A recent study published in the Lancet Planetary Health adds to an expanding body of research that demonstrates the tangible public health benefits that access to public green spaces provides. It found a positive association between more – and better access to – green spaces and mental health outcomes.
The study examined the medical records of a cohort of over 2.3 million adults in Wales over a 10-year period, focusing on common mental health disorders (CMD). It considered three household environmental parameters for the cohort as they evolved over the study period – ambient greenness within a radius of 300m (measured by Enhanced Vegetation Index or EVI*), the number of public-access green and blue spaces (GBS) within 1600m of the household, and the distance to the nearest public-access GBS. Ambient greenness includes parks, gardens, tree-lined streets, farmland, etc. whereas GBS consists of parks, beaches, lakes, and greenways, among others.
Analyzing multiple axes enabled the research to provide a more comprehensive illustration of the impact that green spaces have on public health – for example, urban areas may have more public-access GBS but a lower overall EVI, whereas suburban and rural areas may have a higher EVI but very few public-access GBS. Additionally, the study focused on the household situation of the individuals in the cohort to avoid confounding due to gentrification (and the associated health profile improvements that the new inhabitants bring, due to wealth and access) that would have occurred if the research was location-bound.
The research found that exposure to more ambient greenness and greater access to GBS were independently associated with a reduced likelihood of individuals being affected by a mental health disorder. While the association was observed across the cohort, it found that access to GBS had stronger association among deprived communities than affluent areas (10% reduction of CMD vs. 6% per unit measure increase). Additionally, it found that an increase in ambient greenness had a stronger association with a reduced risk of future episodes of mental health disorders for those with a history of CMD than those with no history of CMD.
Beyond the recognized benefits contributing to improved mental health that green space provides to communities – such as fostering a sense of community, stress reduction, exercise, and improved air quality – the research hypothesized that in deprived communities public access to green infrastructure offers relief and respite to people who would not otherwise have the expendable income for recreational activities and that green space has a kind of restorative effect on people recovering from CMD. Further, the research demonstrates that green spaces contribute to reducing health inequalities in communities. The full article by Geary et al. can be accessed below:
The research offers compelling evidence of the need for policy makers and municipal governments to invest in greening their infrastructure and providing more public access options, distributed more evenly, among populations in their communities. Mental health disorders present a significant burden on public health and come at great cost to the community, driving issues such as reduced work performance, substance abuse, family strife, and shorter life expectancy (1).
Quantifying such a cost can be difficult as there are numerous measures by which the impacts may be assessed – loss of income, loss of tax revenue due to loss of income, expenditure on mental health care by individuals, by the state, and by insurance companies, etc. In the United States, the Federal Government alone spent about 280 billion dollars on mental health care services in 2020 while acknowledging that this figure falls short of what is actually needed to address mental health treatment (2). Thus far, curative measures have not proven to be very successful – so it is imperative that communities invest in preventative measures (1), such as the opportunities presented in green space and green infrastructure.
It is worth noting that this concept is not new, nor is it cutting-edge. The link between mental health – and more broadly public health in general – and access to green space has been recognized for well over a century, in the United States most prominently in the works of Frederick Law Olmsted (3). For over a hundred and fifty years, millions of people have benefited from fin-de-siècle investment in Olmsted’s vision of widespread access to gardens and green space. In a neoliberal age of expanding urban areas where suburban sprawl shapes land use patterns, it is critical that communities invest in ecumenical public access to green spaces to enhance public health outcomes and the general well-being of their citizens. It will pay dividends for generations to come.
*More information on EVI can be found on the US Geological Survey website:
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1 – Ormel, J. and VonKorff, M. (2021). ‘Debate: Giving prevention a chance to prove its worth in lowering common mental disorder prevalence: how long will it take?’, Child and Adolescent Mental Health, 26(1), pp. 86-88. Wiley Online Library [Online]. DOI: https://doi.org/10.1111/camh.12445
2 – Council of Economic Advisors (CEA) (2022). Reducing the economic burden of unmet mental health needs. Issue Briefs, 31 May. Washington, DC: The White House [Online]. Available at: https://www.whitehouse.gov/cea/written-materials/2022/05/31/reducing-the-economic-burden-of-unmet-mental-health-needs/#:~:text=The%20Federal%20Government%20covers%20some,from%20the%20U.S.%20Medicaid%20program.
3 – Fisher, T. (2010). ‘Frederick Law Olmsted and the campaign for public health’, Places Journal, November. [Online]. Available at: https://placesjournal.org/article/frederick-law-olmsted-and-the-campaign-for-public-health/?cn-reloaded=1.
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