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Special Issue "Green-Blue Space and Health: Advances in Methods, Technologies and Applications"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 October 2015)

Special Issue Editors

Guest Editor
Prof. Dr. Agnes van den Berg

University of Groningen, Faculty of Spatial Sciences, Department of Cultural Geography, Landleven 1, 9747 AD Groningen, The Netherlands
Website | E-Mail
Interests: environmental psychology; nature and health; restorative environments
Guest Editor
Dr. Jenny Roe

Stockholm Environment Institute, Department of Environment,University of York, Heslington, York, YO10 5DD, UK
Website | E-Mail
Interests: green space and stress; salutogenic environments; deprived urban communities

Special Issue Information

Dear Colleagues,

The world’s population is exploding. One in every two people nowadays lives in a city (United Nations, 2008). Urbanization and population densification are major contributors to stress-related illness and mental health problems. There is a growing realization, at national and international levels, that the provision of accessible and high quality “green and blue” city spaces (i.e., vegetated settings and water surfaces) is a vital element in combating the adverse health effects of urbanization. In the past decade or so, a solid evidence base linking green and blue space to health has accumulated, including epidemiological studies as well as basic experimental research. However, before green-blue space can be fully integrated into health promotion policies, a comprehensive and socially relevant research approach needs to be established that is better aligned with the needs of urban residents, policy makers, and health professionals. This new green health approach is characterized by advanced research methods, such as prospective longitudinal designs, random controlled trials, meta-analyses, innovative technologies (such as virtual reality, fMRI, eye-tracking, and cortisol measurements), and the application of these methods and technologies in “special needs” groups, including clinical populations, deprived communities, children, and older people. Papers addressing these topics are invited for this Special Issue, especially those combining a high academic standard coupled with a practical focus on providing optimal green-blue space solutions.

Prof. Dr. A.E. (Agnes) van den Berg
Dr. J. (Jenny) Roe
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • green space
  • blue space
  • health and well-being
  • health inequalities
  • stress regulation
  • restorative environment
  • sustainable urban design
  • deprived communities
  • urban green space quality
  • health behavior change programs

Published Papers (13 papers)

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Research

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Open AccessArticle Understanding Relationships between Health, Ethnicity, Place and the Role of Urban Green Space in Deprived Urban Communities
Int. J. Environ. Res. Public Health 2016, 13(7), 681; doi:10.3390/ijerph13070681
Received: 18 December 2015 / Revised: 9 June 2016 / Accepted: 14 June 2016 / Published: 5 July 2016
Cited by 6 | PDF Full-text (892 KB) | HTML Full-text | XML Full-text
Abstract
Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME) groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities
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Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME) groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523) to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID) segmentation analyses identified three distinct general health segments in our sample ranging from “very good” health (people of Indian origin), to ”good” health (white British), and ”poor” health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups), labelled ”Mixed BME” in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness) ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in ”Mixed BME”. Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME communities since this can play an important role in helping address the health inequalities experienced by these groups. Full article
Open AccessArticle Orange Is the New Green: Exploring the Restorative Capacity of Seasonal Foliage in Schoolyard Trees
Int. J. Environ. Res. Public Health 2016, 13(5), 497; doi:10.3390/ijerph13050497
Received: 1 January 2016 / Revised: 5 April 2016 / Accepted: 28 April 2016 / Published: 17 May 2016
Cited by 1 | PDF Full-text (4648 KB) | HTML Full-text | XML Full-text
Abstract
Urban schoolyard environments are increasingly characterized by a proliferation of hard surfaces with little if any greenery. Schoolyard “greening” initiatives are becoming increasingly popular; however, schoolyard designs often fail to realize their restorative potential. In this quasi-experimental study, a proposed schoolyard greening project
[...] Read more.
Urban schoolyard environments are increasingly characterized by a proliferation of hard surfaces with little if any greenery. Schoolyard “greening” initiatives are becoming increasingly popular; however, schoolyard designs often fail to realize their restorative potential. In this quasi-experimental study, a proposed schoolyard greening project was used to visualize alternative planting designs and seasonal tree foliage; these design alternatives were subsequently used as visual stimuli in a survey administered to children who will use the schoolyard to assess the perceived restorative capacity of different design features. The findings indicate that seasonal changes in tree foliage enhance the perceived restorative quality of schoolyard environments. Specifically, fall foliage colour, when compared to green foliage, is rated as being perceived to be equally restorative for children. Additionally, seasonal planting, including evergreen conifers, may enhance the restorative quality of the schoolyard especially when deciduous trees are leafless. Landscape design professionals, community-based organizations, and other decision-makers in schoolyard greening efforts should strategically consider their tree choices to maximize year-round support for healthy attention functioning in children through restoration. Full article
Open AccessArticle Mitigating Stress and Supporting Health in Deprived Urban Communities: The Importance of Green Space and the Social Environment
Int. J. Environ. Res. Public Health 2016, 13(4), 440; doi:10.3390/ijerph13040440
Received: 30 January 2016 / Revised: 13 April 2016 / Accepted: 15 April 2016 / Published: 22 April 2016
Cited by 4 | PDF Full-text (12231 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Environment-health research has shown significant relationships between the quantity of green space in deprived urban neighbourhoods and people’s stress levels. The focus of this paper is the nature of access to green space (i.e., its quantity or use) necessary before any
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Environment-health research has shown significant relationships between the quantity of green space in deprived urban neighbourhoods and people’s stress levels. The focus of this paper is the nature of access to green space (i.e., its quantity or use) necessary before any health benefit is found. It draws on a cross-sectional survey of 406 adults in four communities of high urban deprivation in Scotland, United Kingdom. Self-reported measures of stress and general health were primary outcomes; physical activity and social wellbeing were also measured. A comprehensive, objective measure of green space quantity around each participant’s home was also used, alongside self-report measures of use of local green space. Correlated Component Regression identified the optimal predictors for primary outcome variables in the different communities surveyed. Social isolation and place belonging were the strongest predictors of stress in three out of four communities sampled, and of poor general health in the fourth, least healthy, community. The amount of green space in the neighbourhood, and in particular access to a garden or allotment, were significant predictors of stress. Physical activity, frequency of visits to green space in winter months, and views from the home were predictors of general health. The findings have implications for public health and for planning of green infrastructure, gardens and public open space in urban environments. Full article
Open AccessArticle Natural Environments and Childhood Experiences Promoting Physical Activity, Examining the Mediational Effects of Feelings about Nature and Social Networks
Int. J. Environ. Res. Public Health 2016, 13(4), 439; doi:10.3390/ijerph13040439
Received: 31 October 2015 / Revised: 15 April 2016 / Accepted: 18 April 2016 / Published: 21 April 2016
Cited by 3 | PDF Full-text (596 KB) | HTML Full-text | XML Full-text
Abstract
The importance of natural environments (NEs) for physical activity (PA) has been studied extensively. However, there is scant evidence to explain the motivational processes underlying the NE-PA relation. The aim of this study was to investigate the NE-PA relation using an ecological framework,
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The importance of natural environments (NEs) for physical activity (PA) has been studied extensively. However, there is scant evidence to explain the motivational processes underlying the NE-PA relation. The aim of this study was to investigate the NE-PA relation using an ecological framework, focusing on perception of NEs, childhood experiences and possible intra- and inter-individual mediators. Data were retrieved from a cross-sectional survey among 2168 adults from all over Norway. In addition, the coverage of NEs by municipalities was retrieved from national registers. Logistic regression showed that, unlike the self-reported proximity to NEs, higher ratings of perceived supportiveness of NEs for PA predicted participation in NE-based PA for at least 60 min/week or 150 min/week, before and after controlling for socio-demographic characteristics. Reporting frequent experiences in nature during childhood was also an important predictor of higher levels of NE-based PA. Furthermore, a mediational analysis showed that the effect of both predictors was mediated by “feelings about nature” and “social networks”. These findings indicate that to encourage the use of local NE for PA, not only should environmental perceptions be taken into account, positive feelings towards nature alongside opportunities to share activity in nature with others should also be promoted. Full article
Open AccessArticle Restoration in Its Natural Context: How Ecological Momentary Assessment Can Advance Restoration Research
Int. J. Environ. Res. Public Health 2016, 13(4), 420; doi:10.3390/ijerph13040420
Received: 30 December 2015 / Revised: 22 March 2016 / Accepted: 7 April 2016 / Published: 13 April 2016
PDF Full-text (321 KB) | HTML Full-text | XML Full-text
Abstract
More and more people use self-tracking technologies to track their psychological states, physiology, and behaviors to gain a better understanding of themselves or to achieve a certain goal. Ecological Momentary Assessment (EMA) also offers an excellent opportunity for restorative environments research, which examines
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More and more people use self-tracking technologies to track their psychological states, physiology, and behaviors to gain a better understanding of themselves or to achieve a certain goal. Ecological Momentary Assessment (EMA) also offers an excellent opportunity for restorative environments research, which examines how our physical environment (especially nature) can positively influence health and wellbeing. It enables investigating restorative health effects in everyday life, providing not only high ecological validity but also opportunities to study in more detail the dynamic processes playing out over time on recovery, thereby bridging the gap between laboratory (i.e., short-term effects) and epidemiological (long-term effects) research. We have identified four main areas in which self-tracking could help advance restoration research: (1) capturing a rich set of environment types and restorative characteristics; (2) distinguishing intra-individual from inter-individual effects; (3) bridging the gap between laboratory and epidemiological research; and (4) advancing theoretical insights by measuring a more broad range of effects in everyday life. This paper briefly introduces restorative environments research, then reviews the state of the art of self-tracking technologies and methodologies, discusses how these can be implemented to advance restoration research, and presents some examples of pioneering work in this area. Full article
Open AccessArticle Life Course, Green Space and Health: Incorporating Place into Life Course Epidemiology
Int. J. Environ. Res. Public Health 2016, 13(3), 331; doi:10.3390/ijerph13030331
Received: 30 November 2015 / Revised: 1 March 2016 / Accepted: 14 March 2016 / Published: 17 March 2016
Cited by 2 | PDF Full-text (1387 KB) | HTML Full-text | XML Full-text
Abstract
Researchers interested in the relationships between place and health have been slow to incorporate a life course perspective, probably due to the lack of readily available historical environmental data. This hinders the identification of causal relationships. It also restricts our understanding as to
[...] Read more.
Researchers interested in the relationships between place and health have been slow to incorporate a life course perspective, probably due to the lack of readily available historical environmental data. This hinders the identification of causal relationships. It also restricts our understanding as to whether there are accumulative effects over the life course and if there are critical periods in people’s lives when places are particularly pertinent. This study considers the feasibility of constructing longitudinal data on the availability of urban green space. The suitability of various historical and contemporary data sources is considered, including paper maps, aerial photographs and tabular land use data. Measures of urban green space are created for all neighbourhoods across the Edinburgh region of Scotland at various points during the past 100 years. We demonstrate that it is feasible to develop such measures, but there are complex issues involved in doing so. We also test the utility of the measures via an analysis of how accessibility to green space might alter over the life course of both people, and their residential neighbourhoods. The findings emphasise the potential for utilising historical data to significantly enhance understanding of the relationships between nature and health, and between health and place more generally. We encourage researchers to use data from other locations to consider including a longitudinal perspective to examine relationships between people’s health and their environment. Full article
Open AccessArticle The Effects of Forest Therapy on Coping with Chronic Widespread Pain: Physiological and Psychological Differences between Participants in a Forest Therapy Program and a Control Group
Int. J. Environ. Res. Public Health 2016, 13(3), 255; doi:10.3390/ijerph13030255
Received: 13 November 2015 / Revised: 6 February 2016 / Accepted: 6 February 2016 / Published: 24 February 2016
Cited by 1 | PDF Full-text (2029 KB) | HTML Full-text | XML Full-text
Abstract
This study aimed to investigate the effects of a two-day forest therapy program on individuals with chronic widespread pain. Sixty one employees of a public organization providing building and facilities management services within the Seoul Metropolitan area participated in the study. Participants were
[...] Read more.
This study aimed to investigate the effects of a two-day forest therapy program on individuals with chronic widespread pain. Sixty one employees of a public organization providing building and facilities management services within the Seoul Metropolitan area participated in the study. Participants were assigned to an experimental group (n = 33) who participated in a forest therapy program or a control group (n = 28) on a non-random basis. Pre- and post-measures of heart rate variability (HRV), Natural Killer cell (NK cell) activity, self-reported pain using the visual analog scale (VAS), depression level using the Beck Depression Inventory (BDI), and health-related quality of life measures using the EuroQol Visual Analog Scale (EQ-VAS) were collected in both groups. The results showed that participants in the forest therapy group, as compared to the control group, showed physiological improvement as indicated by a significant increase in some measures of HRV and an increase in immune competence as indicated by NK cell activity. Participants in the forest therapy group also reported significant decreases in pain and depression, and a significant improvement in health-related quality of life. These results support the hypothesis that forest therapy is an effective intervention to relieve pain and associated psychological and physiological symptoms in individuals with chronic widespread pain. Full article
Open AccessArticle The Online Dissemination of Nature–Health Concepts: Lessons from Sentiment Analysis of Social Media Relating to “Nature-Deficit Disorder”
Int. J. Environ. Res. Public Health 2016, 13(1), 142; doi:10.3390/ijerph13010142
Received: 30 October 2015 / Revised: 24 December 2015 / Accepted: 30 December 2015 / Published: 19 January 2016
PDF Full-text (2730 KB) | HTML Full-text | XML Full-text
Abstract
Evidence continues to grow supporting the idea that restorative environments, green exercise, and nature-based activities positively impact human health. Nature-deficit disorder, a journalistic term proposed to describe the ill effects of people’s alienation from nature, is not yet formally recognized as a
[...] Read more.
Evidence continues to grow supporting the idea that restorative environments, green exercise, and nature-based activities positively impact human health. Nature-deficit disorder, a journalistic term proposed to describe the ill effects of people’s alienation from nature, is not yet formally recognized as a medical diagnosis. However, over the past decade, the phrase has been enthusiastically taken up by some segments of the lay public. Social media, such as Twitter, with its opportunities to gather “big data” related to public opinions, offers a medium for exploring the discourse and dissemination around nature-deficit disorder and other nature–health concepts. In this paper, we report our experience of collecting more than 175,000 tweets, applying sentiment analysis to measure positive, neutral or negative feelings, and preliminarily mapping the impact on dissemination. Sentiment analysis is currently used to investigate the repercussions of events in social networks, scrutinize opinions about products and services, and understand various aspects of the communication in Web-based communities. Based on a comparison of nature-deficit-disorder “hashtags” and more generic nature hashtags, we make recommendations for the better dissemination of public health messages through changes to the framing of messages. We show the potential of Twitter to aid in better understanding the impact of the natural environment on human health and wellbeing. Full article
Open AccessArticle Autonomic Nervous System Responses to Viewing Green and Built Settings: Differentiating Between Sympathetic and Parasympathetic Activity
Int. J. Environ. Res. Public Health 2015, 12(12), 15860-15874; doi:10.3390/ijerph121215026
Received: 29 September 2015 / Revised: 7 December 2015 / Accepted: 9 December 2015 / Published: 14 December 2015
Cited by 1 | PDF Full-text (1320 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
This laboratory study explored buffering and recovery effects of viewing urban green and built spaces on autonomic nervous system activity. Forty-six students viewed photos of green and built spaces immediately following, and preceding acute stress induction. Simultaneously recorded electrocardiogram and impedance cardiogram signal
[...] Read more.
This laboratory study explored buffering and recovery effects of viewing urban green and built spaces on autonomic nervous system activity. Forty-six students viewed photos of green and built spaces immediately following, and preceding acute stress induction. Simultaneously recorded electrocardiogram and impedance cardiogram signal was used to derive respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP), indicators of respectively parasympathetic and sympathetic activity. The findings provide support for greater recovery after viewing green scenes, as marked by a stronger increase in RSA as a marker of parasympathetic activity. There were no indications for greater recovery after viewing green scenes in PEP as a marker of sympathetic activity, and there were also no indications of greater buffering effects of green space in neither RSA nor PEP. Overall, our findings are consistent with a predominant role of the parasympathetic nervous system in restorative effects of viewing green space. Full article
Open AccessArticle Green Space Attachment and Health: A Comparative Study in Two Urban Neighborhoods
Int. J. Environ. Res. Public Health 2015, 12(11), 14342-14363; doi:10.3390/ijerph121114342
Received: 2 October 2015 / Revised: 4 November 2015 / Accepted: 5 November 2015 / Published: 12 November 2015
Cited by 3 | PDF Full-text (2655 KB) | HTML Full-text | XML Full-text
Abstract
The positive relationships between urban green space and health have been well documented. Little is known, however, about the role of residents’ emotional attachment to local green spaces in these relationships, and how attachment to green spaces and health may be promoted by
[...] Read more.
The positive relationships between urban green space and health have been well documented. Little is known, however, about the role of residents’ emotional attachment to local green spaces in these relationships, and how attachment to green spaces and health may be promoted by the availability of accessible and usable green spaces. The present research aimed to examine the links between self-reported health, attachment to green space, and the availability of accessible and usable green spaces. Data were collected via paper-mailed surveys in two neighborhoods (n = 223) of a medium-sized Dutch city in the Netherlands. These neighborhoods differ in the perceived and objectively measured accessibility and usability of green spaces, but are matched in the physically available amount of urban green space, as well as in demographic and socio-economic status, and housing conditions. Four dimensions of green space attachment were identified through confirmatory factor analysis: place dependence, affective attachment, place identity and social bonding. The results show greater attachment to local green space and better self-reported mental health in the neighborhood with higher availability of accessible and usable green spaces. The two neighborhoods did not differ, however, in physical and general health. Structural Equation Modelling confirmed the neighborhood differences in green space attachment and mental health, and also revealed a positive path from green space attachment to mental health. These findings convey the message that we should make green places, instead of green spaces. Full article
Open AccessArticle The Effects of Exercising in Different Natural Environments on Psycho-Physiological Outcomes in Post-Menopausal Women: A Simulation Study
Int. J. Environ. Res. Public Health 2015, 12(9), 11929-11953; doi:10.3390/ijerph120911929
Received: 16 July 2015 / Accepted: 3 September 2015 / Published: 23 September 2015
Cited by 2 | PDF Full-text (1190 KB) | HTML Full-text | XML Full-text
Abstract
The current study examined potential psycho-physiological benefits from exercising in simulated natural environments among a sample of post-menopausal women using a laboratory based protocol. Participants cycled on a stationary exercise bike for 15 min while facing either a blank wall (Control) or while
[...] Read more.
The current study examined potential psycho-physiological benefits from exercising in simulated natural environments among a sample of post-menopausal women using a laboratory based protocol. Participants cycled on a stationary exercise bike for 15 min while facing either a blank wall (Control) or while watching one of three videos: Urban (Grey), Countryside (Green), Coast (Blue). Blood pressure, heart rate and affective responses were measured pre-post. Heart rate, affect, perceived exertion and time perception were also measured at 5, 10 and 15 min during exercise. Experience evaluation was measured at the end. Replicating most earlier findings, affective, but not physiological, outcomes were more positive for exercise in the simulated Green and, for the first time, Blue environment, compared to Control. Moreover, only the simulated Blue environment was associated with shorter perceived exercise duration than Control and participants were most willing to repeat exercise in the Blue setting. The current research extended earlier work by exploring the effects of “blue exercise” and by using a demographic with relatively low average levels of physical activity. That this sample of postmenopausal women were most willing to repeat a bout of exercise in a simulated Blue environment may be important for physical activity promotion in this cohort. Full article
Open AccessArticle Moving to Serene Nature May Prevent Poor Mental Health—Results from a Swedish Longitudinal Cohort Study
Int. J. Environ. Res. Public Health 2015, 12(7), 7974-7989; doi:10.3390/ijerph120707974
Received: 4 April 2015 / Revised: 25 June 2015 / Accepted: 2 July 2015 / Published: 14 July 2015
Cited by 7 | PDF Full-text (825 KB) | HTML Full-text | XML Full-text
Abstract
Green spaces are recognized for improving mental health, but what particular kind of nature is required is yet not elucidated. This study explores the effect of specific types of recreational nature qualities on mental health. Longitudinal data (1999/2000 and 2005) from a public
[...] Read more.
Green spaces are recognized for improving mental health, but what particular kind of nature is required is yet not elucidated. This study explores the effect of specific types of recreational nature qualities on mental health. Longitudinal data (1999/2000 and 2005) from a public health survey was distributed to a stratified sample (n = 24,945) of a Swedish population. People from rural or suburban areas (n = 9230) who had moved between baseline and follow-up (n = 1419) were studied. Individual geographic residence codes were linked to five predefined nature qualities, classified in geographic information systems (GIS). Any change in the amount of or type of qualities within 300 m distance between baseline and follow-up was correlated to any change in mental health (as measured by the General Health Questionnaire) by logistic regression models. On average, the population had limited access to nature qualities both pre- and post-move. There was no significant correlation between change in the amount of qualities and change in mental health. However, the specific quality “serene” was a significant determinant with a significantly decreased risk for women of change to mental ill-health at follow-up. The objective definition of the potentially health-promoting quality may facilitate implication in landscape practice and healthy planning. Full article

Review

Jump to: Research

Open AccessReview Mental Health Benefits of Long-Term Exposure to Residential Green and Blue Spaces: A Systematic Review
Int. J. Environ. Res. Public Health 2015, 12(4), 4354-4379; doi:10.3390/ijerph120404354
Received: 26 January 2015 / Revised: 8 April 2015 / Accepted: 15 April 2015 / Published: 22 April 2015
Cited by 50 | PDF Full-text (814 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
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
[...] Read more.
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. Full article

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