Background: Urban Green Spaces (UGS) are broadly associated with improvements in population health and wellbeing, including improvements in mental health, physical activity and educational attainment. However, there is limited evidence around specific interventions to change UGS and their impact on health or education outcomes.
Aims: To explore and evaluate the economic and health impact of UGS interventions.
Methods: The literature on effectiveness and cost-effectiveness of interventions for urban green spaces was systematically identified and reviewed. The data on costs and effectiveness were then consolidated in a model to look at the cost-effectiveness of UGS interventions, and the results were presented in a user-friendly toolkit. The impact of an urban green space intervention on mental health in Bradford was assessed through a difference-in-differences design, using the Born in Bradford dataset, and linked prescription records.
Results: The majority of studies included in the systematic review reported that UGS interventions may have contributed to improvements in physical activity, especially in more deprived settings. Consolidating the data revealed that the three main types of interventions reviewed, namely improving (1) walkways, (2) outdoor fitness equipment, and (3) play areas, were likely to yield cost-effective improvements in physical activity. The difference-in-differences evaluation showed that improvement of UGS in the three most deprived wards of Bradford was associated with a reduction in prescription costs for mental health medications after the intervention. However, no statistically significant effect was observed on the likelihood of receiving a prescription once the model was expanded to adjust for ethnicity.
Conclusions: Improving mental health, physical activity, and reducing health inequalities and inequities are key priorities for the United Kingdom government. The findings of this thesis provide support for the implementation of UGS interventions as a public health strategy to enhance physical activity, improve mental health outcomes, and contribute to overall population health and wellbeing. Further research on additional outcomes, such as educational attainment, and distributional benefits of interventions for UGS can expand on the findings from this thesis.
