Exploring pathways linking greenspace to health: Theoretical and methodological guidance

Iana Markevych*, Julia Schoierer, Terry Hartig, Alexandra Chudnovsky, Perry Hystad, Angel M. Dzhambov, Sjerp de Vries, Margarita Triguero-Mas, Michael Brauer, Mark J. Nieuwenhuijsen, Gerd Lupp, Elizabeth A. Richardson, Thomas Astell-Burt, Donka Dimitrova, Xiaoqi Feng, Maya Sadeh, Marie Standl, Joachim Heinrich, Elaine Fuertes

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish
Pages (from-to)301-317
Number of pages17
JournalEnvironmental Research
Volume158
DOIs
StatePublished - 2017

Keywords

  • Green spaces
  • Greenness
  • Greenspace
  • Mediation analysis
  • Pathways

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