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Environ Res. 2017 Oct;158:301-317. doi: 10.1016/j.envres.2017.06.028. Epub 2017 Jun 30.

Exploring pathways linking greenspace to health: Theoretical and methodological guidance.

Author information

1
Institute for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany; Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany. Electronic address: iana.markevych@helmholtz-muenchen.de.
2
Institute for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
3
Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden.
4
AIRO Lab, Department of Geography and Human Environment, School of Geosciences, Tel-Aviv University, Tel-Aviv, Israel.
5
College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
6
Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.
7
Wageningen University & Research, Environmental Research, Wageningen, The Netherlands.
8
ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
9
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
10
Strategic Landscape Planning and Management, Technical University of Munich, Munich, Germany.
11
Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, Scotland, UK.
12
Population Wellbeing and Environment Research Lab (PowerLab), Faculty of Social Sciences, University of Wollongong, Wollongong, Australia; Early Start, University of Wollongong, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia.
13
Department of Health Management and Healthcare Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.
14
School of Public Health, Tel-Aviv University, Tel-Aviv, Israel.
15
Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
16
Institute for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany; Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.

Abstract

BACKGROUND:

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.

OBJECTIVES:

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.

DISCUSSIONS:

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.

CONCLUSIONS:

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.

KEYWORDS:

Green spaces; Greenness; Greenspace; Mediation analysis; Pathways

PMID:
28672128
DOI:
10.1016/j.envres.2017.06.028
[Indexed for MEDLINE]
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