The health gap between rich and poor people is much lower in areas with the greenest environments. This is the conclusion of an Article in this week's Social Determinants of Health Special Issue of The Lancet, written by Dr Richard Mitchell, University of Glasgow, UK, and colleagues.
Studies have shown that exposure to 'green space' (such as parks, forests and playing fields), has an independent beneficial effect on health and health-related behaviours. The authors proposed that income-related inequality in health would be lower in populations with greater exposure to green space, since access to such areas can affect the pathways through which low socioeconomic position can lead to disease. They assessed the population of England who were younger than retirement age (almost 41 million), and obtained individual mortality records for 366348 people to establish whether the association between income deprivation, all-cause mortality, and cause-specific mortality (circulatory disease, lung cancer, and intentional self-harm) in 2001-05 varied according to exposure to green space.
When looking at all deaths, the authors found that in the most green areas the health gap between the richest and poorest people was about half as big as that in the least green areas (incident rate ratio/IRR* = 1.93 in the least green, 1.43 in the most green). When looking at deaths from circulatory disease, the difference in the health gap was even bigger (IRR = 2.19 in the least green areas, 1.54 in the most green). There was no effect for causes of death unlikely to be affected by green space, such as lung cancer and intentional self-harm. The authors conclude: "The implications of this study are clear: environments that promote good health might be crucial in the fight to reduce health inequalities."
In an accompanying Comment, Dr Terry Hartig, Institute for Housing and Urban Research, Uppsala University, Sweden, says: "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."
Dr Richard Mitchell, University of Glasgow, UK T) +44 (0) 7976 814833 E) r.mitchell@clinmed.gla.ac.uk
Alternative contact: Ray McHugh, Media Relations Manager T) +44 (0)141 330 3535 E) r.mchugh@admin.gla.ac.uk
Dr Terry Hartig, Institute for Housing and Urban Research, Uppsala University, Sweden T) +46 26 420 6532 / +46 70 680 2762 E) terry.hartig@ibf.uu.se
Notes to editors: *Incidence rate ratio/IRR = a measure of how much higher the rate of death is among the poorest, when compared with that among the richest.
Full Article and Comment: http://press.thelancet.com/enivornment.pdf
Journal
The Lancet