Green Space, Health and Well-being:

A Review

Ronald MacfarlaneManager, Healthy Public Policy

The Ontario Public Health ConferencePre-conference Workshop24 March 2015, Toronto

Acknowledgements

Tara Zupancic, Habitus Research

Marianne Kingsley, Toronto Public Health

Timothy Jason, Living Research

Paul LeBel, Parralax Communications

EcoHealth Collaborative partners:

York Public Health Unit

Simcoe Muskoka Public Health Unit

David Suzuki Foundation

Toronto Region Conservation Authority

Credit Valley Conservation Authority

Ontario Health Agency for Protection and Promotion

Built Environment & Health: Air Quality

Air quality in Toronto has improved, but it is still an important contributor to ill health

Impact of air pollution in Toronto

1,300 premature deaths, and

3,550 hospitalizations per year (TPH 2014)

Transportation is the major source of air pollution

Built Environment & Health: Physical Activity

Physical inactivity and obesity are risk factors for many chronic diseases

About 45% of the Toronto adult population were overweight or obese in 2012

51% of Toronto adults were moderately active or higher during leisure time and transportation in 2012

People on lower income are less active (TPH 2013)

Built Environment & Health: Mental Health

Growing recognition of the burden on society due to poor mental health

The overall burden of mental illness and addictions is more than 1.5 times that of all cancers and more than seven times that of all infectious diseases (ICES 2012)

Built Environment & Health: Challenges

Increasing urbanisation and urban sprawl

Increasing pressures on green space

A changing climate

Improving the Built Environment

Promote cycling, walking and transit

Promote a built form that supports active living

Mixed use

Connectivity

Density

Build resilience to climate change

Question

Does green space play a role in maintaining health in a more dense and growing city?

What are the characteristics of green space that are important for health?

What is green space?

Green space in urban and peri-urban areas include:

Natural areas

Parks

Community gardens

Playgrounds

Street trees

Front and back yards

Views of nature

Ulrich (1984):

Patients with the tree view had shorter postoperative hospital stays and fewer post-operative complications

The role of nature in healing has influenced design of health-care facilities

Source: Ulrich (1984)

Summary of findings

106 studies published since 2000 included in the review

2 of 3 studies found lower all-cause mortality with higher green space

1 of 2 studies found lower morbidity with higher green space

7 of 9 reported better general health with higher green space

www.century21.ca

www.century21.ca

Green Space and Well-being

28 of 39 studies showed improved well-being with more green space

Mental health (26 studies showed a positive association)

Frequent access to even small neighbourhood green space

Reduces stress and anxiety (19/23 +ve)

Increases social support

Green Space and Physical Activity

Physical Activity (17 studies)

Some evidence to suggest increased green space is associated with increased physical activity

Overall findings have been mixed

Some evidence of a positive benefit of a walk or run in a natural environment

Improved self-esteem and mood Shutterstock:bikeriderlondon

Other Health Outcomes & Green Space

Green space may also have a positive impact on:

Healthy weights (11/22 +ve)

ADD/ADHD (3/3 +ve)

Cardiovascular health (3/5 +ve)

Respiratory health (1/2 +ve)

Birth outcomes (8/8 +ve)

Courtesy of Jesse Colin Jackson Source: Jesse Colin Jackson

Green Space and Equity

Nearby green space may offer greater health benefits in low-income, high-density neighbourhoods

Quality of Green Space

It is not only the amount, but also the quality, of green space that is important for health

Negative Impacts of Green Space

Few studies address the link between green space and adverse health outcomes

Asthma

Pollen allergies

Poisonous plants found in natural areas

Contact dermatitis

Ingestion

Wikimedia Commons

http://www.omafra.gov.on.ca

Conclusions

The overall strength of evidence related to the impacts of green space on health is weak to moderate

Small and large green spaces are of value

Good maintenance of green spaces increases their beneficial health impacts

The association between green space and better health is likely stronger for disadvantaged populations

Thank you

www.toronto.ca/health