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Utilizing the framework of environmental health risk assessment and healing, the article reviews the effectiveness and potential of green space systems in mitigating the impact of high temperatures, promoting mental health, and improving the risk characteristics of high-temperature heat waves. We utilized CiteSpace software to conduct a time-zone analysis of the relationship between heatwaves, green spaces, and health using clustered data from 2001 to 2023. This study evaluates the role of green space systems in mitigating high temperatures and enhancing mental health within the environmental health risk assessment framework. Using CiteSpace software, we analyzed literature from 2001 to 2023, focusing on the interactions among heatwaves, green spaces, and health. Our results indicate that most existing research concentrates on hazard identification, with insufficient exploration of the dose-response relationships between green spaces and temperature reduction. Quantitative studies on green space design and spatial optimization are scarce, and guidance on effective configurations remains limited. Additionally, the health impacts of heatwaves vary by region, with a noticeable imbalance in research focus; Asia and Africa, in particular, are underrepresented in studies addressing heatwave effects. We conclude that effective mitigation strategies require: (1) a comprehensive environmental health risk assessment framework that integrates advanced methods like big data analysis and geospatial simulations to improve green space planning and design; (2) further theoretical exploration into the mechanisms by which green spaces regulate temperature and mental health, including detailed analysis of spatiotemporal patterns and the functional optimization of green space structures; and (3) the development of robust parameterized design guidance based on specific therapeutic dosages (green space stimulus) to optimize configurations and enhance the effectiveness of green spaces in mitigating adverse mental health impacts from deteriorating thermal environments. Future research should prioritize underrepresented regions, focusing on exposure levels, dose-response relationships, and high-temperature warning systems while fostering multidisciplinary collaboration to develop effective urban planning and climate adaptation strategies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Human activities have induced unprecedented global shifts in natural systems including the climate, the oceans, cryosphere and biosphere. The impacts of these changes on physical health are clear and are accelerating at an alarming rate. Climate change and its consequences, especially disruptive events like floods, droughts and heat waves also impact the mental health of affected populations, increasing risk for post-traumatic stress, depression and anxiety disorders. However, the impact of climate change on mental health is not well examined and has received less attention than climate's impacts on physical health., Goal: The paper examines the planetary health-mental health nexus. It assesses the existing state of knowledge on the association between climate events, natural disasters, pollution, access to green space and mental health. It also presents a global analysis of the economic costs of climate-related mental health disorders by developing scenarios estimating the costs of mental illness at the country level predicted to be attributable to changes in environmental factors during the period 2020-2050., Findings: Globally, the additional societal costs of mental disorders due to changes in climate-related hazards, air pollution and inadequate access to green space are estimated to be almost US$47 billion annually in 2030. These estimated costs will continue to grow exponentially to US$537 billion in 2050, relative to a baseline scenario in which these environmental factors remain at 2020 levels., Conclusions: Our scenario analysis shows that the costs associated with climate-related mental health morbidity and mortality are high already and continue to will increase sharply in coming decades. There is need therefore to strengthen the evidence linking climate change to mental health and to prioritize the development of evidence-based and impactful interventions to address the global burden of environment-related mental disorders., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2023 The Author(s).)

Objective: Empirical evidence on the relationship between environmental factors and mental health remains inconclusive. One reason is that there is only scant evidence on the association between mental health and subjective exposure to environmental stressors, relative to objective pollution. We thus focus on how the perceived and actual presence of noise, air pollution, and green spaces relates to mental health., Methods and Results: Our cross-sectional study is based on a large representative sample of the adult population in Switzerland (n = 5729). Using individual-level geocodes of subjects' residence, we combined data from a survey of these individuals with data on objectively measured longer-term environmental conditions (noise, air pollution, green spaces). Subclinical mental health was assessed with the 12-item General Health Questionnaire (GHQ-12). When fitting multiple regressions and mediation models, we find that perceptions of environmental stressors are a better predictor of mental distress than objectively measured stressors. In addition, the predictive power of actual nature visits is stronger than the predictive power of mere proximity to green spaces at the place of residence. We found no direct link between actual environmental stressors and mental health, but mediation via perceived environmental stressors. Further, the association between the frequency of nature visits and mental health is mediated by perceived, but not actual pollution., Conclusion: Since actual environmental stressors are not perceived as equally burdensome by all people, their subjective perception is crucial when evaluating policy interventions aimed at improving mental health. Even a relatively low level of environmental stressors, classified as non-harmful to human health in a physical or biological sense, may thus contribute to negative mental health outcomes. The main policy implication is that attractive and accessible green spaces may provide individuals with an enhanced sense of control over their exposure to environmental stressors and thereby reduce negative impacts., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Mental health disorders account for over 30% of the global burden of disease. There is a positive association between green space exposure and better mental health, and therefore urban greening can be an effective public health tool. Barcelona is a compact city with one of the highest population and traffic densities in Europe, with limited green spaces. Under the umbrella of the Superblock model, the Barcelona City council is implementing the Eixos Verds Plan for extensive street greening. We estimated the potential mental health benefits of this plan., Methods: We performed a quantitative health impact assessment at the Barcelona grid-cell level (n = 1,096). We compared the baseline green space situation (2015) with the proposed plan and translated the increase in green space into a) percentage of green area (%GA) and b) NDVI. We combined exposure data with Barcelona-specific mental health risk estimates, adult population (n = 1,235,375), and mental health data, and calculated preventable cases., Findings: Under the Eixos Verds Plan, we estimated an average increase of 5·67 %GA (range: 0·00% - 15·77%) and 0·059 NDVI (range: 0·000 - 0·312). We estimated that with the Eixos Verds Plan implementation, 31,353 (95%CI: 18,126-42,882) cases of self-perceived poor mental health (14·03% of total), 16,800 (95%CI: 6828-25,700) visits to mental health specialists (13·37% of total), 13,375 (95%CI: 6107-19,184) cases of antidepressant use (13·37% of total), and 9476 (95%CI: 802-16,391) cases of tranquilliser/ sedative use (8·11% of total) could be prevented annually, along corresponding to over 45 M € annual savings in mental health costs annually., Interpretation: Our results highlight the importance of urban greening as a public health tool to improve mental health in cities. Similar results for green interventions in other cities could be expected., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Climate change may affect mental health. We conducted an umbrella review of meta-analyses examining the association between mental health and climate events related to climate change, pollution and green spaces. We searched major bibliographic databases and included meta-analyses with at least five primary studies. Results were summarized narratively. We included 24 meta-analyses on mental health and climate events ( n = 13), pollution ( n = 11), and green spaces ( n = 2) (two meta-analyses provided data on two categories). The quality was suboptimal. According to AMSTAR-2, the overall confidence in the results was high for none of the studies, for three it was moderate, and for the other studies the confidence was low to critically low. The meta-analyses on climate events suggested an increased prevalence of symptoms of post-traumatic stress, depression, and anxiety associated with the exposure to various types of climate events, although the effect sizes differed considerably across study and not all were significant. The meta-analyses on pollution suggested that there may be a small but significant association between PM 2.5 , PM 10 , NO 2 , SO 2 , CO and mental health, especially depression and suicide, as well as autism spectrum disorders after exposure during pregnancy, but the resulting effect sizes varied considerably. Serious methodological flaws make it difficult to draw credible conclusions. We found reasonable evidence for an association between climate events and mental health and some evidence for an association between pollution and mental disorders. More high-quality research is needed to verify these associations.

This study investigated the influence of designed natural outdoor spaces and space type on the physical, mental, and physiological health status of elderlies. A total of 978 questionnaires were distributed among a population-based randomized sample of elderlies residing in Bandar Abbas city, Iran. Blue space users reported better health status. Park access was associated with physical and physiological health. Those participants who had cardiovascular diseases were more likely to visit the parks more often, while the people with hypertension visited the parks less often. Length of park stay positively was associated with all aspects of health status. In addition, the level of physical activity positively was associated with physical and mental health. The park organizations should work on establishing parks in shorter distances and consider the opportunity for elderlies to participate in social programs to encourage them to frequently visit the parks and increase their length of park stay.

Background: With an increasing volume of research exploring the pathways linking greenspace exposure to mental health, there is a need to synthesise the strength of evidence on the mediation mechanisms. Synthesising the strength of evidence on the pathways can help us better understand how greenspace exposure affects mental health and guide future green space interventions to improve mental health., Purpose: The purpose of this study was to synthesise current evidence on the pathways linking objectively-measured greenspace exposure and mental health using a systematic review approach., Methods: Literature searches were conducted in March 2020 from five common databases (i.e., MEDLINE, Embase, PsycINFO, SPORTDiscus, and Web of Science) using search terms of green spaces and mental health. English language and human population were imposed as search limits. The Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guideline was followed to synthesise and report results., Results: The initial systematic searches yielded 16,415 records, of which 26 studies met the inclusion criteria. Mixed or non-significant evidence was revealed for the mediating effects of air quality, physical activity, perceived stress, perceived restorativeness, residential noise, social cohesion, and social support on the pathways from greenspace exposure to mental illness. The effect of greenspace exposure on mental well-being was mediated by air quality, perceived stress, and physical activity. In addition, mixed evidence was revealed for the mediating role of social cohesion on the path from greenspace exposure to mental well-being., Conclusions: This systematic review highlighted the key pathways linking green spaces to mental well-being via harmful mitigation, psychological restoration, and encouragement of health-related behaviours. Evidence for the pathway between greenspace exposure and mental illness is equivocal at present. Future research is recommended to adopt well-designed longitudinal and experimental studies to establish causal inferences on mental health benefits of greenspace exposure., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Several studies have assessed the relationship between exposure to natural environments (NEs) and childhood mental health and development. In most cases, a positive association has been found, but results are inconsistent, and the strength of association is unclear. This inconsistency may reflect the heterogeneity in measurements used to assess NE., Objectives: This systematic review aims to identify the most common NE metrics used in childhood mental health and development research. Our second aim is to identify the metrics that are most consistently associated with health and assess the relative strength of association depending on type of NE exposure measurement, in terms of metric used (i.e., measurement technique, such as remote sensing), but also rate (i.e., spatial and temporal exposure)., Methods: We used the PRISMA protocol to identify eligible studies, following a set of pre-defined inclusion criteria based on the PECOS strategy. A number of keywords were used for retrieving relevant articles from Medline, Embase, PsychINFO, and Web of Science databases between January 2000-November 2020. From these, we extracted data on type of NE measurement and relative association to a number of indicators of childhood mental health and development. We conducted a systematic assessment of quality and risk of bias in the included articles to evaluate the level of evidence. Case studies and qualitative studies were excluded., Results: After screening of title (283 studies included), abstract, and full article, 45 studies were included in our review. A majority of which were conducted in North America and Europe (n = 36; 80%). The majority of studies used land use or land covers (LULC, n = 24; 35%) to determine exposures to NEs. Other metrics included the normalized difference vegetation index (NDVI), expert measures (e.g., surveys of data collection done by experts), surveys (e.g., self-reported assessments), and use of NE (e.g., measures of a participant's use of NE such as through GPS tracts or parent reports). Rate was most commonly determined by buffer zones around residential addresses or postal codes. The most consistent association to health outcomes was found for buffers of 100 m, 250 m, 500 m, and within polygons boundaries (e.g., census tracts). Six health categories, academic achievement, prevalence of doctor diagnosed disorders, emotional and behavioral functioning, well-being, social functioning, and cognitive skills, were created post hoc. We found sufficient evidence between NDVI (Landsat) and emotional and behavioral well-being. Additionally, we found limited evidence between LULC datasets and academic achievement; use of NE, parent/guardian reported greenness, and expert measures of greenness and emotional and behavioral functioning; and use of NE and social functioning., Discussion: This review demonstrates that several NE measurements must be evaluated further before sufficient evidence for a potential association between distinct NE exposure metrics and childhood mental health and development can be established. Further, we suggest increased coordination between research efforts, for example, by replication of studies and comparing different NE measurements systematically, so that effect sizes can be confirmed for various health outcomes. Finally, we recommend implementing research designs that assess underlying pathways of nature-health relations and utilize measurement techniques that adequately assess exposure, access, use, and perception of NEs in order to contribute to a better understanding of health impacts of surrounding natural environments., (Copyright © 2021 Elsevier GmbH. All rights reserved.)

Background: Our planet is currently experiencing the largest wave of urban growth in history, with 55% of the world's population (4.2 billion people) currently living in urban areas, a figure set to rise to 70% by 2050. Primary care is the first point of treatment for most mental health disorders. Since the urban environment and health are intrinsically linked, it is useful to examine the effectiveness of Nature-Based Solutions in addressing mental health., Aims: The aim of this scoping review was to examine "How urban green spaces can improve mental health and wellbeing among patients attending general practice and primary care?", Methods: The scoping review framework comprised a five-stage process developed by Arksey and O'Malley., Results: Twenty-five studies were included in the review, mostly cross-sectional studies. A wide range of mental health outcomes were identified. Out of the 25 included studies, 23 showed positive associations between mental health and green space characteristics., Conclusion: Our findings suggest that while green spaces are associated with positive mental health outcomes, most studies were cross-sectional in nature and provided limited evidence for association. Furthermore, the population samples used in most of the studies were taken from national survey data and were not specifically primary care patients. Further studies that assess primary care patients specifically are warranted.

Background: Inadequate translation from theoretical to statistical models of the greenspace - health relationship may lead to incorrect conclusions about the importance of some pathways, which in turn may reduce the effectiveness of public health interventions involving urban greening. In this scoping review we aimed to: (1) summarize the general characteristics of approaches to intervening variable inference (mediation analysis) employed in epidemiological research in the field; (2) identify potential threats to the validity of findings; and (3) propose recommendations for planning, conducting, and reporting mediation analyses., Methods: We conducted a scoping review, searching PubMed, Scopus, and Web of Science for peer-reviewed epidemiological studies published by December 31, 2019. The list of potential studies was continuously updated through other sources until March 2020. Narrative presentation of the results was coupled with descriptive summary of study characteristics., Results: We found 106 studies, most of which were cross-sectional in design. Most studies only had a spatial measure of greenspace. Mental health/well-being was the most commonly studied outcome, and physical activity and air pollution were the most commonly tested intervening variables. Most studies only conducted single mediation analysis, even when multiple potentially intertwined mediators were measured. The analytical approaches used were causal steps, difference-of-coefficients, product-of-coefficients, counterfactual framework, and structural equation modelling (SEM). Bootstrapping was the most commonly used method to construct the 95% CI of the indirect effect. The product-of-coefficients method and SEM as used to investigate serial mediation components were more likely to yield findings of indirect effect. In some cases, the causal steps approach thwarted tests of indirect effect, even though both links in an indirect effect were supported. In most studies, sensitivity analyses and proper methodological discussion of the modelling approach were missing., Conclusions: We found a persistent pattern of suboptimal conduct and reporting of mediation analysis in epidemiological studies investigating pathways linking greenspace to health; however, recent years have seen improvements in these respects. Better planning, conduct, and reporting of mediation analyses are warranted., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Contact with the natural environment in green and blue spaces can have a valuable influence on population physical and mental health and wellbeing. The aim of this study is to explore the economic evidence associated with the public's value for accessing, using and improving local environments to undertake recreational activity and consuming the associated health benefits of green and blue spaces. Applying the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature search was conducted. Peer-reviewed articles were sought using electronic databases, scrutiny of reference lists, experts and grey literature. All relevant papers meeting the criteria were critically appraised for methodological quality using the Drummond checklist. The review search concluded with 12 papers applying the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach to assess the quality with a narrative analysis conducted under the themes. Results suggest the public value access to green and blue spaces to undertake recreational activities and avoid delay or losing the recreational experience and associated health benefits. The public are willing to pay between £5.72 and £15.64 in 2019 value estimates for not postponing or losing an outdoor experience and for walking in local environments under current and improved environmental conditions, respectively. Valuation estimates indicate the public value green and blue spaces and are willing to pay to improve local environments to gain the health benefits of undertaking leisure activities in green and blue spaces.

Aim: The aim of this study was to determine the association between levels of residential surrounding greenness, preschool children's park use, sedentary behaviour, and mental and general health., Methods: This cross-sectional study included 1489 4-6-year-old children - residents of Kaunas city, Lithuania. Responses to the questionnaires completed by parents were used to ascertain children's general and mental health. We estimated exposure to greenness by the normalised difference vegetation index (NDVI), and time spent in a park (i.e. park use). We used multivariate logistic regression models to explore the independent associations between health outcomes and surrounding greenness and time spent in the nearest city park, controlling for potential confounders., Results: Of all the studied children, 14% had poor perceived general health, and 44.7% spent 5 or more hours per week in city parks. A significant increase in sedentary behaviour was observed in children with poor health. Every additional hour of time spent in parks was associated with decreased sedentary behaviour and a lower risk of poor health; meanwhile, lower residential greenness was associated with poorer mental and general health. Compared with NDVI-100 m > median and park use exceeding 5 h per week, lower greenness exposure and shorter park usage were associated with the risk of poor health (adjusted odds ratio 2.32 (95% CI: 1.43, 3.78) and the general risk of mental difficulties (adjusted odds ratio 1.43 (95% CI: 1.03, 2.18) in 4-6-year-old children., Conclusions: Lower residential greenness levels and less time spent in a park were associated with poorer general and mental health among 4-6-year-old children. Physical activity in green spaces is recommended as a measure to prevent poor general and mental health among children., (Copyright © 2019 Elsevier GmbH. All rights reserved.)

Background: Evidence is growing for the beneficial impacts of natural outdoor environments on health. However, most of the evidence has focused on green spaces and little evidence is available on health benefits of blue spaces and about possible mediators and modifiers of such impacts. We investigated the association between natural outdoor environments (separately for green and blue spaces) and health (general and mental) and its possible mediators and modifiers., Methods: Cross-sectional data from adults interviewed in Catalonia (Spain) between 2010 and 2012 as part of the Catalonia Health Survey were used. The collected data included sociodemographic characteristics, self-perceived general health, mental health, physical activity and social support. Indicators of surrounding greenness and access to natural outdoor environments within 300 m of the residence and degree of urbanization were derived for residential addresses. Associations were estimated using logistic regression and negative binominal models., Results: Green spaces were associated with better self-perceived general health and better mental health, independent of degree of urbanization. The associations were more consistent for surrounding greenness than for access to green spaces. The results were consistent for different buffers, and when stratifying for socioeconomic status. Slightly stronger associations were found for women and residents of non-densely populated areas. No association was found between green spaces and social contacts and physical activity. The results for blue spaces were not conclusive., Conclusion: Green spaces are associated with better general and mental health across strata of urbanization, socioeconomic status, and genders. Mechanisms other than physical activity or social support may explain these associations., (Copyright © 2015. Published by Elsevier Ltd.)

In the framework of place attachment we explore how green spaces contribute to life satisfaction in a context of high emigration rates. We propose that green spaces affect life satisfaction of the population through the mediation of physical health and mental health, and this relationship is moderated by migration willingness. We conducted our study in March–April 2021 in the city of Tirana, Albania. Using physical and mental health indicators, our results demonstrate that urban green spaces directly and indirectly affect life satisfaction. The mediators with the highest impact on life satisfaction are psychological distress and well-being. Green space exposure plays a role in influencing health outcomes, but the relationship is not moderated by migration willingness, and it shows a higher impact on participants with better mental health. Designing more and improved urban green spaces is a pathway to positively affect the health and well-being of urban populations. [ABSTRACT FROM AUTHOR]

Urban green spaces contribute to improving people's physical and mental health by reducing levels of stress and anxiety. Marginalized communities in the USA experience poor health outcome in part because of health disparities related to social and structural determinants of health. The purpose of this study is to assess the prospective role of Kellogg Park, a newly built community park in a marginalized community in California, in enhancing residents' physical and mental health. The researchers collected the data by conducting an in-person survey, which covered questions related to environmental and safety perceptions, overall satisfaction, changes in physical activity changes and mental health with respondents' pre- and post-occupancy experiences. For analyzing data, bivariate analyses using a t-test and a correlation analysis were conducted to examine if there was a relationship between the overall satisfaction and visiting experience. The results indicated an increased positive environmental perception. Besides, respondents reported positively to questions of safety and their overall satisfaction. This research yielded positive results, indicating an improvement in the respondents' physical activity changes and mental health after the construction of the park. The results will advocate for and assist planners, designers, and policy-makers in prioritizing green spaces in marginalized communities. [ABSTRACT FROM AUTHOR]

People with lower subjective socioeconomic status are more prone to experiencing anxiety and poorer subjective well-being. Nature's restorative ability can play an important role among this group, given that spending time outdoors is often associated with better overall mental health and well-being. In this study, we aim to explore the moderating effect of recent visits to green and blue natural spaces on the mediated relationship between subjective socioeconomic status, anxiety and subjective well-being. A nationally representative sample of 946 Portuguese respondents was recruited. Results showed that anxiety mediated the relationship between subjective socioeconomic status and subjective well-being. In addition, the mediation effect was weaker for those who visited natural spaces more frequently, suggesting that spending time in nature buffers against the anxiety associated with lower subjective socioeconomic status from translating into poorer subjective well-being. These findings highlight the importance of using nature as a cost-effective strategy to assist in mitigating the negative effects of low subjective socioeconomic status. [ABSTRACT FROM AUTHOR]

This study examines the relationship between urban green spaces and residents' mental health, specifically focusing on the role of physical exercise as a mediator. These findings have important implications for urban planning, public health policy, and individual health promotion. This study utilised a cross-sectional design and included 2647 participants from the 2021 China General Social Survey (CGSS 2021), with an average age of (51.34±17.57) years. The study employed the instruments from CGSS 2021 to examine participants' perception of urban green spaces, physical exercise status, and mental health. Data analysis was conducted using SPSS version 21.0 and Stata 12.0. The analysis included Spearman's and Pearson's correlation methods, as well as multi-variable linear regression and mediation analysis. The study revealed a strong positive correlation between urban green spaces, physical exercise engagement, and the promotion of mental well-being. However, there was no statistically significant relationship found between the amount of urban green spaces and the frequency of exercise. Furthermore, after controlling for other variables, a significant positive correlation was found between the presence of urban green spaces and the mental well-being of the community. This relationship was partially mediated by physical exercise. The findings offer a scientific foundation for future urban planning, green space construction, and public health policy formulation. They also provide valuable references for enhancing residents' quality of life and promoting mental health. [ABSTRACT FROM AUTHOR]

Although previous studies have shown that exposure to nature has a positive impact on physical and mental health, the factors that produce such benefits are still not well established, especially in high- and middle-income countries. In the present study, we implemented a mediation approach between green space exposure and psychological distress, body fat percentage and well-being index in Tirana (Albania), through the mediation of physical activity. The significant direct effects of green space on body fat percentage index (BFPI), psychological distress index (PDI) and well-being index, together with the relatively smaller mediating role of physical activity, offer insightful implications for the design and prioritization of urban green spaces. The differential impact on health outcomes suggests a complex association that is not only mediated by physical activity, but also offers clear benefits by reducing psychological distress (as indicated by PDI scores) and significantly improving overall well-being. This dichotomy highlights the multifaceted role of green spaces in public health, requiring a broad lens that goes beyond physical health metrics to include mental health and subjective well-being. Our findings also confirm the intrinsic value of green spaces in improving well-being and reducing psychological distress, independent of the physical activities they may promote.

Green spaces (green infrastructure, green areas) are important components of urban environment. They are able to mitigate health outcomes of climatic risks, exposure to urbanization and adverse environmental factors. Bigger areas covered with plants should increase their accessibility for people living in cities. Analysis of the results reported in foreign studies that addressed influence of green spaces on public health proves that they promote physical activity by urban citizens, sports included, development of interpersonal communication and social interactions, improve mental health, and reduce prevalence of diabetes mellitus and other diseases. In some cases massive construction of residential housing and public buildings in Russian megacities and large cities led to reduction in green areas. The existing construction standards in Russia do not consider the recommendation of the WHO/Europe that requires accessibility of green spaces within a 15–20 minute walking distance and provision of 9 m2 of green spaces per person. Utility of green spaces for public health depends on evenness of their distribution. In case their distribution is mosaic, their benefits for public health and protection capacities are reduced. The present review shows the importance, needs and advantages of developing green infrastructure with continuous canopy that create potent green shading.

Recent years have witnessed a growth in research on urban green spaces given their significance to human wellbeing and environmental management. This paper explores the perceived health benefits of urban green areas by drawing on the experiences of 95 participants sampled from three urban communities in the Kumasi Metropolis of Ghana. It is a qualitative study employing a cross-sectional design. The paper argues that participants' perceptions straddle physical and non-physical dimensions of health. From the physical perspective, the participants revealed that green spaces improved physical activity and reduced incidence of cardiovascular diseases and high blood pressure. The non-physical health benefits included improved attention, reduced stress and positive emotions such as happiness. The findings of this paper call for broad-based multi-sectoral approach to managing green spaces in urban Ghana. [ABSTRACT FROM AUTHOR]

There has been increasing interest in how green spaces and gardening contribute to people's physical, mental and social wellbeing, and this interest has increased due to COVID-19. This article explores the particular experiences of migrant gardeners and the implications for their health and wellbeing. It draws on a qualitative research project that involved conducting semi-structured interviews with participants with migration heritage in and around a city in the north of England. The participants were recruited through purposive and snowball sampling; of the 25 participants, some were allotment holders, whilst the rest cultivated crops in their gardens or even on their balcony. Thematic analysis of the interview transcripts generated themes that reflect current definitions of health, encompassing physical, mental and social wellbeing. However, whilst the findings confirm many positive effects of gardening, they also point to some ambivalence in relation to cultivation, outdoor practices and health, with evidence of neutral or even negative effects at times. The article explores the implications of these findings for initiatives to encourage gardening, such as social prescribing, and to address 'green poverty'. An additional finding is that for gardeners with migration heritage, gardening can be understood in terms of cultural wellbeing. Consequently, there is a need to broaden the concept of wellbeing to include this cultural dimension. [ABSTRACT FROM AUTHOR]

Unrestrained urbanisation and natural space loss are reducing contact with nature in today's society, producing negative consequences for people's mental and physical health and wellbeing. Nature-based therapies, such as physical activity in natural settings, forest bathing, therapeutic hiking, or experiential learning, reduce anxiety and depressive symptoms and improve the quality of life in both general and specific populations. A bibliometric analysis of research on nature-based therapies was performed by applying the traditional laws of bibliometrics (exponential growth law, Bradford's concentration law, Lotka's law, Zipf's law, etc.) to documents published in journals indexed in the Core Collection of the Web of Science (WoS). Graphical visualisation was performed using the VOSviewer software. Annual publications between 2006 and 2021 presented an exponential growth trend (R2 = 91%). The International Journal of Environmental Research and Public Health (MDPI) and Urban Forestry & Urban Greening (Elsevier) were the most productive and cited journals. Ikei, Miyazaki, and Song are the most cited prolific authors. The USA and South Korea were the countries with the highest scientific production. In recent years, there has been a growing interest in adventure, nature, and forest therapies among researchers. Nature-based therapies have experienced a growing interest in recent years. Positive effects on mental, physical, and emotional health have been found in different populations and research lines, although more studies with different designs and populations are needed. [ABSTRACT FROM AUTHOR]

The theory of health fairness requires that improving the benefits of green spaces on health should take into account the characteristics of vulnerable groups such as older adults. Until now, the comprehensive associations of green spaces metrics with older adults' mental health are unclear in China. This study aimed to systematically assess their associations from the perspective of spatiality, sociality and historicality. Data of 879 respondents aged 60 or older in Dalian, China were used, and multilevel linear models were conducted in HLM6.08. Results indicated that in the spatial dimension, green spaces metrics derived from overhead view had a stronger association with older adults' mental health than from street view. The park with gentle slopes and irregular boundaries was more positively related to older adults' mental health. In the social dimension, green spaces could adjust and buffer the negative effects of socio-demographic characteristics such as having no homeownership. In the historical dimension, green spaces had a lasting effect on older adults' mental health, especially for the group of middle income. Our findings confirm the necessity of multidimensional assessments for green spaces to examine associations with older adults' mental health in Chinese settings. The results can provide empirical evidence for realizing fairer allocation of urban green spaces resources taking into account individual differences. [ABSTRACT FROM AUTHOR]

Background: Mental health disorders account for over 30% of the global burden of disease. There is a positive association between green space exposure and better mental health, and therefore urban greening can be an effective public health tool. Barcelona is a compact city with one of the highest population and traffic densities in Europe, with limited green spaces. Under the umbrella of the Superblock model, the Barcelona City council is implementing the Eixos Verds Plan for extensive street greening. We estimated the potential mental health benefits of this plan. Methods: We performed a quantitative health impact assessment at the Barcelona grid-cell level (n = 1,096). We compared the baseline green space situation (2015) with the proposed plan and translated the increase in green space into a) percentage of green area (%GA) and b) NDVI. We combined exposure data with Barcelona-specific mental health risk estimates, adult population (n = 1,235,375), and mental health data, and calculated preventable cases. Findings: Under the Eixos Verds Plan, we estimated an average increase of 5·67 %GA (range: 0·00% − 15·77%) and 0·059 NDVI (range: 0·000 − 0·312). We estimated that with the Eixos Verds Plan implementation, 31,353 (95%CI: 18,126–42,882) cases of self-perceived poor mental health (14·03% of total), 16,800 (95%CI: 6828–25,700) visits to mental health specialists (13·37% of total), 13,375 (95%CI: 6107–19,184) cases of antidepressant use (13·37% of total), and 9476 (95%CI: 802–16,391) cases of tranquilliser/ sedative use (8·11% of total) could be prevented annually, along corresponding to over 45 M € annual savings in mental health costs annually. Interpretation: Our results highlight the importance of urban greening as a public health tool to improve mental health in cities. Similar results for green interventions in other cities could be expected.

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Background: Human activities have induced unprecedented global shifts in natural systems including the climate, the oceans, cryosphere and biosphere. The impacts of these changes on physical health are clear and are accelerating at an alarming rate. Climate change and its consequences, especially disruptive events like floods, droughts and heat waves also impact the mental health of affected populations, increasing risk for post-traumatic stress, depression and anxiety disorders. However, the impact of climate change on mental health is not well examined and has received less attention than climate’s impacts on physical health. Goal: The paper examines the planetary health–mental health nexus. It assesses the existing state of knowledge on the association between climate events, natural disasters, pollution, access to green space and mental health. It also presents a global analysis of the economic costs of climate-related mental health disorders by developing scenarios estimating the costs of mental illness at the country level predicted to be attributable to changes in environmental factors during the period 2020–2050. Findings: Globally, the additional societal costs of mental disorders due to changes in climate-related hazards, air pollution and inadequate access to green space are estimated to be almost US$47 billion annually in 2030. These estimated costs will continue to grow exponentially to US$537 billion in 2050, relative to a baseline scenario in which these environmental factors remain at 2020 levels. Conclusions: Our scenario analysis shows that the costs associated with climate-related mental health morbidity and mortality are high already and continue to will increase sharply in coming decades. There is need therefore to strengthen the evidence linking climate change to mental health and to prioritize the development of evidence-based and impactful interventions to address the global burden of environment-related mental disorders.

Previous studies on the relationship between green spaces exposure and emotions paid limited attention to populations with varying mental health conditions, especially the pathways of influence on high-risk mental health populations are less clear. The current study explored the differences of pathways among people with varying mental health conditions using cross-sectional data from 859 individuals residing in 9 neighborhoods in Nanjing, China. Evident illustrate that the neighborhood safety associated with green spaces is important across all populations. The relationship between green spaces and emotional benefits is more complex in populations with good mental health Environmental attractiveness in serial mediation model was a crucial factor influencing later mediators. This study validated emotional benefits are more sensitive to buffer size. In future urban planning, coordinated interventions for different mental health populations should be emphasized. • Pathways of green spaces effects on different mental health groups vary. • Mental health group focuses more on social benefits. • Safety associated by green spaces is important for all groups. • Environmental attractiveness was a crucial factor influencing later mediators. • Mental well-being effects are spatially sensitive. [ABSTRACT FROM AUTHOR]

Purpose: There is growing interest in and evidence for the benefits of connecting with nature for people living with dementia, sometimes known as "green care", including reduced stress, improved sleeping and even enhanced cognition. However, many people living with dementia are denied such opportunities, often because of practitioner perceptions of risk and poor design of outdoor spaces. This paper reports on the evaluation of a project that worked with national providers to give people living with dementia opportunities and support to access the natural environment. Design/methodology/approach: The evaluation adopted a mixed-methods approach, using a combination of bespoke and commonly used tools and in-depth case study work to identify the facilitators and challenges to delivering the project and explore the experiences of activity participants. Findings: Qualitative measures indicated a significant improvement in mental well-being for participants with dementia and family carers following attendance at activity sessions. Research interviews indicated that participants enjoyed activities based on connecting with nature. Being outdoors was a major factor in the experience, along with taking part in activities that were meaningful and opportunities for social interaction. Originality/value: This paper provides evidence for the benefits of connecting with nature for people living with dementia. This paper concludes that access to the outdoors is not a luxury, it is a basic human right and one which has become increasingly important in light of restrictions that have emerged as a result of the COVID19 pandemic. [ABSTRACT FROM AUTHOR]

The present study investigated the new green spaces modelling in Al-Madinah Al-Munawarah using GIS application. It adopted the mental health theory as a theoretical framework. The data of the study was collected through two data collection instruments, namely, questionnaire as well as interview. The quantitative data was analysed through SPSS software while the qualitative data collected from the interviews was qualitatively analysed using thematic content analysis. The findings of the study revealed the most suitable model for potential new green spaces using GIS analysis (descriptive summaries) for urban planning in Al-Madinah Al-Munawarah is Quba (25.5%). Moreover, the most prominent challenge facing the design of a new green space in Al-Medinah Al-Munawarah, Saudi Arabia, is the weakness of the budget allocated to designing green spaces (86.7%). It is also shown that the most prominent benefits of designing new green spaces for the residents of Al-Madinah Al-Munawarah are the provision of seats and seating areas. Therefore, the participants stress the importance of taking into account the provision of seats and seating places when designing green spaces (93.3%). In terms of the potential of developing urban green spaces in Al-Madinah Al -Munawarah, the majority of the respondents believe that urban green spaces can be developed, to a large degree, in Al-Madinah Al-Munawarah in the future. Therefore, the study recommends that urban green spaces should be developed in Al-Madinah Al-Munawarah and the budget allocated to designing green spaces in Al-Madinah Al-Munawarah should be also increased. This study could be considered as a guideline for future development that can be used by government in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Investigating the Relationship between Different Functions of Urban Parks with Mental Health of the Elderly Rostam Saberifar1 1. Associate Professor of Urban Planning, Department of Urban Planning, Faculty of Social Sciences, Payame Noor University, Tehran, Iran. Iran, Mashhad, Blvd. Moallem, Moallem 71,Email: saberifar@yahoo.com , Tel: 009851386839000 Abstract: Background & Objectives: Providing suitable urban spaces, especially open and natural spaces has an undeniable effect on reaching health-based cities and especially providing mental health for the elderly. To this end, the present study was conducted with the aim of assessing these spaces in Mashhad. Methods: This descriptive-analytic cross- sectional study was conducted on 480 elderly citizens selected through random stratified sampling from 13 districts of Mashhad/ Iran in summer 2018. Data collection tools included Goldberg’s General Health Questionnaire and a researcher-made questionnaire for functions of parks. Data analysis was done through SPSS 2019 software and using one-way analysis of variance, t- test as well as Pearson correlation test. Results: Mental health of subjects showed significant statistical relationship with functions of empowerment, preventing stress and anxiety, and air supply for parks and also with variables of ethnicity, employment status, marital status, income, and education. However, mental health of subjects did not show significant relationship with the functions of providing value and entertainment in parks as well as their age, insurance coverage, gender, place of birth, and the number of children. Conclusion: Regarding the undeniable role of parks in mental and physical health of the elderly, policymakers in the health sector and urban planning should consider the specific needs of this group in designing these spaces, including the removal of up and downs of the paths and the design of special spaces for doing light exercises, fences alongside sloping paths and meeting places for discussion outside of traffic routes. Key­words: Health-based city, Green spaces, Mental health, Urban parks, Elderly ­Citation: Saberifar R. The Relationship of Different Functions of Urban Parks with Mental Health of the Elderly. Journal of Health Based Research 2018; 4(3): 289-300. [In Persian]

In the absence of effective pharmacological interventions against COVID-19, many governments have implemented lockdowns and other measures of social isolation. However, these measures are associated with a deterioration in the mental health and well-being of the population. The deleterious effects of lockdowns in the mental health of the population may be more pronounced in cities, in socially disadvantaged communities and among vulnerable demographic groups, such as children and the elderly. Though, the use and contact with urban green spaces (e.g. urban parks, public and private gardens) and other natural spaces (e.g. beaches, riverside areas) can reduce the stress caused by the lockdown and provide opportunities for relaxation, promoting urban resi-lience. This paper aims to discuss the theoretical models underlying this hypothesis, summarize scientific evidence on the topic and launch possible solutions. [ABSTRACT FROM AUTHOR]

Considerable specific cross-sectional and review studies have linked exposure to green spaces to improving public health, but there is no bibliometric review attempting to systemically and retrospectively analyze these existing articles. Here we aim to uncover global research status, trends, and future prospects in green spaces and health (G-H) research then propose a framework for the underlying mechanisms and pathways that link green space to public health. We obtained 18 961 G-H research publications from the core Web of Science collection from 1901 to 2019, analyzing the characteristics of publication outputs, key scientific disciplines, and differences in performance between countries and institutions. Besides, content analysis was conducted to analyze the keywords, including keyword co-occurrence analysis and keyword clustering analysis. We found: (1) a steady quantitative increase in publications, active journals, and involved countries and institutions since the 1990s; (2) a significant increase and changes in G-H related interdisciplinary categories, with environment-related disciplines becoming the mainstream; (3) research focus and trends that were identified based on the analysis of high-frequency co-occurring keywords; (4) three main knowledge domains, namely, green spaces and physical health, mental health, and ecosystem health, that were identified and visualized based on keyword clustering analysis; (5) a framework of underlying mechanisms and pathways linking green space to public health that is proposed based on visualization of the three main knowledge domains. We suggest that the main challenge of G-H research is to further clarify in-depth the underlying mechanisms and pathways from multiple perspectives, including multiple nations, disciplines, and study designs. The lack of co-occurring keywords and clustering information related to social well-being suggests that research related to ‘social health’ is lacking. Based on a clear understanding of the quantity, quality, and characteristics of green space for public health, a health-based environmental plan should be proposed in the future.

Background Although exposure to natural outdoor environments has been consistently associated with improved perceived general health, available evidence on a protective association between this exposure and specific mental health disorders such as depression and anxiety is still limited. Objective The aim of this study was to evaluate the effects of long-term exposure to residential green and blue spaces on anxiety and depression and intake of related medication. Additionally, we aimed to explore potential mediators and effect modifiers of this association. Methods The study was based on an existing adult cohort (ALFA – Alzheimer and Families) and includes 958 adult participants from Barcelona recruited in 2013–2014. For each participant residential green and blue exposure indicators [surrounding greenness (NDVI), amount of green (land-cover) and access to major green spaces and blue spaces] were generated for different buffers (100 m, 300 m and 500 m). Participants reported their history of doctor-diagnosed anxiety and depressive disorders and intake of related medication. Logistic regression models were applied to assess the corresponding associations. Results Increasing surrounding greenness was associated with reduced odds of self-reported history of benzodiazepines [e.g. Odds ratio - OR (95%CI) = 0.62 (0.43, 0.89) for 1-interquartile range (IQR) increase in NDVI in a 300 m buffer] and access to major green spaces was associated with self-reported history of depression [OR (95%CI) = 0.18 (0.06, 0.58)]. No statistically significant associations were observed with blue spaces. Air pollution (between 0.8% and 29.6%) and noise (between 2.2% and 5.3%) mediated a proportion of the associations observed, whereas physical activity and social support played a minor role. Conclusion Our findings suggest a potential protective role of green spaces on mental health (depression and anxiety) in adults, but further studies, especially longitudinal studies, are needed to provide further evidence of these benefits and of the mediation role of exposures like air pollution and noise. [ABSTRACT FROM AUTHOR]

Increasing urbanisation, changing disease scenarios, and current predictions of climate change impacts require innovative strategies for providing healthy and sustainable cities, now and in the future. The recently coined concept, Nature-based solutions (NBS), is one such strategy referring to actions that are inspired by, supported by, or copied from nature , designed to address a range of environmental challenges. The objective with this article is to evaluate the evidence on public health benefits of exposure to natural environments and explore how this knowledge could be framed within the NBS concept. We conducted a systematic review of reviews following established methodology, including keyword search in several databases, predefined inclusion criteria, and a data extraction in accordance with the PICOS structure. We reviewed literature on associations between public health and natural environments in relation to pathways – sociobehavioural/cultural ecosystem services (e.g. stress and physical activity) and regulating ecosystem services (e.g. heat reduction) – or defined health outcomes (e.g. cardiovascular mortality). The results show that there is strong evidence for improved affect as well as on heat reduction from urban natural environments. These conditions may mediate the effect seen on cardiovascular disease (CVD)-related mortality by exposure to natural environments. By also reviewing existing literature on NBS and health, we phrase the results within the NBS context, providing guidelines on how public health and well-being could be integrated into implementation of NBS for resilient and liveable urban landscapes and health in a changing climate. [ABSTRACT FROM AUTHOR]

How might contact with nature promote human health? Myriad studies have linked the two; at this time the task of identifying the mechanisms underlying this link is paramount. This article offers: (1) a compilation of plausible pathways between nature and health; (2) criteria for identifying a possible central pathway; and (3) one promising candidate for a central pathway. The 21 pathways identified here include environmental factors, physiological and psychological states, and behaviors or conditions, each of which has been empirically tied to nature and has implications for specific physical and mental health outcomes. While each is likely to contribute to nature’s impacts on health to some degree and under some circumstances, this paper explores the possibility of a central pathway by proposing criteria for identifying such a pathway and illustrating their use. A particular pathway is more likely to be central if it can account for the size of nature’s impacts on health, account for nature’s specific health outcomes, and subsume other pathways. By these criteria, enhanced immune functioning emerges as one promising candidate for a central pathway between nature and health. There may be others.