Perceptions of green space usage, abundance, and quality of green space were associated with better mental health during the COVID-19 pandemic among residents of Denver

Living in an Intimate Partner Violence Shelter During a Pandemic: Perspectives from Advocates and Survivors

PURPOSE

With state-wide quarantine policies during the COVID-19 pandemic like those implemented in the state of Texas, intimate partner violence (IPV) shelter staff were forced to incorporate new safety measures to keep survivors and advocates safe. To understand the impact of these adaptations fully, authors interviewed shelter staff and residents to capture both of their experiences living and working in the same shelter during the height of the coronavirus pandemic (summer 2020) to understand how changes in policy and procedure in shelters impacted survivors and advocates.

MATERIALS AND METHODS

A qualitative phenomenological design was utilized to collect and analyze data from 10 staff and 10 survivors to develop both a textual and a structural description of participant experiences living in an IPV shelter.

RESULTS

The current study captured the survivors' and advocates' perspectives related to the 1) vacillating views of shelter social distancing and quarantine policies, 2) shelter occupancy and staffing unpredictability, 3) the broader challenges related to environmental stressors and 4) mobility challenges.

DISCUSSION

Results of this study highlight factors related to interpersonal relationships within the shelter and structural factors of shelter which contributed to stress for participants.

CONCLUSION

The coronavirus is continuing to present challenges for shelters. Implications can be drawn from provider and client experiences that can inform policies and procedures for future health crises, including the need to mitigate environmental stress and transportation challenges, as well as considerations for maintaining social support should social distancing be necessary in future epidemics.

Effects of greenness in university campuses on test anxiety among Chinese university students during COVID-19 lockdowns: a correlational and mediation analysis

The purpose of this study is to investigate the correlations of greenness exposure with test anxiety among university students during COVID-19 lockdowns and to explore their mechanisms. We conducted a cross-sectional study with 2609 university students in Anhui and Shandong provinces, China. We assessed perceived campus greenness using a five-point Likert scale for quality, visibility, abundance, usage, and accessibility. Objective greenness was estimated via average normalised difference vegetation index (NDVI) in 1,000-, 1,500-, and 2,000-m radius zones around each of the campuses. A generalised linear mixed model examined the associations between greenness and test anxiety and to evaluate the mediation effects of physical activity, body mass index (BMI), and air pollution. Results showed that higher NDVI1500-m correlated with lower test anxiety (OR = 0.871; 95% CI: 0.851, 0.891), physical activity may partially mediate this association. Increased campus greenness may alleviate test anxiety among Chinese university students.

Nature exposure and mental health during the COVID-19 pandemic: A Navigation Guide systematic review with meta-analysis

Prior reviews have highlighted that nature exposure was a valuable coping strategy enhancing mental health during the COVID-19 pandemic. However, no existing reviews have determined the quality of evidence and risk of bias of the empirical studies supporting this claim. To address this gap, we employed a Navigation Guide systematic review and meta-analysis approach to investigate associations between nature exposure and mental health during the pandemic. Searches in PubMed, Web of Science, Scopus, CINAHL, and PsycInfo retrieved relevant articles published between January 1, 2020, and March 4, 2024. We used the Navigation Guide methodology to assess the risk of bias and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessments to evaluate the overall quality of evidence. Our search retrieved 113 studies that met the inclusion criteria and reported diverse types of exposure, including nature availability, nature visit frequency, green space accessibility, and green space type, alongside associations with 12 mental health outcomes. Meta-analyses found access to gardens was associated with lower odds of depression [(Pooled odds ratio [OR] = 0.71, 95%CI = 0.61, 0.82), I2 = 0%, n = 3] and anxiety [(Pooled OR = 0.73, 95%CI = 0.63, 0.84), I2 = 0%, n = 3]. Increased time in green spaces was associated with lower level of stress [(Pooled Corr = -0.11, 95%CI = -0.17, -0.05), I2 = 0%, n = 2]. Higher frequency of visits to nature was associated with improved mental well-being [(Pooled standardized beta = 0.10, 95%CI = 0.07, 0.14), I2 = 0%, n = 2] and general mental health [(Pooled standardized beta = 0.11, 95%CI = 0.03-0.38), I2 = 82%, n = 2]. However, the number of pooled studies was small and the overall quality of evidence was "very low" for all outcomes, and high levels of bias were observed (26% of studies had high, 71% probably high). Nonetheless, given the trends in the results, nature-based solutions emphasizing exposure to gardens and green spaces near the home may have promoted psychological resilience during this public health crisis.

Pathways linking greenspace to behavioural problems in Polish children

Background

Previous cross-sectional studies have found a beneficial relationship between greenspace and children's behaviour. Nevertheless, evidence on the mechanisms underlying this association remains scant. We examined whether the availability of greenspace was related to fewer behavioural problems in Polish children and investigated potential mechanisms.

Methods

Data were obtained from the case-control NeuroSmog study, in which children with and without attention deficit hyperactivity disorder (ADHD) were tested from October 2020 to September 2022. The analytic sample comprised 679 children aged 10-13 years. Parents reported internalizing, externalizing, and total behavioural problems using the Child Behaviour Check List (CBCL), as well as information about the presence of a domestic garden and potential mediators: greenspace perception, neighbourhood social cohesion, and physical activity. Tree and grass covers were extracted in 500 m and 1 km buffers around lifelong residences. Structural equation modelling (SEM) was used to examine the psychosocial pathways linking the greenspace metrics to behavioural problems.

Results

Greenspace was only indirectly related to fewer behavioural problems. Specifically, tree cover was related to greater levels of physical activity which, in turn, was related to fewer internalizing and total behavioural problems. Tree cover and presence of garden were related to greenspace perception which, in turn, was associated with higher neighbourhood social cohesion which, in turn, was linked to fewer behavioural problems. The patterns of associations in children without ADHD were very similar to those in the full sample except that the associations from garden to greenspace perception and from physical activity to total behavioural problems were no longer significant. The only association persisted among girls was from neighbourhood social cohesion to behavioural problems and among boys were from tree cover to physical activity and tree cover and garden to greenspace perception.

Conclusion

Trees and garden, but not grass, are linked to fewer behavioural problems through greenspace perception, neighbourhood social cohesion, and physical activity in Polish children.

A systematic review of the relationship between natural environments and physiological and mental health during different stages of the COVID-19 pandemic

COVID-19 has altered how individuals interact with natural environments. Numerous studies have investigated the effects of such environments on health. However, how natural environments influenced individuals' physiological and mental health during various stages of the COVID-19 pandemic remains unclear. Therefore, we conducted this study to investigate the effects of natural environments on individuals' physiological and mental health during different stages of the pandemic; we also identified factors that mediated these effects. Overall, we evaluated the importance of natural environments during challenging times. This study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The pandemic period was divided into three stages on the basis of severity: pandemic (March 2020 - February 2022), easing (February 2022-September 2022), and post-acute COVID pandemic (September 2022 - present). An initial pool of 3018 studies was narrowed down to a final sample of 73 studies. During the pandemic stage, individuals frequenting public green spaces exhibited improved well-being, reduced stress levels, and a sense of nature deprivation. Private green spaces played crucial roles in maintaining health during the pandemic stage. Highquality window views were associated with improved well-being and reduced depression. During the easing stage, the environmental quality of public green spaces influenced individuals' perceived safety and sense of belonging. And coastal areas were the preferred natural destinations in this stage. During the post-acute COVID pandemic stage, individuals acknowledged the importance of natural environments in maintaining physiological and mental health as they gradually returned to prepandemic normalcy. In conclusion, the COVID-19 pandemic highlighted humanity's reliance on nature. Therefore, sufficient urban spaces should be dedicated to preservation of natural environments to mitigate negative emotions arising from prolonged indoor stays.

Anxiety, depression, and suicidal ideation among early adolescents during the COVID-19 pandemic

BACKGROUND

Anxiety and depression are among the most common and debilitating psychiatric disorders affecting youth, with both related to increased suicide risk. While rates of youth anxiety and depression were increasing before the COVID-19 pandemic, the pandemic further negatively impacted adolescent mental health. Unfortunately, few studies have examined prevalence of these concerns among early adolescents (ages 10-13) longitudinally during the pandemic.

METHOD

The current study examined self-reported anxiety and depression symptoms, and suicidal ideation amongst a general pediatrics population of 11- to 13-year-olds (n = 623) from March through September 2020 (early-pandemic) and approximately 7 months later (September 2020 through May 2021; mid-pandemic). Paired samples proportions were used to examine changes in prevalence of moderate to severe anxiety, depression, and suicidal ideation from early- to mid-pandemic.

RESULTS

Results highlight high initial rates and stability in anxiety and suicidal ideation, as well as a significant increase in depression (42.9% increase; p < .05) among the full sample during the COVID-19 pandemic. Prevalance of concerns were greatest for females and Hispanic youth during the early-pandemic, and generally highest for females and Medicaid insured youth at mid-pandemic.

DISCUSSION

Results extend recent research and underscore the need for continued monitoring of mental health concerns across development for youth who grew up during the COVID-19 pandemic; highlighting the need for sustainable, effective, and accessible early detection, prevention, and intervention strategies. Improving these services is critical to support youth who experienced pandemic-related stressors, and to prepare for supporting youth during future disruptive and isolating events.

Geospatial Science for the Environmental Epidemiology of Cancer in the Exposome Era

Geospatial science is the science of location or place that harnesses geospatial tools, such as geographic information systems (GIS), to understand the features of the environment according to their locations. Geospatial science has been transformative for cancer epidemiologic studies through enabling large-scale environmental exposure assessments. As the research paradigm for the exposome, or the totality of environmental exposures across the life course, continues to evolve, geospatial science will serve a critical role in determining optimal practices for how to measure the environment as part of the external exposome. The objectives of this article are to provide a summary of key concepts, present a conceptual framework that illustrates how geospatial science is applied to environmental epidemiology in practice and through the lens of the exposome, and discuss the following opportunities for advancing geospatial science in cancer epidemiologic research: enhancing spatial and temporal resolutions and extents for geospatial data; geospatial methodologies to measure climate change factors; approaches facilitating the use of patient addresses in epidemiologic studies; combining internal exposome data and geospatial exposure models of the external exposome to provide insights into biological pathways for environment-disease relationships; and incorporation of geospatial data into personalized cancer screening policies and clinical decision making.

Does urban greenness reduce loneliness and social isolation among Canadians? A cross-sectional study of middle-aged and older adults of the Canadian Longitudinal Study on Aging (CLSA)

OBJECTIVES

Urban greenness has been shown to confer many health benefits including reduced risks of chronic disease, depression, anxiety, and, in a limited number of studies, loneliness. In this first Canadian study on this topic, we investigated associations between residential surrounding greenness and loneliness and social isolation among older adults.

METHODS

This cross-sectional analysis of the Canadian Longitudinal Study on Aging included 26,811 urban participants between 45 and 86 years of age. The Normalized Difference Vegetation Index (NDVI), a measure of greenness, was assigned to participants' residential addresses using a buffer distance of 500 m. We evaluated associations between the NDVI and (i) self-reported loneliness using the Center for Epidemiological Studies Depression Scale, (ii) whether participants reported "feeling lonely living in the local area", and (iii) social isolation. Logistic regression models were used to characterize associations between greenness and loneliness/social isolation while adjusting for individual socio-economic and health behaviours.

RESULTS

Overall, 10.8% of participants perceived being lonely, while 6.5% reported "feeling lonely in their local area". Furthermore, 16.2% of participants were characterized as being socially isolated. In adjusted models, we observed no statistically significant difference (odds ratio (OR) = 0.99; 95% confidence interval (CI) 0.93-1.04) in self-reported loneliness in relation to an interquartile range (IQR) increase of NDVI (0.06). However, for the same change in greenness, there was a 15% (OR = 0.85; 95% CI 0.72-0.99) reduced risk for participants who strongly agreed with "feeling lonely living in the local area". For social isolation, for an IQR increase in the NDVI, we observed a 7% (OR = 0.93; 95% CI 0.88-0.97) reduction in prevalence.

CONCLUSION

Our findings suggest that urban greenness plays a role in reducing loneliness and social isolation among Canadian urbanites.

Perceived urban green spaces and youth mental health in the post-COVID-19 era

Introduction

The urban green space (UGS) is one of the most significant urban spaces with unique visual and social features, including pleasant air, low noise, and vitality, making it a recreational place for citizens, especially the youth. According to previous studies, perceived green space and the interaction with it is associated with mental health and lower symptoms of anxiety and depression. Although the presence of urban and blue-green spaces in Isfahan has a long history, the UGSs have been out of reach, causing a significant impact on youth mental health due to the spread of COVID-19 and the forcing of the Iranian government to severe and long-term lockdown. This study investigates the relationship between the long-term isolation of youth and being away from UGSs on their mental health in Isfahan city.

Methods

In September 2022, the youth (n = 273) in 12 neighborhoods with similar socio-economic status were asked to answer the online questionnaire. To investigate the correlation between perceived UGS and the mental health of the youth, Structural Equation Modeling (SEM) is done.

Results

The results show that the perceived UGSs negatively relate to the youth's fear of the reoccurrence of COVID-19 infection, anxiety, and depression. Moreover, the model shows that perceived UGS has an inverse correlation with anxiety (β = -0.24, p = 0.00), and no meaningful correlation exists with depression.

Discussion

These results point to a practical solution for designing UDGs in residential areas for youth according to their benefits for mental health during the epidemic era.

Association between perceived neighborhood environment and depression among residents living in mega-communities in Guiyang, China: a cross-sectional study

BACKGROUND

Little was known about the relationship between perceived neighborhood environment and depression among residents living in mega-communities. Furthermore, the mediating effects of physical activity (PA) and anxiety in this relationship have not been investigated. Thus, this study aimed to comprehensively examine the association between perceived neighborhood environment and depression among residents living in mega-communities, and test whether PA and anxiety mediated the association.

METHODS

A cross-sectional study on perceived neighborhood environment and depression was conducted among individuals who lived in mega-communities (n = 665) in Guiyang, China from July to August 2022. Perceived neighborhood environment was assessed from the following six aspects: traffic, building quality, accessibility, neighborhood, indoor, and pollution. Depression was measured by the Patients Health Questionnaire-9. Structural equation model was used to evaluate the association between perceived neighborhood environment and depression, and test the mediating effect of PA and anxiety in this association.

RESULTS

We found that neighborhood (β = -0.144, p = 0.002) and PA (β = -0.074, p < 0.001) were both negatively associated with depression, while anxiety was positively associated with depression (β = 0.447, p < 0.001). Married residents were less likely to experience depression than residents of other marital status. PA played a mediator role in the relationship between accessibility and depression (β = 0.014, p = 0.033). PA mediated the relationship between neighborhood and depression (β = -0.032, p = 0.015). The mediating effect of anxiety in the relationship between perceived neighborhood environment and depression was not significant.

CONCLUSIONS

This study demonstrated that neighborhood, which was assessed by satisfaction with safety, hygiene, parking, greening, lighting, and building shape, was negatively associated with depression, and PA mediated the relationship.

The influence of meaningful work on the mental health of SME employees in the COVID-19 era: can coping strategies mediate the relationship?

BACKGROUND

Stress, depression, and anxiety are prevalent issues among SME employees during the COVID-19 pandemic. Even while having meaningful work that expressively contributes to individual growth has been related to improving mental health, employees' work may also need to adopt coping strategies to increase outcomes. The purpose of this study was to examine the relationship between meaningful work (positive meaning, meaning-making, and greater good motivations) and mental health, as well as coping strategies (problem-focused and emotion-focused) as a mediator of this relationship.

METHODS

Meaningful work, coping strategies, and mental health were evaluated in empirical research based on a sample of 462 SME employees working in Malaysia. Structured questionnaires were used to collect the data and analyze it through Structural Equation Modelling (SEM) using AMOS 21.0.

RESULTS

The findings of the study show the importance of meaningful work in influencing the mental health of SME employees, particularly during a crisis like the COVID-19 pandemic. This suggests that the more they value and see their work as meaningful, the more capable they are of dealing with limitations and mental health problems associated with crises. The study also discovered a partial mediating role for coping strategies between employees' mental health and meaningful work.

CONCLUSION

This study encourages employees to constantly feel connected and discover continued possibilities to work and learn even during crisis situations. In order to improve human resource efficiency in emerging markets, managers and owners of SMEs must implement the model developed by the researchers.

Green and blue spaces, COVID-19 lockdowns, and mental health: An Australian population-based longitudinal analysis

Australia experienced some of the world's longest and most stringent lockdowns during the COVID-19 pandemic. While lockdown measures had consequences for mental health, investigation is lacking on the potential for green and blue space coverage within people's local environments to ameliorate the impact of lockdowns with varied lengths using longitudinal cohorts. This study examined the impact of lockdown durations on population mental health and tests the effect modification of neighbourhood green and inland and coastal blue space coverage in metropolitan areas. We merged population-based longitudinal data on more than 11,000 individuals collected over a ten-year period from 2012 to 2021 with national land use data describing green and blue space coverage. We used fixed effect models to estimate the relationship between lockdowns (with different durations and staggered introduction) and mental health, controlling for sociodemographic, health, and geographical confounders, and tested the significance of effect modification of green and blue space. Results show that extended lockdowns led to considerably larger decreases in mental health (COVID-y1: -2.66, 95%CI: -3.43, -1.89; COVID-y2: -2.65, 95%CI: -3.33, -1.97) relative to short lockdowns. The mental health effect of lockdowns was smaller where green spaces and inland and coastal blue spaces were available. Effect modification was statistically significant for green space, with smaller negative mental health effects observed where there was sizeable green space coverage, particularly during long lockdowns (COVID-y1: -2.69, 95%CI: -3.63, -1.76 for coverage <5%; -3.27, 95%CI: -4.70, -1.84 for coverage 5%-10%; -0.60, 95%CI: -2.03, 0.83 for coverage ≥30%; COVID-y2: -2.74, 95%CI: -3.62, -1.87 for coverage <5%, -2.95, 95%CI: -3.98, -1.92 for coverage 5%-10%; -2.08, 95%CI: -3.28, -0.88 for coverage ≥30%). Findings support the consideration of nature exposure to improve people's mental wellbeing and resilience when designing lockdown measures in response to future public health emergencies.

Green infrastructure inequality in the context of COVID-19: Taking parks and trails as examples

Inequality in access to urban green infrastructures has been a major concern among scholars and governments, especially since the COVID-19 outbreak. There is a lack of knowledge on how people respond to the pandemic regarding the usage of green infrastructure in cities. This paper explores the shifts in visitation to parks and trails, two popular green infrastructures in Salt Lake County, Utah, by analyzing the results of a survey conducted during the pandemic. Our conceptualization considers personal and neighborhood-level factors, including personal socioeconomic status, existing inequalities of green infrastructures, urban form, and neighborhood conditions. People who reside close to the city center tend to go to parks more often, while those living in urban edges use trails more. Visiting green infrastructures less often is more likely in areas with higher COVID-19 infection rates. The regression results confirm the importance of neighborhood-level factors and illustrate the intricate elements influencing people's decisions to visit different green infrastructures during the pandemic, which shows non-linear relationships. Richer, white, and younger people seem to enjoy green infrastructures more often, leading to the concern of amplified inequality. Higher COVID-19 cases result in higher demands for green infrastructures, which are not fulfilled during the pandemic, especially for vulnerable communities, leading to spatial exclusion. The results highlight the importance of smart growth, including compact development, public transit, and pocket parks, in promoting the urban resilience of park and trail visits, as they may provide more access opportunities and alternatives to green infrastructures even in the context of the pandemic.

Contact with Nature in Social Deprivation during COVID-19: The Positive Impact on Anxiety

The 2019 outbreak of the novel coronavirus disease (COVID-19) had a devastating impact on millions of people worldwide. Following the constantly changing course of the pandemic, the Italian government massively restricted public and private life to prevent the further spread of the virus. Unfortunately, lockdown policies negatively impacted many people's mental and physical health. Numerous studies recognized an essential role of urban green areas in promoting human well-being. The present study aims to evaluate the effect of personal dispositions towards nature, measured using the connectedness to nature scale (CNS) and actual contact with green spaces (CwN) on human well-being (i.e., anxiety) and medicine intake during COVID-19 lockdowns. A total of 637 Italian residents answered a survey aimed at gathering information about the above variables. A series of path analyses were performed. The results showed that the CNS was positively associated with the CwN, and the latter, in turn, was negatively associated with anxiety. Finally, anxiety was positively related to medicine intake. In sum, these results identify the positive role of person-nature relationships for individual well-being during COVID-19 restrictions.

What is Nature-Based Medicine and What Does It Do?

One's personal health and well-being can improve with activity in natural environments or decline without it. Many chronic illnesses to which personal nature deficiency contributes-including anxiety, depression, attention deficit, diabetes, hypertension, myopia, and obesity-have been exacerbated with the pandemic. That those illnesses may be preventable, treatable, and even reversible with an added nature-based approach may seem novel, but it is not. Though the field of nature-based medicine is just emerging in the U.S., it has been taught and practiced in Asia and the EU for decades. As the prescriptive, evidence-based use of natural settings and nature-based interventions, it aims to prevent and treat disease and improve well-being. Nature-based medicine blends particular activity in nature with the science of medicine to attempt to empower self-care safely, effectively, and happily. Its vision is to be readily available to all, regardless of proximity to blue (water-related) or green (land-related) space. The common sense of nature-based medicine belies its scientific evidence base, which is growing but not well-known, so it may seem unfamiliar to prescribe nature to patients. It will take education, training and practice to help patients access nature-based medicine and to help clinicians prescribe it.

Enhancing human resilience beyond COVID-19-related stress: public responses to multi-benefits of home gardening

The SARS-CoV-2 virus has caused a public health crisis globally. Against the backdrop of global resilience, studies have demonstrated the therapeutic value of home gardening as a measure to strengthen human health. However, there is a lack of comparative studies on its benefits across countries. Studies need to examine the role of home gardening in improving public health in various societies to understand and encourage this practice broadly and effectively. We chose Taiwan, Thailand, and Vietnam as case studies, which have suffered substantial pandemic impacts, with millions of infections and thousands of deaths. We explored and compared the perceptions of people on home gardening and its health benefits during the COVID-19 pandemic. We conducted online surveys in three countries between May 1 and September 30, 2022, with a total of 1172 participants. Data were collated on perceived pandemic stress, challenges and solutions in gardening, home gardening intentions, and mental and physical health benefits. In these countries, we found that perceived pandemic stress positively affects home gardening intentions, whereby the motivation of Vietnamese people is the highest. Challenges hinder gardening intentions, while the solutions only positively affect gardening intentions in Taiwan and Vietnam. Home gardening intentions positively affect mental and physical health, whereby there are higher mental health benefits in Taiwanese people than in Thai people. Our findings potentially support public health recovery and promote healthy lifestyles during the COVID-19 pandemic.

Influence of the COVID-19 pandemic on climate change summit negotiations from the climate governance perspective

The COVID-19 pandemic has caused significant disruptions to the world since 2020, with over 647 million confirmed cases and 6.7 million reported deaths as of January 2023. Despite its far-reaching impact, the effects of COVID-19 on the progress of global climate change negotiations have yet to be thoroughly evaluated. This discussion paper conducts an examination of COVID-19's impact on climate change actions at global, national, and local levels through a comprehensive review of existing literature. This analysis reveals that the pandemic has resulted in delays in implementing climate policies and altered priorities from climate action to the pandemic response. Despite these setbacks, the pandemic has also presented opportunities for accelerating the transition to a low-carbon economy. The interplay between these outcomes and the different levels of governance will play a crucial role in determining the success or failure of future climate change negotiations.

The neighborhood built environment and COVID-19 hospitalizations

Research on the associations between the built environment and COVID-19 outcomes has mostly focused on incidence and mortality. Also, few studies on the built environment and COVID-19 have controlled for individual-level characteristics across large samples. In this study, we examine whether neighborhood built environment characteristics are associated with hospitalization in a cohort of 18,042 individuals who tested positive for SARS-CoV-2 between May and December 2020 in the Denver metropolitan area, USA. We use Poisson models with robust standard errors that control for spatial dependence and several individual-level demographic characteristics and comorbidity conditions. In multivariate models, we find that among individuals with SARS-CoV-2 infection, those living in multi-family housing units and/or in places with higher particulate matter (PM2.5) have a higher incident rate ratio (IRR) of hospitalization. We also find that higher walkability, higher bikeability, and lower public transit access are linked to a lower IRR of hospitalization. In multivariate models, we did not find associations between green space measures and the IRR of hospitalization. Results for non-Hispanic white and Latinx individuals highlight substantial differences: higher PM2.5 levels have stronger positive associations with the IRR of hospitalization for Latinx individuals, and density and overcrowding show stronger associations for non-Hispanic white individuals. Our results show that the neighborhood built environment might pose an independent risk for COVID-19 hospitalization. Our results may inform public health and urban planning initiatives to lower the risk of hospitalization linked to COVID-19 and other respiratory pathogens.

Natural environments, psychosocial health, and health behaviors in a crisis - A scoping review of the literature in the COVID-19 context

The COVID-19 outbreak led to major restrictions globally, affecting people's psychosocial health and their health behaviors. Thus, the purpose of this scoping review was to summarize the available research regarding nature and health in the COVID-19 context. Keywords relating to natural environments and COVID-19 were combined to conduct a systematic online search in six major databases. Eligibility criteria were a) published since 2020 with data collected in the COVID-19 context b) peer-reviewed, c) original empirical data collected on human participants, d) investigated the association between natural environments and psychosocial health or health behaviors, and e) English, German, or Scandinavian languages. Out of 9126 articles being screened, we identified 188 relevant articles, representing 187 distinct studies. Most research focused on adults in the general population and was predominantly conducted in the USA, Europe, and China. Overall, the findings indicate that nature may mitigate the impact of COVID-19 on psychological health and physical activity. Through a systematic thematic analysis of the extracted data, three primary themes were identified: 1) type of nature assessed, 2) psychosocial health and health behaviors investigated, and 3) heterogeneity in the nature-health relationship. Research gaps in the COVID-19 context were identified regarding I) nature characteristics that promote psychosocial health and health behaviors, II) investigations of digital and virtual nature, III) psychological constructs relating to mental health promotion, IV) health-promoting behaviors other than physical activity, V) underlying mechanisms regarding heterogeneity in the nature-health relationship based on human, nature, and geographic characteristics, and VI) research focusing on vulnerable groups. Overall, natural environments demonstrate considerable potential in buffering the impact of stressful events on a population level on mental health. However, future research is warranted to fill the mentioned research gaps and to examine the long-term effects of nature exposure during COVID-19.

Integrating social and ecological considerations in floodplain relocation and restoration programs

In the United States, most floodplain relocation (or buyout) programs focus on moving homeowners, then deal separately with what happens with the land afterward. These programs typically divide processes for relocation planning, engagement, funding, and implementation from those related to post-buyout land management and restoration. The structural and operational conditions that lead to this separation of roles and responsibilities miss out on opportunities to create more synergistic socio-ecological strategies that may produce healthier outcomes for both people and the environment. In other domains, research shows that healthy people and healthy environments can co-create each other through more virtuous cycles. In this perspective essay, we argue that we can better create such virtuous cycles in floodplain relocation programs by integrally considering social and ecological components. Such efforts can encourage more people to decide to relocate, thereby creating more contiguous places to restore. They can also empower more residents to help steward these sites, an action that in turn helps heal and strengthen flood-affected communities. These arguments, while particular to the United States, have resonance for floodplain management and land use planning worldwide.

Demographic and spatial variables associated with spending time in nature during COVID-19 lockdowns

To stop the spread of SARS-CoV-2 coronavirus (COVID-19) governments around the world implemented lockdowns restricting public travel. In the Australian state of Victoria, this included limiting permitted reasons for leaving home and restricting movements to within a 5 km radius of one's home. In 2020, we conducted a state-wide survey (N = 1024) of Victorians that coincided with a lockdown. We asked respondents where they had spent time in nature and how they perceived lockdowns affected the amount of time they spent in nature. We then considered demographic and spatial predictors of spending more or less time in nature. Women, younger people, and those living in areas with higher socio-economic status were likely to report spending more time in nature. Closer proximity of residents to parks and waterways and higher proportional area of native vegetation within a 1-km radius were also associated with more time in nature. Understanding how different groups were affected by restrictions on access to nature can help improve government management of crises like pandemics, including through urban planning for green space, supporting improved individual and societal resilience. We discuss the implications of our findings for improving access to nature during lockdowns as well as opportunities for a post-pandemic relationship with nature, particularly in urban settings.

The Economic Value of Health Benefits Associated with Urban Park Investment

The allocation of resources towards the development and enhancement of urban parks offers an effective strategy for promoting and improving the health and well-being of urban populations. Investments in urban parks can result in a multitude of health benefits. The increased usage of greenspace by park users has been linked to positive physical and mental health outcomes. Additionally, the expansion of greenspace in urban areas can mitigate harmful impacts from air pollutants, heat, noise, and climate-related health risks. While the health benefits attributed to urban parks and greenspaces are well documented, few studies have measured the economic value of these benefits. This study applied a novel ecohealth economic valuation framework to quantify and estimate the potential economic value of health benefits attributed to the development of a proposed park in the downtown core of Peterborough, Canada. The results indicated that development of the small urban park will result in annual benefits of CAD 133,000 per year, including CAD 109,877 in the avoided economic burden of physical inactivity, CAD 23,084 in health savings associated with improved mental health, and CAD 127 in health savings attributed to better air quality. When including the economic value of higher life satisfaction, the economic benefit is more than CAD 4 million per year. The study demonstrates the value of developing and enhancing urban parks as a strategy to improve population health and well-being, and as a means of cost savings to the medical system.

Associations of greenspace use and proximity with self-reported physical and mental health outcomes during the COVID-19 pandemic

Research has shown that the COVID-19 pandemic affected individual's mental and physical health. The aim of this study was to estimate associations between greenspace use and proximity with perceived mental and physical health during the COVID-19 pandemic. We surveyed metropolitan Philadelphia residents, October 20-December 1, 2020, about walking time to the nearest greenspace from their home, frequency of greenspace use in the past 30 days, change in frequency of greenspace use during the COVID-19 pandemic, and perceived physical and mental health outcomes. We ran unadjusted and adjusted log-binomial regression models to derive Risk Ratio (RR) and 95% Confidence Intervals (CI) estimates of associations of loneliness, physical and mental health outcomes with: (1) self-reported walking time to nearest greenspace; (2) reported greenspace use frequency; and (3) changes in greenspace use frequency. Of 485 survey participants, 244 (51.4%) reported feeling lonelier, 147 (31.37%) reported higher perceived stress, 261 (54.9%) reported worsened mental health, and 137 (28.7%) reported worsened physical health during vs. before the start of pandemic-restrictions in mid-March of 2020. After adjustment for gender, age, and change in financial status, RR estimates suggested modest protective associations between visiting greenspaces more frequently during vs. before the pandemic and worsened mental (RR: 0.84, 95% CI: 0.70-1.00), and physical health (RR 0.77, 95% CI: 0.56-1.10), and loneliness (RR: 0.91, 95% CI: 0.75-1.1) and perceived stress (RR 0.83, 95% CI: 0.61-1.13). Shorter walking distances to the nearest greenspace were associated with reduced risk of reporting worsened physical health and higher perceived stress; however, living shorter walking distances from greenspace were not associated with protection against worsened mental health or loneliness. These results suggest that active greenspace use may provide mental and physical health protection, particularly during a stressful public health crisis.

How the COVID-19 pandemic changed patterns of green infrastructure use: A scoping review

The use of green infrastructure (GI) has been established as a way to alleviate stress and the COVID-19 pandemic has placed a new emphasis on the importance of GI as both a coping mechanism and a source of recreation. This scoping review seeks to address whether the COVID-19 pandemic affected the use of GI, specifically the ways in which the pandemic altered visitation patterns and the frequency of the use of GI. This review identifies studies that explore the relationship between the COVID-19 pandemic and GI use and assesses whether the pandemic has altered the use of GI, including whether GI use increased, decreased, or remained the same and examines potential changes in visitation structure as well as other effects studied. This review also discusses how future planning for GI can consider the lessons learned from the pandemic. Key findings suggest that GI use increased, as did visitors' appreciation for GI and its benefits. The use of local GI to one's home also increased in importance. Decreases in visitation were typically a result of COVID-19 lockdown restrictions and fear of viral transmission within GI.

Visiting Urban Green Space and Orientation to Nature Is Associated with Better Wellbeing during COVID-19

The COVID-19 pandemic has severely challenged mental health and wellbeing. However, research has consistently reinforced the value of spending time in green space for better health and wellbeing outcomes. Factors such as an individual's nature orientation, used to describe one's affinity to nature, may influence an individual's green space visitation behaviour, and thus influence the wellbeing benefits gained. An online survey in Brisbane and Sydney, Australia (n = 2084), deployed during the COVID-19 pandemic (April 2021), explores if nature experiences and nature orientation are positively associated with personal wellbeing and if increased amounts of nature experiences are associated with improvement in wellbeing in the first year of the COVID-19 pandemic. We found that both yard and public green space visitation, as well as nature orientation scores, were correlated with high personal wellbeing scores, and individuals who spent more time in green space compared to the previous year also experienced a positive change in their health and wellbeing. Consistently, people with stronger nature orientations are also more likely to experience positive change. We also found that age was positively correlated to a perceived improvement in wellbeing over the year, and income was negatively correlated with a decreased change in wellbeing over the year, supporting other COVID-19 research that has shown that the effects of COVID-19 lifestyle changes were structurally unequal, with financially more established individuals experiencing better wellbeing. Such results highlight that spending time in nature and having high nature orientation are important for gaining those important health and wellbeing benefits and may provide a buffer for wellbeing during stressful periods of life that go beyond sociodemographic factors.

Air pollution, greenness and risk of overweight among middle-aged and older adults: A cohort study in China

BACKGROUND

Exposure to air pollution may increase the risk of obesity, but living in greener space may reduce this risk. Epidemiological evidence, however, is inconsistent.

METHODS

Using data from the China Health and Retirement Longitudinal Study (2011-2015), we conducted a nationwide cohort study of 7424 adults. We measured overweight/obesity according to body mass index. We used annual average ground-level air pollutants, including ozone (O₃), nitrogen dioxide (NO2), and particulate matter with aerodynamic diameters ≤2.5 μm (PM_2.5), to demonstrate air pollution levels. We used the Normalized difference vegetation index (NDVI) to measure greenness exposure. We used time-varying Cox proportional hazard regression models to analyze the connections among air pollution, greenness, and the development of overweight/obesity in middle-aged and older adults in China. We also conducted mediation analyses to examine the mediating effects of air pollution.

RESULTS

We found that lower risk of overweight/obesity was associated with more greenness exposure and lower levels of air pollution. We identified that an interquartile increment in NDVI was correlated with a lower hazard ratio (HR) of becoming overweight or obese (HR = 0.806, 95% confidence interval [CI]: 0.754-0.862). Although a 10 μg/m³ increase in PM_2.5 and NO₂ was correlated with higher risks (HR = 1.049, 95% CI = 1.022-1.075, HR = 1.376, 95% CI = 1.264-1.499). Effects of PM_2.5 on being overweight or obese were stronger in men than in women. According to the mediation analysis, PM_2.5 and NO₂ mediated 8.85% and 19.22% of the association between greenness and being overweight or obese.

CONCLUSIONS

An increased risk of being overweight or obese in middle-aged and older adults in China was associated with long-term exposure to higher levels of PM_2.5 and NO₂. This risk was reduced through NDVI exposure, and the associations were partially mediated by air pollutants. To verify these findings, fine-scale studies are needed.

Green spaces for mental disorders

PURPOSE OF REVIEW

Mental illness is a global challenge, exacerbated by the coronavirus pandemic. Research suggests access to local green spaces is associated with better mental health, yet access is not always equitable. Evaluation of how nature-based interventions protect and support mental health is therefore required.

RECENT FINDINGS

Accessible local green spaces are associated with better mental health. They encourage active behaviours and social interaction, reduce loneliness and stress. Green views from the home are associated with increased self-esteem, life satisfaction and happiness and reduced depression, anxiety and loneliness. Nature-based interventions and green social prescriptions effectively target vulnerable groups, resulting in significant reductions in depression, anxiety and anger alongside positive mental health outcomes.

SUMMARY

Although existing evidence is encouraging, robust, high-quality research that strengthens the evidence base and informs future clinical practice and policy decision making is needed. Evidence of the long-term effectiveness in individuals with diagnosed mental illness is also required to ascertain the potential social and wider returns on investment. Barriers to use of green social prescriptions like mental health symptoms and geographical accessibility need to be overcome to increase accessibility and uptake of green social prescriptions for the prevention and treatment of mental illness.

Spatial accessibility analysis of green space from a health-benefit perspective: Implications for healthy urban development

The spatial accessibility of urban park green space (UPGS) plays a crucial role in promoting the healthy development of cities and their residents. However, previous studies have overestimated the accessibility of UPGS and failed to adequately consider the impact of variegated parks on residents’ needs. To fill this gap in the research, we first propose an improved two-step floating catchment area (Huff-2SFCA) method that takes into consideration the trade-offs between supply, demand, and walking time to calculate the UPGS accessibility index for the built-up area of Mianyang, China. Next, we assess the spatial characteristics of UPGS accessibility from both partial and overall points of view and further explore the relationship between accessibility and population size. Our results show that (1) every street area has a different form of UPGS construction, and most of these spaces are of poor quality; (2) municipal-level parks are significantly more accessible than district-level parks, community-level parks, or neighborhood-level parks; (3) the overall distribution of accessibility is generally characterized by a decreasing trend along both sides of the river, with poor overall accessibility; and (4) 243 residential districts are located in high-demand–low-supply areas that need improving. This study can be employed to identify areas that are underserved by UPGS and can provide a basis for improving the accessibility of UPGS and promoting its health benefits.

Negotiating Complexity: Challenges to Implementing Community-Led Nature-Based Solutions in England Pre- and Post-COVID-19

Nature-based solutions (NbS), including green social prescribing (GSP), are sustainable ways to address health and wellbeing, especially since the COVID-19 pandemic exacerbated the strain on healthcare. NbS require national and local cross-sector coordination across complex, interrelated systems, but little is known about the specific challenges this poses for community-led NbS. We carried out a traditional literature review to establish the context and knowledge base for this study and interviewed 26 stakeholders. These came from environment, health and social care sectors at national and local levels, with local-level stakeholders from Bradford and Walsall: English cities significantly affected by the pandemic, with high levels of deprivation and health inequality. The interviews explored experiences of implementing NbS, both pre- and post-pandemic and the resulting renewed interest in the salutogenic effects of engaging with natural environments. We coded the interview transcriptions using NVivo to identify the challenges existing in the systems within which these stakeholders operate to create and manage NbS. By synthesizing what is known about the challenges from existing literature with findings from the interviews, we developed eight categories of challenges (perception and knowledge, political, financial, access to natural spaces, engagement, institutional and organisational, coordination, GSP referral and services) faced by multiple sectors in implementing community-led NbS in England. Furthermore, this study highlights the new challenges related to the pandemic. Identifying these challenges helps stakeholders in existing complex systems recognise what is needed to support and mainstream NbS in England.

Exploring public values through Twitter data associated with urban parks pre- and post- COVID-19

Since school and business closures due to the evolving COVID-19 outbreak, urban parks have been a popular destination, offering spaces for daily fitness activities and an escape from the home environment. There is a need for evidence for parks and recreation departments and agencies to base decisions when adapting policies in response to the rapid change in demand and preferences during the pandemic. The application of social media data analytic techniques permits a qualitative and quantitative big-data approach to gain unobtrusive and prompt insights on how parks are valued. This study investigates how public values associated with NYC parks has shifted between pre- COVID (i.e., from March 2019 to February 2020) and post- COVID (i.e., from March 2020 to February 2021) through a social media microblogging platform -Twitter. A topic modeling technique for short text identified common traits of the changes in Twitter topics regarding impressions and values associated with the parks over two years. While the NYC lockdown resulted in much fewer social activities in parks, some parks continued to be valued for physical activity and nature contact during the pandemic. Concerns about people not keeping physical distance arose in parks where frequent human interactions and crowding seemed to cause a higher probability of the coronavirus transmission. This study demonstrates social media data could be used to capture park values and be specific per park. Results could inform park management during disruptions when use is altered and the needs of the public may be changing.

Urban Green Space and Subjective Well-Being of Older People: A Systematic Literature Review

A growing number of articles have identified and reported the benefits and importance of urban green spaces for improving human well-being, but there is a significant knowledge gap regarding the impact of urban green spaces on the subjective well-being of older adults. The literature search (August 2015-August 2022) was derived from two major scientific databases, Google Scholar, and Web of Science. As a result, 2558 articles were found, 1527 of which were retrieved from WOS and the rest from Google Scholar. Bibliometric methods and VOSviewer software were used to screen and organize the articles in the relevant fields. Finally, 65 articles met the review criteria. The included studies aim to capture the benefits of various features of urban green spaces in meeting or enhancing the subjective well-being needs of older adults. The results of our review further support the existence of a strong link between older adults' subjective well-being and various features of urban green spaces, providing new insights for future in-depth reexamination and policy development. Furthermore, the relationship between urban green spaces and older adults' subjective well-being depends not only on the urban green spaces themselves but also on the characteristics of the older adult population that uses them.

Tourism as a Tool in Nature-Based Mental Health: Progress and Prospects Post-Pandemic

The healthcare sector recognises the role of nature in mental health. The tourism sector is equipped to take people to national parks. The conservation sector gains support from visitors. Theoretical frameworks for mental health benefits from nature tourism include: tourism destinations and activities; tourist personalities and life histories; sensory and emotional components of tourist experiences; and intensity and duration of memories. Mental health deteriorated worldwide during the COVID-19 pandemic. Recovery of global economic productivity requires immediate, accessible, affordable mental health measures at national scales, and nature-based approaches provide the best option. Different countries have adopted a variety of public, private, or voluntary mechanisms. Some focus on design of activities, others on provision of facilities. Costs and implementation depend on key research questions: marginal benefits of nature tour guides or psychologists compared to self-guided nature experiences; comparisons between repeated brief visits and one-off nature holidays; effects of biodiversity, flagship species, and scenic or wilderness quality; and differences between individuals, depending on personalities, life histories, and mental health status and symptoms.

A review of the environmental implications of the COVID-19 pandemic in the United Arab Emirates

This paper reviews the environmental implications associated with the COVID-19 pandemic at the individual and community levels in the UAE. The positive effects emanating from the pandemic include improved air quality and reduced contamination of public spaces with pollutants. On the other hand, far-reaching negative effects include poor disposal of medical plastic waste and facemasks and the rise in unhygienic health practices amongst residents of UAE. The long-term ecological implications of the pandemic are still not well understood. The findings shed the light on the importance of addressing the consequences of the COVID-19 pandemic through preventative policies and strategies for better environmental health and readiness for future crises. Future research could assess the long-term environmental conse-quences of the pandemic on the UAE.

Using Crowdsourced Big Data to Unravel Urban Green Space Utilization during COVID-19 in Guangzhou, China

Urban green spaces (UGSs) can meet the spiritual and cultural needs of citizens and provide various ecosystem services. In the context of the COVID-19 pandemic, the utilization of UGSs has been affected in various countries worldwide. This study considered 13 UGSs in Guangzhou, China, as examples. It obtained user check-in data by sampling the check-in pages of Sina Weibo locations using a Python-based web crawler program. The study was conducted for 731 days from 1 October 2019 to 30 September 2021, during different phases of the pandemic. Based on automated Chinese corpus recognition technology, statistical results were obtained after periodization and sentiment calculation. The study assessed the pandemic’s impact on the use of UGSs by analyzing the time, frequency, and emotions of residents visiting UGSs. The study concluded that the emotions of UGS users during COVID-19 tended to be positive. They tended to choose UGSs with low expected population density and visited UGSs on weekdays. Additionally, the religious attributes of UGSs also influenced their utilization.

Agroforestry Contributions to Urban River Rehabilitation

The context of urban rivers is one of pollution of their courses, the degradation of riparian habitats, the loss of biodiversity, and the marginalization of the human populations that live next to them. Due to urban growth, the hydrological dynamics in entire basins and the hydromorphology of rivers are changing. This situation increases flooding, decreases the availability of water for human use, and disconnects the rivers from the dynamics of the city. Agroforestry is the integration of cultural, wild, and domesticated diversity with use, conservation, and restoration objectives. These practices in cities can contribute to addressing the problems mentioned. We analyze agroforestry practices and the socio-ecological contributions to urban river rehabilitation. We review 37 experiences worldwide. Agroforestry practices included in the review are trees and hedgerows; wetland agroforestry; aquatic, botanical, edible, educational, and rain gardens; bioswales; green parking lots; food forestry; vegetation in alleys and streets; vertical terrace walls, among others. Agroforestry contributes to efforts to solve urban river problems, improve water quality and access, restore riparian habitats, enhance river hydromorphology, support local economies, and create a river culture. We emphasize promoting multi-relational people–river interactions based on theoretical and practical frameworks that integrate diverse disciplines, perspectives, and experiences.

Perceived Qualities, Visitation and Felt Benefits of Preferred Nature Spaces during the COVID-19 Pandemic in Australia: A Nationally-Representative Cross-Sectional Study of 2940 Adults

We investigated how the perceived quality of natural spaces influenced levels of visitation and felt benefits during the COVID-19 pandemic in Australia via a nationally representative online and telephone survey conducted on 12–26 October (Social Research Centre’s Life in AustraliaTM panel aged > 18 years, 78.8% response, n = 3043). Our sample was restricted to those with complete information (n = 2940). Likert scale responses to 18 statements regarding the quality of local natural spaces that participants preferred to visit were classified into eight quality domains: access; aesthetics; amenities; facilities; incivilities; potential usage; safety; and social. These domains were then summed into an overall nature quality score (mean = 5.8, range = 0–16). Associations between these quality variables and a range of nature visitation and felt benefits were tested using weighted multilevel models, adjusted for demographic and socioeconomic confounders. Compared with participants in the lowest perceived nature quality quintile, those in the highest quality quintile had higher odds of spending at least 2 h in their preferred local nature space in the past week (Odds Ratio [OR] = 3.40; 95% Confidence Interval [95%CI] = 2.38–4.86), of visiting their preferred nature space almost every day in the past four weeks (OR = 3.90; 2.77–5.47), and of reporting increased levels of nature visitation in comparison with before the COVID-19 pandemic (OR = 3.90; 2.54–6.00). Participants in the highest versus lowest perceived nature quality quintile also reported higher odds of feeling their visits to nature enabled them to take solace and respite during the pandemic (OR = 9.49; 6.73–13.39), to keep connected with their communities (OR = 5.30; 3.46–8.11), and to exercise more often than they did before the pandemic (OR = 3.88; 2.57–5.86). Further analyses of each quality domain indicated time in and frequency of visiting nature spaces were most affected by potential usage and safety (time in nature was also influenced by the level of amenity). Feelings of connection and solace were most affected by potential usage and social domains. Exercise was most influenced by potential usage, social and access domains. In conclusion, evidence reported in this study indicates that visits to nature and various health-related benefits associated with it during the COVID-19 pandemic were highly contingent upon numerous qualities of green and blue spaces.

Urgent Biophilia: Green Space Visits in Wellington, New Zealand, during the COVID-19 Lockdowns

Urgent biophilia describes the conscious desire of humans to seek interactions with nature during periods of stress. This study examines the changes in frequency and reason for visiting urban green spaces by residents of Wellington, New Zealand, to determine whether resident behavior during a stressful period exemplifies the principles of urgent biophilia. The COVID-19 pandemic and resulting lockdowns were used as the study period due to the significant physical and mental health stressors they triggered. Pedestrian and cyclist counters located in key urban green spaces in Wellington were used to collect data on visits pre- and post-pandemic. Two surveys were used to assess residents’ reasons for visiting urban green spaces during lockdowns. Increased green space visits were seen during the strictest lockdowns, though there was some variation in visits depending on the location of the green space. The most frequently reported reason for visiting green spaces during lockdown was mental wellbeing, followed by recreation. These results suggest that Wellington residents used urban green spaces as a coping mechanism during stressful lockdown periods for wellbeing benefits, exemplifying the principles of urgent biophilia. Urban planners and policymakers must consider and implement urban green infrastructure as a public health resource.

Landscape Architecture Design and Well-Being—Research Challenges and Opportunities

For this Special Issue (SI), we set out to gather empirical studies that examine relationships between the design of public urban outdoor environments and the well-being of users of these spaces [...]