An inequitable distribution of parks and other ‘green spaces’ could exacerbate health inequalities if people on lower incomes, who are already at greater risk of preventable diseases, have poorer access.
The availability of green space within 1 kilometre of a Statistical Area 1 (SA1) was linked to data from the 2011 Australian census for Sydney (n = 4.6 M residents); Melbourne (n = 4.2 M); Brisbane (n = 2.2 M); Perth (n = 1.8 M); and Adelaide (n = 1.3 M). Socioeconomic circumstances were measured via the percentage population of each SA1 living on < $21,000 per annum. Negative binomial and logit regression models were used to investigate association between the availability of green space in relation to neighbourhood socioeconomic circumstances, adjusting for city and population density.
Green space availability was substantively lower in SA1s with a higher percentage of low income residents (e.g. an incidence rate ratio of 0.82 (95% confidence interval (95% CI) 0.75, 0.89) was observed for SA1s containing ≥20% versus 0-1% low income residents). This association varied between cities (p < 0.001). Adelaide reported the least equitable distribution of green space, with approximately 20% greenery in the most affluent areas versus 12% availability in the least affluent. Although Melbourne had a smaller proportion of SA1s in the top quintile of green space availability (13.8%), the distribution of greenery was the most equitable of all the cities, with only a 0.5% difference in the availability of green space between SA1s containing 0-1% low income households versus those with ≥20%. Inequity of access, however, was reported across all cities when using logit regression to examine the availability of at least 20% (odds ratio 0.74, 95% CI 0.59, 0.93) or 40% (0.45, 0.29, 0.69) green space availability in the more disadvantaged versus affluent neighbourhoods.
Affirmative action on green space planning is required to redress the socioeconomic inequity of access to this important public health resource.
2014 Astell-Burt et al.; licensee BioMed Central Ltd.
Sutton SB: Civilizing American Cities; A Selection of Frederick Law Olmsted’s Writings on City Landscapes. Cambridge: MIT Press; 1971.
Nilsson K, Sangster M, Konijnendijk CC: Introduction. In Forests, trees and human health. Edited by Nilsson K, Sangster M, Gallis C, Hartig T, de Vries S, Seeland K, Schipperijn J. Netherlands: Springer; 2011:1-19.
Australian Government: Our Cities Our Future: A national urban policy for a productive, sustainable and liveable future. Department of Infrastructure and Transport: Canberra; 2011.
The Scottish Government: Good places, better health in Scotland. The Scottish Government: Edinburgh; 2008.
Lachowycz K, Jones AP: Greenspace and obesity: a systematic review of the evidence. Obes Rev 2011, 12:e183-e189.
Lee ACK, Maheswaran R: The health benefits of urban green spaces: a review of the evidence. J Public Health 2010, 33:212-222.
Bowler DE, Buyung-Ali LM, Knight TM, Pullin AS: A systematic review of evidence for the added benefits to health of exposure to natural environments. BMC Public Health 2010, 10:456. BioMed Central Full Text
Hartig T: Green space, psychological restoration, and health inequality. Lancet 2008, 372:1614-1615.
Hartig T, Book A, Garvill J, Olsson T, Garling T: Environmental influences on psychological restoration. Scand J Psychol 1996, 37:378-393.
Hartig T, Evans GW, Jamner LD, Davis DS, Gärling T: Tracking restoration in natural and urban field settings. J Environ Psychol 2003, 23:109-123.
Ulrich RS: Aesthetic and affective response to natural environment. In Human behaviour and environment: Advances in theory and research Behaviour and the natural environment. Volume 6. Edited by Altman I, Wohlwill JF. New York: Plenum Press; 1983:85-125.
Astell-Burt T, Feng X, Kolt GS: Mental health benefits of neighbourhood green space are stronger among physically active adults in middle-to-older age: evidence from 260,061 Australians. Prev Med 2013, 57:601-606.
Pretty J, Peacock J, Sellens M, Griffin M: The mental and physical health outcomes of green exercise. Int J Environ Health Res 2005, 15:319-337.
Bodin M, Hartig T: Does the outdoor environment matter for psychological restoration gained through running? Psychol Sport Exerc 2003, 4:141-153.
Hug SM, Hartig T, Hansmann R, Seeland K, Hornung R: Restorative qualities of indoor and outdoor exercise settings as predictors of exercise frequency. Health Place 2009, 15:971-980.
Thompson Coon J, Boddy K, Stein K, Whear R, Barton J, Depledge MH: Does participating in physical activity in outdoor natural environments have a greater effect on physical and mental wellbeing than physical activity indoors? A systematic review. Environ Sci Technol 2011, 45:1761-1772.
Mitchell R: Is physical activity in natural environments better for mental health than physical activity in other environments? Soc Sci Med 2012, 91:130-134.
Astell-Burt T, Mitchell R, Hartig T: The association between green space and mental health varies across the lifecourse. A longitudinal study. J Epidemiol Community Health 2014. doi:10.1136/jech-2013-203767
Sugiyama T, Giles-Corti B, Summers J, du Toit L, Leslie E, Owen N: Initiating and maintaining recreational walking: a longitudinal study on the influence of neighborhood green space. Prev Med 2013, 57:178-182.
Giles-Corti B, Broomhall MH, Knuiman M, Collins C, Douglas K, Ng K, Lange A, Donovan RJ: Increasing walking: How important is distance to, attractiveness, and size of public open space? Am J Prev Med 2005, 28:169-176.
Astell-Burt T, Feng X, Kolt GS: Neighbourhood green space is associated with more frequent walking and moderate to vigorous physical activity (MVPA) in middle-to-older aged adults. Findings from 203,883 Australians in The 45 and Up Study. Br J Sports Med 2014, 48:404-406.
Astell-Burt T, Feng X, Kolt GS: Greener neighborhoods, slimmer people? Evidence from 246,920 Australians. Int J Obes 2014, 38:156-159.
Richardson EA, Pearce J, Mitchell R, Kingham S: Role of physical activity in the relationship between urban green space and health. Public Health 2013, 127:318-324.
Cummins S, Fagg J: Does greener mean thinner? Associations between neighbourhood greenspace and weight status among adults in England. Int J Obes 2011, 36:1108-1113.
Maas J, Verheij RA, Spreeuwenberg P, Groenewegen PP: Physical activity as a possible mechanism behind the relationship between green space and health: a multilevel analysis. BMC Public Health 2008, 8:206. BioMed Central Full Text
Mytton OT, Townsend N, Rutter H, Foster C: Green space and physical activity: an observational study using health survey for England data. Health Place 2012, 18:1034-1041.
Francis J, Giles-Corti B, Wood L, Knuiman M: Creating sense of community: The role of public space. J Environ Psychol 2012, 32:401-409.
Kweon BS, Sullivan WC, Wiley AR: Green common spaces and the social integration of inner-city older adults. Environ Behav 1998, 30:832-858.
Astell-Burt T, Feng X, Kolt GS: Does access to neighborhood green space promote a healthy duration of sleep? Novel findings from 259,319 Australians. BMJ Open 2013, 3:e003094.
Maas J, Verheij RA, de Vries S, Spreeuwenberg P, Schellevis FG, Groenewegen PP: Morbidity is related to a green living environment. J Epidemiol Community Health 2009, 63:967-973.
Astell-Burt T, Feng X, Kolt GS: Is Neighborhood Green Space Associated With a Lower Risk of Type 2 Diabetes? Evidence From 267,072 Australians. Diabetes Care 2014, 37:197-201.
Mitchell R, Popham F: Effect of exposure to natural environment on health inequalities: an observational population study. Lancet 2008, 372:1655-1660.
Mitchell R, Astell-Burt T, Richardson EA: A comparison of green space measures for epidemiological research. J Epidemiol Community Health 2011, 65:853-858.
Richardson E, Pearce J, Mitchell R, Day P, Kingham S: The association between green space and cause-specific mortality in urban New Zealand: an ecological analysis of green space utility. BMC Public Health 2010, 10:240. BioMed Central Full Text
Department of Health: Fair Society, Healthy Lives: Strategic Review of Health Inequalities in England Post 2010. London: Department of Health; 2010.
Kweon B-S, Ellis CD, Leiva PI, Rogers GO: Landscape components, land use, and neighborhood satisfaction. Environ Plann B, Plann Des 2010, 37:500.
de Jong K, Albin M, Skärbäck E, Grahn P, Björk J: Perceived green qualities were associated with neighborhood satisfaction, physical activity, and general health: results from a cross-sectional study in suburban and rural Scania, southern Sweden. Health Place 2012, 18(6):1374-1380.
Hur M, Nasar JL, Chun B: Neighborhood satisfaction, physical and perceived naturalness and openness. J Environ Psychol 2010, 30:52-59.
Smith D: Working Paper 42: Valuing housing and green spaces: Understanding local amenities, the built environment and house prices in London. Edited by Authority GL. London: Greater London Authority; 2010.
Conway D, Li CQ, Wolch J, Kahle C, Jerrett M: A spatial autocorrelation approach for examining the effects of urban greenspace on residential property values. J Real Estate Finance Econ 2010, 41:1-20.
Wen M, Zhang X, Harris CD, Holt JB, Croft JB: Spatial Disparities in the Distribution of Parks and Green Spaces in the USA. Ann Behav Med 2013, 45:18-27.
Macintyre S: Deprivation amplification revisited; or, is it always true that poorer places have poorer access to resources for healthy diets and physical activity? Int J Behav Nutr Phys Act 2007, 4:32. BioMed Central Full Text
Timperio A, Ball K, Salmon J, Roberts R, Crawford D: Is availability of public open space equitable across areas? Health Place 2007, 13:335-340.
Pearce J, Witten K, Hiscock R, Blakely T: Are socially disadvantaged neighbourhoods deprived of health-related community resources? Int J Epidemiol 2007, 36:348-355.
Department of Sustainability and Environment: Victorian Planning Provisions. Melbourne: Victorian State Government; 2013.
Western Australian Planning Commission: Liveable neighbourhoods: a Western Australian Government Sustainable Cities Initiative. Western Australian Planning Commission: Perth, WA; 2004.
Australian Bureau of Statistics: 3218.0 - Regional Population Growth, Australia, 2011: Population estimates and Australia’s new statistical geography. Canberra: Australian Bureau of Statistics; 2012.
Australian Bureau of Statistics: Australian Statistical Geography Standard (ASGS): Volume 4 - Significant Urban Areas, Urban Centres and Localities, Section of State. Canberra: Australian Bureau of Statistics; 2011.
Australian Bureau of Statistics: Australian Statistical Geography Standard (ASGS): Volume 1 - Main Structure and Greater Capital City Statistical Areas. Canberra: ; 2011.
Australian Bureau of Statistics: Information paper, Draft Mesh Blocks. Canberra: Australian Bureau of Statistics; 2005.
Burrough P: McDonnell R: Principles of geographical information systems. Oxford: Clarendon Press; 1998.
Maas J, Verheij RA, Groenewegen PP, de Vries S, Spreeuwenberg P: Green space, urbanity, and health: how strong is the relation? J Epidemiol Community Health 2006, 60:587-592.
Giles-Corti B, Donovan RJ: The relative influence of individual, social and physical environment determinants of physical activity. Soc Sci Med 2002, 54:1793-1812.
Pink B: Technical Paper: Socio-Economic Indexes for Areas (SEIFA). Australian Bureau of Statistics: Canberra; 2011.
Lovett A, Flowerdew R: Analysis of count data using poisson regression. Prof Geogr 1989, 41:190-198.
Lovett A, Bentham C, Flowerdew R: Analysing geographic variations in mortality using poisson regression: the example of ischaemic heart disease in England and Wales 1969–1973. Soc Sci Med 1986, 23:935-943.
Astell-Burt T, Flowerdew R, Boyle PJ, Dillon JF: Does geographic access to primary healthcare influence the detection of hepatitis C? Soc Sci Med 2011, 72:1472-1481.
Williams R: A note on robust variance estimation for cluster-correlated data. Biometrics 2000, 56:645-646.
Colagiuri S, Vita P, Cardona-Morrell M, Singh MF, Farrell L, Milat A, Haas M, Bauman A: The Sydney Diabetes Prevention Program: a community-based translational study. BMC Public Health 2010, 10:328. BioMed Central Full Text
Richardson EA, Mitchell R, de Vries S, Hartig T, Astell-Burt T, Frumkin H: Green cities and health: a question of scale. J Epidemiol Community Health 2012, 66:160-165.
Francis J, Wood LJ, Knuiman M, Giles-Corti B: Quality or quantity? Exploring the relationship between Public Open Space attributes and mental health in Perth, Western Australia. Soc Sci Med 2012, 74:1570-1577.
van Dillen SM, de Vries S, Groenewegen PP, Spreeuwenberg P: Greenspace in urban neighbourhoods and residents’ health: adding quality to quantity. J Epidemiol Community Health 2012, 66:e8-e8.
Crawford D, Timperio A, Giles-Corti B, Ball K, Hume C, Roberts R, Andrianopoulos N, Salmon J: Do features of public open spaces vary according to neighbourhood socio-economic status? Health Place 2008, 14:889-893.
Badland H, Keam R, Witten K, Kearns R: Examining public open spaces by neighborhood-level walkability and deprivation. J Phys Activ Health 2010, 7:818.
Foster S, Giles-Corti B, Knuiman M: Neighbourhood design and fear of crime: a social-ecological examination of the correlates of residents’ fear in new suburban housing developments. Health Place 2010, 16:1156-1165.
Mitchell R, Popham F: Greenspace, urbanity and health: relationships in England. J Epidemiol Community Health 2007, 61:681.
Seaman PJ, Jones R, Ellaway A: It’s not just about the park, it’s about integration too: why people choose to use or not use urban greenspaces. Int J Behav Nutr Phys Act 2010, 7:2-9. BioMed Central Full Text
Colagiuri S, Lee CMY, Colagiuri R, Magliano D, Shaw JE, Zimmet PZ, Caterson ID: The cost of overweight and obesity in Australia. Med J Aust 2010, 192:20-264.
Lee CMY, Colagiuri R, Magliano DJ, Cameron AJ, Shaw J, Zimmet P, Colagiuri S: The cost of diabetes in adults in Australia. Diabetes Res Clin Pract 2013.