Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada; Child Health Informatics Group, Great Ormond Street Institue of Child Health, University College London, London, UK; Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK.
Office for National Statistics, London, UK.
Lancet Planet Health. 2023 Jun;7(6):e459-e468. doi: 10.1016/S2542-5196(23)00057-8.
Urban greenspaces could reduce non-communicable disease (NCD) risk. The links between greenspaces and NCD-related mortality remain unclear. We aimed to estimate associations between residential greenspace quantity and access and all-cause mortality, cardiovascular disease mortality, cancer mortality, respiratory mortality, and type 2 diabetes mortality.
We linked 2011 UK Census data of London-dwelling adults (aged ≥18 years) to data from the UK death registry and the Greenspace Information for Greater London resource. We calculated percentage greenspace area, access point density (access points per km), and distance in metres to the nearest access point for each respondent's residential neighbourhood (defined as 1000 m street network buffers) for greenspaces overall and by park type using a geographic information system. We estimated associations using Cox proportional hazards models, adjusted for a range of confounders.
Data were available for 4 645 581 individuals between March 27, 2011, and Dec 31, 2019. Respondents were followed up for a mean of 8·4 years (SD 1·4). All-cause mortality did not differ with overall greenspace coverage (hazard ratio [HR] 1·0004, 95% CI 0·9996-1·0012), increased with increasing access point density (1·0076, 1·0031-1·0120), and decreased slightly with increasing distance to the nearest access point (HR 0·9993, 0·9987-0·9998). A 1 percentage point (pp) increase in pocket park (areas for rest and recreation under 0·4 hectares) coverage was associated with a decrease in all-cause mortality risk (0·9441, 0·9213-0·9675), and an increase of ten pocket park access points per km was associated with a decreased respiratory mortality risk (0·9164, 0·8457-0·9931). Other associations were observed, but the estimated effects were small (eg, all-cause mortality risk for increases of 1 pp in regional park area were 0·9913, 0·9861-0·9966 and increases of ten small open space access points per km were 1·0247, 1·0151-1·0344).
Increasing the quantity of, and access to, pocket parks might help mitigate mortality risk. More research is needed to elucidate the mechanisms that could explain these associations.
Health Data Research UK (HDRUK).
城市绿地可以降低非传染性疾病（NCD）的风险。绿地与 NCD 相关死亡率之间的联系仍不清楚。我们旨在估计居住绿地数量和可达性与全因死亡率、心血管疾病死亡率、癌症死亡率、呼吸死亡率和 2 型糖尿病死亡率之间的关联。
我们将 2011 年英国伦敦居住成年人（年龄≥18 岁）的英国人口普查数据与英国死亡登记处和大伦敦绿地信息资源的数据相链接。我们使用地理信息系统计算了每个受访者居住社区的绿地总面积、可达性点数密度（每公里可达性点数）和到最近可达性点的距离（定义为 1000 米街道网络缓冲区），包括公园类型的绿地总面积和可达性点数密度。我们使用 Cox 比例风险模型进行了关联估计，该模型调整了一系列混杂因素。
2011 年 3 月 27 日至 2019 年 12 月 31 日期间，共获得 4645581 名参与者的数据。参与者的随访平均时间为 8.4 年（标准差 1.4 年）。全因死亡率与整体绿地覆盖率无差异（危险比[HR]1.0004，95%CI 0.9996-1.0012），与可达性点数密度增加（1.0076，1.0031-1.0120）相关，与到最近可达性点的距离略有降低（HR 0.9993，0.9987-0.9998）。口袋公园（面积在 0.4 公顷以下的休息和娱乐区）覆盖率每增加 1 个百分点（pp），全因死亡率风险降低（0.9441，0.9213-0.9675），每公里增加 10 个口袋公园可达性点，与呼吸死亡率降低相关（0.9164，0.8457-0.9931）。还观察到其他关联，但估计的效果很小（例如，区域公园面积每增加 1pp，全因死亡率风险为 0.9913，0.9861-0.9966，每公里增加 10 个小开放空间可达性点，风险为 1.0247，1.0151-1.0344）。
增加口袋公园的数量和可达性可能有助于降低死亡率风险。需要进一步研究阐明可能解释这些关联的机制。
英国健康数据研究（HDRUK）。
