In examining health inequalities between the rich and the poor, the gap becomes narrower in areas with the greenest environments, according to an article released on November 7, 2008 in The Lancet.
Previously, it has been shown that exposure to parks, forests, playing fields, and other “green space” has a beneficial effect on health and health-related behaviors that is independently significant. Dr Richard Mitchell, University of Glasgow, UK, and colleagues investigated the possibility that this effect may help mediate income-related health disparity, proposing that such exposure can affect the pathways through which low socioeconomic position can initiate disease.
To do this, the authors examine the population of England below the age of retirement, obtaining mortality records for 366,348 individuals between 2001 and 2005 to elucidate any association between low income, all-cause mortality, and cause-specific mortalities in conjunction with exposure to green space. The specific mortality rates examined included those due to circulatory diseases, lunch cancer, and intentional self-harm.
In an examination of deaths regardless of cause, the authors discovered that the most green areas had a health gap between richest and poorest that was about half the magnitude of those in the least green areas. Specifically, in comparison to higher-income people, the incidence of death in low-income people was 1.93 times greater in the least green areas and only 1.43 times greater in the most green. When narrowing their focus to deaths from circulatory disease, the health gap difference became even larger, as low-income people had 2.19 times the incidence of high-income people in less green areas, while this factor was only 1.54 in the most green area.
Other causes of death, such as lung cancer and intentional self-harm, are less likely to be affected by green space, and this was reflected in the results. The authors concluded that this study notes the importance of the environment in public health: “The implications of this study are clear: environments that promote good health might be crucial in the fight to reduce health inequalities.”
Dr Terry Hartig, Institute for Housing and Urban Research, Uppsala University, Sweden, contributed an accompanying comment noting the importance of this study: “This study offers valuable evidence that green space does more than pretty up the neighbourhood; it appears to have real effects on health inequality, of a kind that politicians and health authorities should take seriously.”
Effect of exposure to natural environment on health inequalities: an observational population study
Richard Mitchell, Frank Popham
Lancet 2008; 372: 1655-60
Green space, psychological restoration, and health inequality
Terry Hartig
Lancet 2008; 372: 1614-15
Written by Anna Sophia McKenney