Urban Green Space: Creating a Triple Win for Environmental Sustainability, Health, and Health Equity through Behavior Change

High-resolution greenspace dynamic data cube from Sentinel-2 satellites over 1028 global major cities

Greenspace, offering multifaceted ecological and socioeconomic benefits to the nature system and human society, is integral to the 11th Sustainable Development Goal pertaining to cities and communities. Spatially and temporally explicit information on greenspace is a premise to gauge the balance between its supply and demand. However, existing efforts on urban greenspace mapping primarily focus on specific time points or baseline years without well considering seasonal fluctuations, which obscures our knowledge of greenspace's spatiotemporal dynamics in urban settings. Here, we combined spectral unmixing approach, time-series phenology modeling, and Sentinel-2 satellite images with a 10-m resolution and nearly 5-day revisit cycle to generate a four-year (2019-2022) 10-m and 10-day resolution greenspace dynamic data cube over 1028 global major cities (with an urbanized area >100 km2). This data cube can effectively capture greenspace seasonal dynamics across greenspace types, cities, and climate zones. It also can reflect the spatiotemporal dynamics of the cooling effect of greenspace with Landsat land surface temperature data. The developed data cube provides informative data support to investigate the spatiotemporal interactions between greenspace and human society.

"When she goes out, she feels better:" co-designing a Green Activity Program with Hispanic/Latino people living with memory challenges and care partners

Purpose

Utilizing a participatory approach, we sought to co-design a 12-week Green Activity Program (GAP) with Hispanic/Latino individuals living with memory challenges and their care partners, local outdoor professionals, and healthcare providers.

Methods

Participants were recruited via convenience and snowball sampling in the Bronx, New York with Hispanic/Latino persons living with memory challenges and care partners, outdoor activity professionals, and interdisciplinary healthcare providers/dementia experts. Co-design occurred iteratively with 5 focus groups and 4 individual interviews lasting 30-90 min and focused on program and research design. Sessions were recorded and transcribed. Utilizing directed content analysis data was coded using a priori codes program design and research design.

Results

21 participants completed co-design activities: (n = 8 outdoor activity professionals, n = 6 Hispanic/Latino persons living with memory challenges and care partners, and n = 7 interdisciplinary healthcare providers/dementia experts). Participant preferences for program design were captured by subcodes session duration (30-90 min), frequency (4-8 sessions), and delivery modes (in-person and phone). Participants' preferred nature activities included group exercise and outdoor crafts [crocheting], outcomes of social participation, connectedness to nature, decreased loneliness, and stewardship were identified. Preferred language for recruiting and describing the program were "memory challenges," "Hispanic/Latino," and "wellbeing." Referral pathways were identified including community-based organizations and primary care.

Conclusion

Co-design was a successful form of engagement for people living with memory challenges that enabled participants to help design key elements of the GAP and research design. Our processes, findings, and recommendations for tailoring co-design to engage Hispanic/Latino people living with memory challenges can inform the development of other programs for this population.

Greenspaces and Health: Scoping Review of studies in Europe

Objectives

Access to greenspaces and contact with nature can promote physical activity and have positive effects on physical and mental health. This scoping literature review aims to examine current evidence linking greenspaces and (a) behaviour change, (b) health outcomes and (c) co-benefits.

Methods

This review was conducted in accordance with the PRISMA scoping review guidelines. Searches were conducted through PubMed and EMBASE databases for studies published between 2000 and March 2023 with a focus on Europe.

Results

122 scientific articles and grey literature reports were identified. Access to greenspaces is positively associated with physical and mental health, and reduced risk of all-cause mortality and some non-communicable diseases. Greenspace quality is associated with increased physical activity and reduced risk of obesity. Nature-based therapies or green prescription are effective in improving mental health outcomes and overall health. Importantly, numerous co-benefits of greenspaces are identified.

Conclusion

Increasing access to greenspaces for populations with particular attention to greenspace quality is important for co-benefits. Responsible governance and use of greenspaces are crucial to minimize public health risks and human disturbance of nature.

Urban densification in the Netherlands and its impact on mental health: An expert-based causal loop diagram

Urban densification is a key strategy to accommodate rapid urban population growth, but emerging evidence suggests serious risks of urban densification for individuals' mental health. To better understand the complex pathways from urban densification to mental health, we integrated interdisciplinary expert knowledge in a causal loop diagram via group model building techniques. Six subsystems were identified: five subsystems describing mechanisms on how changes in the urban system caused by urban densification may impact mental health, and one showing how changes in mental health may alter urban densification. The new insights can help to develop resilient, healthier cities for all.

Investigating factors underlying why householders remain in at-risk areas during bushfire disaster in Australia

Although most homes lack design and construction features to withstand bushfires, there is a growing trend of householders relocating to bushfire-prone areas. Notably, many bushfire-related fatalities have occurred within proximity, specifically within 100 m of bushland. Therefore, this paper explores the factors that drive householders to remain in at-risk areas, despite the imminent threat of bushfires. Thirty semi-structured interviews were conducted with participants residing in the southeastern region of New South Wales (NSW). The interviews were recorded, transcribed using Otter.AI, and subjected to thematic analysis using NVivo 12 Pro. The findings shed light on why certain householders decided to stay on their properties during the catastrophic 2019/2020 bushfires. Upon analysis, we uncovered thirty-six distinct factors that underlie householders' choices to remain during bushfires. These factors were categorized into nine groups: protection-related, attitude-related, information-related, operation-related, road-related, shelter-related, finance-related, health-related, and rebuilding-related factors. The study underscores the importance of understanding gender-based differences and pet ownership in bushfire evacuation decisions, emphasizing the need for tailored communication strategies. These findings hold several important implications for research and practice regarding early self-evacuation from bushfires.

Connected Community Classification (C3): Development, Validation, and Geospatial Application for Population Health Promotion and Equity

CONTEXT

Social determinants of health (SDOH) impact population health. Leveraging community-level strengths related to SDOH through a social infrastructure perspective can optimize health behaviors and health outcomes to promote health equity.

OBJECTIVE

Our aims were to develop, validate, and apply the Connected Community Classification (C3) as comprehensive community-level measure of protective SDOH and structural factors in the Four Corners states region of the United States.

DESIGN

C3 was developed using an iterative principal component analysis of publicly available data mapped to 5 SDOH domains. Regional clustering of C3 by zip code tabulation area (ZCTA) was identified using spatial autocorrelation methods.

MAIN OUTCOMES

In adjusted spatial autoregressive models, we analyzed the association of C3 with high-risk health behaviors and chronic disease prevalence using publicly available data for population-level estimates of fruit and vegetable intake, physical activity, obesity, smoking, alcohol use, coronary heart disease (CHD), diabetes, and cancer.

RESULTS

C3 was found to be reliable and valid; a C3 value of 10 indicates communities with greater connection (high), while a value of 1 indicates communities with greater separation (low) to social infrastructure. Lower connection, as measured by C3, was significantly inversely associated with lower fruit and vegetable intake, lower physical activity, and higher rates of obesity, smoking, CHD, diabetes, and cancer. C3 was significantly positively associated with heavy alcohol use.

CONCLUSIONS

These findings demonstrate that communities connected to social infrastructure have better population health outcomes. C3 captures protective community attributes and can be used in future applications to assist health researchers, practitioners, nonprofits, and policymakers to advance social connection and health equity in geographically diverse underserved regions.

The role of the environmental subsystem in sustainable urban development: Evidence from megacities in China

Conflicts in urban subsystems have severely hindered the realization of sustainable development, among which the most serious is the conflict between the environmental subsystem and urban development. Differing from studies considering individual environmental elements, this paper innovatively investigates the quantitative relationship between overall environmental performance and other development dimensions to understand the quantitative role of the environmental subsystem in sustainable urban development. Taking the nine megacities in China as an example, this paper first develops the performance variables of four urban subsystems, including the environment, by entropy method and analyzes the conflict or coordination level between the environment and other subsystems through the coupling coordination degree model (CCDM). Then, the interaction mechanism is further analyzed by the fully modified ordinary least square (FMOLS) and vector error correction model (VECM). This paper tries to provide a new reference for management and decision-making by focusing on the whole environmental subsystem rather than separate elements, which is of theoretical and practical significance. The main conclusions are as follows: (1) The coordination level between the environment and other urban subsystems is low; (2) 1 % rise in the economic and resource performance can respectively lead to 0.2014 % and 0.1388 % declines in the environmental performance; (3) 1 % increase in social performance can bring a 0.3738 % rise in environmental performance; (4) Improving environmental and resource subsystems' performance is the priority; (5) Coordinating urban subsystems is the key to long-run sustainable development. Despite the case studies on megacities in China, we hope to provide a new reference for cities worldwide with concentrated populations, rapid growth, and complex development contradictions.

Structural analysis modeling of participatory stakeholder management for green space improvement: evidence from Tehran Metropolis

Encouraging stakeholder participation is now considered an appropriate approach to green space improvement. The main question is how to have people participate in the improvement process. This study aims to propose a participatory stakeholder management model of green space improvement in Tehran Metropolis. Therefore, 190 of Tehran Municipality's green space experts were selected as the statistical population for in-person and field interviews. The dependent research variable was defined as the green space improvement measured in four dimensions (i.e., green space planning, green space designing, green space implementation, and green space maintenance). However, the independent variable included the aspects of participatory management (i.e., participation in goal-setting, participation in decision-making, participation in organizational change, participation in problem-solving, and organizational culture). The results indicated that only organizational culture and participation in organizational change explained nearly 96% of participatory management variations and improved 67% of the green space.

Assessment of street-level greenness and its association with housing prices in a metropolitan area

Rapid global urbanization has made environmental amenities scarce despite their considerable advantages, ranging from aesthetics to health benefits. Street greenness is a key urban environmental amenity. This study developed a green index as an objective measure of greenness using street view images and assessed its predictive power along with that of other environmental amenities for metropolitan housing prices. Spatial interpolation was used to transform point data into areal data, enabling effective analysis of a dataset covering an entire metropolis. A series of hedonic models revealed that (1) street greenness is significantly and negatively associated with housing prices, (2) a traditional greenness indicator and the green index provide complementary information, indicating that they could be used for different purposes, and (3) environmental amenities, in general, demonstrated significant relationships with housing prices. Our analysis strategy including spatial interpolation can be widely employed for studies using different types of data. The findings demonstrating a complementary relationship between our two greenness indicators provide valuable insights for policymakers and urban planners to improve street-level greenness and green accessibility. Considering the significance of environmental amenities, this study provides practical approaches for executing sustainable and healthy city development.

Does the Use of Perennials in Flower Beds Necessarily Imply Sustainability?

Green spaces are becoming increasingly important for cities due to the growing pressures of urbanization and climate change. Along with trees, shrubs, and lawns, flower beds are an important part of urban green spaces. The majority of flower beds in public spaces consist of annual and biennial flower species. Such seasonal flower beds feature eye-catching colors but require significant effort to maintain and manage. Compared to these conventional flower beds, those with herbaceous perennials are more ecologically effective and less costly to maintain, and therefore more sustainable. The aim of this research was to analyze flower beds with perennials in the public green spaces of the city of Zagreb and to develop a tool based on predefined criteria and indicators to evaluate the sustainability of flower beds. In the context of the research, sustainability meant appropriate selection of flower species based on environmental conditions (temperature, light, precipitation), species diversity, greater ground cover and extensiveness of maintenance. The research results showed that there were 327 flower beds with perennials planted in the ground. The constructed Flower Bed Sustainability Index (FBSI) showed that the majority of these perennial beds (56.3%) had a conventional character, as only 28.1% of the beds had a completely correct species selection. This result indicates that the use of perennials does not necessarily guarantee the sustainability of flower beds, since, as in the case of flower beds with seasonal flowers, it depends, among other things, on the correct selection of species adapted to local environmental conditions. The FBSI is shown to be a suitable tool for assessing the degree of sustainability of a flower bed and could be a useful tool in landscape design and management of such types of green spaces.

The role of connection with nature in empirical studies with physiological measurements: a systematic literature review

It is well described that exposure to nature reduces physiological stress, and connectedness to nature can have a moderating effect. However, few studies have so far examined the construction of the connection with nature in relation to physiological processes. In this systematic review, we collected studies that used a physiological measure and included a scale to measure connectedness to nature. Our aim was to assess the role of nature relatedness at the level of physiological processes and to summarize the results published so far. Our review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was conducted in 3 different databases (PubMed, ScienceDirect and Google Scholar). As keywords, we used all the different questionnaires that measure connectedness to nature, combined with terms related to physiological measures. After final screening, 28 articles met the inclusion criteria for the review. The studies were very diverse in terms of purpose, intervention and methods, so narrative synthesis was conducted without measures of effect. We found evidence for a mediating effect of nature connectedness on the associations between nature exposure and cognitive function, brain activity, blood pressure, cortisol level and mental health. Studies investigating nature relatedness as state-like characteristics have shown that exposure to nature increases the level of connection to nature. Eye-tracking studies have confirmed that this measurement method can be used to investigate nature relatedness at a physiological level, which could be a useful complement to self-report questionnaires in future studies.

The effects of the natural visual-aural attributes of urban green spaces on human behavior and emotional response

Introduction

Nature-based solutions (NBS) have been used to address a wide range of urban environmental challenges, an important aspect of which is to improve human health and well-being. However, most relevant studies focus either on what positive influences nature may have or on identifying what natural factors can have these benefits. Few have investigated the sensory composition of nature and the effects of nature in different sensory aspects on human health. Setting out from the multi-sensory perspective, this study aims to explore human behavior and emotional response from visual and aural contact with urban nature.

Methods

Taking Jiangjia Art Garden in Chengdu as an example, natural attributes such as its visual (landscape) and aural (sound source) characteristics as well as people's activities (behavioral responses) were measured by on-site mapping analysis. This was done while a questionnaire-based survey was conducted to investigate people's emotional responses regarding their overall satisfaction, pleasantness, calm, and agreeableness.

Results

The results indicated that nature-dominated visual landscapes such as grassland, waterscapes, and woodlands, as well as natural sounds such as bird sounds, chirp sounds, and wind sounds were found to be positively correlated to the vitality of activities and people's emotional status. Regarding behavioral responses, it was shown that grasslands and woodlands are more likely to be attractive places for recreation, and the vitality measured became extremely high when these two were paired with lakes. As for the emotional responses, people's perceived overall satisfaction, calm, and agreeableness were equally reflected in their behavioral patterns, suggesting a strong relationship with natural factors.

Discussion

The research findings were visually presented in behavior and emotional maps to provide direct cues of informing the future design of high-quality urban green spaces and promoting the application of aural-visual experience in the design of urban nature areas.

Factors influencing the effectiveness of nature-based interventions (NBIs) aimed at improving mental health and wellbeing: Protocol of an umbrella review

Several systematic reviews support the use of nature-based interventions (NBIs) as a mechanism of enhancing mental health and wellbeing. However, the available evidence for the effectiveness of these interventions is fragmentary and mixed. The heterogeneity of existing evidence and significant fragmentation of knowledge within the field make it difficult to draw firm conclusions regarding the effectiveness of NBIs. This mixed method umbrella review aims to synthesise evidence on the effectiveness of nature-based interventions through a summative review of existing published systematic reviews and meta-analyses. A systematic search in PsycINFO, PubMed, Greenfile, Web of Science, Embase, Scopus, Academic Search Complete (EBSCO), Environment Complete (EBSCO), Cochrane Library, CINAHL, Health Policy Reference Centre and Google Scholar will be performed from inception to present. The search strategy will aim to find published systematic reviews of nature-based interventions (NBIs) where improving health and wellbeing is an explicit goal. This is a mixed method review, and systematic reviews with both quantitative and qualitative data synthesis will be considered. Two authors will independently perform the literature search, record screening, data extraction, and quality assessment of each included systematic review and meta-analysis. The individual qualitative and quantitative syntheses will be conducted in parallel and combined in an overarching narrative synthesis. The quantitative evidence will be used to assess the strength and direction of the effect of nature-based interventions on mental health and wellbeing outcomes. Evidence drawn from qualitative studies will be analysed and synthesised to understand the various pathways to engagement, involvement process and experiential factors that may mediate experiences. The risk of bias of the systematic reviews will be assessed using a 16-item Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklist. Trail registration: This review is registered on PROSPERO (CRD42022329179).

Effects of green space on physical activity and body weight status among Chinese adults: a systematic review

Background

Green space may provide many benefits to residents' health behaviors and body weight status, but the evidence is still relatively scattered among Chinese adults. The purpose of this study was to review the scientific evidence on the effects of green space on physical activity (PA) and body weight status among Chinese adults.

Methods

A keyword and reference search was conducted in Pubmed, Web of Science, MEDLINE, and PsycINFO. Studies examining the associations between green space and PA, body mass index (BMI) among Chinese adults were included. The quality of the included literature was evaluated using the National Institutes of Health's Observational Cohort and Cross-Sectional Study Quality Assessment Tool.

Results

A total of 31 studies were included that met the inclusion criteria, including 25 studies with a cross-sectional design, 3 studies with a longitudinal design, and 3 studies with an experimental design. Street-level green view index and green space accessibility were found to be positively associated with PA, but negatively associated with BMI. In most studies, there was a correlation between green space ratio in local areas and BMI. In addition, green space interventions were effective in increasing PA and decreasing BMI among Chinese adults. In contrast, further evidence is needed to support the association between the design characteristics of green space and PA and BMI.

Conclusion

Preliminary evidence suggests that green space has a positive effect on PA and BMI among Chinese adults. However, there are contradictory findings, and future studies adopting longitudinal and quasi-experimental studies are needed to further explore the causal relationship between green space and PA and BMI to provide a relevant theoretical basis for policymakers.

Opportunities for Nature-based Solutions to contribute to Climate-Resilient Development Pathways

There is potential for Nature-based Solutions (NbS) to contribute to Climate Resilient Development (CRD) due to their integrated approach to mitigation, adaptation, and sustainable development. However, despite alignment between NbS and CRD's objectives, realization of this potential is not guaranteed. A CRD Pathways (CRDP) approach helps to analyze the complexities of the relationship between CRD and NbS, and a climate justice lens enables the identification of the multiple ways that NbS can support or undermine CRD by foregrounding the politics inherent in deciding between NbS trade-offs. We use stylized vignettes of potential NbS to examine how the dimensions of climate justice reveal the potential of NbS to contribute to CRDP. We consider tensions in NbS projects between local and global climate objectives, and the potential for NbS framing to reinforce inequalities or unsustainable practices. Ultimately, we present a framework that combines climate justice and CRDP in an analytical tool for understanding the potential for a NbS to support CRD in specific places.

Sustainability and Equity in Urban Development (S&EUD): A Content Analysis of "Bright Spots" from the Accelerating City Equity (ACE) Project

Sustainable and equitable urban development (S&EUD) is vital to promote healthy lives and well-being for all ages. Recognizing equity as core to urban development is essential to ensure that cities are inclusive, safe, resilient, and sustainable. The aim of this study was to identify and assess the elements of equity and sustainability in exemplary bright spots using the ACE Framework and the United Nations' 5 Ps of Sustainable Development. A content analysis process was performed to identify initial case studies, obtain bright spot information, and select final case studies. The exemplary bright spots selected were assessed for drivers of equity and the five pillars of sustainability. Results showed that equity and sustainability have become key considerations in urban development work. Numerous effective strategies and outcomes identified in the exemplary bright spots could be replicated in other contexts.

Do Multiple Sex/Gender Dimensions Play a Role in the Association of Green Space and Self-Rated Health? Model-Based Recursive Partitioning Results from the KORA INGER Study

Exposure to green space has a positive impact on health. Whether sex/gender modifies the green space-health association has so far only been studied through the use of a binary sex/gender category; however, sex/gender should be considered more comprehensively as a multidimensional concept based on theoretical approaches. We therefore explored whether sex/gender, operationalized through multiple sex/gender- and intersectionality-related covariates, modifies the green space-self-rated health association. We collected data from participants involved in the German KORA study (Cooperative Health Research in the Region of Augsburg) in 2019. Self-rated health was assessed as a one-question item. The availability of green spaces was measured subjectively as well as objectively. The multiple sex/gender- and intersectionality-related covariates were measured via self-assessment. To analyze the data, we used model-based recursive partitioning, a decision tree method that can handle complex data, considering both multiple covariates and their possible interactions. We showed that none of the covariates operationalizing an individual sex/gender self-concept led to subgroups with heterogeneous effects in the model-based tree analyses; however, we found effect heterogeneity based on covariates representing structural aspects from an intersectionality perspective, although they did not show the intersectional structuring of sex/gender dimensions. In one identified subgroup, those with a lower education level or a feeling of discrimination based on social position showed a positive green space-self-rated health association, while participants with a higher education level or no feeling of discrimination based on social position had a high level of self-rated health regardless of the availability of green spaces. Model-based recursive partitioning has the potential to detect subgroups exhibiting different exposure-outcome associations, with the possibility of integrating multiple sex/gender- and intersectionality-related covariates as potential effect modifiers. A comprehensive assessment of the relevance of sex/gender showed effect heterogeneity based on covariates representing structural aspects from an intersectionality perspective.

Ticks and Tick-Borne Pathogens in Recreational Greenspaces in North Central Florida, USA

Tick-borne infections are an increasing medical and veterinary concern in the southeastern United States, but there is limited understanding of how recreational greenspaces influence the hazard of pathogen transmission. This study aimed to estimate the potential human and companion animal encounter risk with different questing tick species, and the bacterial or protozoal agents they carry in recreational greenspaces. We collected ticks bimonthly along trails and designated recreational areas in 17 publicly accessible greenspaces, in and around Gainesville, Florida, USA. We collected Amblyomma americanum, Ixodes scapularis, Amblyomma maculatum, Dermacentor variabilis, Ixodes affinis, and Haemaphysalis leporispalustris. Across the six tick species collected, we detected 18 species of bacteria or protozoa within the Babesia, Borrelia, Cytauxzoon, Cryptoplasma (Allocryptoplasma), Ehrlichia, Hepatozoon, Rickettsia, and Theileria genera, including pathogens of medical or veterinary importance. While tick abundance and associated microorganism prevalence and richness were the greatest in natural habitats surrounded by forests, we found both ticks and pathogenic microorganisms in manicured groundcover. This relationship is important for public health and awareness, because it suggests that the probability of encountering an infected tick is measurable and substantial even on closely manicured turf or gravel, if the surrounding landcover is undeveloped. The presence of medically important ticks and pathogenic microorganisms in recreational greenspaces indicates that public education efforts regarding ticks and tick-borne diseases are warranted in this region of the United States.

The association of park use and park perception with quality of life using structural equation modeling

Introduction

The literature is limited on the impact of neighborhood parks on quality of life (QoL) and the mechanism linking them.

Methods

In this paper, we applied the structural equation model to data from a cross-sectional sample of 650 participants in low-income communities of New York City, we examined the associations of neighborhood park use vs. park perception and QoL, and whether these associations were mediated through self-reported perceived stress. We also examined whether park use mediated the relationship between park perception and QoL.

Results

We found that park use had a significant but weak association with QoL (standardized β = 0.08, 95% confidence interval (CI): 0.02, 0.15, p = 0.02), but this relationship was not mediated by self-reported stress. Park perception was more strongly associated with QoL than park use (standardized β = 0.23, 95% CI: 0.16, 0.30, p < 0.01), and this was partly mediated by self-reported stress (indirect effect- standardized β = 0.08, 95% CI: 0.03, 0.13, p < 0.01) and, to a lesser extent, by park use (indirect effect- standardized β = 0.01, 95% CI: 0.00, 0.02, p = 0.01).

Discussion

Having well-perceived parks appears to be an important factor for QoL independent of park use, suggesting that quality parks may benefit everyone in a community beyond park users. This strengthens the argument in favor of increasing park investment as a strategy to improve population wellbeing.

Investigating the Usage Patterns of Park Visitors and Their Driving Factors to Improve Urban Community Parks in China: Taking Jinan City as an Example

Urban community parks have significant benefits for city residents, both physical and spiritual. This is especially true in developing countries, such as China. The purpose of our study is to describe the current situation of the community parks in five main districts of Jinan City while recognizing features of the community parks that influence usage patterns. Our study also means to determine the desired improvements of visitors that promote access to and use of community parks on the basis of the Chinese context. We conducted a survey among 542 community park visitors and obtained valid responses. The findings of respondents show that community parks are mostly used by people over 55 years (34.7%) and children under 10 years (23.6%). The main motives for using community parks are for exercise (24.2%) and to socialize with others (21.6%). The majority of respondents (65.7%) rated the community park as satisfactory and considered only a few improvements needed. Regarding the desired improvements, numerous respondents mentioned adding more physical training facilities (13.3%) and activity areas (7.6%), as well as emergency call buttons in areas frequented by children and older people (7.6%). Furthermore, most of the respondents (79.9%) indicated that they would like to use the community parks more frequently if there is additional progress to make the parks more attractive, cleaner, and friendlier. These results can help park designers, government agencies, and community groups to provide the planning and design strategies for community parks to promote their upgrading in China.

News consumption and green habits on the use of circular packaging in online shopping in Taiwan: An extension of the theory of planned behavior

The COVID-19 pandemic is far from over as outbreaks continue to spread around the world. The demand for packaging bags and cartons has also risen sharply in e-commerce shopping and takeaways because consumers have changed their shopping habits during the pandemic. The primary purpose of this study was to explore the factors prompting consumers to accept and use circular packaging when they shop online. From January to February 2022, a total of 373 online questionnaires were completed. The results showed that news consumption positively affected environmental attitudes, subjective norms, perceived behavioral control and circular packaging behavior intentions. Environmental attitudes, subjective norms, perceived behavioral control also affected the intention of circular packaging. Furthermore, news consumption influenced circular packaging behavioral intentions through environmental attitudes and green habits. Developing green habits in people’s daily lives will be of great help in guiding consumers to engage in other sustainable behaviors that are beneficial to life.

Urban environment and health behaviours in children from six European countries

BACKGROUND

Urban environmental design is increasingly considered influential for health and wellbeing, but evidence is mostly based on adults and single exposure studies. We evaluated the association between a wide range of urban environment characteristics and health behaviours in childhood.

METHODS

We estimated exposure to 32 urban environment characteristics (related to the built environment, traffic, and natural spaces) for home and school addresses of 1,581 children aged 6-11 years from six European cohorts. We collected information on health behaviours including total amount of overall moderate-to-vigorous physical activity, physical activity outside school hours, active transport, sedentary behaviours and sleep duration, and developed patterns of behaviours with principal component analysis. We used an exposure-wide association study to screen all exposure-outcome associations, and the deletion-substitution-addition algorithm to build a final multi-exposure model.

RESULTS

In multi-exposure models, green spaces (Normalized Difference Vegetation Index, NDVI) were positively associated with active transport, and inversely associated with sedentary time (22.71 min/day less (95 %CI -39.90, -5.51) per interquartile range increase in NDVI). Residence in densely built areas was associated with more physical activity and less sedentary time, and densely populated areas with less physical activity outside school hours and more sedentary time. Presence of a major road was associated with lower sleep duration (-4.80 min/day (95 %CI -9.11, -0.48); compared with no major road). Results for the behavioural patterns were similar.

CONCLUSIONS

This multicohort study suggests that areas with more vegetation, more building density, less population density and without major roads are associated with improved health behaviours in childhood.

Transformation towards Green Cities: Key Conditions to Accelerate Change

Cities worldwide are growing at unprecedented rates, compromising their surrounding landscapes, and consuming many scarce resources [...]

Selected Research Issues of Urban Public Health

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

Buffer Green Patches around Urban Road Network as a Tool for Sustainable Soil Management

Urban areas are facing a range of environmental challenges including air, water and soil pollution as a result of industrial, domestic and traffic emissions. In addition, global climate change is likely to aggravate certain urban problems and disturb the urban ecology by increasing the frequency and severity of extreme weather events. In the context of urbanization growth and the consequent impact on the environment, there is a growing interest in maintaining urban soil quality and functions as they are the medium for green infrastructure development. Furthermore, urban soils are becoming one of the key factors in the delivery of many ecosystem services such as carbon storage, climate regulation, water flow regulation, etc. On the other hand, urban soils are well-known to be a major sink of air pollutants due to the wet and dry atmospheric deposition and recirculation. Soil has the ability to degrade some chemical contaminants but when the levels are high, urban soils could hold on large amounts and pose a risk to human health. A cost-effective technological solution is to use the ability of some plant species to metabolize, accumulate and detoxify heavy metals or other harmful organic or inorganic compounds from the soil layer. The establishment of urban lawns (grass covered surfaces) is a helpful, environmentally friendly, economically sustainable and cost-effective approach to remove contaminants from polluted soils (terrains), which also has some aesthetic benefits. In this paper, an overview of the benefits and limitations of urban lawn construction is presented. The focus is on the perspectives for sustainable management of urban lawns, especially as buffer green patches in the road network surroundings, that can represent strategies to provide ecological and social multifunctionality of urban soils, and thus, increasing their ecosystem services capacity. Specifically, the paper highlights (i) the possibilities for phytoremediation of urban soils, (ii) potential of some perennial grasses and (iii) key issues that should be considered in the planning and design of urban lawns.

Understanding Urban Green Space Usage through Systems Thinking: A Case Study in Thamesmead, London

Urban green spaces provide environmental, economic, societal and health benefits to cities. However, policy and planning interventions aiming to improve usage have often led to unintended consequences, including, in some circumstances, an actual decline in usage. Previous research has identified factors influencing the use of urban green space, more often with a focus on the ‘quality’ and physical features of the space, rather than on the broader social factors. This study aims to unpack the complexity of factors that influence the use of urban green space through the application of Systems Thinking. A qualitative mixed-method approach integrating System Dynamics with rapid ethnography was adopted to elicit the views of local residents in Thamesmead, London. A thematic analysis of interviews was undertaken to systematically map the causal relations between factors, which were compared to wider stakeholders’ views. Our findings highlight the relevance of dynamics and social influences on the use of green space, which include social interactions and stewardship, health conditions, availability of services and amenities. These are factors that are underexplored in the literature and, sometimes, overlooked in urban green space policy by decision-makers. We infer that attendance of urban green spaces requires time, which may be occupied in other practices determined by local conditions and needs. Expanding the spatial and temporal boundaries of investigation, wider than debates on ‘quality’, should, in our view, increase the chances of identifying critical influences and foster an increased use of green space.

Nature-Based Physical Activity and Hedonic and Eudaimonic Wellbeing: The Mediating Roles of Motivational Quality and Nature Relatedness

The current study evaluated the degree to which nature-based physical activity (NPA) influenced two distinct types of psychological wellbeing: hedonic wellbeing and eudaimonic wellbeing. The type of motivation an individual experiences for physical activity, and the extent to which individuals have a sense of relatedness with nature, have been shown to influence the specific type of psychological wellbeing that is experienced as a result of NPA. However, the role of these two variables in the relationship between NPA and psychological wellbeing has not been examined. Thus, this study assessed the potential mediating influence of (1) motivational quality and (2) nature relatedness on the relationships between NPA and hedonic and eudaimonic wellbeing, respectively. Participants (N = 262) completed an online survey assessing hedonic and eudaimonic wellbeing, NPA, intrinsic motivation, autonomous extrinsic motivation, and nature relatedness. Data were analysed using Partial Least Squares Structural Equation Modelling. Results showed that motivational quality and nature relatedness both fully mediated the relationships between NPA and hedonic and eudaimonic wellbeing. Specifically, intrinsic motivation positively mediated the relationship between NPA and hedonic wellbeing. Autonomous extrinsic motivation and nature relatedness positively mediated the relationship between NPA and eudaimonic wellbeing. These findings suggest that the associations between NPA and eudaimonic wellbeing and hedonic wellbeing, respectively, are driven by different mechanisms relating to an individual's (1) underlying motivation and (2) sense of connection to nature. These findings suggest that promoting distinct types of wellbeing (hedonic vs. eudaimonic) through NPA requires distinct approaches. Emphasising enjoyment, pleasure, and positive kinaesthetic experiences within NPA may be more conducive to hedonic wellbeing, while highlighting opportunities for connecting with nature or experiencing valued outcomes of NPA may be more conducive to eudaimonic wellbeing.

The Visual Attention and Psychological Responses from Older Customers to Wellness Service Pictures of Hotels

Understanding the visual attention and psychological responses of consumers to marketing pictures allows hotel managers to design more attractive advertisements. Therefore, the purposes of the present study were to use an eye-tracking analysis to explore whether there were different effects from tourist hotels’ wellness service pictures based on whether they had natural or built clues. The psychological responses with regard to perceived well-being and willingness to pay were also examined. Eighty-five older consumers were recruited. Their eye movement performance while observing marketing pictures with different visual clues and their subsequent psychological responses were measured. It was found that wellness service pictures with natural clues captured more visual attention and induced higher willingness-to-pay perceptions than those with built clues in these older consumers. The present results suggest that marketing pictures with natural clues may create positive visual responses in older customers and further enhance their purchase intention.

Dual process model of farmers' mindfulness and sustainable economic behavior: Mediating role of mental health and emotional labor

Mindful awareness of our interconnection with the natural environment could help to redeem our lost environmentally entrenched identity and help us to act more sustainably, concluding the predictable gaps between mindfulness and sustainable behavior. We propose more precisely that mindful attentiveness may be essential to establishing sustainable economic behavior through understanding emotional labor and enhanced mental health. Likewise, with an ever-rising concern related to mental health and emotional labor, recent industrialization and commoditization of agricultural products have stressed the need for mindfulness, and causing sustainable economic behavior of farmers that is imminent. Hence, the study will not only explore the connection between mindfulness and sustainable economic behavior, but there is a need to examine the mediating role of emotional labor and the mental health of farmers in China. The study selected the farmers because mindful awareness, emotional labor, and mental health of a farmer can significantly contribute to sustainable economic behavior and bring a connection with the natural environment. The data of 358 responses were analyzed using SPSS-AMOS. The results revealed that mindfulness, mental health, and emotional labor have a significant connection with the sustainable economic behavior of farmers in China. The results also indicated that mental health and emotional labor mediate between mindfulness and sustainable economic behavior. The results set the tone for the policy-makers to create awareness among all the stakeholders about the importance of mindfulness to help farmers manage their emotional labor and mental health for better, sustainable performance outcomes.

Exploring the Potential Relationship Between Global Greenness and DALY Loss Due to Depressive Disorders

OBJECTIVE

Prior studies have shown that greenness can reduce the burden of depressive disorders. However, most were focused on local-scale analyses while limited evaluated globally. We aimed to investigate the association between greenness and the burden of depressive disorders using data from 183 countries worldwide.

METHODS

We used the normalized difference vegetation index (NDVI) to estimate greenness. Country-level disability-adjusted life year (DALY) loss due to depressive disorders was used to represent depressive disorder burdens. A generalized linear mixed model was applied to assess the relationship between greenness and depressive disorders after controlling for covariates. Stratified analyses were conducted to determine the effects of greenness across several socio-demographic levels.

RESULTS

The findings showed a significant negative association between greenness and the health burden of depressive disorders with a coefficient of -0.196 (95% CI: -0.356, -0.035) in the DALY changes per interquartile unit increment of NDVI. The stratified analyses suggested beneficial effects of greenness on depressive disorders across sex, various age groups especially for those aged <49 years, with low-income and/or those living in highly urbanized countries.

CONCLUSIONS

Our study noted that greenness exposure was significant negative association with the burden of depressive disorders. The findings should be viewed as recommendations for relevant authorities in supporting environmental greenness enhancement to reduce the mental burdens.

Beyond Proximity and Towards Equity: A Multidimensional View of Urban Greenspace Access

Park access is primarily conceived of as a question of proximity. We sought to develop a multidimensional tool based on a broad theory of green space access to better understand objective and subjective factors that capture varying dimensions of urban green space access that may be associated with its use.

Methods

We conducted a cross-sectional study in two communities bordering a large park in Baltimore City, Maryland. We randomly selected households for an in-person survey conducted between April to September 2019. Our primary outcome was self-reported number of park visits over the last 30 days. The main independent variables conceptualized park access based on Penchansky and Thomas' theory of access.

Results

Based on 87 respondents, living within a 10-minute walk was not associated with park use. Park use was associated with the perception that there were park events that individuals could participate in (adjusted IRR 6.83 [95% CI 2.57, 18.2]) and feeling safe in the park during the day (adjusted IRR 6.26 [95% CI 2.18, 18.0]). Those who reported that living near the park was affordable reported fewer park visits (adjusted IRR 0.53 [95% CI 0.32, 0.86]).

Conclusions

Physical proximity was not significantly associated with green space use, but perceptions of safety, programming, and neighborhood affordability were. Our findings highlight the importance of subjective factors as part of a broader theory of park access.

Resilience and Equity in a Time of Crises: Investing in Public Urban Greenspace Is Now More Essential Than Ever in the US and Beyond

The intersecting negative effects of structural racism, COVID-19, climate change, and chronic diseases disproportionately affect racial and ethnic minorities in the US and around the world. Urban populations of color are concentrated in historically redlined, segregated, disinvested, and marginalized neighborhoods with inadequate quality housing and limited access to resources, including quality greenspaces designed to support natural ecosystems and healthy outdoor activities while mitigating urban environmental challenges such as air pollution, heat island effects, combined sewer overflows and poor water quality. Disinvested urban environments thus contribute to health inequity via physical and social environmental exposures, resulting in disparities across numerous health outcomes, including COVID-19 and chronic diseases such as cancer and cardiovascular diseases (CVD). In this paper, we build off an existing conceptual framework and propose another conceptual framework for the role of greenspace in contributing to resilience and health equity in the US and beyond. We argue that strategic investments in public greenspaces in urban neighborhoods impacted by long term economic disinvestment are critically needed to adapt and build resilience in communities of color, with urgency due to immediate health threats of climate change, COVID-19, and endemic disparities in chronic diseases. We suggest that equity-focused investments in public urban greenspaces are needed to reduce social inequalities, expand economic opportunities with diversity in workforce initiatives, build resilient urban ecosystems, and improve health equity. We recommend key strategies and considerations to guide this investment, drawing upon a robust compilation of scientific literature along with decades of community-based work, using strategic partnerships from multiple efforts in Milwaukee Wisconsin as examples of success.

Does surrounding greenness moderate the relationship between apparent temperature and physical activity? Findings from the PHENOTYPE project

BACKGROUND

Physical activity can be affected by both meteorological conditions and surrounding greenness, but few studies have evaluated the effects of these environmental factors on physical activity simultaneously. This multi-city comparative study aimed to assess the synergetic effects of apparent temperature and surrounding greenness on physical activity in four European cities. Specifically, we aimed to identify an interaction between surrounding greenness and apparent temperature in the effects on physical activity.

METHODS

Data were collected from 352 adult residents of Barcelona (Spain), Stoke-on-Trent (United Kingdom), Doetinchem (The Netherlands), and Kaunas (Lithuania) as part of the PHENOTYPE study. Participants wore a smartphone for seven consecutive days between May-December 2013 and provided additional sociodemographic survey data. Hourly average physical activity (Metabolic Equivalent of Task (MET)) and surrounding greenness (NDVI) were derived from the Calfit mobile application collecting accelerometer and location data. Hourly apparent temperature was calculated from temperature and relative humidity, which were obtained from local meteorological stations along with other meteorological covariates (rainfall, windspeed, and sky darkness). We assessed the interaction effects of apparent temperature and surrounding greenness on hourly physical activity for each city using linear mixed models, while adjusting for meteorological, demographic, and time-related variables.

RESULTS

We found significant interactions between apparent temperature and surrounding greenness on hourly physical activity in three of four cities, aside from the coastal city of Barcelona. Significant quadratic effects of apparent temperature were found in the highest level of surrounding greenness for Stoke-on-Trent and Doetinchem, with 4% decrease in median MET observed for a 10°C departure from optimal temperature (15.2°C and 14.6°C, respectively). Significant linear effects were found for higher levels of surrounding greenness in Kaunas, whereby an increase of 10°C was associated with ∼4% increase in median MET.

CONCLUSION

Apparent temperature and surrounding greenness interacted in the effect on hourly physical activity across three of four European cities, with varying effect between cities. While quadratic effects of temperature suggest diminishing levels of physical activity in the highest greenness levels in cities of temperate climates, the variation in surrounding greenness between cities could be further explored, particularly by looking at indoor-outdoor locations. The study findings support the need for evidence-based physical activity promotion and urban design.

The Urban Environment Impact of Climate Change Study and Proposal of the City Micro-Environment Improvement

The water management of cities and villages faces many challenges. Aging infrastructure systems operate for many years after their theoretical lifetime (operation) with a very high need for reconstruction and repair. The solution is proper rainwater management. The investigated area is part of the cadastral area of the Nitra city. This article is based on the use of geographic information systems (GIS) as tools in proposing water retention measures that are needed to improve the microenvironment of the city. We proceeded in several steps, which consisted of area analysis, survey, surface runoff calculations in urbanized areas, proposal of a suitable solution for given location. For real possibilities of rainwater management procedures, a new site on the outskirts of the city was selected. In the given locality, it was possible to use water infiltration as a solution. The locality has suitable conditions of land ownership, pedological conditions, the slope of the area and also the interest of the inhabitants in the ecological solution. The outlined study indicates the need to continue research on the reliability of rainwater management practices.

Green Infrastructure in the Time of Social Distancing: Urban Policy and the Tactical Pandemic Urbanism

The COVID-19 pandemic generated a number of changes in the functioning of urban areas all over the world and had a visible impact on the use of green infrastructure, including city parks. The study discusses and compares operation and use of two such parks located in Wellington, New Zealand and Warsaw, Poland by adopting “pandemic urban ethnography”, an approach that includes autoethnography, interviews with users, non-participant observation, and analysis of social media content. As indicated by the findings of the study, the importance of less rigidly designed, multifunctional spaces that give their users freedom of “tactical” adjustments, significantly grows during times of lockdown and “social distancing”. During such a crisis, the management and everyday use of urban parks are highly related to urban policies. The article provides insight into how those policies impact the functional values of green infrastructure confronting it with user-generated adaptations and the landscape design itself. The global health emergency showed how access to green areas becomes a crucial determinant on environmental justice while proving the significance of “tactical pandemic urbanism” as both a design and management method.

A cross-sectional study of the impact of school neighbourhood on children obesity and body composition

Schools' neighbourhoods provide an important environmental context that may influence the risk of obesity among children. The aim of this study was to assess the effect of neighbourhood surrounding schools on obesity and body composition in schoolchildren. Data on 845 children aged 7 to 12 years old from 20 primary schools were considered. Anthropometric measurements and bioelectrical impedance analysis were performed to assess body mass index (BMI) and characterize body composition. Land use characteristics were quantified within a 500-m buffer zone around schools. Mixed-effect models measured the effects of school neighbourhood on obesity and body composition. The results showed a tendency between green urban areas around schools and lower values of BMI and better body composition parameters compared with built areas, being BMI z-scores CDC, and body fat percentage significantly higher in-built than in green urban areas (β = 0.48, 95% CI 0.05; 0.90, and β = 2.56, 95% CI 0.39; 4.73, respectively).Conclusion: Our findings suggest that the school neighbourhood has an effect on BMI and body fat percentage in schoolchildren. These results may contribute to the creation of healthier cities and help reduce health expenses by focusing on prevention programmes towards the expansion of green spaces. What is Known: • Living in greener areas has been associated with healthy weight outcomes and to the lower impact of obesogenic urban environments. • The school environment may be especially important for youth health outcomes. What is New: • Neighbourhoods around schools may affect child health, specifically the development of obesity. • The presence of urban green areas around school may promote a framework of lifestyle or behaviours conducive to achieving a healthy weight.

Using SPOT Data and FRAGSTAS to Analyze the Relationship between Plant Diversity and Green Space Landscape Patterns in the Tropical Coastal City of Zhanjiang, China

Urban green spaces provide a host of ecosystem services, the quantity and structure of which play an important role in human well-being. Rapid urbanization may modify urban green spaces, having various effects on plant diversity. Tropical coastal cities have urbanized rapidly in recent decades, but few studies have been conducted with a focus on their green spaces. We studied the responses of cultivated and spontaneous plants, both key components of urban flora, to the landscape structure of urban green spaces and possible social drivers. We analyzed existing relationships between plant diversity indices, urban green space landscape metrics (using Systeme Probatoire d’Observation de la Terre (SPOT) data,), and social factors, including the type, population density, construction age, and GPS coordinates of each Urban Functional Unit, or UFU. We found that UFUs with more green space patches had higher cultivated and spontaneous species richness than those with fewer green space patches. Spontaneous species richness decreased when green space patches became fragmented, and it increased when green space patches were more connected (e.g., via land bridges). Conversely, cultivated species richness increased with green space patch fragmentation. The phylogenetic diversity of both cultivated and spontaneous plants were weakly associated with green space structure, which was strongly driven by land use. Old UFUs and those with larger populations had more green space patches overall, although they tended to be small and fragmented. Green space patch density was found to increase as the UFU age increased. From the viewpoint of knowledge transfer, understanding the effects and drivers of landscape patterns of urban green spaces could inform the development of improved policies and management of urban green space areas.

Encouraging and Enabling Lifestyles and Behaviours to Simultaneously Promote Environmental Sustainability, Health and Equity: Key Policy Messages from INHERIT

Human consumption and activity are damaging the global ecosystem and the resources on which we rely for health, well-being and survival. The COVID-19 crisis is yet another manifestation of the urgent need to transition to more sustainable societies, further exposing the weaknesses in health systems and the injustice in our societies. It also underlines that many of the factors leading to environmental degradation, ill health and social and health inequities are interlinked. The current situation provides an unprecedented opportunity to invest in initiatives that address these common factors and encourage people to live more healthily and sustainably. Such initiatives can generate the positive feedback loops needed to change the systems and structures that shape our lives. INHERIT (January 2016-December 2019), an ambitious, multisectoral and transnational research project that involved 18 organisations across Europe, funded by the European Commission, explored such solutions. It identified, defined and analysed promising inter-sectoral policies, practices and approaches to simultaneously promote environmental sustainability, protect and promote health and contribute to health equity (the INHERIT "triple-win") and that can encourage and enable people to live, move and consume more healthfully and sustainably. It also explored the facilitators and barriers to working across sectors and in public private cooperation. The insights were brought together in guidelines setting out how policy makers can help instigate and support local "triple-win" initiatives that influence behaviours as an approach to contributing to the change that is so urgently needed to stem environmental degradation and the interlinked threats to health and wellbeing. This article sets out this guidance, providing timely insights on how to "build back better" in the post pandemic era.

Analytical approaches to testing pathways linking greenspace to health: A scoping review of the empirical literature

BACKGROUND

Inadequate translation from theoretical to statistical models of the greenspace - health relationship may lead to incorrect conclusions about the importance of some pathways, which in turn may reduce the effectiveness of public health interventions involving urban greening. In this scoping review we aimed to: (1) summarize the general characteristics of approaches to intervening variable inference (mediation analysis) employed in epidemiological research in the field; (2) identify potential threats to the validity of findings; and (3) propose recommendations for planning, conducting, and reporting mediation analyses.

METHODS

We conducted a scoping review, searching PubMed, Scopus, and Web of Science for peer-reviewed epidemiological studies published by December 31, 2019. The list of potential studies was continuously updated through other sources until March 2020. Narrative presentation of the results was coupled with descriptive summary of study characteristics.

RESULTS

We found 106 studies, most of which were cross-sectional in design. Most studies only had a spatial measure of greenspace. Mental health/well-being was the most commonly studied outcome, and physical activity and air pollution were the most commonly tested intervening variables. Most studies only conducted single mediation analysis, even when multiple potentially intertwined mediators were measured. The analytical approaches used were causal steps, difference-of-coefficients, product-of-coefficients, counterfactual framework, and structural equation modelling (SEM). Bootstrapping was the most commonly used method to construct the 95% CI of the indirect effect. The product-of-coefficients method and SEM as used to investigate serial mediation components were more likely to yield findings of indirect effect. In some cases, the causal steps approach thwarted tests of indirect effect, even though both links in an indirect effect were supported. In most studies, sensitivity analyses and proper methodological discussion of the modelling approach were missing.

CONCLUSIONS

We found a persistent pattern of suboptimal conduct and reporting of mediation analysis in epidemiological studies investigating pathways linking greenspace to health; however, recent years have seen improvements in these respects. Better planning, conduct, and reporting of mediation analyses are warranted.

Providing Access to Urban Green Spaces: A Participatory Benefit-Cost Analysis in Spain

The opening up of green spaces could provide significant benefits to society. This study develops a framework to assess the economic benefits and costs of public interventions providing citizen access to urban green spaces. The Thinking Fadura project in Getxo (Spain) was used as a case study. A method for participatory benefit-cost analysis is developed, where a stakeholder-participatory evaluation is combined with a standard cost-benefit analysis. The participatory evaluation followed a bottom-up approach in a sequential evaluation including three main focal points: key stakeholders and experts, visitors and the general public. The assessment demonstrates that the Thinking Fadura project's benefits outweigh the costs. The results suggest that projects designed with the purpose of improving green space accessibility to the general public can be beneficial from a societal perspective. The highest economic benefits were an increase in the amenity and recreational value and an increase in people's physical activity. The participatory evaluation indicates that giving access to people of lower socio-economic status and vulnerable groups and improving recreational use were perceived as the most beneficial. An increase in noise, dirt, and risk of criminal activities as well as potential conflicts between green space users were perceived as the most negative impacts of opening a previously restricted area to the general public. The economic assessment of Thinking Fadura project could serve as a model in the decision-making process in locations where the use of greenspaces is restricted.

Ten Lessons for Good Practice for the INHERIT Triple Win: Health, Equity, and Environmental Sustainability

The world’s challenges of climate change, damage to ecosystems, and social and health inequalities require changes in human behaviours at every level of organisation, among governments, business, communities, and individuals. An important question is how behaviour change can be enabled and supported at the scale and speed required. The research reported in this paper describes important lessons for good practice in changing contexts to modify behaviours for a triple win for health, equity and environmental sustainability. Authors synthesised learning from qualitative, quantitative and cost benefit evaluations of 15 case studies conducted in 12 countries in Europe. The case studies address ways of living (green spaces and energy efficient housing), moving (active transport) and consuming (healthy and sustainable diets) that support the triple win. Ten lessons for good practice were identified. These include bringing a triple win mindset to policy and practice in planning interventions, with potential to improve environmental sustainability, health and equity at the same time. The lessons for good practice are intended to support governmental and non-governmental actors, practitioners and researchers planning to work across sectors to achieve mutual benefits for health and environmental sustainability and in particular to benefit poorer and more socio-economically disadvantaged groups.