Table 1.
Study characteristics.
| Study | Location * | Study Design | Sample Size ** | Population | % Female | Age | Description of Green Space Types | Mediating Factors | Factors Adjusted in Analysis |
|---|---|---|---|---|---|---|---|---|---|
| Aerts, 2020 [34] |
Belgium | Eco | 1872 census tracts | Children aged 6–12 and 13–18 years | N/A ≠ | Range: 6–18 |
Grassland (permanent grassland, hay meadows and lawns); gardens (ornamental gardens and vegetable gardens); forest (coniferous, mixed and broadleaved woodlands) | - | Time, green space coverage, mean annual PM10 concentration, %houses with basic or insufficient, administrative region |
| Astell-Burt, 2019 [45] |
New South Wales, Australia | CS-Pros | 46,786 | Adults ≥ 45 years old | 53.8 | Mean: 61.0 ± 10.2 | Tree canopy, grass and other low-lying vegetation | - | Age, sex, household income, employment status, education, couple status |
| Astell-Burt, 2020 [46] |
New South Wales, Australia | CS-Pros | 109,688 | Adults ≥ 45 years old | 52.3 | Median range: 55–64 | Trees and grass | - | Age, gender, economic status, education, household income, couple status, area-level disadvantage, total green space |
| Astell-Burt, 2020 [47] | New South Wales, Australia | CS-Pros | 46,786 | Adults ≥ 45 years old | 53.8 | Median range: 55–64 | Street trees and trees in parks | - | Age, gender, couple status, education, household income, employment |
| Astell-Burt, 2020 [48] |
New South Wales, Australia | CS-Pros | 45,644 | Adults ≥ 45 years old | N/R | N/R | Tree canopy, open grass and shrubs | - | Age, sex, living arrangement, education, household income, economic status |
| Astell-Burt, 2021 [49] |
New South Wales, Australia | CS-Pros | 45,644 | Adults ≥ 45 years old with type 2 diabetes mellitus | N/R | N/R | Tree canopy, open grass | - | Age, sex, living arrangement, education, household income, economic status |
| Bai, 2013 [50] |
Kansas, USA | CSS | 893 | Urban residents living within 0.5 miles from parks | 60.7 | Mean: 50.9 ± 16.5 | Parks | - | Age, sex, race/ethnicity, income, past park use |
| Bird, 2016 [27] |
Canada | CS-Retro | 380 | Caucasian children 8–10 yo with at least one obese parent | 52.4 | Mean: 9.7 ± 0.89 | Parks and open spaces | - | Age, sex, puberty, household income |
| Bojorquez, 2018 [40] |
Tijuana, Mexico | CSS | 2345 | Urban female residents | 100.0 | Mean: 37.0 | Parks | Being active in a public space | Age, marital status, children, SES (employment, education), park coverage |
| Camargo, 2017 [51] |
Bucaramanga, Colombia | CSS | 1392 | Urban park visitors | 58.4 | Median: 42 (28–55) | Zonal and local urban parks | - | Education, health status, walking difficulty, anxiety/depression, visiting with a companion, active park use |
| Carter, 2014 [52] |
Perth, Australia | CSS | 440 | Residents in inner-city and suburban neighbourhoods | 64.0 | Range: 45–54 |
Parks, gardens, play and social green spaces, bushland, sports fields, streetscapes, private yards | - | Age, SES (income, education), family structure, living arrangement, neighbourhood |
| Dennis, 2020 [53] | Manchester, UK | Eco | 1673 LSOAs | Urban residents in young vs. old neighbourhoods of various income levels | N/R | Old areas: >23.6% population are ≥60 yo Young areas: ≤23.6% |
Public parks, recreational spaces (playing fields, allotments and sports facilities), landscaped open spaces, private gardens, institutional land, previously-developed land, peri-urban and informal urban greenery (street trees, road verges) | - | Age, sex, income, employment, barriers to housing and services, educations/skills/training, crime levels |
| Dillen, 2012 [54] | Netherlands | CSS | 1553 | General population | 52.0 | Median range: 45–65 | Streetscape greenery Green areas: parks, forests, nature and recreation areas | - | Age, sex, SES (education, income) |
| Dobbinson, 2020 [55] |
Melbourne, Australia | QES | 1670 | Park visitors in a deprived neighbourhood | 44.7 | Median range: 34–37 | Parks | - | - |
| Donovan, 2018 [56] |
New Zealand | CS-Retro | 39,108 | Adults aged 18 | 48.7 | Mean: 18.0 ± 0 | Urban parkland/open space, grassland, herbfield, orchards, vineyards, crops, grassland, freshwater and saline vegetation, flaxland, gorse, shrublands, mangroves, forests and hardwoods | - | Premature birth, low birth weight, antibiotic use, parental smoking, ethnicity, birth order and number of siblings, and parental occupation |
| Droomers, 2015 [57] |
Netherlands | QES | 48,132 | Residents living in neighbourhoods with history of green intervention projects | N/R | N/R | Parks, natural playgrounds, community gardens or fruit orchards, children’s farms, fishponds, public allotment gardens, etc. | - | Living circumstances, neighbourhood, characteristics, safety |
| Dzhambov, 2018 [58] |
Plovdiv, Bulgaria | CSS | 399 | High school and university students 15–25 yo | 32.0 | Mean: 17.89 ± 2.27 | Any green space | Restorative quality, social cohesion, physical activity, noise annoyance, perceived air pollution | Age, sex, ethnicity individual-level SES, time spent at home/day, duration of residence, population density, month |
| Egorov, 2020 [59] |
North Carolina, USA | CSS | 186 | Urban residents | 67.2 | Mean: 37.1 | Trees and forest, grass and other herbaceous | - | Age, smoking status, education, BMI, density of residential units, concentration of NOx from local traffic, geographic coordinates |
| Feng, 2018 [39] |
Australia | CS-Pros | 3897 | Mothers in postpartum period | 100.0 | Median range: 35–39 | Parkland | - | ARIA score, SEIFA score |
| Feng, 2019 [38] |
Australia | CS-Pros | 3843 | Mothers in postpartum period | 100.0 | Median range: 40–44 | Parkland | - | Maternal age, SES (education, employment), years since childbirth, indigenous status, area disadvantage, remoteness (seia & aria), family structure |
| Francis, 2012 [60] |
Perth, Australia | CS-Pros | 911 | Residents moving to newly-built homes | 62.0 | Median range: 40–59 | Public open spaces: parks, recreational grounds, sports fields, commons, esplanades and bushland/wilderness | - | Age, sex, SES (income, employment, education), marital status, children living at home, neighbourhood SES |
| Gernes, 2019 [28] |
Ohio & Kentucky, USA | CS-Pros | 478 | Children aged 7 years | Cases: 42.4 Control: 49.0 |
Mean: 7.0 ± 0 | Trees and grass | - | Race, sex, environmental tobacco smoke exposure, exposure to traffic-related air pollution, mother’s education, neighbourhood SESneighbourhood SES (7 years). |
| Herranz-Pascual, 2019 [61] |
Vitoria-Gasteiz, Spain | CSS | 137 | Urban park visitors | 54.0 | Mean: 42.3 ± 14.2 | Urban parks | - | Age, sex, education, acoustic and environmental comfort of the environment (13 dimensions in a semantic differential scale) |
| Honold, 2016 [62] |
Berlin, Germany | CSS | 32 | Residents living in inner-city neighbourhoods | 59.4 | Mean: 36.0 ± 10.2 | View of vegetation from windows | - | Age, exercise, range of view, perceived chronic stress |
| Jaafari, 2020 [63] |
Tehran, Iran | Eco | 87 hexagons | General population | N/R | N/R | Green space | Air pollution | - |
| Jarvis, 2020 [64] |
Vancouver, Canada | CSS | 1,960,575 | General population | 51.7 | Median range: 25–44 | Coniferous trees, deciduous trees, shrubs and grass-herbs | - | Age, sex, racial/cultural background, education level, household income, persons < 18 years old in household, urbanicity |
| Jiang, 2020 [65] | USA | Cross-sectional study | 212 | General population | 57.1 | Median range: 30–45 | Tree canopy, low-level vegetation | - | Age, income |
| Jonker, 2014 [66] |
Netherlands | Eco | 1190 neighbourhoods | General population | N/R | N/R | Any green space except horticulture and streetscape vegetation | - | Sex, neighbourhood income, household disposable income, nursing home migration of frail elderly |
| Kim, 2014 [29] |
Texas, USA | CSS | 61 | Primary school students 9–11 yo from a deprived area with large Hispanic population | 60.7 | Mean: 10.1 ± 0.67 | Tree canopy | - | Sex, maternal marital status and education, number of cars, neighbourhood satisfaction, accessibility to play areas |
| Kim, 2016 [30] |
Texas, USA | CSS | 92 | Primary school students 9–11 yo from a deprived area with large Hispanic population | 62.0 | Mean: 10.0 ± 0.68 | Tree canopy | - | Age, sex, maternal employment status, physical activity time, TV watching hours, neighbourhood environmental perceptions |
| Kim, 2021 [67] |
Los Angeles, USA | Eco | 2301 census tracts | General population | N/R | N/R | Private green spaces (yards, gardens, landscaped areas), semi-public green spaces (golf courses, schools, cemeteries, agricultural lands), public green spaces (parks and recreational areas) | - | Poverty rate, education, ethnic group, children population, senior population |
| Kruize, 2020 [68] |
Europe | CSS | 3947 | Urban residents | 55.4 | Mean: 51.4 ± 16.0 | Natural outdoor environment: any outdoor spaces that contain green or blue natural elements (street trees, forests, city parks, water bodies) | - | Age, sex, education, ndvi within 300 m, city |
| Lai, 2019 [69] |
New York City, USA | Eco | 174 zip codes | General population | N/R | N/R | Street trees | - | Buffering traffic noise and air pollution |
| Leng, 2020 [70] |
Harbin, China | CSS | 4155 | Urban residents of a winter city | 47.7 | Mean: 54.6 ± 10.3 | Any green space | - | Age, sex, SES (education), smoking, cardiovascular family history |
| Marselle, 2015 [22] |
UK | BAS | 127 | Elderly ≥ 55 years who participated in outdoor walks | 55.5 | Range: 55–74 | Natural and semi-natural places, green corridors, urban green spaces, farmland, urban public spaces, coastal spaces | Perceived restorativeness | Type of environments, walk characteristics (duration, intensity) |
| McCarthy, 2017 [31] |
USA | CSS | 13,469 | Children in elementary schools in a multi-ethnic, deprived region | 49.2 | Mean: 9.7 ± 0.99 | Parks | - | Age, sex, race/ethnicity, SES (education, income), nativity, marital status, children in household, self-reported health |
| McEachan, 2018 [37] |
UK | CS-Pros | 805 | Children of age 4 of South Asian parents in a multi-ethnic, deprived city | 50.0 | Mean: 4.5 ± 0.4 | Public parks, play areas for children, sports fields, any natural habitats with plants and vegetation | - | Demographics, SES, maternal health behaviours, maternal mental wellbeing |
| Mears, 2020 [32] | Sheffield, UK | Eco | 345 LSOAs | Children in first and final years of primary school | N/R | Range: 4–5 and 10–11 | Any natural land covers, including water | - | Age, sex, income deprivation, air pollution, address density |
| Mears, 2020 [42] |
Sheffield, UK | Eco | 345 LSOAs | General population in a highly-deprived region | N/R | N/R | Any natural land covers, including water | - | Age, sex, income deprivation, air pollution, smoking rates, address density |
| Ngom, 2016 [71] |
Montreal and Quebec, Canada | Eco | N/A | General population | N/R | N/R | Parks and woodlands, golf courses or any sport facilities | - | Age, ambient air pollution, immigrant population, total population, social and material deprivation scores |
| Nishigaki, 2020 [26] |
Japan | CSS | 126,878 | Elderly ≥ 60 years with pollen allergy | 51.5 | Median range: 70–74 | Fields (rice paddy, crops), grassland, trees (deciduous, evergreen) | - | Age, sex, education, household income, living with others, employment, frequency of going outside, driving a car, residence duration, total daylight, annual snowfall amount, annual rainfall, residential population density |
| Orstad, 2020 [72] |
New York City, USA | CSS | 3652 | Urban residents in areas with high prevalence of obesity | 58.9 | Median range: 45–64 | Parks | Park use for physical activity, park crime | Age, sex, race/ethnicity, language of interview, SES (education, income, employment, car ownership), marital status, BMI, perceived traffic volume, perceived retail access, survey wave and strata |
| Parmes, 2020 [35] |
Europe | CSS | 8063 | Children aged 3–14 years | 47.7 | Range: 3–14 | Green urban areas, sport and leisure facilities, broad-leaved forest, coniferous forest, mixed forest, natural grassland, moors and heathland, sclerophyllous vegetation, transitional woodland/shrub | - | Age, sex, BMI, parental history of allergy, maternal education, parental smoking |
| Pazhouhanfar, 2018 [73] |
Gorgan, Iran | CSS | 250 | Urban park visitors | 57.3 | N/R | Parks | - | sex |
| Pope, 2018 [43] |
Sandwell, UK | CSS | 578 | Urban residents in a deprived area | 51.1 | Median range: 40–59 | Any green space | - | Age, sex, index of multiple deprivation |
| Putra, 2020 [36] |
Australia | CS-Pros | 4969 | Children 4–15 yo | 48.7 | Range: 4–15 | Parks, playground and place space | - | Age, sex, ethnicity (indigenous), non-English speaking, family SES, family structure, SEIFA score, ARIA score, neighbourhood safety |
| Reid, 2017 [74] |
New York City, USA | CSS | 1387 | Urban residents | 63.6 | Mean: 44.7 (Range 18–90) | Streetscape greenery | - | Age, sex, race/ethnicity, season, neighbourhood tenure, individual SES (income, education), area-level SES (% living below poverty, % unemployed), no2, % park and non-park open space |
| Richardson, 2018 [41] |
Scotland | CS-Pros | 46,093 | Mothers | 100.0 | Median range: 25–29 | Natural space: all public and private natural surfaces (vegetation, water, sand, mud and rock) | - | Infant’s sex, parity, gestational age, year of birth, season of conception, maternal age, height, education, ethnicity, tenure, smoking during pregnancy |
| Rundle, 2013 [75] |
New York City, USA | CSS | 13,102 | Urban residents | 64.0 | Median: 45 | Parks | - | Age, sex, race/ethnicity, individual SES: education, neighbourhood SES: % residents in poverty, %black/African American, %Latino/Hispanic, % park land by park size |
| Sander, 2017 [76] |
Ohio, USA | Eco | 546 census blocks | General population | N/R | Mean: 43.02 ± 4.37 | Publicly accessible conservation lands, recreational parks and cemeteries | - | Age, ethnicity, education, urban development intensity, population density, household income |
| Shen, 2017 [77] |
Taipei, Taiwan | Eco | 48 districts | Urban residents | N/R | N/R | Green structure | Temperature, primaryand secondary air pollutants | - |
| Stark, 2014 [78] |
New York City, USA | CSS | 44,282 | Urban residents | 58.5 | Mean: 26.6 ± 5.5 | Parks | - | Age, sex, race/ethnicity, SES (education, income), nativity, marital status, children in household, self-reported health |
| Stas, 2021 [79] |
Belgium | CCS | 189 | Adults ≥ 20 years old with pollen allergy | 59.3 | Mean: 40.4 ± 9.9 | Gardens, grassland and forests | - | Age, sex, exposure to birch pollen and air pollutants, geographic regions |
| Sugiyama, 2009 [25] |
UK | CSS | 271 | Elderly ≥ 65 yo | 60.0 | Mean: 75 ± 7.2 | Neighbourhood open spaces: parks, community gardens, play and sports areas, village greens, river or canal banks, beaches | - | Age, functional capability, education |
| Tan, 2019 [23] | Tainan, Taiwan; Hong Kong | CSS | 326 | Elderly ≥ 55 yo | 56.0 | Median range: 70–79 | Urban green space | - | Age, park usage |
| Tsai, 2016 [80] |
USA | Eco | 52 MSAs | General population | N/R | N/R | Forests (woody vegetation > 6 m in heights, including deciduous, evergreen and mixed); shrubland (woody vegetation and young trees < 6 m in heights); herbaceous (grassland, wildflowers) | - | Total population, total housing units, household income, % African American population |
| Vries, 2013 [81] |
Netherlands | CSS | 1641 | General population | 51.0 | Mean: 51.0 ± 16.0 | Any visible streetscape vegetation: flower boxes, green facades, view of woodlands, etc. | Stress, social cohesion, green activity | Age, sex, SES (education, income), life events, children, smokers, excessive drinkers |
| Wang, 2019 [82] |
Philadelphia, USA | Eco | 369 census tracts | General population | 53.4 | N/R | Tree canopy, grass cover and shrub cover with area ≥ 83.6 m2 | - | Age, sex, ethnicity, education, population density, land area |
| Wheeler, 2015 [83] |
UK | Eco | 31,672 LSOAs | General population | N/R | N/R | Any natural landscape | - | Age, sex, SES (income, education and employment), urban/rural status, indices of deprivation |
| Wood, 2017 [84] |
Perth, Australia | CS-Pros | 492 | Residents moving to newly-built homes | 61.6 | Mean: 47.8 ± 12.1 | Parks, gardens, reserves, grassed open spaces and any freely-accessible sports fields | - | Age, sex, SES (income, employment, education), marital status, children living at home |
| Wood, 2018 [44] |
Bradford, UK | CSS | 128 | Urban park visitors in a multicultural, deprived area | 46.0 | Median range: 36–45 | Formal parks and recreation grounds | - | Age, sex, ethnicity, connected to nature |
| Wu, 2017 [33] |
California, USA | Eco | 543 districts | Children in public elementary schools | 49.1 | Range: 5–12 | Forest, grassland, tree canopy | - | Sex, household income, race |
| Wu, 2018 [85] |
North Carolina, USA | Eco | 187 census tracts | General population | N/R | N/R | Forest, grassland, tree canopy, and greenway | - | Age group, population density, household income, %Asian population |
| Wyles, 2019 [86] |
UK | CSS | 4515 | General population | 52.2 | Median range: 35–44 | Any open space: parks and canals in cities and towns; coast and beaches; farmland, woodland, hills and rivers in the countryside | Connectedness to nature | Age, sex, SES, activities taken during visit, average time spent, distance to site, mode of transport, presence of companions |
| Zhang, 2017 [87] |
Netherlands | QES | 223 | Residents from two neighbourhoods with contrasting green space qualities | 55–61 | Mean: 49.6 years (exposure) 39 years (comparison) |
Any green space | Neighbourhood satisfaction | Quantity of green space, age, length of residence, income |
| Zhang, 2019 [88] |
Guangzhou, China | CSS | 250 | Urban park visitors | 58.0 | Median range: 31–45 | Park with a flowers garden, an entertainment and leisure zone, an elderly activity area, a forest rest zone, and a logistics management zone | Emotional responses, behavioural activities in parks | - |
| Zhang, 2019 [24] |
Hong Kong | CSS | 909 | Residents ≥ 65 years from elderly health centres and community centres | 66.3 | Mean: 76.5 ± 6.0 | Parks | - | Age, sex, education, area-level SES, marital status, living arrangement, housing type, household with car, type of recruitment centre, number of current health problems |
| Zhu, 2020 [89] |
Harbin, China | CSS | 240 | Urban park visitors | 43.0 | Median range: 20–29 | Island/archipelago within a city | - | - |
* Abbreviations: CCS: case-crossover study; CSS: cross-sectional study; CS-Retro: retrospective cohort study; CS-Pros: prospective cohort study; QES: quasi-experimental study; BAS: before-after study; Eco: ecological study; ** Default unit is person unless specified otherwise. Abbreviations: DA: dissemination area; LSOA: lower layer super output area; MSA: metropolitan statistical area. ≠ analysis was stratified by sex.