The association between green space and cause-specific mortality in urban New Zealand: an ecological analysis of green space utility

<b>Background:</b> There is mounting international evidence that exposure to green environments is associated with health benefits, including lower mortality rates. Consequently, it has been suggested that the uneven distribution of such environments may contribute to health inequalities. Possible causative mechanisms behind the green space and health relationship include the provision of physical activity opportunities, facilitation of social contact and the restorative effects of nature. In the New Zealand context we investigated whether there was a socioeconomic gradient in green space exposure and whether green space exposure was associated with cause-specific mortality (cardiovascular disease and lung cancer). We subsequently asked what is the mechanism(s) by which green space availability may influence mortality outcomes, by contrasting health associations for different types of green space. <b>Methods:</b> This was an observational study on a population of 1,546,405 living in 1009 small urban areas in New Zealand. A neighbourhood-level classification was developed to distinguish between usable (i.e., visitable) and non-usable green space (i.e., visible but not visitable) in the urban areas. Negative binomial regression models were fitted to examine the association between quartiles of area-level green space availability and risk of mortality from cardiovascular disease (n = 9,484; 1996 - 2005) and from lung cancer (n = 2,603; 1996 - 2005), after control for age, sex, socio-economic deprivation, smoking, air pollution and population density. <b>Results:</b> Deprived neighbourhoods were relatively disadvantaged in total green space availability (11% less total green space for a one standard deviation increase in NZDep2001 deprivation score, p < 0.001), but had marginally more usable green space (2% more for a one standard deviation increase in deprivation score, p = 0.002). No significant associations between usable or total green space and mortality were observed after adjustment for confounders. <b>Conclusion</b> Contrary to expectations we found no evidence that green space influenced cardiovascular disease mortality in New Zealand, suggesting that green space and health relationships may vary according to national, societal or environmental context. Hence we were unable to infer the mechanism in the relationship. Our inability to adjust for individual-level factors with a significant influence on cardiovascular disease and lung cancer mortality risk (e.g., diet and alcohol consumption) will have limited the ability of the analyses to detect green space effects, if present. Additionally, green space variation may have lesser relevance for health in New Zealand because green space is generally more abundant and there is less social and spatial variation in its availability than found in other contexts

Is level of neighbourhood green space associated with physical activity in green space?

Background There is accumulating evidence that greater availability of green space in a neighbourhood is associated with health benefits for the local population. One mechanism proposed for this association is that green space provides a venue for, and therefore encourages, physical activity. It has also been suggested that socio-economic health inequalities may be narrower in greener areas because of the equalised opportunity for physical activity green spaces provide. However, research exploring associations between the availability of green space and physical activity has produced mixed results. Limits to the assessment of the type and amount of physical activity which occurs specifically in green space may account for these mixed findings. This observational study was therefore concerned with the extent to which green space is a venue for physical activity and whether this could account for narrower socio-economic health inequalities in greener neighbourhoods.<p></p> Method Secondary analysis of cross sectional data on 3679 adults (16+) living in urban areas across Scotland matched with a neighbourhood level measure of green space availability. Associations between green space availability and both total physical activity, and activity specifically within green space, were explored using logistic regression models. Interactions between socio-economic position and physical activity were assessed. All models adjusted for age, sex and household income.<p></p> Results The availability of green space in a neighbourhood was not associated with total physical activity or that specifically in green space. There was no evidence that income-related inequalities in physical activity within green space were narrower in greener areas of Scotland.<p></p> Conclusion Physical activity may not be the main mechanism explaining the association between green space and health in Scotland. The direct effect of perceiving a natural environment on physiological and psychological health may offer an alternative explanation.<p></p&gt

Is green space in the living environment associated with people's feelings of social safety?

Abstract. The authors investigate whether the percentage of green space in people's living environ- ment affects their feelings of social safety positively or negatively. More specifically they investigate the extent to which this relationship varies between urban and rural areas, between groups in the community that can be identified as more or less vulnerable, and the extent to which different types of green space exert different influences. The study includes 83736 Dutch citizens who were interviewed about their feelings of social safety. The percentage of green space in the living environment of each respondent was calculated, and data analysed by use of a three-level latent variable model, controlled for individual and environmental background characteristics. The analyses suggest that more green space in people's living environment is associated with enhanced feelings of social safetyöexcept in very strongly urban areas, where enclosed green spaces are associated with reduced feelings of social safety. Contrary to the common image of green space as a dangerous hiding place for criminal activity which causes feelings of insecurity, the results suggest that green space generally enhances feelings of social safety. The results also suggest, however, that green space in the most urban areas is a matter of concern with respect to social safety.

Green space and child weight status : does outcome measurement matter? Evidence from an Australian longitudinal study

Taren Sanders is supported by an Australian Postgraduate Award. Thomas Astell-Burt is supported by a Fellowship with the National Heart Foundation of Australia.Objective. To examine whether neighbourhood green space is beneficially associated with (i) waist circumference (WC) and (ii) waist-to-height ratio (WtHR) across childhood. Methods. Gender-stratified multilevel linear regressions were used to examine associations between green space and objective measures of weight status in the Longitudinal Study of Australian Children, a nationally representative source of data on 4,423 children aged 6 y to 13 y. WC and WtHR were measured objectively. Percentage green space within the local area of residence was calculated. Effect modification by age was explored, adjusting for socioeconomic confounding. Results. Compared to peers with 0-5% green space locally, boys and girls with >40% green space tended to have lower WC (βboys -1.15, 95% CI -2.44, 0.14; βgirls -0.21, 95% CI -1.47, 1.05) and WtHR (βboys -0.82, 95% CI -1.65, 0.01; βgirls -0.32, 95% CI -1.13, 0.49). Associations among boys were contingent upon age (p valuesage green space40% green space at 73.85 cm and 45.75% compared to those with 0-5% green space at 75.18 cm and 46.62%, respectively. Conclusions. Greener neighbourhoods appear beneficial to alternative child weight status measures, particularly among boys.Publisher PDFPeer reviewe

Natural environments and suicide mortality in the Netherlands: a cross-sectional, ecological study

Background: Natural outdoor environments, such as green spaces (ie, grass, forests, or parks), blue spaces (ie, visible bodies of fresh or salt water), and coastal proximity, have been increasingly shown to promote mental health. However, little is known about how and the extent to which these natural environments are associated with suicide mortality. Our aim was to investigate whether the availability of green space and blue space within people's living environments and living next to the coast are protective against suicide mortality. Methods: In this cross-sectional, ecological study, we analysed officially confirmed deaths by suicide between 2005 and 2014 per municipality in the Netherlands. We calculated indexes to measure the proportion of green space and blue space per municipality and the coastal proximity of each municipality using a geographical information system. We fitted Bayesian hierarchical Poisson regressions to assess associations between suicide risk, green space, blue space, and coastal proximity, adjusted for risk and protective factors. Findings: Municipalities with a large proportion of green space (relative risk 0·879, 95% credibility interval 0·779–0·991) or a moderate proportion of green space (0·919, 0·846–0·998) showed a reduced suicide risk compared with municipalities with less green space. Green space did not differ according to urbanicity in relation to suicide. Neither blue space nor coastal proximity was associated with suicide risk. The geographical variation in the residual relative suicide risk was substantial and the south of the Netherlands was at high risk. Interpretation: Our findings support the notion that exposure to natural environments, particularly to greenery, might have a role in reducing suicide mortality. If confirmed by future studies on an individual level, the consideration of environmental exposures might enrich suicide prevention programmes

Multi-stakeholder involvement and urban green space performance

This study aimed to identify the main factors influencing urban green space performance. Therefore, a conceptual framework on the relations of multi-stakeholder involvement (MSI) and the performance was conducted by a mixed-method approach. The study covered all urban green space projects (UGSPs) published in international journals as its population which were obtained from three main databases: ISI Web of Knowledge, Scopus and Picarta. Using a few combinations of keywords, 29 relevant journals were identified, which included 42 UGSPs as the main units of analysis in this study. A content analysis was used to determine the contribution of MSI to the performance of urban green space. The main internal (state, private, society, planning/design, implementation, maintenance, input for management, and financial support) and external (regulation, good leadership and financial support) MSI indicators were further identified. The findings showed that the main indicators that significantly influence urban green space performance are 'state, society, implementation and regulation'. The study concluded that the state plays a critical role in the UGSPs' performance although it is not the only actor. The influential role of the state and society should also be considered since most of green space projects are non-profit oriented. 'Society' involvement also contributes to the performance and 'regulation' is also needed as a legal basis for green space development and management. To validate the conceptual framework and mixed-method approach developed here, it is recommended that more studies should be conducted to compare the relationship of the MSI and the UGSPs' performance in different categories

A comparison of green space indicators for epidemiological research

<p><b>Background</b> The potential for natural environments to be salutogenic has received growing interest from epidemiologists, but there has been no critical examination of the extent to which associations between green space and health might vary according to the indicator of green space coverage used.</p> <p><b>Methods</b> Three different indicators of green space coverage were derived for a set of 268 small areas in four cities within Britain. The indicators had different origins and provided a spectrum of sensitivity from larger spaces only, through to ambient greenery. Two indicators reproducible for anywhere in Europe were included. Agreement between the indicators on the quantity of green space in a small area, and their independent association with measures of mortality and self-reported morbidity, were compared.</p> <p><b>Results</b> Overall, the indicators showed relatively close overall agreement (all r2>0.89, p<0.001). However, agreement varied by level of area socioeconomic deprivation (p<0.001). The indicator that detected larger spaces only found less green space in areas of socioeconomic deprivation than the other two. Despite this difference, all indicators showed similar protective associations with the risk of mortality and self-reported morbidity suggesting that larger green spaces may be more important for health effects than smaller spaces.</p> <p><b>Conclusions</b> Associations between green space indicator and health were not sensitive to indicator origin and type. This raises the possibility of trans-European epidemiological studies. Larger green spaces may be the most important for health effects, but may also be less prevalent in more deprived areas.</p&gt

Green cities and health: a question of scale?

<p><b>Background:</b> Cities are expanding and accommodating an increasing proportion of the world's population. It is important to identify features of urban form that promote the health of city dwellers. Access to green space has been associated with health benefits at both individual and neighbourhood level. We investigated whether a relationship between green space coverage and selected mortality rates exists at the city level in the USA.</p> <p><b>Methods:</b> An ecological cross-sectional study. A detailed land use data set was used to quantify green space for the largest US cities (n=49, combined population of 43 million). Linear regression models were used to examine the association between city-level ‘greenness’ and city-level standardised rates of mortality from heart disease, diabetes, lung cancer, motor vehicle fatalities and all causes, after adjustment for confounders.</p> <p><b>Results:</b> There was no association between greenness and mortality from heart disease, diabetes, lung cancer or automobile accidents. Mortality from all causes was significantly higher in greener cities.</p> <p><b>Conclusions:</b> While considerable evidence suggests that access to green space yields health benefits, we found no such evidence at the scale of the American city. In the USA, greener cities tend also to be more sprawling and have higher levels of car dependency. Any benefits that the green space might offer seem easily eclipsed by these other conditions and the lifestyles that accompany them. The result merits further investigation as it has important implications for how we increase green space access in our cities.</p&gt

Green Space

Our time spent looking at, experiencing, and engaging with nature improves our lives. Posting about ­­­­­­­­the psychological benefits of time spent outdoors from In All Things - an online hub committed to the claim that the life, death, and resurrection of Jesus Christ has implications for the entire world. http://inallthings.org/green-space

Studying the preoccupations that prevent people from going into green space

That urban green space can provide opportunities for psychological restoration which could prove valuable in promoting public health now seems relatively well established. What is less clear is whether many of us will continue to avail ourselves of these opportunities. Perhaps the question to pose is less one of whether green space experience can be good for people and more one of how best to tempt them there. This essay draws on a serial interview study with a sample of city professionals who ventured relatively infrequently into the various parks and gardens scattered around their offices. The aim is to stage a broader discussion about ways of researching those who seem happy to go without green space experience and the role of qualitative methods in questioning the most effective means of engaging with them