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- Astell-Burt, Thomas, et al.
(författare)
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Green space and loneliness : A systematic review with theoretical and methodological guidance for future research
- 2022
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Ingår i: Science of the Total Environment. - : Elsevier. - 0048-9697 .- 1879-1026. ; 847
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Forskningsöversikt (refereegranskat)abstract
- Persistent loneliness troubles people across the life span, with prevalence as high as 61% in some groups. Urban greening may help to reduce the population health impacts of loneliness and its concomitants, such as hopelessness and despair. However, the literature lacks both a critical appraisal of extant evidence and a conceptual model to explain how green space would work as a structural intervention. Both are needed to guide decision making and further research. We conducted a systematic review of quantitative studies testing associations between green space and loneliness, searching seven databases. Twenty two studies were identified by 25/01/2022. Most of the studies were conducted in high-income countries and fifteen (68 %) had cross-sectional designs. Green space was measured inconsistently using either objective or subjective indicators. Few studies examined specific green space types or qualities. The majority of studies measured general loneliness (e.g. using the UCLA loneliness scale). Different types of loneliness (social, emotional, existential) were not analysed. Of 132 associations, 88 (66.6 %) indicated potential protection from green space against loneliness, with 44 (33.3 %) reaching statistical significance (p < 0.05). We integrated these findings with evidence from qualitative studies to elaborate and extend the existing pathway domain model linking green space and health. These elaborations and extensions acknowledge the following: (a) different types of green space have implications for different types of loneliness; (b) multilevel circumstances influence the likelihood a person will benefit or suffer harm from green space; (c) personal, relational, and collective processes operate within different domains of pathways linking green space with loneliness and its concomitants; (d) loneliness and its concomitants are explicitly positioned as mediators within the broader causal system that links green space with health and wellbeing. This review and model provide guidance for decision making and further epidemiological research on green space and loneliness.
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- Astell-Burt, Thomas, et al.
(författare)
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More green, less lonely? : A longitudinal cohort study
- 2022
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Ingår i: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 51:1, s. 99-110
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundUrban greening may reduce loneliness by offering opportunities for solace, social reconnection and supporting processes such as stress relief. We (i) assessed associations between residential green space and cumulative incidence of, and relief from, loneliness over 4 years; and (ii) explored contingencies by age, sex, disability and cohabitation status.MethodsMultilevel logistic regressions of change in loneliness status in 8049 city-dwellers between 2013 (baseline) and 2017 (follow-up) in the Household, Income and Labour Dynamics in Australia study. Associations with objectively measured discrete green-space buffers (e.g. parks) (<400, <800 and <1600 m) were adjusted for age, sex, disability, cohabitation status, children and socio-economic variables. Results were translated into absolute risk reductions in loneliness per 10% increase in urban greening.ResultsThe absolute risk of loneliness rose from 15.9% to 16.9% over the 4 years; however, a 10% increase in urban greening within 1.6 km was associated with lower cumulative incident loneliness [odds ratio (OR) = 0.927, 95% confidence interval (CI) = 0.862 to 0.996; absolute risk reduction = 0.66%]. Stronger association was observed for people living alone (OR = 0.828, 95% CI = 0.725 to 0.944). In comparison to people with <10% green space, the ORs for cumulative incident loneliness were 0.833 (95% CI = 0.695 to 0.997), 0.790 (95% CI = 0.624 to 1.000) and 0.736 (95% CI = 0.549 to 0.986) for 10–20%, 20–30% and >30% green space, respectively. Compared with the <10% green-space reference group with 13.78% incident loneliness over 4 years and conservatively assuming no impact on incident loneliness, associations translated into absolute risk reductions of 1.70%, 2.26% and 2.72% within populations with 10–20%, 20–30% and >30% green space, respectively. These associations were stronger again for people living alone, with 10–20% (OR = 0.608, 95% CI = 0.448 to 0.826), 20–30% (OR = 0.649, 95% CI = 0.436 to 0.966) and >30% (OR = 0.480, 95% CI = 0.278 to 0.829) green space within 1600 m. No age, sex or disability-related contingencies, associations with green space within 400 or 800 m or relief from loneliness reported at baseline were observed.ConclusionsA lower cumulative incidence of loneliness was observed among people with more green space within 1600 m of home, especially for people living alone. Potential biopsychosocial mechanisms warrant investigation.
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| 7. |
- Astell-Burt, Thomas, et al.
(författare)
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The association between green space and mental health varies across the lifecourse. A longitudinal study
- 2014
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 68:6, s. 578-583
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Tidskriftsartikel (refereegranskat)abstract
- Background Epidemiological studies on green space and health have relied almost exclusively on cross-sectional designs, restricting understanding on how this relationship could vary across the lifecourse. Methods We used multilevel linear regression to analyse variation in minor psychiatric morbidity over nine annual waves of the British Household Panel Survey (1996-2004). The sample was restricted to residents of urban areas who remained within their neighbourhoods for at least 12 months. The 12-item General Health Questionnaire and confounders were reported for 29 626 male and 35 781 female observations (person-years). This individual-level dataset was linked to a measure of green space availability within each ward of residence. Regression models included age, gender, employment status, household tenure, marital status, education, smoking status and household income. Results When not considering age, green space was associated with better mental health among men, but not women. Interaction terms fitted between age and green space revealed variation in the association between green space and mental health across the lifecourse and by gender. For men, the benefit of more green space emerged in early to mid-adulthood. Among older women, a curvilinear association materialised wherein those with a moderate availability of green space had better mental health. Conclusions These findings illustrate how the relationship between urban green space and health can vary across the lifecourse, and they highlight the need for longitudinal studies to answer why green space may be better for health at some points in the lifecourse than others.
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| 8. |
- Bryazka, D., et al.
(författare)
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Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020
- 2022
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Ingår i: Lancet. - 0140-6736. ; 400:10347, s. 185-235
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Tidskriftsartikel (refereegranskat)abstract
- Background The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0.603 (0.400-1.00) standard drinks per day, and the NDE varied between 0.002 (0-0) and 1.75 (0.698-4.30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0.114 (0-0.403) to 1.87 (0.500-3.30) standard drinks per day and an NDE that ranged between 0.193 (0-0.900) and 6.94 (3.40-8.30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59.1% (54.3-65.4) were aged 15-39 years and 76.9% (7.0-81.3) were male. Interpretation There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.
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| 9. |
- Chang, Chia-chen, et al.
(författare)
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A lower connection to nature is related to lower mental health benefits from nature contact
- 2024
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Ingår i: Scientific Reports. - 2045-2322. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Increasing evidence demonstrates the psychological benefits of nature contact. However, the evidence is often established at the population level, and the individual differences in the psychological benefits gained from nature are considered negligible variations. In this study, we performed a cross-sectional online survey in Brisbane and Sydney, Australia, from April 15th and May 15th, 2021 around one year after the first covid-19 pandemic lockdowns. The results show that individuals with a stronger connection to nature are linked with a lower level of stress and anxiety with increased frequency in public greenspace visits, while such an association is less clear for individuals with a weaker connection to nature. We also find that, through the answer to an open-ended question, individuals with a lower connection to nature tend to mention nature-related words less as the reason for visiting greenspace. This indicates that a person’s connection to nature is linked with how they interact with nature and thus might determine whether and how much psychological benefit a person gains from experiencing nature.
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| 10. |
- Cousin, E., et al.
(författare)
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Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019
- 2022
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Ingår i: Lancet Diabetes & Endocrinology. - : Elsevier BV. - 2213-8587. ; 10:3, s. 177-192
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Tidskriftsartikel (refereegranskat)abstract
- Background Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990-2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73.7% (68.3 to 77.4) were classified as due to type 1 diabetes. The age-standardised death rate was 0.50 (0.44 to 0.58) per 100 000 population, and 15 900 (97.5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0.13 (0.12 to 0.14) per 100 000 population in the high SDI quintile, 0.60 (0.51 to 0.70) per 100 000 population in the low-middle SDI quintile, and 0.71 (0.60 to 0.86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r(2)=0.62). From 1990 to 2019, age-standardised death rates decreased globally by 17.0% (-28.4 to -2.9) for all diabetes, and by 21.0% (-33.0 to -5.9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (-13.6% [-28.4 to 3.4]) and for type 1 diabetes (-13.6% [-29.3 to 8.9]). Interpretation Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.
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| 12. |
- Hartig, Terry, 1959-, et al.
(författare)
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Associations between greenspace and mortality vary across contexts of community change : a longitudinal ecological study
- 2020
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 74:6, s. 534-540
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Tidskriftsartikel (refereegranskat)abstract
- Background Concerns about loss of greenspace with urbanisation motivate much research on nature and health; however, contingency of greenspace-health associations on the character of community change remains understudied.Methods With aggregate data from governmental sources for 1432 Swedish parishes, we used negative binomial regression to estimate incidence rate ratios (IRRs) for all-cause and cardiovascular disease (CVD) mortality during 2000–2008 in relation to percentage area (in 2000) of urban residential greenspace, urban parks and rural greenspace, looking across parishes with decrease, stability or increase in population density. We also assessed interactions between land use and population change.Results Parishes with ≥1 decile increase in population density had lower incidence of all-cause (IRR=0.91, 95% CI 0.87 to 0.95) and CVD mortality (IRR=0.89, 95% CI 0.84 to 0.94) compared with parishes with stable populations. In stable parishes, all-cause mortality was lower with higher percentages of urban green (IRR=0.998, 95% CI 0.996 to 1.000) and rural green land uses (IRR=0.997, 95% CI 0.996 to 0.999). These results were inverted in densifying parishes; higher all-cause mortality attended higher initial percentages of urban (IRR=1.081, 95% CI 1.037 to 1.127) and rural greenspace (IRR=1.042, 95% CI 1.007 to 1.079) as measured in 2000. Similar associations held for CVD mortality.Conclusions More greenspace was associated with lower all-cause and CVD mortality in communities with relatively stable populations. In densifying communities, population growth per se may reduce mortality, but it may also entail harm through reductions in amount per capita and/or quality of greenspace.
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- Kingsley, Jonathan, et al.
(författare)
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Pandemic gardening: A narrative review, vignettes and implications for future research
- 2023
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Ingår i: Urban Forestry & Urban Greening. - : ELSEVIER GMBH. - 1618-8667 .- 1610-8167. ; 87
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Forskningsöversikt (refereegranskat)abstract
- There is a significant amount of evidence highlighting the health, wellbeing and social benefits of gardening during previous periods of crises. These benefits were also evident during the COVID-19 pandemic. This paper presents a narrative review exploring gardening during the early stages of the COVID-19 pandemic to understand the different forms of gardening that took place during this crisis and key elements of this activity. Research about gardening during the pandemic focused on food (in)security and disrupted food systems, the health and wellbeing benefits of gardening, and the social dimensions of gardening. We offer three vignettes of our own research to highlight key insights from local, national and international perspectives of gardening during the pandemic. The papers conclusion outlines how researchers, policy makers and public health practitioners can harness what has been learned from gardening during the pandemic to ensure these benefits are more widely available and do not exacerbate already entrenched health inequalities in society.
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| 14. |
- Lin, Brenda B., et al.
(författare)
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Nature experience from yards provide an important space for mental health during Covid-19
- 2023
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Ingår i: npj Urban Sustainability. - : Springer Science and Business Media LLC. - 2661-8001. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- Urban dwellers' use of public and private green spaces may have changed during the early years of the Covid-19 pandemic due to movement restriction. A survey was deployed in Brisbane and Sydney, Australia 1 year after the start of Covid-19 restrictions (April 2021) to explore relationships of mental health and wellbeing to different patterns of private yard versus public green space visitation. More frequent yard use during the initial year of Covid-19 was correlated with lower stress, depression, and anxiety and higher wellbeing. However, greater duration of yard visits (week prior to survey) was associated with higher stress, anxiety, and depression scores, potentially because individuals may seek to use nature spaces immediately available for emotional regulation during difficult times. The results highlight the importance of yards for mental health and wellbeing during the Covid-19 pandemic and that relationships between nature interaction and mental health may be context and timeframe dependent.
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| 15. |
- Markevych, Iana, et al.
(författare)
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Exploring pathways linking greenspace to health : theoretical and methodological guidance
- 2017
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Ingår i: Environmental Research. - : Elsevier BV. - 0013-9351 .- 1096-0953. ; 158, s. 301-317
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Forskningsöversikt (refereegranskat)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.
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| 17. |
- Richardson, Elizabeth A., et al.
(författare)
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Green cities and health : A question of scale?
- 2012
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 66:2, s. 160-165
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Tidskriftsartikel (refereegranskat)abstract
- Background 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.Methods 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.Results 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.Conclusions 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.
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| 18. |
- Shanahan, Danielle F., et al.
(författare)
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Nature-Based Interventions for Improving Health and Wellbeing : The Purpose, the People and the Outcomes
- 2019
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Ingår i: Sports. - : MDPI AG. - 2075-4663. ; 7:6
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Tidskriftsartikel (refereegranskat)abstract
- Engagement with nature is an important part of many people's lives, and the health and wellbeing benefits of nature-based activities are becoming increasingly recognised across disciplines from city planning to medicine. Despite this, urbanisation, challenges of modern life and environmental degradation are leading to a reduction in both the quantity and the quality of nature experiences. Nature-based health interventions (NBIs) can facilitate behavioural change through a somewhat structured promotion of nature-based experiences and, in doing so, promote improved physical, mental and social health and wellbeing. We conducted a Delphi expert elicitation process with 19 experts from seven countries (all named authors on this paper) to identify the different forms that such interventions take, the potential health outcomes and the target beneficiaries. In total, 27 NBIs were identified, aiming to prevent illness, promote wellbeing and treat specific physical, mental or social health and wellbeing conditions. These interventions were broadly categorized into those that change the environment in which people live, work, learn, recreate or heal (for example, the provision of gardens in hospitals or parks in cities) and those that change behaviour (for example, engaging people through organized programmes or other activities). We also noted the range of factors (such as socioeconomic variation) that will inevitably influence the extent to which these interventions succeed. We conclude with a call for research to identify the drivers influencing the effectiveness of NBIs in enhancing health and wellbeing.
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