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dc.contributor.authorBennett, Caoimhe
dc.contributor.authorJones, Andy
dc.date.accessioned2018-11-22T15:28:01Z
dc.date.available2018-11-22T15:28:01Z
dc.date.issued2018-10
dc.identifier.issn1096-0953
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/285725
dc.description.abstractBackground: The health benefits of greenspaces have demanded the attention of policymakers since the 1800s. Although much evidence suggests greenspace exposure is beneficial for health, a gap exists for a systematic review and meta-analysis to synthesise and quantify the impact of greenspace on many health outcomes. Objective: To quantify evidence of the impact of greenspace on a wide range of health outcomes. Methods: We searched five online databases and reference lists up to January 2017. Studies satisfying a priori eligibility criteria were evaluated independently by two authors. Results: We included 103 observational and 40 interventional studies investigating ~100 health outcomes. Meta-analysis results showed increased greenspace exposure was associated with decreased salivary cortisol -0.05 (95% CI -0.07, -0.04), heart rate -2.57 (95% CI -4.30, -0.83), diastolic blood pressure -1.97 (95% CI -3.45, -0.19), HDL cholesterol -0.03 (95% CI -0.05, <-0.01), low frequency heart rate variability (HRV) -0.06 (95% CI -0.08, -0.03) and increased high frequency HRV 91.87 (95% CI 50.92, 132.82), as well as decreased risk of preterm birth 0.87 (95% CI 0.80, 0.94), type II diabetes 0.72 (95% CI 0.61, 0.85), all-cause mortality 0.69 (95% CI 0.55, 0.87), small size for gestational age 0.81 (95% CI 0.76, 0.86), cardiovascular mortality 0.84 (95% CI 0.76, 0.93), and an increased incidence of good self-reported health 1.12 (95% CI 1.05, 1.19). Incidence of stroke, hypertension, dyslipidaemia, asthma, and coronary heart disease were reduced, as well as reductions in systolic blood pressure and fasting blood glucose, HbA1c, and increased gestational age were also found, however these results were not statistically significant. For several non-pooled health outcomes, between 66.7% and 100% of studies showed health-denoting associations with increased greenspace exposure including neurological and cancer-related outcomes, and respiratory mortality. Conclusions: Greenspace exposure is associated with numerous health benefits in intervention and observational studies. These results are indicative of a beneficial influence of greenspace on a wide range of health outcomes, however a number of meta-analyses results are limited by poor study quality and high levels of heterogeneity. Green prescriptions involving greenspace use may have substantial benefits. Our findings should encourage practitioners and policymakers to give due regard to how they can create, maintain, and improve existing accessible greenspaces in deprived areas. Furthermore the development of strategies and interventions for the utilisation of such greenspaces by those who stand to benefit the most.
dc.languageeng
dc.publisherElsevier
dc.rightsAttribution 4.0 International
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectGreenspace
dc.subjectGreenness
dc.subjectBuilt environment
dc.subjectNatural capital
dc.subjectHealth
dc.subjectNon-communicable disease
dc.titleThe health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes
dc.typeArticle
prism.endingPage637
prism.publicationNameEnvironmental Research
prism.startingPage628
prism.volume166
dc.identifier.doi10.17863/CAM.33070
dcterms.dateAccepted2018-06-13
rioxxterms.versionofrecord10.1016/j.envres.2018.06.030
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.licenseref.startdate2018-06-13
dc.identifier.eissn1096-0953
dc.publisher.urlhttps://www.sciencedirect.com/science/article/pii/S0013935118303323?via=ihub
rioxxterms.typeJournal Article/Review
pubs.funder-project-idWellcome Trust (087636/Z/08/Z)
pubs.funder-project-idEconomic and Social Research Council (ES/G007462/1)
pubs.funder-project-idMedical Research Council (MR/K023187/1)
cam.issuedOnline2018-07-05
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S0013935118303323?via=ihub


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International