research was retrospectively registered at the Netherlands Trial Register (NL8108).

Effects of built and natural environments on leisure physical activity in residential and workplace neighborhoods

Few studies have investigated relative contributions of the built and natural environments to and their nonlinear associations with leisure physical activity (PA) in different spatial contexts. Applying gradient boosting decision tree models to data comprising 1049 adults collected in Shanghai, we investigated the associations between built and natural environments and leisure PA in residential and workplace neighborhoods. Results show that the built environment is more important than the natural environment to leisure PA in both residences and workplaces. Environmental attributes have nonlinear and threshold effects. Within certain ranges, land use mix and population density have opposite associations with leisure PA in residences and workplaces, whereas the distance to the city center and the area of water are associated with leisure PA in residences and workplaces with the same direction. These findings help urban planners design context-specific environmental interventions for supporting leisure PA.

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

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

Supplementary Information

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

Factors affecting cultural ecosystem services use in Vilnius (Lithuania): A participatory mapping survey approach

Assessing preferences of recreational activities related to cultural ecosystem services (CES) in urban areas is essential for decision-making and urban green space (UGS) management. This work aims to assess the preferences and factors (based on socio-demographic and motivation variables) influencing CES-related activities in Vilnius, Lithuania, to provide scientific knowledge to support more efficient UGS design and management. Participatory mapping was reported as relevant for urban park planning and decision-making and was applied to identify spatially explicit CES. We assessed the perceived relevance of five CES-related activities groups (Social activities, Inspirational activities, Cultural activities, Spiritual activities, and Physical activities) via participatory mapping through an online survey (n = 1.114). The users selected one preferred geographic location for each CES-related activities group and attributed relevance (using a 5-point Likert scale) for a set of motivation items. The results showed that Physical and Social activities were the respondents' most important CES-related activity groups, while Spiritual activities were the less popular. Factor Analysis showed that the respondent's recreation experience preferences, or motivations, were the most relevant variables influencing all the groups except for the Social activities group. Regarding Cultural activities, preferences for understanding things & learn about history were the most relevant variables. For Inspirational activities, the variables developing knowledge & to learn were the most important. Enjoying nature's quietness & frequency was the most relevant for Physical activities. Regarding Spiritual activities, the most important variables were related to the development of spiritual activities and the reflection on personal religious values. Finally, socio-demographic variables mainly influenced social activities, namely education level, gender and age group. The spatial distribution was different between activity groups. Inspirational activities showed the highest dispersion, and Spiritual activities the highest concentration. The results of this work are relevant to municipal managers, as they allow for a better understanding of users' interactions with the territory, its multifunctionality, and potential areas of conflict between conservation and recreation.

Users' preferences and perceptions towards urban green spaces in rapidly urbanized cities: The case of Debre Berhan and Debre Markos, Ethiopia

Urban green spaces are essential elements of cities that play an important role in urban sustainability and human health. This study analyzed the users' preferences and perceptions towards urban green spaces. A total of five parks were purposively selected from Debre Berhan and Debre Markos cities. A questionnaire survey was administered to 350 park users in both cities. Data were analyzed with descriptive statistics, and the independence of variables was tested using a chi-square test using IBM SPSS 20. The chi² test shows that visits' purpose depended on the users' age, gender, and education level (P < 0.05). 26.1% and 13.8% of the users visit the parks "always" to chill with friends and to enjoy nature, respectively. The existence of fences, safety and security, and spaciousness of the park were the major encouraging factors, with the average Likert value of 3.04, 3.01, and 2.72, respectively. Alcoholic drinks and chewing Khat (stimulant green leafy plant) within the parks, lack of comfortable sitting areas, absence of safety and security, and improper park management were the main discouraging factors. There was a very strong statistical association between perceptions of users to the benefits of green spaces and occupation (χ2 (95, N = 350) = 158.908, p < 0.001), age (χ2 (76, N = 350) = 175.135, p < 0.001), gender (χ2 (19, N = 350) = 68.226, p < 0.001), and education level (χ2 (114, N = 350) = 240.798, p < 0.001). The "highly" perceived benefits of green spaces were recreational, aesthetic, and pollution protection. 50% of the respondents "never" participated in any green space development activities. Therefore, rapidly urbanized cities in Africa and Asia could take a lesson from this study about the importance of incorporating citizens' preferences for green spaces and public participation in urban green space development and management.

Healthy Cities, A comprehensive dataset for environmental determinants of health in England cities

This paper presents a fine-grained and multi-sourced dataset for environmental determinants of health collected from England cities. We provide health outcomes of citizens covering physical health (COVID-19 cases, asthma medication expenditure, etc.), mental health (psychological medication expenditure), and life expectancy estimations. We present the corresponding environmental determinants from four perspectives, including basic statistics (population, area, etc.), behavioural environment (availability of tobacco, health-care services, etc.), built environment (road density, street view features, etc.), and natural environment (air quality, temperature, etc.). To reveal regional differences, we extract and integrate massive environment and health indicators from heterogeneous sources into two unified spatial scales, i.e., at the middle layer super output area (MSOA) and the city level, via big data processing and deep learning. Our data holds great promise for diverse audiences, such as public health researchers and urban designers, to further unveil the environmental determinants of health and design methodology for a healthy, sustainable city.

Applying an ecosystem services framework on nature and mental health to recreational blue space visits across 18 countries

The effects of 'nature' on mental health and subjective well-being have yet to be consistently integrated into ecosystem service models and frameworks. To address this gap, we used data on subjective mental well-being from an 18-country survey to test a conceptual model integrating mental health with ecosystem services, initially proposed by Bratman et al. We analysed a range of individual and contextual factors in the context of 14,998 recreational visits to blue spaces, outdoor environments which prominently feature water. Consistent with the conceptual model, subjective mental well-being outcomes were dependent upon on a complex interplay of environmental type and quality, visit characteristics, and individual factors. These results have implications for public health and environmental management, as they may help identify the bluespace locations, environmental features, and key activities, that are most likely to impact well-being, but also potentially affect recreational demand on fragile aquatic ecosystems.

Place, health and dis/advantage: A sociomaterial analysis

The substantial literature on interactions between places/spaces and well-being/health often differentiate between physical and social aspects of geographical location. This paper sidesteps this dualism, instead considering places as sociomaterial assemblages of human and non-human materialities. It uses this posthuman and 'new materialist' perspective to explore how place-assemblages affect human capacities, in terms of both health and social dis/advantage. Based on secondary analysis of interview data on human/place interactions, it analyses the physical, sociocultural, psychological and emotional effects of place-assemblages, assessing how these produce opportunities for, and constraints upon human bodies. It than assesses how these emergent capacities affect both social dis/advantage and well-being. This analysis of how place-assemblages contribute positively or negatively to health and dis/advantage offers possibilities for further research and for social and public health policy.

Associations between greenness and kidney disease in Massachusetts: The US Medicare longitudinal cohort study

BACKGROUND

Recent studies have identified the association of environmental stressors with reduced kidney function and the development of kidney disease. While residential greenness has been linked to many health benefits, the association between residential greenness and the development of kidney disease is not clear. We aimed to investigate the association between residential greenness and the development of kidney disease.

METHODS

We performed a longitudinal population-based cohort study including all fee-for-service Medicare Part A beneficiaries (aged 65 years or older) in Massachusetts (2000-2016). We assessed greenness with the annual average Enhanced Vegetation Index (EVI) based on residential ZIP codes of beneficiaries. We applied Cox-equivalent Poisson models to estimate the association between EVI and first hospital admission for total kidney disease, chronic kidney disease (CKD), and acute kidney injury (AKI), separately.

RESULTS

Data for 1,462,949 beneficiaries who resided in a total of 644 ZIP codes were analyzed. The total person-years of follow-up for total kidney disease, CKD, and AKI were 9.8, 10.9, and 10.8 million person-years, respectively. For a 0.1 increase in annual EVI, the hazard ratios (HRs) were 0.95 (95% CI: 0.93 to 0.97) for the first hospital admission for total kidney disease, and the association was more prominent for AKI (HR: 0.94 with 95% CI: 0.92 to 0.97) than CKD (HR: 0.98 with 95% CI: 0.95-1.01]). The estimated effects of EVI on kidney disease were generally more evident in White beneficiaries and those residing in metropolitan areas compared to the overall population.

CONCLUSIONS

This study found that higher levels of annual residential greenness were associated with a lower risk of the first hospital admission for kidney diseases. Results are consistent with the hypothesis that higher residential greenness benefits kidney patients.

Association between greenness and cardiovascular risk factors: Results from a large cohort study in Thailand

BACKGROUND

The risk of cardiovascular diseases may be reduced by residing in green environments. However, there are relatively few longitudinal cohort studies, especially in Southeast Asia, that focused on the health benefits of long-term greenness exposure in young adults. The present study examined the association between long-term exposure to residential greenness and self-reported morbidities in participants of the Thai Cohort Study (TCS) in Thailand from 2005 to 2013.

METHODS

The self-reported outcomes, including high blood pressure, high blood cholesterol, and diabetes, were reported in 2005, 2009, and 2013, where the study participants provided the exact year of disease occurrence. Greenness was assessed by the satellite-based Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), with a spatial resolution of 250 m. Long-term exposure to NDVI and EVI of each participant's sub-district was averaged over the period of person-time. We used Cox proportional hazards models to examine the association between greenness and health outcomes. Associations with self-reported morbidity were measured using hazard ratios (HRs) per interquartile range (IQR) increase in NDVI and EVI.

RESULTS

After adjusting for potential confounders, we observed that an IQR increase in NDVI was associated with lower incidence of high blood pressure (HR = 0.92, 95% CI: 0.89, 0.97) and high blood cholesterol (HR = 0.89, 95%CI: 0.87, 0.92), but not significantly associated with diabetes (HR = 0.93, 95%CI: 0.85, 1.01). EVI was also inversely associated with self-reported high blood pressure (HR = 0.92, 95%CI: 0.88, 0.96), high blood cholesterol (HR = 0.89, 95%CI: 0.87, 0.91), and diabetes (HR = 0.92, 95%CI: 0.85, 0.99).

CONCLUSIONS

Long-term exposure to residential greenness was inversely associated with self-reported high blood pressure, high blood cholesterol, and diabetes in participants of TCS. Our study provides evidence that greenness exposure may reduce cardiovascular disease risk factors in adult population.

Australian golfers with and without osteoarthritis report reduced psychological distress and improved general health compared to a general population-based sample

OBJECTIVES

To (i) evaluate psychological distress and general health in Australian golfers and compare with a general population-based sample, and (ii) explore the relationship between playing golf, psychological distress and general health in individuals with osteoarthritis.

DESIGN

Cross sectional.

METHODS

A cross-sectional survey collected outcomes in 459 Australian Golfers (Kessler-10 Psychological Distress Scale, Short-Form 12 (Health Status), International Physical Activity Questionnaire, osteoarthritis status). Outcomes were compared between Australian golfers and a general population-based sample (Australian Health Survey, n = 16,370). Modified Poisson regression estimated the relationship between playing golf and general health in all participants and a subgroup with osteoarthritis (n = 128 golfers, n = 2216 general population). All analyses were adjusted for age, sex, education and smoking status.

RESULTS

Playing golf was associated with lower psychological distress (adjusted mean difference (95 % confidence interval) -2.5 (-4.1 to -0.9)) and a greater likelihood of reporting good to excellent general health (adjusted relative risk (95 % confidence interval) 1.09 (1.05 to 1.13)) compared to the general population. Amongst people with osteoarthritis, playing golf was associated with lower psychological distress (adjusted mean difference -4.0 (95 % confidence interval -6.5 to -1.5)) and a greater likelihood of reporting good to excellent general health (adjusted relative risk (95 % confidence interval) 1.3 (1.2 to 1.4)).

CONCLUSIONS

Golfers had lower levels of psychological distress and better general health than the general population, and this relationship was strongest in individuals with osteoarthritis.

Can Potted Plants Catch Mosquitoes? Applying Rare-Earth Luminescent Materials and Plant Energy to the Development of Innovative Mosquito-Trapping Potted Plants

Due to the global warming crisis, the spread of various infectious diseases is worsening, with mosquito-borne contagious diseases posing a significant threat. While many residential and public spaces contain plants, often for greening the environment and improving mental and physical well-being, the carbon dioxide released by these plants produces ideal habitats for mosquitoes. Considering the quality of life of urban residents and the development of health-related products simultaneously is an important topic. This study used diverse complementary techniques, such as energy-storing rare-earth luminescent materials, sustainable power generation using plant energy, blue light-emitting diodes, and environmentally friendly fermentation formula, to develop planting products with potential mosquito control functionality. The prototype design for this mosquito-trapping potted plant has been patented. The aim of this paper is to discuss the design principles adopted to improve the defects of existing mosquito-trapping designs, the green energy materials and techniques employed, the architecture configuration of the product prototype, and the test results. By integrating green materials and technology, the prototype can be self-powered without being plugged in to yield conspicuous energy savings. The results showed that the developed multi-function products, combined with the concept of energy sustainability, can improve global public health as well as individuals' physical and mental health.

Onsite restorative effect of a rural ecological farm versus an urban public greenery space

Accessible urban greenery allows short breaks and leisure activities while experiencing nature. Studies have shown that contact with nature elicits psychological and physical health benefits. However, the immediate impact and influence of exposure to artificial versus rural ecological nature have yet to be examined. This study investigates their psychophysiological restorative effects onsite, specifically when individuals view a ubiquitous urban public greenery space or a more indigenous ecological forest-like nature area, to compare levels of restorativeness and relaxation. Participants were asked to sit and view a scene onsite for 6 min while their facial muscle tension was recorded. The data were used to evaluate the degree of facial relaxation for both scenes. In addition, participant self-reports measured perceived restorativeness after the 6-min period. The self-reported data showed that the ecological farm scene was rated significantly higher for perceived restorativeness (t [49.136] = 9.094, p < .001) after 6 min of viewing. The muscle tension analysis showed that facial tension significantly declined when participants viewed the farm scene compared to the urban greenery space. These results, especially those on the farm, show that nature with more forest-like and rural elements elicited more powerful restorative effects and significantly lowered facial muscle tension (t [65] =  − 2.785, p < .05), thus verifying that a more ecological nature landscape provides immediate, significant health benefits through attention recovery and reduced facial muscle stress.

Do We Need Public Green Spaces Accessibility Standards for the Sustainable Development of Urban Settlements? The Evidence from Wrocław, Poland

Public green spaces (PGSs) have a positive impact on the health and wellbeing of urban residents. However, their accessibility can be limited due to high urbanisation pressures and inadequate or insufficient regulatory provisions. This problem has been recognised for Central European cities, of which Wrocław is an example, where the provision of PGS accessibility has not received major attention in recent decades, and the planning system has been in constant transformation since the transition from a centrally planned to a free-market economy. This study therefore aimed to examine the distribution and accessibility of PGSs in the expanding area of Wrocław today and upon implementation of the plans under the proposed standards. These analyses were performed using the QGIS application, network analysis, and the ISO-Area as polygon algorithm. The findings revealed a conspicuous lack of available PGSs, which includes areas above 2 ha, such as district and neighbourhood parks. New PGSs are now being planned, but even so, part of the residential areas will remain outside their catchment zone. The results obtained provide strong evidence that it is essential that standards should be a tool implemented in urban planning, and that the adopted procedure can be transferred to other cities.

The Effects of Winter Parks in Cold Regions on Cognition Recovery and Emotion Improvement of Older Adults: An Empirical Study of Changchun Parks

Urban parks are one of the primary settings for older adults to exercise, and their health benefits have been confirmed by a large number of studies. However, with the increased social attention to mental health, there is not enough research on the short-term mental health recovery of older adults in parks. Meanwhile, the health recovery effects of winter parks in special climate areas have not been well explored. This study aimed to explore the effects of winter parks in cold regions on the short-term mental health recovery of older adults and the potential predictors of these effects, including individual status, park characteristics, and behavioral characteristics. This study divided short-term mental health recovery into cognitive recovery and emotional improvement, and selected the digit span test and 10 kinds of emotional expression as the experimental methods, recruited 92 older adults from 6 parks in Changchun, and compared the pre-test and post-test results for evaluation. The results showed that winter parks in cold cities still had short-term cognitive recovery and emotional improvement effects on older adults. The main park characteristic factors affecting the overall cognitive recovery were the evergreen vegetation area and the existence of structures, and that which affected the overall emotional improvement was the main pathway length. Furthermore, individual conditions, including gender, age, physical health, living and customary conditions, and park characteristics, including park type, park area, main pathway length, square area, equipment area, evergreen vegetation area, the presence of water, and structures, all related to short-term mental health recovery effects. Among behavioral characteristics, stay time in parks and MVPA (Moderate and Vigorous Physical Activity) times were also related to certain effects, but behavior type was not.

Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

BACKGROUND

Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity at a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.

METHODS

We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.

RESULTS

We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).

CONCLUSIONS

Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.

TRIAL REGISTRATION

PROSPERO 2018 CRD42018093429.

Green Physical Activity Indicator: Health, Physical Activity and Spending Time Outdoors Related to Residents Preference for Greenery

Spending time in the natural outdoor environment is a part of a healthy lifestyle. This study focused on identifying elements of green infrastructure that have a positive impact on both increasing physical activity, spending time outdoors and improving overall health. The aim of the research was to identify which elements of the settlement units' green and blue infrastructure, related to residents' preferences for greenery, influence more physical activity and spending time in green spaces and improve the healthy feeling of users as perceived by respondents. A total of 721 respondents from Poland took part in the survey. Using multiple regression models, the factors that influence an increase in outdoor physical activity Green Physical Activity Index (GPAI) were: using green spaces for exercise, spending time outdoors, exposure to nature and sufficiently large amounts of green space in the neighborhood and proximity to places to walk the dog. In contrast, physical activity has been shown to improve feeling healthy (health declaration). The main findings show that the increase in physical activity outdoors (GPAI) is positively influenced by factors related to respondents' reasons for being outdoors, rather than the attractiveness and availability of green infrastructure. The research confirmed the necessity of arranging green areas with rich offerings in terms of a variety of activities for leisure visitors, to give them more opportunities for being outdoors.

Barriers to physical activity for father's living in marginalising conditions

Physical activity can be a conduit for improving men's social connectedness as well as physical gains for well-being. However, marginalised men, and fathers in particular, can be challenged to engage in leisure time physical activity. This qualitative study reports how fathers, who experience complex and significant social and health inequities, conceptualise and experience barriers to physical activity. Drawing from focus groups with 17 fathers, and semi-structured interviews with seven service providers about their perspectives on men's physical activity in Vancouver's Downtown Eastside (DTES), a highly marginalised neighbourhood. A masculinities framework was used to describe and contextualise physical activity in fathers' lives. Three themes were inductively derived through the analyses: (1) 'they're busy surviving' a finding referencing the work and limits invoked by poverty wherein survival was triaged ahead of leisure time physical activity; (2) 'there is no activity centre' chronicling the lack of physical activity spaces, programmes and resources available to fathers; and (3) 'lifestyle affects our capability to exercise' a theme detailing how social isolation amplified by factors including housing and opioid crises, and being a father in a resource poor setting imposed significant barriers to physical activity. The findings support reconceptualising physical activity programmes with men who are living in marginalising conditions to address behavioural and structural health inequities in tailoring father-centred programmes and resources.

Healthy lifestyles and wellbeing reduce neuroinflammation and prevent neurodegenerative and psychiatric disorders

Since the mid-20th century, Western societies have considered productivity and economic outcomes are more important than focusing on people's health and wellbeing. This focus has created lifestyles with high stress levels, associated with overconsumption of unhealthy foods and little exercise, which negatively affect people's lives, and subsequently lead to the development of pathologies, including neurodegenerative and psychiatric disorders. Prioritizing a healthy lifestyle to maintain wellbeing may slow the onset or reduce the severity of pathologies. It is a win-win for everyone; for societies and for individuals. A balanced lifestyle is increasingly being adopted globally, with many doctors encouraging meditation and prescribing non-pharmaceutical interventions to treat depression. In psychiatric and neurodegenerative disorders, the inflammatory response system of the brain (neuroinflammation) is activated. Many risks factors are now known to be linked to neuroinflammation such as stress, pollution, and a high saturated and trans fat diet. On the other hand, many studies have linked healthy habits and anti-inflammatory products with lower levels of neuroinflammation and a reduced risk of neurodegenerative and psychiatric disorders. Sharing risk and protective factors is critical so that individuals can make informed choices that promote positive aging throughout their lifespan. Most strategies to manage neurodegenerative diseases are palliative because neurodegeneration has been progressing silently for decades before symptoms appear. Here, we focus on preventing neurodegenerative diseases by adopting an integrated "healthy" lifestyle approach. This review summarizes the role of neuroinflammation on risk and protective factors of neurodegenerative and psychiatric disorders.

Alleviating mental health disorders through doses of green spaces: an updated review in times of the COVID-19 pandemic

The COVID-19 pandemic has highlighted issues due to mental health disorders, in particular the serious consequences derived from lockdown measures. This paper aims to analyse the literature on the potential direct impact of the natural environment on mental health disorders. We have systematically reviewed the studies analysing green spaces and mental health included in this review using PubMed, Web of Science, Scopus and Cochrane Library. A retrospective time-frame is considered, covering the COVID-19 pandemic. We have found that exposure to, use and proximity to green spaces have a beneficial impact on mental health among elderly, students and patients with underlying pathologies. However, it has negative effects on the mental health of women and young adults. Exposure to and interaction with the natural environment can improve certain mental health disorders and should be taken into account for strategies and policies related to future threats to public health.

Using smartphone-GPS data to quantify human activity in green spaces

Cities are growing in density and coverage globally, increasing the value of green spaces for human health and well-being. Understanding the interactions between people and green spaces is also critical for biological conservation and sustainable development. However, quantifying green space use is particularly challenging. We used an activity index of anonymized GPS data from smart devices provided by Mapbox (www.mapbox.com) to characterize human activity in green spaces in the Greater Toronto Area, Canada. The goals of our study were to describe i) a methodological example of how anonymized GPS data could be used for human-nature research and ii) associations between park features and human activity. We describe some of the challenges and solutions with using this activity index, especially in the context of green spaces and biodiversity monitoring. We found the activity index was strongly correlated with visitation records (i.e., park reservations) and that these data are useful to identify high or low-usage areas within green spaces. Parks with a more extensive trail network typically experienced higher visitation rates and a substantial proportion of activity remained on trails. We identified certain land covers that were more frequently associated with human presence, such as rock formations, and find a relationship between human activity and tree composition. Our study demonstrates that anonymized GPS data from smart devices are a powerful tool for spatially quantifying human activity in green spaces. These could help to minimize trade-offs in the management of green spaces for human use and biological conservation will continue to be a significant challenge over the coming decades because of accelerating urbanization coupled with population growth. Importantly, we include a series of recommendations when using activity indexes for managing green spaces that can assist with biomonitoring and supporting sustainable human use.

Associations of greenness surrounding schools and self-reported depressive and anxiety symptoms in Chinese adolescents

BACKGROUND

The effect of school-based greenness exposure on mental health among adolescents remains unclear. The study aimed to estimate the associations between school-based greenness and depressive and anxiety symptoms among adolescents and explore potential modifier and mediator between the associations.

METHODS

A cross-sectional survey involving 15,559 adolescents was conducted in China. The Chinese version of the Center for Epidemiologic Studies Depression 9-Item Scale and the Generalized Anxiety Disorder 7-Item Scale were used to assess the depressive and anxiety symptoms among adolescents. The Normalized Difference Vegetation Index within a 400 m and 800 m zone surrounding schools was used to indicate the adolescents' exposure to greenness. We estimated daily concentrations of PM_1.0, PM_2.5, and NO₂ from the China High Air Pollutants dataset. Multiple logistic regression models were used.

RESULTS

Higher exposure to greenness surrounding schools was negatively associated with depressive (OR: 0.774, 95%CI: 0.685-0.875) and anxiety symptoms (0.740, 0.669-0.818). We observed stronger associations between greenness and depressive and anxiety symptoms among girls, lower age group (11-15 years), and adolescents born to parents with lower education levels. PM_1.0 (proportion mediated estimates: 14.3 %; 95 % CI: 4.2 %, 24.5 %) and PM_2.5 (10.5 %; 95 % CI: 3.0 %, 17.9 %) mediated the associations between greenness exposure and depressive symptoms. The number of days adolescents attended physical education classes per week mediated -22.8 % (95 % CI: -38.5 %, -7.1 %) and -9.7 % (95 % CI: -15.5 %, -3.8 %) of the effects of greenness on depressive and anxiety symptoms.

CONCLUSIONS

Increasing the greenness and improving the environment surrounding schools is effective in promoting the mental health of adolescents.

Moving to greener pastures: Health selection into neighborhood green space among a highly mobile and diverse population in California

Global urbanization has sparked substantial environmental, public health, and social science research on the importance of conserving and propagating natural environments. A large subset of this work focuses on the benefits of green space for health. An often-overlooked methodological concern when examining relations between green space and health, however, involves residential self-selection. The selective movement of individuals into greener neighborhoods on the basis of preexisting health and correlated social factors may bias associations, particularly in cross-sectional studies, which predominate existing green space/health research. To quantify the extent of residential self-selection bias, this study used a longitudinal sibling comparison design with repeated individual and neighborhood measures to estimate associations between pre-move health factors, including maternal body mass index (BMI) and infant birthweight, and post-move neighborhood green space in a residentially mobile sample of mothers in California, 2007 to 2015 (n = 288,333). Results show that better health before moving predicted higher levels of neighborhood green space after moving, providing evidence of health selection. Findings also indicate some support for differential health selection into neighborhood green space by race/ethnicity, including that evidence of selection emerges for white and Hispanic, but not Black, mothers. However, weak relations between pre-move individual factors and post-move neighborhood green space across analyses suggest that potential bias due to residential self-selection appears relatively minimal in a large, diverse, and highly mobile sample of families in California. Findings support calls to increase green space in historically marginalized neighborhoods as a means to promote environmental and health equity.

Green Space Exposure and Obesity in the Mexican Adult Population

Green space or natural vegetation may reduce obesity risk by increasing opportunities for physical activity or reducing stress and exposure to other pollutants. Obesity prevalence in Mexico is ranked among the highest in the world. However, research on the association between green space and obesity in Mexico is lacking. We used data from the National Nutrition Survey in Mexico (2018-2019), a nationally representative sample of Mexican adults. The analytical sample included participants between 20-59 years of age (n = 12,631). We assessed exposure to green space using a 30 m resolution Landsat satellite Normalized Difference Vegetation Index (NDVI) from 2018. Linear regression models examined associations between NDVI and body mass index (BMI), adjusting for confounders. The mean age of the study sample was 38 (SD 0.19) years. Participants living in areas with the highest green space exposure had the lowest education level (53.51%) and socioeconomic status (28.38%) and were located in central (33.01%), south (30.37%), and rural areas (21.05%). Higher residential exposure to green space was associated with a mean decrease in BMI of -1.1 kg/m² (95% CI: -1.59, -0.68). This is one of the first studies in Latin America to suggest a protective association between green space and obesity among Mexican adults.