Perception of safety is a prerequisite for the association between neighbourhood green qualities and physical activity: Results from a cross-sectional study in Sweden.

In this study, we assess how the Scania Green Score (SGS5), and the five distinct perceived neighbourhood green dimensions within this area-aggregated index (1km2 squares), is associated with self-reported physical activity and general health, and if perceived safety and social coherence has a moderating effect. Two independent surveys, both conducted in Scania, Sweden, was used for data on SGS5 and health outcomes (N=28 198 and N=23 693), respectively. SGS5 was more clearly associated with physical activity (OR 1.06; 95% CI 1.02-1.10) than with general health (OR 1.02; 95% CI 1.00-1.04). This association was moderated by safety (p for interaction <0.001); SGS5 was positively associated with physical activity only among individuals who perceived high safety in their neighbourhood (OR 1.07; 95% CI 1.02-1.11). No moderating effect was seen for social coherence. Among specific dimensions, cultural history was positively associated with both physical activity and general health. Our results suggest that perception of safety is a prerequisite for the positive effects of neighbourhood green qualities.

Moving to Serene Nature May Prevent Poor Mental Health--Results from a Swedish Longitudinal Cohort Study.

Green spaces are recognized for improving mental health, but what particular kind of nature is required is yet not elucidated. This study explores the effect of specific types of recreational nature qualities on mental health. Longitudinal data (1999/2000 and 2005) from a public health survey was distributed to a stratified sample (n = 24,945) of a Swedish population. People from rural or suburban areas (n = 9230) who had moved between baseline and follow-up (n = 1419) were studied. Individual geographic residence codes were linked to five predefined nature qualities, classified in geographic information systems (GIS). Any change in the amount of or type of qualities within 300 m distance between baseline and follow-up was correlated to any change in mental health (as measured by the General Health Questionnaire) by logistic regression models. On average, the population had limited access to nature qualities both pre- and post-move. There was no significant correlation between change in the amount of qualities and change in mental health. However, the specific quality "serene" was a significant determinant with a significantly decreased risk for women of change to mental ill-health at follow-up. The objective definition of the potentially health-promoting quality may facilitate implication in landscape practice and healthy planning.

Effects of changing exposure to neighbourhood greenness on general and mental health: A longitudinal study.

Green neighbourhood environments have been associated with physical and psychological wellbeing in adults. Access to greenness is potentially more important in vulnerable subgroups. In this study based on longitudinal survey data from southern Sweden the cohort was divided into prognostic groups for good self-reported general (n=8891) and mental (n=9444) health. We used independent survey data to assess perceived neighbourhood greenness in 1km(2) areas, and estimated effects of changing exposure longitudinally stratified by prognostic group. The overall effect on health was small and statistically uncertain (for general health OR 1.04, 95% CI 0.98-1.10, for mental health OR 1.07, 95% CI 1.00-1.14). A more beneficial effect of increased greenness was indicated among subjects with lowest prognostic of good general health (OR 1.24, 95% CI 1.01-1.52). The study provided only weak evidence for beneficial effects of increased neighbourhood greenness triggered by changing residence. It seems that altered life circumstances, e.g. changed civil or socioeconomic status that often trigger a decision to move, are also the key determinants of the health consequences of changing residence.

Solving problems in social-ecological systems: definition, practice and barriers of transdisciplinary research.

Translating policies about sustainable development as a social process and sustainability outcomes into the real world of social-ecological systems involves several challenges. Hence, research policies advocate improved innovative problem-solving capacity. One approach is transdisciplinary research that integrates research disciplines, as well as researchers and practitioners. Drawing upon 14 experiences of problem-solving, we used group modeling to map perceived barriers and bridges for researchers' and practitioners' joint knowledge production and learning towards transdisciplinary research. The analysis indicated that the transdisciplinary research process is influenced by (1) the amount of traditional disciplinary formal and informal control, (2) adaptation of project applications to fill the transdisciplinary research agenda, (3) stakeholder participation, and (4) functional team building/development based on self-reflection and experienced leadership. Focusing on implementation of green infrastructure policy as a common denominator for the delivery of ecosystem services and human well-being, we discuss how to diagnose social-ecological systems, and use knowledge production and collaborative learning as treatments.

Perceived green qualities were associated with neighborhood satisfaction, physical activity, and general health: results from a cross-sectional study in suburban and rural Scania, southern Sweden.

In this study using cross-sectional survey data from suburban and rural Scania, Sweden (N=24,847), we assessed how the recently validated index score of area-aggregated perceived green neighborhood qualities (Scania Green Score; SGS), and the five distinct qualities within this index were associated with three self-reported indicators of well-being: neighborhood satisfaction, physical activity and general health. Effect sizes were compared with objective (GIS-based) assessments of the same five qualities. Area-aggregated SGS was positively associated with neighborhood satisfaction, physical activity and general health. The association with general health was mediated by physical activity and neighborhood satisfaction. Three perceived qualities had salutogenic potential: historical remains (culture), silence such that sounds of nature can be heard (serene) and species richness (lush). Spacious and wild were not appreciated. Some independent positive effects of the GIS-based index were noted, but could not be consistently attributed to specific qualities. Perceived qualities within green areas, not merely quantity, are related to aspects of well-being in suburban and rural areas.

Green qualities in the neighbourhood and mental health - results from a longitudinal cohort study in Southern Sweden.

BACKGROUND: Poor mental health is a major issue worldwide and causality is complex. For diseases with multifactorial background synergistic effects of person- and place- factors can potentially be preventive. Nature is suggested as one such positive place-factor. In this cohort study we tested the effect of defined green qualities (Serene, Space, Wild, Culture, Lush) in the environment at baseline on mental health at follow-up. We also studied interaction effects on mental health of those place factors and varied person factors (financial stress, living conditions, and physical activity). METHODS: Data on person factors were extracted from a longitudinal (years 1999/2000 and 2005) population health survey (n = 24945). The participants were geocoded and linked to data on green qualities from landscape assessments, and stored in the Geographical Information System (GIS). Crude odds ratios (OR) and 95% confidence intervals (CI) were calculated, and multivariate logistic analyses were performed. RESULTS: Mental health was not affected by access to the chosen green qualities, neither in terms of amount nor in terms of any specific quality. However, we found a reduced risk for poor mental health at follow-up among women, through a significant interaction effect between physical activity and access to the qualities Serene or Space. For men the tendencies were similar, though not significant. Regarding the other three green qualities, as well as amount of qualities, no statistically certain synergistic effects were found. Likewise, no significant synergies were detected between green qualities and the other person-factors. Only advanced exercise significantly reduced the risk for poor mental health among women, but not for men, compared to physical inactivity. CONCLUSIONS: The results do not directly support the hypothesis of a preventive mental health effect by access to the green qualities. However, the additive effect of serene nature to physical activity contributed to better mental health at follow-up. This tendency was equal for both sexes, but statistically significant only for women.Objective landscape assessments may be important in detangling geographic determinants of health. This study stresses the importance of considering interaction effects when dealing with disorders of multifactorial background.

Area-aggregated assessments of perceived environmental attributes may overcome single-source bias in studies of green environments and health: results from a cross-sectional survey in southern Sweden.

BACKGROUND: Most studies assessing health effects of neighborhood characteristics either use self-reports or objective assessments of the environment, the latter often based on Geographical Information Systems (GIS). While objective measures require detailed landscape data, self-assessments may yield confounded results. In this study we demonstrate how self-assessments of green neighborhood environments aggregated to narrow area units may serve as an appealing compromise between objective measures and individual self-assessments. METHODS: The study uses cross-sectional data (N = 24,847) from a public health survey conducted in the county of Scania, southern Sweden, in 2008 and validates the Scania Green Score (SGS), a new index comprising five self-reported green neighborhood qualities (Culture, Lush, Serene, Spacious and Wild). The same qualities were also assessed objectively using landscape data and GIS. A multilevel (ecometric) model was used to aggregate individual self-reports to assessments of perceived green environmental attributes for areas of 1,000 square meters. We assessed convergent and concurrent validity for self-assessments of the five items separately and for the sum score, individually and area-aggregated. RESULTS: Correlations between the index scores based on self-assessments and the corresponding objective assessments were clearly present, indicating convergent validity, but the agreement was low. The correlation was even more evident for the area-aggregated SGS. All three scores (individual SGS, area-aggregated SGS and GIS index score) were associated with neighborhood satisfaction, indicating concurrent validity. However, while individual SGS was associated with vitality, this association was not present for aggregated SGS and the GIS-index score, suggesting confounding (single-source bias) when individual SGS was used. CONCLUSIONS: Perceived and objectively assessed qualities of the green neighborhood environment correlate but do not agree. An index score based on self-reports but aggregated to narrow area units can be a valid approach to assess perceived green neighborhood qualities in settings where objective assessments are not possible or feasible.