This cross-sectional study investigated whether physical activity, social cohesion, and loneliness mediate the association between time spent visiting green spaces and perceived mental health and ...vitality. Questionnaire data were collected from 3,948 residents from 124 neighborhoods across four European cities. Multilevel linear regression analysis revealed positive, but weak, associations between time spent visiting green space and Medical Outcome Study Short Form (SF-36) mental health and vitality score, which suggest small mental health benefits. Single mediation analyses showed that different indicators of physical activity (total, during leisure time, and walking during leisure time), social cohesion, and loneliness were mediators. Multiple mediation analyses showed that physical activity during leisure time and loneliness may explain about 25% of the relationship. The unmediated part of the association suggests that other mediators may explain the association.
Many studies conducted during the last decade suggest the mental health benefits of green and blue spaces. We aimed to systematically review the available literature on the long-term mental health ...benefits of residential green and blue spaces by including studies that used standardized tools or objective measures of both the exposures and the outcomes of interest. We followed the PRISMA statement guidelines for reporting systematic reviews and meta-analysis. In total 28 studies were included in the systematic review. We found limited evidence for a causal relationship between surrounding greenness and mental health in adults, whereas the evidence was inadequate in children. The evidence was also inadequate for the other exposures evaluated (access to green spaces, quality of green spaces, and blue spaces) in both adults and children. The main limitation was the limited number of studies, together with the heterogeneity regarding exposure assessment. Given the increase in mental health problems and the current rapid urbanization worldwide, results of the present systematic review should be taken into account in future urban planning. However, further research is needed to provide more consistent evidence and more detailed information on the mechanisms and the characteristics of the green and blue spaces that promote better mental health. We provide recommendations for future studies in order to provide consistent and evidence-based recommendations for policy makers.
Green spaces are associated with improved health, but little is known about mechanisms underlying such association. We aimed to assess the association between greenness exposure and subjective ...general health (SGH) and to evaluate mental health status, social support, and physical activity as mediators of this association. This cross-sectional study was based on a population-based sample of 3461 adults residing in Barcelona, Spain (2011). We characterized outcome and mediators using the Health Survey of Barcelona. Objective and subjective residential proximity to green spaces and residential surrounding greenness were used to characterize greenness exposure. We followed Baron and Kenny's framework to establish the mediation roles and we further quantified the relative contribution of each mediator. Residential surrounding greenness and subjective residential proximity to green spaces were associated with better SGH. We found indications for mediation of these associations by mental health status, perceived social support, and to less extent, by physical activity. These mediators altogether could explain about half of the surrounding greenness association and one-third of the association for subjective proximity to green spaces. We observed indications that mental health and perceived social support might be more relevant for men and those younger than 65years. The results for objective residential proximity to green spaces were not conclusive. In conclusion, our observed association between SGH and greenness exposure was mediated, in part, by mental health status, enhanced social support, and physical activity. There might be age and sex variations in these mediation roles.
•Mechanisms underlying health benefits of green spaces are not established.•Residential surrounding greenness is associated with better general health.•Subjective residential proximity to green spaces is associated with better general health.•Mental health, social support, and physical activity mediated these associations.•Objective residential proximity to green spaces did not influence general health.
Commuting routes with natural features could promote walking or cycling for commuting. Commuting through natural environments (NE) could have mental health benefits as exposure to NE can reduce ...stress and improve mental health, but there is little evidence. This study evaluates the association between NE and commuting, whether active or not, and the association between commuting (through NE), whether active or not, and mental health. We also evaluate the moderating effect of NE quality on the association between NE commuting and mental health.
This cross-sectional study was based on adult respondents (n = 3599) of the Positive Health Effects of the Natural Outdoor Environment in Typical Populations in Different Regions in Europe (PHENOTYPE) project. Data were collected in four European cities in Spain, the Netherlands, Lithuania and the United Kingdom. Data on commuting behavior (active commuting at least one day/week, daily NE commuting) and mental health were collected with questionnaires. Associations were estimated with multilevel analyses including random intercepts at city- and neighborhood level.
Adjusted multilevel analyses showed that daily NE commuters were more often active commuters (OR 1.42; 95% CI 1.19, 1.70). There was no association between active commuting and mental health, but daily NE commuters had on average a 2.74 (95% CI 1.66, 3.82) point higher mental health score than those not commuting through NE. The association with mental health was stronger among active commuters (4.03, 95% CI 2.13, 5.94) compared to non-active commuters (2.21; 95% CI 0.90, 3.51) when daily commuting through NE, but NE quality did not have a moderating effect.
Daily NE commuting was associated with better mental health, especially for active commuters. Daily NE commuters were likely to be active commuters. Active commuting itself was not associated with mental health. These findings suggest that cities should invest in commuting routes with nature for cycling and walking.
•Daily natural environment commuters were likely to be active commuters.•Daily natural environment commuting was associated with better mental health, especially for active commuters.•Active commuting itself was not associated with mental health.
In a rapidly urbanizing world, many people have little contact with natural environments, which may affect health and well-being. Existing reviews generally conclude that residential greenspace is ...beneficial to health. However, the processes generating these benefits and how they can be best promoted remain unclear.
During an Expert Workshop held in September 2016, the evidence linking greenspace and health was reviewed from a transdisciplinary standpoint, with a particular focus on potential underlying biopsychosocial pathways and how these can be explored and organized to support policy-relevant population health research.
Potential pathways linking greenspace to health are here presented in three domains, which emphasize three general functions of greenspace: reducing harm (e.g. reducing exposure to air pollution, noise and heat), restoring capacities (e.g. attention restoration and physiological stress recovery) and building capacities (e.g. encouraging physical activity and facilitating social cohesion). Interrelations between among the three domains are also noted. Among several recommendations, future studies should: use greenspace and behavioural measures that are relevant to hypothesized pathways; include assessment of presence, access and use of greenspace; use longitudinal, interventional and (quasi)experimental study designs to assess causation; and include low and middle income countries given their absence in the existing literature. Cultural, climatic, geographic and other contextual factors also need further consideration.
While the existing evidence affirms beneficial impacts of greenspace on health, much remains to be learned about the specific pathways and functional form of such relationships, and how these may vary by context, population groups and health outcomes. This Report provides guidance for further epidemiological research with the goal of creating new evidence upon which to develop policy recommendations.
•Although it appears that greenspace benefits health, the pathways are unclear.•We have organized pathways into three domains that emphasize greenspace functions.•Pathways likely intertwine and vary by context, populations and health outcomes.•We identify diverse challenges in measurement and analysis that require attention.•Research guided by our discussion will better efforts to enable greenspace-related health benefits.
This article explores the role that green gentrification plays in exacerbating racial tensions within historically marginalized urban communities benefiting from new environmental amenities such as ...parks, gardens, waterfront restoration and greenways. Building on extensive qualitative data from three cities in Europe (Amsterdam, Vienna, Lyon) and four cities in the United States (Washington, Austin, Atlanta, Cleveland), we use thematic analysis and grounded theory to examine the complex relationship between historical environmental and racial injustices and current racial green inequities produced by the green city agenda. Our analysis also offers insights into the main differences in how community members articulate concerns and demands over racial issues related to green gentrification in Europe versus North America. Results show that urban greening—and green gentrification specifically—can create ‘compounded environmental racisms’ by worsening racial environmental injustices and further perpetrating green racialized displacement, re‐segregation and exclusion. The latter is produced by the racial inequities embedded in green infrastructure projects and the related unequal access to environmental benefits, affordable housing, political rights and place‐making. Moreover, we find that settler colonial practices combined with persisting exposure to toxins and re‐segregation in the United States together with neocolonial spatial and social practices in Europe shape how racialized community members perceive and interact with new green amenities.
Evidence is growing for the beneficial impacts of natural outdoor environments on health. However, most of the evidence has focused on green spaces and little evidence is available on health benefits ...of blue spaces and about possible mediators and modifiers of such impacts. We investigated the association between natural outdoor environments (separately for green and blue spaces) and health (general and mental) and its possible mediators and modifiers.
Cross-sectional data from adults interviewed in Catalonia (Spain) between 2010 and 2012 as part of the Catalonia Health Survey were used. The collected data included sociodemographic characteristics, self-perceived general health, mental health, physical activity and social support. Indicators of surrounding greenness and access to natural outdoor environments within 300m of the residence and degree of urbanization were derived for residential addresses. Associations were estimated using logistic regression and negative binominal models.
Green spaces were associated with better self-perceived general health and better mental health, independent of degree of urbanization. The associations were more consistent for surrounding greenness than for access to green spaces. The results were consistent for different buffers, and when stratifying for socioeconomic status. Slightly stronger associations were found for women and residents of non-densely populated areas. No association was found between green spaces and social contacts and physical activity. The results for blue spaces were not conclusive.
Green spaces are associated with better general and mental health across strata of urbanization, socioeconomic status, and genders. Mechanisms other than physical activity or social support may explain these associations.
•Little evidence on modificators and mediators of benefits of green and blue spaces•Exposure to green spaces was associated with better general and mental health.•Such benefits were independent of urbanization, gender and socioeconomic status.•Underlying mechanisms were theorized to not be physical activity or social support.•No consistent results were found on blue spaces.
•COVID-9 lockdowns are associated with worsening mental health and well-being.•Exposure to nature might alleviate the negative mental health effects of lockdowns.•In Portugal exposure to public ...natural spaces was related with better mental health.•In Spain, under a stricter lockdown, private greenery was more beneficial.•Safe and controlled opportunities for exposure to nature should be guaranteed.
To control the spread of the SARS-CoV-2 virus, countries around the world implemented lockdowns with varying intensities. Lockdowns, however, have been associated with a deterioration of mental health, including post-traumatic stress symptoms, anger and anxiety. Exposure to nature might reduce stress and provide relaxation opportunities.
Firstly, we aimed to determine which sociodemographic, housing and lockdown-related characteristics were associated with changes in exposure to nature during the COVID-19 lockdown in Portugal and Spain. Secondly, we sought to estimate the associations of these changes with mental health, and test whether these associations differed according to sociodemographic characteristics and between the two countries, which experienced different restrictions and epidemiological situations.
A cross-sectional study was conducted between March 27 and May 6, 2020, using an online questionnaire to measure changes in exposure to nature (including private green space and other greenery, views of nature from home and public natural spaces); sociodemographic, housing and lockdown-related characteristics; stress levels (visual stress scale); psychological distress (General Health Questionnaire − 12 items) and somatization (somatization scale). Adjusted regression models were fitted to estimate associations.
This study included 3157 participants (1638 from Portugal, 1519 from Spain). In Portugal, maintaining/increasing the use of public natural spaces during the lockdown was associated with lower levels of stress (adjusted beta −0.29; 95%CI −0.49, −0.08) and maintaining/increasing the frequency of viewing nature from home was associated with reduced psychological distress (0.27; −0.51, −0.03), somatization (−0.79; −1.39, −0.20), and stress levels (−0.48; −0.74, −0.23). In Spain, maintaining/increasing contact with private green space and greenery was associated with lower stress levels: for contact with indoor plants (−0.52; −0.96, −0.07) and for use of private community green spaces (−0.82; −1.61, −0.03).
Exposure to nature was associated with better mental health outcomes during lockdowns, but the natural features associated with improved mental health differed between the two countries. Nature should be incorporated into urban planning interventions and housing design and exposure to nature should be promoted during lockdowns.
•Biodiversity underpins human health as an essential life-support system.•We present an integrated biodiversity-health framework.•Biodiversity influences human health via four domains of ...pathways.•The four pathway domains are: reducing harm, restoring capacities, building capacities, and causing harm.•Understanding biodiversity-health pathways can inform public health interventions.
Biodiversity is a cornerstone of human health and well-being. However, while evidence of the contributions of nature to human health is rapidly building, research into how biodiversity relates to human health remains limited in important respects. In particular, a better mechanistic understanding of the range of pathways through which biodiversity can influence human health is needed. These pathways relate to both psychological and social processes as well as biophysical processes. Building on evidence from across the natural, social and health sciences, we present a conceptual framework organizing the pathways linking biodiversity to human health. Four domains of pathways—both beneficial as well as harmful—link biodiversity with human health: (i) reducing harm (e.g. provision of medicines, decreasing exposure to air and noise pollution); (ii) restoring capacities (e.g. attention restoration, stress reduction); (iii) building capacities (e.g. promoting physical activity, transcendent experiences); and (iv) causing harm (e.g. dangerous wildlife, zoonotic diseases, allergens). We discuss how to test components of the biodiversity-health framework with available analytical approaches and existing datasets. In a world with accelerating declines in biodiversity, profound land-use change, and an increase in non-communicable and zoonotic diseases globally, greater understanding of these pathways can reinforce biodiversity conservation as a strategy for the promotion of health for both people and nature. We conclude by identifying research avenues and recommendations for policy and practice to foster biodiversity-focused public health actions.
Abstract
Although urban greening is universally recognized as an essential part of sustainable and climate-responsive cities, a growing literature on green gentrification argues that new green ...infrastructure, and greenspace in particular, can contribute to gentrification, thus creating social and racial inequalities in access to the benefits of greenspace and further environmental and climate injustice. In response to limited quantitative evidence documenting the temporal relationship between new greenspaces and gentrification across entire cities, let alone across various international contexts, we employ a spatially weighted Bayesian model to test the green gentrification hypothesis across 28 cities in 9 countries in North America and Europe. Here we show a strong positive and relevant relationship for at least one decade between greening in the 1990s–2000s and gentrification that occurred between 2000–2016 in 17 of the 28 cities. Our results also determine whether greening plays a “lead”, “integrated”, or “subsidiary” role in explaining gentrification.