Disadvantaged groups worldwide, such as low-income and racially/ethnically minoritized people, experience worse health outcomes than more privileged groups, including wealthier and white people. Such health disparities are a major public health issue in several countries around the world. In this systematic review, we examine whether green space shows stronger associations with physical health for disadvantaged groups than for privileged groups. We hypothesize that disadvantaged groups have stronger protective effects from green space because of their greater dependency on proximate green space, as they tend to lack access to other health-promoting resources. We use the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method and search five databases (CINAHL, Cochrane, PubMed, Scopus, and Web of Science) to look for articles that examine whether socioeconomic status (SES) or race/ethnicity modify the green space-health associations. Based on this search, we identify 90 articles meeting our inclusion criteria. We find lower-SES people show more beneficial effects than affluent people, particularly when concerning public green spaces/parks rather than green land covers/greenness. Studies in Europe show stronger protective effects for lower-SES people versus higher-SES people than do studies in North America. We find no notable differences in the protective effects of green space between racial/ethnic groups. Collectively, these results suggest green space might be a tool to advance health equity and provide ways forward for urban planners, parks managers, and public health professionals to address health disparities.

We review the methods and findings of experiments that have examined the effects of exposure to simulated natural landscapes on human health and cognitive performance. Keyword searches of PubMed, Scopus, and Web of Science resulted in the inclusion of 175 experiments in 148 research articles. that were published/in press by December 31, 2018. We report how often landscape features and human factors are controlled for within these experiments, thereby—for the first time—recording specifically what elements of “nature” and the built/social environment are used when testing the benefits of green space and blue space exposure. We also document all the simulation methods that are used (e.g., duration, number of exposures, senses engaged, and devices used). Next, to determine what methodological decisions influence study findings, we compare positive versus mixed/null or negative findings across 14 potential moderators. Only study quality and outcome measure influence findings; experiments without control groups or randomized treatments reported more positive findings than expected. Experiments studying perceived restoration also reported more positive findings than expected—remarkably, 95% of such experiments reported simulated nature was indeed restorative. We discuss the possibility that these findings may indicate publication bias in favor of overreporting the salutory impacts of natural landscapes. We conclude our review with a synthesis of best practices for future research studies.

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