Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities

Abstract

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.

COVID-19, the Built Environment, and Health

“…An ecological study of 135 urbanized U.S. counties found that more countylevel greenspace was associated with lower racial disparities in infection (Lu et al 2021). This finding aligns with earlier evidence of an equigenic impact of greenspace (Mitchell and Popham 2008;Rigolon et al 2021) and supports the value of greenspace as a strategy for health equity in the pandemic recovery (Geary et al 2021;Mell and Whitten 2021).…”

Associations between Nature Exposure and Health: A Review of the Evidence

“…Based on the theory of equigenic environments, one study showed that populations exposed to the greenest environments also had the lowest levels of health inequality related to income deprivation, suggesting that green space might be an important factor in reducing socioeconomic health disparities [ 89 ]. A review of 90 studies on green space and health outcomes demonstrated that individuals of lower socioeconomic status showed more beneficial effects than those of higher socioeconomic status; the authors found no significant differences in the protective effects of green space on health outcomes among different racial/ethnic groups [ 134 ]. The evidence is inconsistent, and more work is needed to elucidate potential mechanisms.…”

Municipality Data as a Rapid and Effective Tool to Analyse Spatial and Temporal Variations of All-Cause Mortality by Town District: The Experience in Genoa (Italy)

“…Municipal authorities are also responsible for green spaces; the link between green spaces and population health is evident from a review of 90 studies [29] and a paper about the association between green spaces, population health, and income deprivation [30].…”