Noncommunicable Diseases, Park Prescriptions, and Urban Green Space Use Patterns in a Global South Context: The Case of Dhaka, Bangladesh

Abstract

Urban green space use is often associated with improved physical and mental health and lower noncommunicable disease (NCDs) burdens. Factors that influence green space visits have been documented in cities of the Global North, but evidence of urban green space use patterns for cities in the Global South is scarce. The aim of this study is to investigate factors influencing urban green space use patterns in Dhaka, Bangladesh, a megacity of the Global South, with a particular focus on how poor health condition and healthcare professionals’ prescriptions to exercise outdoors (park prescriptions—ParkRx) impact the green space use of middle-aged adults. We collected green space characteristics and use factors (i.e., availability, accessibility, attractiveness, and attachment), health condition, ParkRx, and urban green space use intensity (i.e., frequency and duration) via a self-reported questionnaire from 169 middle-aged residents of Dhaka. We used multivariate modeling to estimate the association of green space characteristics, health condition, and ParkRx with use intensity. We further applied a mediation analysis to determine the influence of ParkRx on the relationship between residents’ poor health conditions and use intensity. We found that green space availability and accessibility did not significantly influence use intensity, but attractiveness was negatively associated with use intensity. Green space use intensity was significantly and positively associated with attachment to the green space, poor health condition (i.e., having noncommunicable diseases), and ParkRx. ParkRx significantly mediated the relationship between health condition and use intensity. We observed limited supply, poor access, and low attractiveness when studying the urban green spaces in Dhaka, but these qualities did not affect use intensity, as found in many case studies in the Global North. In contrast, urban green space use intensity in our case study is mostly dependent on poor health condition and park prescriptions.

Does greenery experienced indoors and outdoors provide an escape and support mental health during the COVID-19 quarantine?

“…Several other factors related to health, nature, and geography were measured. Presence of non-communicable chronic physical illness (es) was assessed to control for its potential effects on interaction with outdoor greenery ( Labib et al, 2020 ). Participant's feeling that they are “connected” with nature ( Tam, 2013 ) was measured with the Nature Connection Index (NCI, Richardson et al, 2019 ) to control for lower or higher levels of “connectedness” impacting the relationship between greenery and mental health ( Bakir-Demir et al, 2019 ; Cleary et al, 2017 ).…”

Connectedness among Urban Parks from the Users’ Perspective: A Systematic Literature Review

“…Through word density analysis and clustering of the total indicators, facilities and amenities were the most frequently mentioned words. These affect users’ activity and the park’s quality, including (1) park infrastructure facilities, including lighting, seating furniture [ 41 ], public toilet [ 4 ], and trash bins [ 18 ]; (2) park recreational amenities [ 41 ], such as sport/fitness facilities [ 17 , 66 ] and children’s entertainment facilities [ 17 , 18 , 42 , 43 ]; (3) cultural and aesthetic facilities, such as landscape sketches and sculptures [ 1 , 15 , 43 ].…”

The association of park use and park perception with quality of life using structural equation modeling

“…In general, urban green space shares a complex relationship with health. It is inversely associated with the prevalence of non-communicable diseases related morbidity, and mortality ( 14 , 62 – 64 ), premature death ( 65 , 66 ), and stress ( 23 , 24 ). It is also positively associated with improved pregnancy outcomes ( 67 ), mental health ( 68 , 69 ), and life expectancy ( 70 ).…”