Department of Health Sciences, University of York, York YO10 4DD, UK.
York Environmental Sustainability Institute, University of York, York YO10 4DD, UK.
Int J Environ Res Public Health. 2021 Aug 26;18(17):9010. doi: 10.3390/ijerph18179010.
There is growing interest in the ways natural environments influence the development and progression of long-term health conditions. Vegetation and water bodies, also known as green and blue spaces, have the potential to affect health and behaviour through the provision of aesthetic spaces for relaxation, socialisation and physical activity. While research has previously assessed how green and blue spaces affect mental and physical wellbeing, little is known about the relationship between these exposures and health outcomes over time. This systematic review summarised the published evidence from longitudinal observational studies on the relationship between exposure to green and blue space with mental and physical health in adults. Included health outcomes were common mental health conditions, severe mental health conditions and noncommunicable diseases (NCDs). An online bibliographic search of six databases was completed in July 2020. After title, abstract and full-text screening, 44 eligible studies were included in the analysis. Depression, diabetes and obesity were the health conditions most frequently studied in longitudinal relationships. The majority of exposures included indicators of green space availability and urban green space accessibility. Few studies addressed the relationship between blue space and health. The narrative synthesis pointed towards mixed evidence of a protective relationship between exposure to green space and health. There was high heterogeneity in exposure measures and adjustment for confounding between studies. Future policy and research should seek a standardised approach towards measuring green and blue space exposures and employ theoretical grounds for confounder adjustment.
人们越来越关注自然环境对长期健康状况的发展和演变的影响方式。植被和水体（也称为绿色和蓝色空间）具有通过提供放松、社交和体育活动的美学空间来影响健康和行为的潜力。虽然之前的研究评估了绿色和蓝色空间如何影响身心健康，但对于这些暴露与随时间推移的健康结果之间的关系知之甚少。本系统综述总结了关于暴露于绿色和蓝色空间与成年人心理健康和身体健康之间关系的纵向观察性研究的已发表证据。纳入的健康结果包括常见的心理健康状况、严重的心理健康状况和非传染性疾病（NCDs）。2020 年 7 月，我们在六个数据库中进行了在线文献检索。在标题、摘要和全文筛选后，有 44 项符合条件的研究纳入分析。在纵向关系中，抑郁、糖尿病和肥胖是最常研究的健康状况。大多数暴露包括绿色空间可用性和城市绿色空间可达性的指标。很少有研究探讨蓝色空间与健康之间的关系。叙述性综述表明，暴露于绿色空间与健康之间存在保护关系的证据不一。研究之间的暴露措施存在高度异质性，且调整混杂因素的方法也各不相同。未来的政策和研究应寻求一种标准化的方法来衡量绿色和蓝色空间的暴露，并采用理论基础来调整混杂因素。
