ArticlePDF AvailableLiterature Review

Fifty Shades of Green: Pathway to Healthy Urban Living

August 2016
Epidemiology 28(1):1

August 2016
28(1):1

DOI:10.1097/EDE.0000000000000549

Authors:

Haneen Khreis

University of Cambridge

Margarita Triguero-Mas

Instituto de Salud Global de Barcelona & BCNUEJ (ICTA-UAB, IMIM)

Mireia Gascon

CREAL Center for Research in Environmental Epidemiology

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Currently half the world population lives in cities, and this proportion is expected to increase rapidly to 70% over the next years. Over the years we have created large, mostly grey cities with many high-rise buildings and little green space. Disease rates tend to be higher in urban areas than in rural areas. More green space in cities could reduce these rates. Here, we describe the importance of green space for health, and make recommendations for further research.Green space has been associated with many beneficial health effects, including reduced all-cause and cardiovascular mortality and improved mental health, possibly through mediators such as reduced air pollution, temperature and stress and increased physical activity, social contacts and restoration.Further studies are needed to strengthen the evidence base and provide further guidelines to transport planners, urban planners and landscape architects. We need more longitudinal studies and intervention studies, further understanding of the contribution of various mechanisms towards health, and more information on susceptible populations and on where, when, how much, and what type of green space is needed. Also needed are standardized methods for green space quality assessments and evaluations of effectiveness of green prescriptions in clinical practice. Many questions are ideally suited for environmental epidemiologists, who should work with other stakeholders to address the right questions and translate knowledge into action.In conclusion, a growing evidence base supports the hypothesis that greener cities are healthier cities.

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Epidemiology Publish Ahead of Print

DOI: 10.1097/EDE.0000000000000549

FIFTY SHADES OF GREEN: PATHWAY TO HEALTHY URBAN LIVING

Mark J Nieuwenhuijsen1,2,3 PhD, Haneen Khreis4 MSc , Margarita Triguero-Mas1,2,3

Msc, Mireia Gascon1,2,3 PhD and Payam Dadvand1,2,3 PhD

1 ISGlobal, Center for Research in Environmental Epidemiology (CREAL), Barcelona

2 Universitat Pompeu Fabra (UPF), Barcelona, Spain

3 Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública

(CIBERESP), Madrid, Spain

4 Institute for Transport Studies, University of Leeds, Leeds

Address for correspondence:

Mark J Nieuwenhuijsen PhD

Center for Research in Environmental Epidemiology (CREAL)

Parc de Recerca Biomèdica de Barcelona - PRBB (office 183.05)

C. Doctor Aiguader, 88, 08003 Barcelona , SPAIN

Tel.: direct (++34) 93 2147337

Email address: MJN: mnieuwenhuijsen@creal.cat

Acknowledgements

This paper was presented as a keynote speech at the 27th ISEE conference in Sao Paulo,

2015 by Mark J Nieuwenhuijsen with input from Haneen Khreis, Margarita Triguero-

Mas, Mireia Gascon and Payam Dadvand. Payam Dadvand is funded by a Ramón y

Cajal fellowship (RYC-2012-10995) awarded by the Spanish Ministry of Economy and

Competitiveness.

The authors declare no conflict of interests

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Abstract

Currently half the world population lives in cities, and this proportion is expected to

increase rapidly to 70% over the next years. Over the years we have created large,

mostly grey cities with many high-rise buildings and little green space. Disease rates

tend to be higher in urban areas than in rural areas. More green space in cities could

reduce these rates. Here, we describe the importance of green space for health, and

make recommendations for further research.

Green space has been associated with many beneficial health effects, including reduced

all-cause and cardiovascular mortality and improved mental health, possibly through

mediators such as reduced air pollution, temperature and stress and increased physical

activity, social contacts and restoration.

Further studies are needed to strengthen the evidence base and provide further

guidelines to transport planners, urban planners and landscape architects. We need more

longitudinal studies and intervention studies, further understanding of the contribution

of various mechanisms towards health, and more information on susceptible populations

and on where, when, how much, and what type of green space is needed. Also needed

are standardized methods for green space quality assessments and evaluations of

effectiveness of green prescriptions in clinical practice. Many questions are ideally

suited for environmental epidemiologists, who should work with other stakeholders to

address the right questions and translate knowledge into action.

In conclusion, a growing evidence base supports the hypothesis that greener cities are

healthier cities.

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Introduction

It is remarkable that when you talk to people about green space they tend to have

positive experiences to tell. They remember their childhood climbing a tree, a long hike

in the forest, a barbeque with friends in the garden, or some time spent with their

beloved in a park (Figure 1). Perhaps this is not so surprising as for tens of thousands of

years humans have lived in forests and savannahs surrounded by nature, and only over

the past few thousand years have they moved into cities, where nature is often less

available. Our bodies and minds may be best adapted to living with nature, a concept

EO Wilson (1) described with the term biophilia: people´s innate affinity for the natural

world.

Currently half the world’s population live in cities, and this proportion is expected to

increase rapidly to 70% over the next 20 to 30 years.(2) This rapid increase is

particularly happening in low and medium income countries; 80 to 90% of people

already live in cities in high income countries.

Cities have long been known to be society’s predominant engine of innovation and

wealth creation, yet they are also its main source of crime, pollution, and disease.(3)

Over the years we have created large, mostly grey cities with many high rise buildings

and little green space. (Shenzhen, China; Beirut, Lebanon; Buenos Aires, Argentina;

Kuwait City, Kuwait; and Athens, Greece are a few examples.) It is therefore not

surprising that only 23% of the residents of Athens are very or rather satisfied with

available green space.(4) The amount of green space available to people in cities also

varies considerably from, for example, 1.9 m2 per person in Buenos Aires, Argentina to

52.0 m2 in Curitiba, Brazil.(5) Rates of diseases such as mental illnesses tend to be higher

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in urban areas compared to rural areas. For example, in a meta-analysis Peen et al (6)

found that the risk of mood disorders was 39% higher in urban areas than rural areas.

People value green space and are increasingly willing to pay for it. Donovan et al (7)

found that house prices in Portland, Oregon, were on average US$8870 higher if there

were street trees and they sold 1.7 days faster. A small 15 meter garden in London sold

recently for 1.2 million pound sterling

This topic area is a rapidly evolving field with a substantial number of studies and

reviews emerging in the past few years, but a broad overview of the current state-of-

research is lacking. We therefore aim to describe the evidence linking green space in

cities to health and to make recommendations for further research. We have three main

premises. The first is that green cities are healthy cities, but that there generally is lack

of sufficient green space in at least parts of many cities. The second is that green space

is beneficial for healthy psychophysiological functioning, health, and wellbeing. The

third is that there are still many important open questions in terms of when, where, or

how much green space is needed and what are the underlying mechanisms of the

relation of green space to health.

Methods

This review is not comprehensive; there have been a number of recent extensive

reviews on this topic (Table 1).(8-22) Instead, we aim to provide a holistic and narrative

overview of the available reviews to highlight the current state of the evidence base,

pointing out key reviews, strength of evidence, and influential studies on the importance

for healthy green urban living.

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In the introduction above we set the context, and in the results section we describe a

conceptual framework and proposed mechanisms, followed by the description of

existing green space indicators, health effects of green space, and the contribution of

these mechanisms. Finally we provide recommendations for further research.

In this review we adopt the United States Environmental Protection Agency definition

of green spaces as “land that is partly or completely covered with grass, trees, shrubs, or

other vegetation,” which can include parks, community gardens, and cemeteries.(23) All

studies we review here define green space consistently with this definition.

Results

Conceptual framework

We use a modified version of the conceptual framework recently proposal by Hartig et

al (11). In this framework, the relationship between contact with the natural environment

and health is mediated through a number of possible mechanisms including air quality,

physical activity, social contacts, stress, and restoration. The mechanisms have a

number of possible modifiers such as distance to green space, accessibility factors,

perceived safety in the green space, societal context, cultural context, gender, age, and

socioeconomic status (Figure 2). Improvement in air quality, increase in social

contacts, physical activity, and a reduction in stress are all well known to be associated

with improved health. Below we briefly describe the possible mechanisms for these

associations and give some key examples.

Green space indicators

Before describing possible mechanisms and health effects of green space, we briefly

discuss the current methods for assessment of green space indicators in epidemiologic

studies. Generally surrounding greenness and/or access to green space are used in

epidemiological studies.(14,18) With surrounding greenness (an indicator of general

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greenness of living environment), a buffer is built around the home or another location

and the percentage of green space or the amount of greenness is estimated within the

buffer using satellite-derived indices such as the Normalized Different Vegetation

Index. For access to green space, the Euclidean distance to a park, or the network

distance to a park based on the closest route using street networks, or the presence of

park within a given area around the home is estimated. At times the estimation is not

only done for the home, but also for work or school and commuting route. Furthermore,

some epidemiologic studies obtain information on the use, perception of, and visual

access to green space by questionnaire. Other epidemiologic studies use tracking

devices and motion sensors such as GPS, accelerometers, and smartphones with

applications for measuring location, ecological momentary assessment, and physical

activity.(14) Finally, some epidemiologic studies perform audits to assess the quality of

the green space.

Possible Mechanisms

Environmental exposures

Tallis et al (24) found that the tree canopy of the urban forest in the Greater London Area

removed between 852 and 2121 tonnes of PM10 annually, which equates to between

0.7% and 1.4% PM10 air-quality improvement. Regional plans to increase tree cover

from the current 20% to 30% are expected to remove 1.1% to 2.6% of PM10 by the year

2050. Dadvand et al (25) found a reduction of around 5 g/m3 in personal exposure to

PM2.5 and NO2 in pregnant women in Barcelona per interquartile range of the

Normalized Difference Vegetation Index (NDVI). The former study is an example of

the possible filtering effect of green space, and the effect is generally fairly small. The

latter shows that the combined effects of filtering and replacement of mobile pollution

sources by green space can be larger.

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Green space also reduces temperature in cities, and therefore reduces the urban heat

island effect. In a meta-analysis, Bowler et al (26) found a 1 degree Celsius reduction in

temperature when comparing temperatures in parks with urban areas.

Physical activity

More than 50 studies have been conducted aiming to relate access to green space to

physical activity levels, but the results have been inconsistent. (8) A recent systematic

review of the association of proximity and density of parks and objectively measured

physical activity in the United States and found that the associations varied, possibly

due to the heterogeneity of exposure measurements. However, there are examples of

beneficial associations, such as a recent large Australian study (N=203,883), which

found that with an increase in the percentage of green space the odds of moderate to

vigorous physical activity increased by up to 30%.(27)

Social contacts and cohesion

The cover of the 20th July 2015 issue of the New Yorker(28) showed people drinking tea

under trees. “Sitting together for tea is what friends do” says Jean-Jacques Sempé, the

designer of the cover, and he goes on to say that “Time spent with friends is one of the

greatest pleasures of my life.” Relatively few studies have evaluated the relationship

between green space and social contacts. Some of the classic studies in the Robert

Taylor Homes, Chicago have shown that apartment greenness and building greenness

improve neighborhood social ties.(29)

Biodiversity

The newly promoted biodiversity hypothesis suggests that reduced contact with nature

may adversely affect the human commensal microbiota and its immunomodulatory

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capacity. Hanski et al (30) found a relationship between generic composition of skin

microbiota and land use type around the home. They also found a reduced level of

allergic disease, mediated through acinetobacter and gammaproteobacteria. However,

very few studies so far have focused on this mechanism.

Biogenics hypothesis

Moore et al (31) recently suggested the “biogenics” hypothesis, suggesting that regular

exposure to low concentrations of mixtures of natural compounds and toxins in natural

environments confers pleiotropic health benefits by inhibiting the activities of

interconnected cell signaling systems, particularly PI3K/Akt/mTORC1. When

overactive, Akt and mTOR (mTORC1) can lead to pathological processes resulting in

cancers, diabetes, inflammation, immunosuppression, and neurodegenerative diseases.

Future evaluation of this mechanism is required.

Restoration and stress reduction

The more consistent and promising pathways are stress reduction and restoration. The

Stress Reduction Theory suggests natural environments promote recovery from stress

and help to lessen states of arousal and negative thoughts through psycho-physiological

pathways. Natural elements with characteristics such as a level of ground surface,

spatial openness, curving sightlines, and the presence of water may induce recovery

from any form of stress, even mild short-term stress, via an unconscious and innate

response.(32) The Attention Restoration Theory suggests that nature can replenish

directed attention fatigue. Natural environments abound with "soft fascinations" that a

person can reflect upon in "effortless attention", such as clouds moving across the sky,

leaves rustling in a breeze or water bubbling over rocks in a stream.(33) For example,

Ulrich (32) found that patients who underwent a gall bladder operation and had a view

from a window with trees recovered faster and used fewer potent analgesics than

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patients with a view of a brick building wall. Ulrich et al(34) also found that subjects

recovered from stress faster, measured in terms of skin conductance and pulse transit

time, when they viewed photos from nature compared to traffic and pedestrian malls. In

subjects who initially underwent a stressful interview, Jiang et al(35) found that the

percentage of tree cover in videos (ranging from 2% to 61%) was directly related in an

exposure response fashion with stress recovery. The Japanese have developed a

practice called ´´Shinrin Yoku´´ or forest bathing to relieve stress.(36)

The more recent use of technology such as electroencephalography, in which

electroencephalography signals are translated and classified in different emotional

states, showed different responses for volunteers walking around in different

neighborhoods (urban shopping streets, green space, and busy commercial districts).(37)

Volunteers showed lower frustration, engagement, and arousal, and higher meditation

when moving into the green space zones. Bratman et al.(38) showed that after a walk in

nature subjects showed reduced rumination, as measured by questionnaire and reduced

blood perfusion in the subgenual prefrontal cortex compared to a walk in an urban area.

Reduced activity in the subgenual prefrontal cortex has been associated with improved

symptoms in people with depression and regulation of cortisol levels, which is related to

reduced stress.

Health effects

Mental health and cognitive function

A recent systematic review found limited evidence for a causal relationship between

surrounding greenness and mental health status in adults, but little or no relationship

with access to green space.(18) Although the review found many associations, the main

limitation was the cross-sectional nature of most of the studies. For example, a recent

cross-sectional study by Triguero-Mas et al(39) found a 10% to 20% reduction in

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perceived risk of poor mental health, perceived depression and/or anxiety, and intake of

tranquilizers or sedatives, antidepressants, and sleeping medications per interquartile

range increase in average Normalized Difference Vegetation Index around the homes,

suggesting that substantial health benefits are possible. Alcock et al(40) used a

longitudinal design by following up the mental health status of people moving house.

They found an improvement of mental health scores for those moving to greener areas,

with effects lasting at least 3 years, and deterioration in mental scores for those moving

to less green areas. Green space may reduce health inequalities emanating from

differences in socioeconomic status. Mitchell et al(41) found a 20% difference in mental

well being when comparing the most and least financially strained among those who

had great difficulty with access to green space, while the difference was only 11.9% for

those with very easy access to green space. Finally, Dadvand et al(42) measured the

cognitive development of children 7 to 10 years old using repeated computer tests over

a year and found a 6% better development of the working memory and superior

working memory among those in the highest tertiles of greenness in school compared to

those in the lowest tertile of greenness.

Mortality

A seminal study on the relationship between green space and all-cause mortality in the

United Kingdom found that all-cause mortality was around 6% lower in the highest

quintile of green space compared to the lowest quintile.(43) Furthermore, the difference

in all-cause and circulatory disease mortality between different socioeconomic classes

was much smaller among those in the highest quintile of green space compared to the

lowest quintile, further suggesting that green space may reduce health inequalities. A

natural experiment reported by Donovan et al(44), in which they evaluated the effect of

the loss of 100 million trees to the emerald ash borer, an invasive forest pest on

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mortality, found that the presence of the borer was associated with 6.8 additional deaths

per 100,000 adults and 16.7 additional cardiovascular deaths per 100,000 adults. In

meta-analyses of green space and mortality, Gascon et al(18) found an 8% reduction in

all-cause mortality and a 4% reduction in cardiovascular mortality when comparing the

highest with the lowest exposure group of green space.

Other outcomes

Other beneficial impacts of access to green space have been reported, such as a

reduction in crime(22) and obesity (8, 17) and an increase in birth weight.(12) But there are

also risks with green space such as physical risks when trees fall on people or property,

the spread of Lyme disease, and an increase in skin cancer, allergies, and asthma.(11,21)

Contribution of mechanisms

Very few studies have evaluated the contribution of the different mediators between

green space and morbidity and mortality. De Vries et al(45) estimated the contribution of

different potential mediators of green space on health (stress, social cohesion, and green

physical activity) to general health, acute complaints, and mental health and found that

stress and social cohesion contributed the most to the outcomes (around 20% to 40%)

while green physical activity contributed less than 10%.

Discussion

The recent surge in studies of green space and health has strengthened the evidence base

considerably. Many of these new and emerging studies have shown evidence of

beneficial associations with health outcomes, but some concerns has been raised about

potential residual confounding by socio-economic status. Green space is valued by

people and they are willing to pay more for having greener residences. There is also

some evidence showing differential access to green spaces among racial and ethnic

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minorities.(46) There may therefore be a relationship between green space and

socioeconomic position (47) making socioeconomic position a potential confounder;

however, the impact of the socioeconomic position on the findings of studies of the

health effects of green spaces depends on local context and the type of health outcome

and can vary from minimal to moderate.48,49 Furthermore, people with poorer mental

health may be more inclined to move to greener areas, but there is little evidence this

happens so far.40

Even though it appears that green space is associated with benefits to mental health,

mortality, and other outcomes, questions remain in terms of where, when, how much,

and what type of green space is required –if causal -- for those benefits, the contribution

of various mechanisms, and the effectiveness of green prescriptions. The epidemiologic

studies so far have used fairly crude green space indicators, which may not be enough to

guide transport and urban planners, landscape architects and policy makers to start

planning or refitting our cities and investing more in green infrastructure. For example,

can we get our ´´dose´´ of green space when we visit a large natural area outside the city

once in a while, or can we get it when commuting to work in our car, or do we need

local parks and trees in our streets? Is blue space as important? So what more is needed,

particularly in urban environments?

Agenda for improved research designs

To date, most epidemiologic studies have been cross-sectional in design and we need

more longitudinal studies and Intervention studies to ensure that access to green space,

or the lack of it, precedes the measured health outcomes. For cost effectiveness, green

space exposure indicators could be assigned to subjects in existing cohort studies that

have good data on individual and area level or individual socioeconomic status

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information and other covariates (14). Pooled analyses that exploit the wealth of data

available within existing cohorts also provide opportunities to strengthen the evidence

base. These pooled cohorts have been used to investigate other exposures such as air

pollution at larger scales than would have been possible if only relying on the individual

cohorts(54)Information on potential mediators would be desirable.

Although easily obtained green space measures such as Normalized Difference

Vegetation Index or percentage green space are attractive, researchers should go beyond

these measures and include more information on type and quality of the green space.

This type of information is critical for urban planning, so must be provided to translate

research results into interventions. Although exposure estimates are traditionally

assigned to the home of study participants, it may be important to assign green space

estimates to commuting routes, as there is evidence to show that only short duration of

green space exposure –such as that obtained during a commute -- may be needed to

obtain beneficial effects. Assigning green space indicators to work or school is also

important as these places are attended during daylight hours and subjects can see green

space. People within a cohort or cohorts who change residence may be an interesting

subgroup to study as their exposure to green space may change, allowing estimates of

longitudinal effects.

Also, cohort studies may provide the opportunity to look at the relation between green

space and health for multiple and new outcomes and to examine the underlying

biological pathways by using -omics technologies that these studies often already

apply.(50) Various studies have shown that green space may be able to reduce health

inequalities and this needs replication and confirmation. Setting up a new cohort for

green space and health research only may be prohibitively expensive, but if new cohorts

are set up for other purposes, green space should be considered as a potential exposure

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of interest from the early stages of design and planning so that the required data will be

available.

In general it appears that there are health benefits associated with an increase in green

space, especially around the home, and even short-term exposure to green space may

offer improvement in acute psychophysiological parameters(14). However, it is still

unclear how much, where, when and what type of green space is needed to improve

and/or sustain long term health benefits. For example, is green space needed around the

home, or around work, or is exposure to green space during commuting sufficient? Is

there an exposure–response relationship, and if so what is the shape and is there some

minimum level? Further work is needed on these questions, using appropriate study

designs in order to inform transport and urban planners, landscape architects and policy

makers.

Quality assessments in future epidemiologic studies are therefore also essential to better

address these questions. Quality characteristics of green spaces such as aesthetics,

biodiversity, walkability, sport and play facilities, safety, and organized social events

have been suggested to affect the use of green spaces for physical activity.(53) Badly

maintained and unsafe parks with few attractions may be a deterrent to park visits. This

deterrence may partly explain the inconsistent evidence for the association of green

space with physical activity as generally the quality aspect of green spaces has not been

considered. Having highly allergenic trees in the street may lead to an increase in

allergies and asthma. A number of GIS-based studies have started to include quality or

perception measures in the research. These have not been widely used in epidemiologic

studies, but are likely to be important. Future studies should include audits to assess the

quality of green space or subjects’ satisfaction with green space.

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Agenda for research topics

Many cities have recently started to introduce or improve green space or green space

programs; such efforts lend themselves to evaluation of effects on health and other

indicators.(51,52) Changes to the urban environment—such as introducing new parks or

upgrading existing ones, greening of vacant lots, and introducing green corridors, urban

gardens or green exercise programs—provide opportunities for evaluation of effects on

health. The main challenges are to find good populations to study before and after the

changes and to find a valid control group as cities change continuously. Improvements

to the urban environment often lead to gentrification with a large influx of wealthier

residents and outgoing of the traditional residents, which makes it difficult to have valid

before and after comparisons. Furthermore, these types of studies lend themselves to

both quantitative and qualitative approaches to evaluation. Collaboration with social

scientists is essential.

Furthermore, there are very few studies on the magnitude of the contribution of various

mechanisms of the benefits of green space (e.g. air quality, physical activity, social

contacts and cohesion, stress and restoration) to health(45) and some of these

mechanisms have been very poorly studied. Foremost among the understudied

mechanisms is the importance of biogenics and biodiversity. More studies on the

contribution of these mechanisms are needed to plan effective interventions in cities.

The problem is often that, in existing epidemiologic studies, either some information on

the mechanisms or on health outcomes exists, but rarely, if ever, information on both.

Therefore, studies on the health benefits of green space rarely comprise complete

information to answer research questions. Some attempts are made with specially

designed studies to evaluate the contribution of the various mechanisms.(14) In the

foreseeable future it is most likely that we can only estimate the contribution of some

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mediators, unless new cohort studies are set up in which they can be incorporated from

the beginning, but as mentioned above, these are expensive.

There is some indication in the literature that some groups of the population may benefit

more than others, such as people with lower social economic positions and women,

including pregnant women, and these results need further confirmation(43, 46, 49). A group

of particular interest may be racial or ethnic minorities moving into cities, for whom

there is little data.

In addition to their ability to improve mental and physical health, green spaces have also

been suggested to have “therapeutic effects” on a range of health problems for people

with diseases such as mental health problems, pulmonary diseases, and Alzheimer’s

disease. Evaluations of these green prescriptions are generally small in size or lacking

entirely. Further work is needed in this area as it is a promising aspect of clinical

practice, but a good evidence base is needed.

Conclusions

Cities can be healthier for people, not by painting trees on walls, but by having a nearby

park, planting trees in the streets, and introducing urban gardens. Urban gardens may

have additional benefits in terms of local food production and economy and, if done at a

sufficiently large scale, can contribute to the sustainability and self-sufficiency of cities.

Many cities need more parks, which can also become part of the identity and attraction

of cities. Think, for example, of the iconic Central Park in New York. Finally, green

roofs may transform the city, not only in terms of resilience but also in terms of visual

attractiveness. More research is needed to tease out the important aspects, but in general

to strengthen the evidence that more green space leads to better health.

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Acknowledgements

This paper was presented as a keynote speech at the 27th ISEE conference in Sao Paulo,

2015 by Mark J Nieuwenhuijsen with input from Haneen Khreis, Margarita Triguero-

Mas, Mireia Gascon and Payam Dadvand (more information is available in the

eAppendix; http://links.lww.com/EDE/B101). Payam Dadvand is funded by a Ramón y

Cajal fellowship (RYC-2012-10995) awarded by the Spanish Ministry of Economy and

Competitiveness.

The authors declare no conflict of interests.

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References

1. Wilson EO. Biophilia. The human bond with other species. Cambridge: Harvard

University Press; 1984.

2. Rydin Y, Bleahu A, Davies M, et al. Shaping cities for health: complexity and the

planning of urban environments in the 21st century. Lancet. 2012;379(9831):2079-108.

3. Bettencourt LMA, Lobo J, Helbing D, et al. Growth, innovation, scaling, and the

pace of life in cities. PNAS. 2007;104:7301–7306.

4. Urban Audit. Survey on perceptions of quality of life in 75 European cities. European

Commission. 2007.

5. Skyscrapercity. http://www.skyscrapercity.com/showthread.php?t=1660203.

Accessed August, 2015

6. Peen J, Schoevers RA, Beekman AT, et al. The current status of urban-rural

differences in psychiatric disorders. Acta Psychiatr Scand. 2010;121:84–93

7. Donovan GH, Butry DT. Trees in the city: Valuing street trees in Portland, Oregon.

Landscape and Urban Planning. 2010;94:77–83.

8. Lachowycz K, Jones AP. Greenspace and obesity: a systematic review of the

evidence. Obesity Reviews. 2011;12(5):e183-e189. doi: 10.1111/j.1467-

789X.2010.00827.x

9. Thornton LE, Pearce JR, Kavanagh AM. Using Geographic Information Systems

(GIS) to assess the role of the built environment in influencing obesity: a glossary. Int J

Behav Nutr Phys Act. 2011;8:71. doi: 10.1186/1479-5868-8-71.

10. Lee AC, Maheswaran R. The health benefits of urban green spaces: a review of the

evidence. J Public Health (Oxf). 2011;33(2):212-22.

11. Hartig T, Mitchell R, de Vries S, et al. Nature and health. Annu Rev Public Health.

2014;35:207-228.

12. Dzhambov AM, Dimitrova DD, Dimitrakova ED. Association between residential

greenness and birth weight:Systematic review and meta-analysis. Urban Forestry &

Urban Greening 2014: 13: 621-629

13. Bancroft C, Joshi S, Rundle A, et al. Association of proximity and density of parks

and objectively measured physical activity in the United States: A systematic review.

Social Science & Medicine. 2015;138:22-30.

14. Nieuwenhuijsen MJ, Kruize H, Gidlow C, et al. Positive health effects of the

natural outdoor environment in typical populations in different regions in Europe

(PHENOTYPE): a study programme protocol. BMJ Open. 2014;4(4):e004951. doi:

10.1136/bmjopen-2014-004951.

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15. Kuo M. How might contact with nature promote human health? Promising

mechanisms and a possible central pathway. Front Psychol. 2015:25;6:1093.

16. Coutts C, Hahn M. Green Infrastructure, Ecosystem Services, and Human Health.

Int J Environ Res Public Health. 2015;12(8):9768-98.

17. James P, Banay RF, Hart JE, et al. A Review of the Health Benefits of Greenness.

Curr Epidemiol Rep. 2015;2:131-142.

18. Gascon M, Triguero-Mas M, Martínez D, et al. Mental Health Benefits of Long-

Term Exposure to Residential Green and Blue Spaces: A Systematic Review. Int J

Environ Res Public Health. 2015;12:4354-4379.

19. Gascon M, Triguero-Mas M, Martínez D, et al. Residential green spaces and

mortality: a systematic review. Environment Int. (unpublished data, 2015)

20. van den Berg M, Wendel-Vos W, van Poppel M, et al. Health Benefits of Green

Spaces in the Living Environment: A Systematic Review of Epidemiological Studies.

Urban Forestry and urban greening. August 2015.

21. Lohmus M and Balbus J. Making green infrastructure healthier infrastructure.

Infection Ecology and Epidemiology 2015, 5: 30082

22. Bogar S and Beyer KM. Green Space, Violence, and Crime: A Systematic Review.

TRAUMA, VIOLENCE, & ABUSE 2015; 1-12

23. USEPA 2015 http://www3.epa.gov/region1/eco/uep/openspace.html Accessed 11

December 2015

24. Tallis M, Taylor G, Sinnett D, et al. Estimating the removal of atmospheric

particulate pollution by the urban tree canopy of London, under current and future

environments. Landscape and Urban Planning. 2011;103:129-138.

25. Dadvand P, de Nazelle A, Triguero-Mas M, et al. Surrounding Greenness and

Exposure to Air Pollution During Pregnancy: An Analysis of Personal Monitoring Data.

Environ Health Perspect. 2012;120(9):1286-90.

26. Bowler D, Buyung-Ali L, Knight T & Pullin AS. 2010. How effective is ‘greening’

of urban areas in reducing human exposure to ground level ozone concentrations, UV

exposure and the ‘urban heat island effect’? CEE review 08-004 (SR41). Environmental

Evidence: www.environmentalevidence.org/SR41.html.

27. Astell-Burt T, Feng X, Kolt GS. Green space is associated with walking and

moderate-to-vigorous physical activity (MVPA) in middle-to-older-aged adults:

findings from 203 883 Australians in the 45 and Up Study. Br J Sport Med.

2014;48(5):404-6.

ACCEPTED

28. The New Yorker, July 20, 2015

29. Kuo FE, Sullivan WC, Coley RL, et al. Fertile Ground for Community: Inner-City

Neighborhood Common Spaces. American Journal of Community Psychology.

1998;26:823-851.

30. Hanski I, von Hertzen L, Fyhrquist N, et al. Environmental biodiversity, human

microbiota, and allergy are interrelated. Proc Natl Acad Sci USA. 2012;109(21):8334-9.

31. Moore MN. Do airborne biogenic chemicals interact with the PI3K/Akt/mTORcell

signalling pathway to benefit human health and wellbeing in rural and coastal

environments?. Environment Res. 2015;140:65–75.

32. Ulrich RS. Views through a Windows may influence recovery from surgery.

Science. 1984;224(4647):420-1.

33. Kaplan R, Kaplan S. The experience of nature: A psychological perspective. New

York: Cambridge University Press; 1989.

34. Ulrich RS, Simons RF, Losito BD, et al. Stress recovery during exposure to natural

and urban environments. Journal of Environmental Psychology. 1991;11:201–230.

35. Jiang B, Chun-Yen Chang C-Y, Sullivan WC. A dose of nature: Tree cover, stress

reduction, and gender differences. Landscape and Urban Planning. 2014;132:26–36.

36. Tsunetsugu Y, Park BJ,Miyazaki Y. Trends in research related to "Shinrin-yoku"

(taking in the forest atmosphere or forest bathing) in Japan. Environ Health Prev

Med. 2010;15(1):27-37.

37. Aspinall P, Mavros P, Coyne R, et al. The urban brain: analysing outdoor physical

activity with mobile EEG. Br J Sports Med. 2015;49(4):272-6.

38. Bratman GN, Hamilton JP, Hahn KS, et al. Nature experience reduces rumination

and subgenual prefrontal cortex activation. Proc Natl Acad Sci

USA. 2015;112(28):8567-72.

39. Triguero-Mas M, Dadvand P, Cirach M, et al. Natural outdoor environments and

mental and physical health: Relationships and mechanisms. Environ Int. 2015;77:35-41.

40. Alcock I, White MP, Wheeler BW, et al. Longitudinal effects on mental health of

moving to greener and less green urban areas. Environ Sci Technol. 2014;48(2):1247-

55.

41. Mitchell RJ, Richardson EA, Shortt NK, et al. Neighborhood Environments and

Socioeconomic Inequalities in Mental Well-Being. Am J Prev Med. 2015;49(1):80-4.

42. Dadvand P, Nieuwenhuijsen MJ, Esnaola M, et al. Green spaces and cognitive

development in primary schoolchildren. Proc Natl Acad Sci. 2015;112(26):7937-42.

ACCEPTED

43. Mitchell R, Popham F. Effect of exposure to natural environment on health

inequalities: An observational population study. The Lancet. 2008;372(9650):1655–

1660.

44. Donovan GH, Butry DT, Michael YL, et al. The relationship between trees and

human health: evidence from the spread of the emerald ash borer. Am J Prev Med.

2013;44(2):139-45.

45. de Vries S, van Dillen SME, Groenewegen PP, et al. Streetscape greenery and

health: Stress, social cohesion and physical activity as mediators. Social Science &

Medicine. 2013;94:26-33.

46. Dai D. Racial/ethnic and socioeconomic disparities in urban green space

accessibility: Where to intervene? Landscape and Urban Planning 2011: 102: 234–244

47. Wolch JR, Byrne J and Newell JP. Urban green space, public health, and

environmental justice: The challenge of making cities ‘just green enough’ Landscape

and Urban Planning 2014: 125: 234-244

48. Dadvand P, Nieuwenhuijsen MJ, Esnaola M, Forns J, Basagaña X, Alvarez-Pedrerol

M, Rivas I, López-Vicente M, De Castro Pascual M, Su J, Jerrett M, Querol X, Sunyer

J. Green spaces and cognitive development in primary schoolchildren. Proceedings of

the National Academy of Sciences of the United States of America. 2015; 112(26):

7937–7942.

49. Dadvand P, Nazelle A, Figueras F, Basagaña X, Su J, Amoly E, Jerrett M, Vrijheid

M; Sunyer J, Nieuwenhuijsen MJ. Green space, health inequality and pregnancy.

Environment International. 2012; 40:110-5.

50. Vrijheid M, Slama R, Robinson O, et al. The Human Early-Life Exposome

(HELIX): Project Rationale and Design. Environ Health Perspect. 2014;122(6):535-44.

51. Branas CC, Cheney RA, MacDonald JM, et al. A Difference-in-Differences

Analysis of Health, Safety, and Greening Vacant Urban Space. Am J Epidemiol.

2011;174:1296–1306.

52. Hunter RF, Christian H, Veitch J, et al. The impact of interventions to promote

physical activity in urban green space: A systematic review and recommendations for

future research. Social Science & Medicine. 2015;124:246-256.

53. McCormack GR, Rock M, Toohey AM, et al. Characteristics of urban parks

associated with park use and physical activity: A review of qualitative research. Health

Place. 2010;16(4):712-726.

54. Pedersen M, Giorgis-Allemand L, Bernard C, Aguilera I, Nybo Andersen AM,

Ballester F, Beelen RMJ, Chatzi L, Cirach M, Danileviciute A, Dedele A, van Eijsden

M, Estarlich M, Fernández-Somoano A, Fernández MF, Forastiere F, Gehring U,

Grazuleviciene R, Gruzieva O, Heude B, Hoek G, de Hoogh K, van den Hooven EH,

Håberg SE, Jaddoe V, Klümper C, Korek M, Krämer U, Lerchundi A, Lepeule J,

Nafstad P, Nystad W, Patelarou E, Porta D, Postma D, Raaschou-Nielsen O, Rudnai P,

ACCEPTED

Sunyer J, Stephanou E, Sørensen M, Thiering E, Tuffnell D, Varró MJ, Vrijkotte TJM,

Wijga A, Wilhelm M, Wright J, NIEUWENHUIJSEN MJ, Pershagen G, Brunekreef B,

Kogevinas M, Slama R. Ambient Air Pollution and Low Birth Weight: A European

Cohort Study (ESCAPE). Lancet Respir Med. 2013;1(9):695-704

ACCEPTED

Figure 1 Parks and trees in streets are essential for human health and well being

Figure 2 Conceptual framework of green space, mechanisms, health effects and current

status of evidence

Table 1 Summary of recent reviews relevant to studying the relationship between green

space and health.

ACCEPTED

Study

Type of Review

Exposures and

outcomes

Key results and

conclusions

Lachowycz K, Jones AP

2011 (8)

Systematic review

Physical activity

and weight status

The majority (68%) of

papers found a positive

or weak association

between greenspace and

obesity-related health

indicators, but findings

were inconsistent and

mixed across studies.

Thornton et al 2011 (9)

Review, glossary

GIS terminology

Key concepts

Lee AC, Maheswaran

2011 (10)

Review

A range of health

outcomes,

including

physical and

mental health

There is weak evidence

for the links between

physical health, mental

health and well-being,

and urban green space.

Hartig et al 2014 (11)

Review, systematic

search for reviews

A range of

different health

outcomes

A conceptual

framework

Dzhambov et al 2014 (12)

Systematic review

and meta-analysis

Birth weight

Neighbourhood

greenness within 100-m

buffer was weakly and

positively associated

with birth weight.

Bancroft et al 2015 (12)

Systematic review

Parks and

objectively

measured

physical activity

in the US

The association between

access to parks and

physical

activity varied between

studies, possibly due to

heterogeneity of

exposure measurement.

Nieuwenhuijsen et al

2014 (13)

Review and Study

protocol

A range of

different health

outcomes

Positive associations

with health of green

space have

been observed on

longevity,

ACCEPTED

cardiovascular

diseases, people’s self-

reported general

health, mental health,

sleep patterns,

recovery from illness,

social health

aspects, and birth

outcomes.

Kuo 2015 (14)

Review and

compilation of

possible pathways

A range of

possible

pathways

21 pathways of health

effects of green spaces

were identified

Coutts C, Hahn M 2015

(15)

Survey of the

literature

Health outcomes

including

physical activity

and mental health

in the light of

ecosystems

services

(Co) benefits of

ecosystems services on

various health outcomes

James et al 2015 (16)

Review

Mental health

outcomes,

cardiovascular

disease, physical

activity, weight,

and mortality and

birth weight

Greenness is protective

against adverse

mental health outcomes,

cardiovascular disease,

and mortality.

Intermediate evidence

for physical activity and

weight. Consistent

evidence that greenness

exposure during

pregnancy is positively

associated

with birth weight,

though findings for

other birth outcomes

are less conclusive.

Gascon et al 2015 (17)

Systematic review

Objectively

measured green

space and mental

health

Limited evidence for a

causal relationship

between surrounding

greenness and mental

ACCEPTED

health in adults,

whereas the evidence

was inadequate in

children.

Gascon et al 2015 (18)

Systematic review

and meta-analysis

All-cause

mortality,

cardiovascular

mortality and

lung cancer

The majority of studies

show

lower risk of

cardiovascular disease

mortality in areas with

higher residential

greenness.

Evidence of lower all-

cause mortality is more

limited, and no

beneficial association of

residential greenness

with lung cancer

mortality are observed.

van den Berg et al 2015

(19)

Systematic reviews

A number of

health outcomes

including mental

health, perceived

health, and

mortality

Strong evidence for

positive associations

between the

quantity of green space

(objectively measured

around the residence)

and perceived mental

health

and all-cause mortality,

and moderate evidence

for an association with

perceived general health

Lohmus and Balbus 2015

(21)

Review

Harmful effects

of green space on

health

Possible increased risk

for infectious disease

and allergies

Bogar S and Beyer KM

2015 (22)

Systematic review

Crime and

violence

Evidence supports the

positive associations of

green space with

violence and crime,

indicating great

potential for green

space to shape health-

ACCEPTED

promoting

environments.

ACCEPTED

Figure 1.

ACCEPTED

Figure 2.

ACCEPTED

Figures paper 2

ACCEPTED

Nieuwenhuijsen et al 2017 Fifty Shades of Green Pathway to Healthy Urban.11

Data

December 2016

Mark J Nieuwenhuijsen · Haneen Khreis · Margarita Triguero-Mas · Mireia Gascon · Payam Dadvand

Air pollution, greenspace exposure and risk of Parkinson's disease: a prospective study of 441,462 participants

Article

Full-text available

Jun 2024
J NEUROL

Background The current understandings of the relationship between air pollution (AP), greenspace exposure and Parkinson's Disease (PD) remain inconclusive. Methods We engaged 441,462 participants from the UK Biobank who were not diagnosed with PD. Utilizing Cox proportional hazard regression model, relationships between AP [nitrogen dioxide (NO2), and nitrogen oxides (NOX), particulate matter < 2.5 μm in aerodynamic diameter(PM2.5), coarse particulate matter between 2.5 μm and 10 μm in aerodynamic diameter(PM2.5–10), particulate matter < 10 μm in aerodynamic diameter(PM10)], greenspace exposure, and PD risk were determined independently. Our analyses comprised three models, adjusted for covariates, and affirmed through six sensitivity analyses to bolster the robustness of our findings. Moreover, mediation analysis was deployed to discern the mediating effect of AP between greenspaces and PD. Results During a median follow-up of 12.23 years (5,574,293 person-years), there were 3,293 PD events. Each interquartile (IQR) increment in NO2 and PM10 concentrations were associated with 10% and 8% increase in PD onset risk, while the increases in NOX, PM2.5 and PM2.5–10 were not associated with PD risk. Additionally, greenspace may safeguard by reducing NO2 and PM10 levels, with the effect mediated by NO2 and PM10 in greenspace—PD relationship. Conclusion Our findings indicate that an IQR increase in ambient NO2 and PM10 concentrations was associated with risk of PD development, while other pollutants (NOX, PM2.5 and PM2.5–10) were not associated with PD risk. Firstly, we find that augmented exposure to greenspace was associated with the lower PD risk by reducing NO2 and PM10 levels.

MIESTO APLINKOS ŽALUMA IR STRESAS: TEIGIAMOS ASOCIACIJOS

Article

Jun 2024

Nustatytas teigiamas gyvenamosios aplinkos žalumos poveikis fizinei ir psichinei sveikatai. Didesnė žaluma susijusi su mažesniu triukšmu ir oro tarša, ji gali skatinti fizinį aktyvumą, kuris lemia geresnę tiek fizinę psichologinę būklę. Tikslas – apžvelgti ir įvertinti asociacijas tarp miesto aplinkos žalumos ir streso. Medžiaga ir metodai. Apžvelgėme mokslinius tyrimus, kurie paaiškina miesto aplinkos žalumos ir streso rodiklių, tokių kaip kortizolio koncentracija kraujyje, arterinio kraujo spaudimo, širdies ritmo sąveikas. Rezultatai. Analizės rezultatai parodė, kad pagrindiniai streso vertinimo rodikliai yra kortizolio, kraujospūdžio, širdies ritmo variabilumo, kvėpavimo dažnio bei raumenų įtampos pokyčiai. Tyrimai rodo, kad miesto vietovėse, kuriose yra daugiau žaliųjų plotų, žmonės patiria mažesnį streso lygį. Natūralios gamtos vaizdai turi teigiamos įtakos psichologinei būklei, mažina nuovargį, gerina atsigavimą po įtampos. Išvada. Gyvenamosios aplinkos žaluma turi teigiamos įtakos fiziologiniams rodikliams, susijusiems su stresu.

Introducing a Scale for Measuring Attachment to Urban Green

Article

Full-text available

Jun 2024

Urban green contributes to enhanced well-being and overall quality of life in urban populations. The concept of place attachment provides an established avenue for exploring the intricate connections between urban environments and personal experiences. Building on the notion of place attachment, we investigated the perceptions of horizontal and vertical urban green by introducing a novel Urban Green Attachment (UGA) scale. A cross-sectional study using an online survey in German, measuring emotional, cognitive, and behavioral relations to urban vegetation, was conducted among 164 adult inhabitants of the Volkert quarter in Vienna, Austria. Using principal component analysis, we found that the UGA scale was a reliable measure of attachment to urban green, with ten items within the "attachment" factor. Study participants highly valued vertical green, but did not differentiate their attachment to it from horizontal greenery within the specific local context and by design of the measures we used. Thus, further studies and ethnographic investigations, preferentially accompanied by methods such as walking interviews, are needed to test the scale for other populations and settings. The UGA scale emerges as a valuable tool for advancing understanding in this critical area, given the current climate change-driven transformations of cities, building on the creation of green infrastructure.

The potential of urban trees to reduce heat-related mortality in London

Article

Full-text available

Apr 2024
ENVIRON RES LETT

Increasing temperatures and more frequent heatwave events pose threats to population health, particularly in urban environments due to the urban heat island (UHI) effect. Greening, in particular planting trees, is widely discussed as a means of reducing heat exposure and associated mortality in cities. This study aims to use data from personal weather stations (PWS) across the Greater London Authority to understand how urban temperatures vary according to tree canopy coverage and estimate the heat-health impacts of London’s urban trees. Data from Netatmo PWS from 2015–2022 were cleaned, combined with official Met Office temperatures, and spatially linked to tree canopy coverage and built environment data. A generalized additive model was used to predict daily average urban temperatures under different tree canopy coverage scenarios for historical and projected future summers, and subsequent health impacts estimated. Results show areas of London with higher canopy coverage have lower urban temperatures, with average maximum daytime temperatures 0.8 °C and minimum temperatures 2.0 °C lower in the top decile versus bottom decile canopy coverage during the 2022 heatwaves. We estimate that London’s urban forest helped avoid 153 heat attributable deaths from 2015–2022 (including 16 excess deaths during the 2022 heatwaves), representing around 16% of UHI-related mortality. Increasing tree coverage 10% in-line with the London strategy would have reduced UHI-related mortality by a further 10%, while a maximal tree coverage would have reduced it 55%. By 2061–2080, under RCP8.5, we estimate that London’s current tree planting strategy can help avoid an additional 23 heat-attributable deaths a year, with maximal coverage increasing this to 131. Substantial benefits would also be seen for carbon storage and sequestration. Results of this study support increasing urban tree coverage as part of a wider public health effort to mitigate high urban temperatures.

How do contextual factors mediate and moderate the association between green infrastructure and respiratory health? A systematic review and meta-analysis

Article

May 2024

Does the morphology of residential greenspaces contribute to the development of a cardiovascular-healthy city?

Article

May 2024
ENVIRON RES

Association between residential greenness and incident delirium: A prospective cohort study in the UK Biobank

Article

May 2024
SCI TOTAL ENVIRON

Index Air Quality Monitoring for Light and Active Mobility

Article

Full-text available

May 2024
SENSORS-BASEL

Light and active mobility, as well as multimodal mobility, could significantly contribute to decarbonization. Air quality is a key parameter to monitor the environment in terms of health and leisure benefits. In a possible scenario, wearables and recharge stations could supply information about a distributed monitoring system of air quality. The availability of low-power, smart, low-cost, compact embedded systems, such as Arduino Nicla Sense ME, based on BME688 by Bosch, Reutlingen, Germany, and powered by suitable software tools, can provide the hardware to be easily integrated into wearables as well as in solar-powered EVSE (Electric Vehicle Supply Equipment) for scooters and e-bikes. In this way, each e-vehicle, bike, or EVSE can contribute to a distributed monitoring network providing real-time information about micro-climate and pollution. This work experimentally investigates the capability of the BME688 environmental sensor to provide useful and detailed information about air quality. Initial experimental results from measurements in non-controlled and controlled environments show that BME688 is suited to detect the human-perceived air quality. CO2 readout can also be significant for other gas (e.g., CO), while IAQ (Index for Air Quality, from 0 to 500) is heavily affected by relative humidity, and its significance below 250 is quite low for an outdoor uncontrolled environment.

A cohort study of the multipollutant effects of PM2.5, NO2, and O3 on C-reactive protein levels during pregnancy

Article

Full-text available

May 2024

Background PM 2.5, NO 2 , and O 3 contribute to the development of adverse pregnancy complications. While studies have investigated the independent effects of these exposures, literature on their combined effects is limited. Our objective was to study the multipollutant effects of PM 2.5 , NO 2 , and O 3 on maternal systemic C-reactive protein (CRP) levels. Methods We used data from 1170 pregnant women enrolled in the Maternal-Infant Research on Environmental Chemicals Study (MIREC) study in Canada. Air pollution exposures were assigned to each participant based on residential location. CRP was measured in third-trimester blood samples. We fit multipollutant linear regression models and evaluated the effects of air pollutant mixtures (14-day averages) using repeated-holdout Weighted Quantile Sum (WQS) regression and by calculating the Air Quality Health Index (AQHI). Results In multipollutant models adjusting for NO 2, O 3 , and green space, each interquartile range (IQR) increase in 14-day average PM 2.5 (IQR: 6.9 µg/m ³ ) was associated with 27.1% (95% confidence interval [CI] = 6.2, 50.7) higher CRP. In air pollution mixture models adjusting for green space, each IQR increase in AQHI was associated with 37.7% (95% CI = 13.9, 66.5) higher CRP; and an IQR increase in the WQS index was associated with 78.6% (95% CI = 29.7, 146.0) higher CRP. Conclusion PM 2.5 has the strongest relationship of the individual pollutants examined with maternal blood CRP concentrations. Mixtures incorporating all three pollutants, assessed using the AQHI and WQS index, showed stronger relationships with CRP compared with individual pollutants and illustrate the importance of conducting multipollutant analyses.

اولویت‌بندی شاخص‌های زیست‌پذیری مبتنی بر مؤلفه‌های محیط زیستی تأثیرگذار در سکونت شهروندان (مطالعه موردی: شهر مشهد)

Article

Mar 2023

با رشد سریع شهرنشینی و تمایلات به زندگی در شهرها و همچنین ازدحام بیش‌ازحد شهرها، گذران اوقات فراغت و تعاملات شهروندان با فضاهای باز و سبز عمومی بیش‌ازپیش اهمیت یافته است و ازآنجایی‌که تعامل با فضای سبز و محیط اطراف پیرامون نقش مهمی در زیست پذیری جوامع محلی دارد، این پژوهش در نظر دارد تا با تحلیلی تطبیقی تأثیر مؤلفه‌های زیست‌محیطی بر روی زیست پذیری به اولویت‌بندی شاخص‌ها در محلات امامیه و استاد یوسفی شهر مشهد بپردازد. روش پژوهش شامل دو بخش اسنادی و پیمایشی است و حجم نمونه پرسشنامه از طریق محاسبه با روش کوکران برابر با 384 نفر و روش نمونه‌گیری تصادفی تکمیل‌شده است. روش تجزیه‌وتحلیل داده‌ها به دو صورت کمی و کیفی که درروش کمی از روش معادلات ساختاری در نرم‌افزار SPSS و SMART-PLS و تحلیل کیفی بر اساس تکمیل و تحلیل چک‌لیست کنترلی پرشده توسط ناظر تعلیم‌یافته و نقشه‌های تراکمی تطبیقی بین محلات مورد مقایسه مطالعه گرفته است. نتایج حاصل از این پژوهش حکایت از آن دارد در میان دو نمونه موردمطالعه مؤلفه‌های زیست‌محیطی در زیست پذیری تفاوت معناداری ندارد و ازنظر اولویت‌بندی، مؤلفه پایداری اکولوژیکی به دلیل دارا بودن پارک‌های بزرگ‌مقیاس در محله و اطراف محله بیشترین امتیاز را به خود اختصاص داده است (76/4 امتیاز) و بعدازآن به ترتیب مؤلفه‌های بهداشت و پاکیزگی (32/3 امتیاز)، آلودگی آب‌وهوا (02/3 امتیاز)، آسایش اقلیمی (77/2 امتیاز) و آلودگی صوتی (14/1 امتیاز) اولویت‌های بعدی را به خود اختصاص داده است. نوآوری پژوهش حاضر ازآن‌جهت می‌باشد که تمرکز آن بر روی بعد محیط زیستی به‌عنوان یکی از ابعاد مهم زیست پذیری بوده و در کنار آن سایر ابعاد زیست پذیری نیز موردتوجه پژوهشگران قرارگرفته‌اند.

Fertile Ground for Community: Inner‐City Neighborhood Common Spaces

Article

Full-text available

Dec 1998
AM J COMMUN PSYCHOL

Research suggests that the formation of neighborhood social ties (NSTs) may substantially depend on the informal social contact which occurs in neighborhood common spaces, and that in inner‐city neighborhoods where common spaces are often barren no‐man's lands, the presence of trees and grass supports common space use and informal social contact among neighbors. We found that for 145 urban public housing residents randomly assigned to 18 architecturally identical buildings, levels of vegetation in common spaces predict both use of common spaces and NSTs; further, use of common spaces mediated the relationship between vegetation and NSTS. In addition, vegetation and NSTs were significantly related to residents' senses of safety and adjustment. These findings suggest that the use and characteristics of common spaces may play a vital role in the natural growth of community, and that improving common spaces may be an especially productive focus for community organizing efforts in inner‐city neighborhoods.

How effective is ‘greening’ of urban areas in reducing human exposure to ground-level ozone concentrations, UV exposure and the ‘urban heat island effect’? A protocol to update a systematic review

Article

Full-text available

Dec 2016

Background The impact of climate change on public health may occur through a number of main pathways including increased temperature, ground-level ozone levels and ultra-violet radiation, which have a range of consequences for human health. One strategy for adaptation to the predicted effects of climate change on health that has been proposed, is to ‘green’ urban areas, essentially by increasing the abundance and cover of vegetation. This protocol is for an update of a systematic review which aimed to address the question: How effective is ‘greening’ of urban areas in reducing human exposure to ground-level ozone concentrations, UV exposure and the ‘urban heat island effect’? MethodsA sensitive search of multiple databases and relevant journals for relevant published articles will be conducted. A search for relevant unpublished articles will be undertaken through an internet search and of websites of relevant organisations. Inclusion criteria will be applied at title, abstract and full-text. Repeatability checks of this screening process will be undertaken. Articles included at full-text will be critically appraised using a standardised checklist. A repeatability check will be made of this process. Pre-defined data items will be extracted from included articles. If appropriate, quantitative synthesis will be undertaken through meta-analysis and/or a narrative synthesis will be undertaken.

Urban green space, public health, and environmental justice: The challenge of making cities `just green enough'

Article

Full-text available

May 2014
LANDSCAPE URBAN PLAN

Making green infrastructure healthier infrastructure

Article

Full-text available

Nov 2015

Increasing urban green and blue structure is often pointed out to be critical for sustainable development and climate change adaptation, which has led to the rapid expansion of greening activities in cities throughout the world. This process is likely to have a direct impact on the citizens' quality of life and public health. However, alongside numerous benefits, green and blue infrastructure also has the potential to create unexpected, undesirable, side-effects for health. This paper considers several potential harmful public health effects that might result from increased urban biodiversity, urban bodies of water, and urban tree cover projects. It does so with the intent of improving awareness and motivating preventive measures when designing and initiating such projects. Although biodiversity has been found to be associated with physiological benefits for humans in several studies, efforts to increase the biodiversity of urban environments may also promote the introduction and survival of vector or host organisms for infectious pathogens with resulting spread of a variety of diseases. In addition, more green connectivity in urban areas may potentiate the role of rats and ticks in the spread of infectious diseases. Bodies of water and wetlands play a crucial role in the urban climate adaptation and mitigation process. However, they also provide habitats for mosquitoes and toxic algal blooms. Finally, increasing urban green space may also adversely affect citizens allergic to pollen. Increased awareness of the potential hazards of urban green and blue infrastructure should not be a reason to stop or scale back projects. Instead, incorporating public health awareness and interventions into urban planning at the earliest stages can help insure that green and blue infrastructure achieves full potential for health promotion.

How might contact with nature promote human health? Promising mechanisms and a possible central pathway

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Full-text available

Aug 2015

Ming Kuo

How might contact with nature promote human health? Myriad studies have linked the two; at this time the task of identifying the mechanisms underlying this link is paramount. This article offers: (1) a compilation of plausible pathways between nature and health; (2) criteria for identifying a possible central pathway; and (3) one promising candidate for a central pathway. The 21 pathways identified here include environmental factors, physiological and psychological states, and behaviors or conditions, each of which has been empirically tied to nature and has implications for specific physical and mental health outcomes. While each is likely to contribute to nature’s impacts on health to some degree and under some circumstances, this paper explores the possibility of a central pathway by proposing criteria for identifying such a pathway and illustrating their use. A particular pathway is more likely to be central if it can account for the size of nature’s impacts on health, account for nature’s specific health outcomes, and subsume other pathways. By these criteria, enhanced immune functioning emerges as one promising candidate for a central pathway between nature and health. There may be others.

Green Infrastructure, Ecosystem Services, and Human Health

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Full-text available

Aug 2015
Int J Environ Res Publ Health

Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture-in the form of a primer-of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.

GREEN SPACE, HEALTH INEQUALITY, AND PREGNANCY

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