Centre for Health Economics, University of York, York YO10 5DD, UK.
Department of Health Sciences, University of York, York YO10 5NG, UK.
Int J Environ Res Public Health. 2024 Oct 31;21(11):1452. doi: 10.3390/ijerph21111452.
Several reviews have consolidated the evidence on the impact of living near an urban green space on improving health and education outcomes and reducing mortality. However, there is limited evidence on the effectiveness or cost-effectiveness of specific improvements to these urban green spaces, which would help decision-makers make informed decisions on how to invest in urban green spaces. Therefore, this review synthesizes the impact of more specific changes to, or investments in, urban green spaces on health and education outcomes, synthesizes the cost-effectiveness of these interventions, and critiques the applicability of the evidence for an economic evaluation. We find that interventions targeted towards improving play areas or fitness equipment tended to have mostly positive impacts on physical activity, while interventions on improving walking path, or the overall greenery showed a more mixed impact on physical activity. There were only two studies on the impact of changes to urban green spaces on mental health, with only one finding a positive association of the intervention with depression, and there were no studies measuring the impact of changes to urban green spaces and educational outcomes. From a cost-effectiveness perspective, we find that typically very small improvements are required to make the interventions a cost-effective policy choice; however, we found several limitations with using the existing evidence to estimate the cost-effectiveness of the intervention. Overall, we found that most of the evidence does suggest that improvements to urban green spaces can lead to improvements in physical activity, but further research is needed on the impact on mental health and educational outcomes. Furthermore, additional evidence with longer time horizons, multi-sectoral benefits, distributional outcomes, and more consistent outcome measures would assist in informing cost-effectiveness and may ultimately lead to improved decision-making around investments for urban green spaces in specific contexts.
已有多篇综述综合了城市绿地对改善健康和教育成果以及降低死亡率的影响方面的证据。然而，关于这些城市绿地具体改进措施的有效性或成本效益的证据有限，这将有助于决策者就如何投资城市绿地做出明智的决策。因此，本综述综合了更具体的城市绿地变化或投资对健康和教育成果的影响，综合了这些干预措施的成本效益，并对经济评估证据的适用性进行了评价。我们发现，针对改善游乐区或健身器材的干预措施往往对身体活动产生了积极的影响，而改善步行道或整体绿化的干预措施对身体活动的影响则较为复杂。仅有两项关于城市绿地变化对心理健康影响的研究，只有一项研究发现干预与抑郁之间存在积极关联，并且没有研究衡量城市绿地变化和教育成果之间的关系。从成本效益的角度来看，我们发现，通常只需要进行非常小的改进就可以使干预措施成为一种具有成本效益的政策选择；然而，我们发现，利用现有证据来估计干预措施的成本效益存在一些局限性。总体而言，我们发现，大多数证据确实表明，城市绿地的改善可以导致身体活动的改善，但需要进一步研究其对心理健康和教育成果的影响。此外，具有更长时间跨度、多部门效益、分配结果和更一致的结果衡量标准的额外证据将有助于为成本效益提供信息，并且可能最终会导致在特定背景下改善对城市绿地的投资决策。
Zotero 插件