Park quality and frequency of park use have both been found to be higher amongst high-socioeconomic status (SES) residents ( Leslie et al., 2010).
Research has shown that low income neighbourhoods have reduced greenspace availability (Thomas Astell-Burt et al., 2014a, Astell-Burt et al., 2014b), and residents of more deprived neighbourhoods are less likely to use those greenspaces that exist ( Jones et al., 2009). Environmental factors form one of the many potential explanations as to their cause ( World Health Organisation, 2016b). Socioeconomic health inequalities have consistently commanded the attention of researchers and policymakers, with evidence that inequalities are currently increasing ( Townsend et al., 1982). Yet a challenge is to ensure those who might benefit the most have sufficient opportunities for exposure to greenspace. Collaborations between health care providers and local nature partnerships are becoming increasingly common across the UK ( Bloomfield, 2014, Kent Nature Partnership, 2014, Naturally Healthy Cambridgeshire, 2016, West of England Nature Partnership, 2016) and further afield ( New Zealand Ministry of Health, 2016), and aim to better capitalise on ways the health of the natural environment is intrinsically linked to human health, striving for “healthy communities in healthy environments” ( Naturally Healthy Cambridgeshire, 2016). Recognition of the health benefits of greenspace exposure was one of the motivations of Oxford General Practitioner William Bird MBE in establishing the UK’s first health walk scheme at his practice in 1995, leading to the foundation of the English Walking for Health programme (WfH) ( Walking for Health, 2016). The term greenspace is typically defined as open, undeveloped land with natural vegetation ( Centres for Disease Control, 2013), although it also exists in many other forms such as urban parks and public open spaces as well as street trees and greenery. However, increasing urbanicity and modern lifestyles can mean that opportunities for human contact with nature become less frequent.
More recent Healthy City guidelines from the WHO support this view, defining a healthy city as “one that continually creates and improves its physical and social environments and expands the community resources that enable people to mutually support each other in performing all the functions of life and developing to their maximum potential” ( World Health Organisation, 2016a). The idea that greenspaces are beneficial for the health of the population became a generally accepted principle as early as the 1800s, when various London-based organisations including the Commons Preservation Society and the National Health Society called for the preservation, creation, and accessibility of open spaces and parks within crowded residential areas, referring to them as the “lungs” of the town or city ( Hickman, 2013).
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. Incidence of stroke, hypertension, dyslipidaemia, asthma, and coronary heart disease were reduced. We included 103 observational and 40 interventional studies investigating ~100 health outcomes.
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