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Nature underpins human well-being in critical ways, especially in health. Nature provides pollination of nutritious crops, purification of drinking water, protection from floods, and climate security, among other well-studied health benefits. A crucial, yet challenging, research frontier is clarifying how nature promotes physical activity for its many mental and physical health benefits, particularly in densely populated cities with scarce and dwindling access to nature. Here we frame this frontier by conceptually developing a spatial decision-support tool that shows where, how, and for whom urban nature promotes physical activity, to inform urban greening efforts and broader health assessments. We synthesize what is known, present a model framework, and detail the model steps and data needs that can yield generalizable spatial models and an effective tool for assessing the urban nature-physical activity relationship. Current knowledge supports an initial model that can distinguish broad trends and enrich urban planning, spatial policy, and public health decisions. New, iterative research and application will reveal the importance of different types of urban nature, the different subpopulations who will benefit from it, and nature's potential contribution to creating more equitable, green, livable cities with active inhabitants.

Urban greening is a major goal in policies for sustainable cities, and spatial planners are nowadays strongly interested in the benefits of greenspace for the well-being of urban residents. We present a novel, model-based approach to support the development of effective greening strategies. The approach is quantitative and spatially explicit and accounts for multiple health benefits as well as burdens. In our study, we applied this generic approach to the city of Maastricht (The Netherlands) and conducted an integrated, city-scale assessment of the health benefits and burdens of four urban greenspace designs. These included: 'No greenspace', 'Current greenspace', 'Green parking lots and squares', and 'Optimized greenspace locations'. For each greenspace design, indicator values were calculated for five determinants of health and well-being: heat stress, air pollution, perceived unsafety, unattractive views, and tick-bite risk. To assess the health contribution of urban greenspace in a given design, these indicator values were compared with the values in the 'No greenspace' design. The study produced clear, quantitative conclusions about the health benefits and burdens of the urban greenspace designs for the case of Maastricht but also generated novel, more general insights relevant to the planning of urban greenspace for health and well-being. These insights concern the importance of translating health policy objectives into specific target values or thresholds and the importance of 'smart' choices in greenspace type and location that can effectively reduce trade-offs between health benefits and burdens, as well as the insights that adding more greenery not always improves urban health and that urban greenspace alone cannot solve major air pollution problems. The priorities for future research, which will address the limitations of the presented approach, concern a further expansion of the range of health benefits and burdens covered by the model and the development of a common metric for the entire range of health benefits and burdens to optimize greenspace design and maximize its overall net health benefit. [ABSTRACT FROM AUTHOR]

Urban green space (UGS) has important impacts on human health, but an integrated participatory approach to UGS design for improved residents' health has been lacking to date. The aim of our study was to develop and evaluate such a novel approach to address this gap. The approach was developed following guiding principles from the literature and tested with groups of children and elderly as participants in two neighborhoods of Maastricht (The Netherlands) with a low score in economic and health indicators. The novel aspects of the approach are the inclusion of both positive and negative health effects, the combination of resident self-assessment and model-based assessment of the health effects of UGS designs, and the use of maps to visualize UGS designs and health effects. The participant-generated UGS designs resulted in a considerable (up to fourfold) self-assessed increase in the use of the UGSs for meeting, stress reduction, and leisure-based physical activity as compared to the current situation. The model-assessed positive and negative health effects of the participant-generated UGS designs were limited: heat stress slightly decreased (by 0.1 °C), active transport slightly increased (by 30 m per day), and the perceived unsafety slightly increased (8%). The effects on unattractive views, air pollution, tick bite risk, and traffic unsafety were negligible. The major strength of this approach is that it combines active participation of residents in UGS (re)design with assessment of the health effects of these UGS designs. While in other participatory approaches to UGS design, it often remains unclear whether the resulting designs represent an improvement in terms of health, our combination of computer model-based assessment and a participatory process produced clear outcomes regarding the health benefits and use of UGS designs. A major recommendation for improvement is to involve decision makers already in the initial steps of the approach. [ABSTRACT FROM AUTHOR]