Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, Australia.
Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden.
Sci Total Environ. 2022 Nov 15;847:157521. doi: 10.1016/j.scitotenv.2022.157521. Epub 2022 Jul 22.
Persistent loneliness troubles people across the life span, with prevalence as high as 61 % in some groups. Urban greening may help to reduce the population health impacts of loneliness and its concomitants, such as hopelessness and despair. However, the literature lacks both a critical appraisal of extant evidence and a conceptual model to explain how green space would work as a structural intervention. Both are needed to guide decision making and further research. We conducted a systematic review of quantitative studies testing associations between green space and loneliness, searching seven databases. Twenty two studies were identified by 25/01/2022. Most of the studies were conducted in high-income countries and fifteen (68 %) had cross-sectional designs. Green space was measured inconsistently using either objective or subjective indicators. Few studies examined specific green space types or qualities. The majority of studies measured general loneliness (e.g. using the UCLA loneliness scale). Different types of loneliness (social, emotional, existential) were not analysed. Of 132 associations, 88 (66.6 %) indicated potential protection from green space against loneliness, with 44 (33.3 %) reaching statistical significance (p < 0.05). We integrated these findings with evidence from qualitative studies to elaborate and extend the existing pathway domain model linking green space and health. These elaborations and extensions acknowledge the following: (a) different types of green space have implications for different types of loneliness; (b) multilevel circumstances influence the likelihood a person will benefit or suffer harm from green space; (c) personal, relational, and collective processes operate within different domains of pathways linking green space with loneliness and its concomitants; (d) loneliness and its concomitants are explicitly positioned as mediators within the broader causal system that links green space with health and wellbeing. This review and model provide guidance for decision making and further epidemiological research on green space and loneliness.
持续性孤独困扰着各个年龄段的人群，某些群体的患病率高达 61%。城市绿化可能有助于减轻孤独及其伴随的绝望和无助等问题对人群健康的影响。然而，现有文献缺乏对现有证据的批判性评估，也缺乏解释绿地如何作为一种结构性干预发挥作用的概念模型。这两者都是指导决策和进一步研究的必要条件。我们对测试绿地与孤独感之间关联的定量研究进行了系统回顾，检索了七个数据库。截至 2022 年 1 月 25 日，共确定了 22 项研究。大多数研究是在高收入国家进行的，其中 15 项（68%）采用了横断面设计。绿地使用客观或主观指标进行了不一致的测量。很少有研究检查特定的绿地类型或质量。大多数研究测量了一般孤独感（例如使用 UCLA 孤独量表）。不同类型的孤独感（社交、情感、存在）没有进行分析。在 132 个关联中，88 个（66.6%）表明绿地对孤独感有潜在的保护作用，其中 44 个（33.3%）达到统计学意义（p<0.05）。我们将这些发现与定性研究的证据相结合，详细阐述和扩展了将绿地与健康联系起来的现有途径领域模型。这些阐述和扩展承认以下几点：（a）不同类型的绿地对不同类型的孤独感有影响；（b）多层次的环境会影响一个人从绿地中受益或遭受伤害的可能性；（c）个人、关系和集体过程在将绿地与孤独及其伴随物联系起来的途径的不同领域中运作；（d）孤独感及其伴随物在将绿地与健康和幸福联系起来的更广泛因果系统中被明确定位为中介。本综述和模型为绿地与孤独感的决策和进一步的流行病学研究提供了指导。
