Green spaces are associated with improved health, but little is known about mechanisms underlying such association. We aimed to assess the association between greenness exposure and subjective general health (SGH) and to evaluate mental health status, social support, and physical activity as mediators of this association. This cross-sectional study was based on a population-based sample of 3461 adults residing in Barcelona, Spain (2011). We characterized outcome and mediators using the Health Survey of Barcelona. Objective and subjective residential proximity to green spaces and residential surrounding greenness were used to characterize greenness exposure. We followed Baron and Kenny's framework to establish the mediation roles and we further quantified the relative contribution of each mediator. Residential surrounding greenness and subjective residential proximity to green spaces were associated with better SGH. We found indications for mediation of these associations by mental health status, perceived social support, and to less extent, by physical activity. These mediators altogether could explain about half of the surrounding greenness association and one-third of the association for subjective proximity to green spaces. We observed indications that mental health and perceived social support might be more relevant for men and those younger than 65years. The results for objective residential proximity to green spaces were not conclusive. In conclusion, our observed association between SGH and greenness exposure was mediated, in part, by mental health status, enhanced social support, and physical activity. There might be age and sex variations in these mediation roles.

Our findings indicate that contact with NOE benefits mental health. Our results also suggest that having contact with NOE that can facilitate stress reduction could be particularly beneficial.

Background:The urban exposome is the set of environmental factors that are experienced in the outdoor urban environment and that may influence child development.Objective:The authors’ goal was to describe the urban exposome among European pregnant women and understand its socioeconomic determinants.Methods:Using geographic information systems, remote sensing and spatio-temporal modeling we estimated exposure during pregnancy to 28 environmental indicators in almost 30,000 women from six population-based birth cohorts, in nine urban areas from across Europe. Exposures included meteorological factors, air pollutants, traffic noise, traffic indicators, natural space, the built environment, public transport, facilities, and walkability. Socioeconomic position (SEP), assessed at both the area and individual level, was related to the exposome through an exposome-wide association study and principal component (PC) analysis.Results:Mean±standard deviation (SD) NO2 levels ranged from 13.6±5.1 μg/m3 (in Heraklion, Crete) to 43.2±11 μg/m3 (in Sabadell, Spain), mean±SD walkability score ranged from 0.22±0.04 (Kaunas, Lithuania) to 0.32±0.07 (Valencia, Spain) and mean±SD Normalized Difference Vegetation Index ranged from 0.21±0.05 in Heraklion to 0.51±0.1 in Oslo, Norway. Four PCs explained more than half of variation in the urban exposome. There was considerable heterogeneity in social patterning of the urban exposome across cities. For example, high-SEP (based on family education) women lived in greener, less noisy, and less polluted areas in Bradford, UK (0.39 higher PC1 score, 95% confidence interval (CI): 0.31, 0.47), but the reverse was observed in Oslo (−0.57 PC1 score, 95% CI: −0.73, −0.41). For most cities, effects were stronger when SEP was assessed at the area level: In Bradford, women living in high SEP areas had a 1.34 higher average PC1 score (95% CI: 1.21, 1.48).Conclusions:The urban exposome showed considerable variability across Europe. Pregnant women of low SEP were exposed to higher levels of environmental hazards in some cities, but not others, which may contribute to inequities in child health and development. https://doi.org/10.1289/EHP2862

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We conducted a health impact assessment (HIA) of cycling network expansions in seven European cities. We modeled the association between cycling network length and cycling mode share and estimated health impacts of the expansion of cycling networks. First, we performed a non-linear least square regression to assess the relationship between cycling network length and cycling mode share for 167 European cities. Second, we conducted a quantitative HIA for the seven cities of different scenarios (S) assessing how an expansion of the cycling network [i.e. 10% (S1); 50% (S2); 100% (S3), and all-streets (S4)] would lead to an increase in cycling mode share and estimated mortality impacts thereof. We quantified mortality impacts for changes in physical activity, air pollution and traffic incidents. Third, we conducted a cost-benefit analysis. The cycling network length was associated with a cycling mode share of up to 24.7% in European cities. The all-streets scenario (S4) produced greatest benefits through increases in cycling for London with 1,210 premature deaths (95% CI: 447-1,972) avoidable annually, followed by Rome (433; 95% CI: 170-695), Barcelona (248; 95% CI: 86-410), Vienna (146; 95% CI: 40-252), Zurich (58; 95% CI: 16-100) and Antwerp (7; 95% CI: 3-11). The largest cost-benefit ratios were found for the 10% increase in cycling networks (S1). If all 167 European cities achieved a cycling mode share of 24.7% over 10,000 premature deaths could be avoided annually. In European cities, expansions of cycling networks were associated with increases in cycling and estimated to provide health and economic benefits.

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a b s t r a c tBackground: Cycling for transportation has become an increasingly important component of strategies to address public health, climate change, and air quality concerns in urban centers. Within this context, planners and policy makers would benefit from an improved understanding of available interventions and their relative effectiveness for cycling promotion. We examined predictors of bicycle commuting that are relevant to planning and policy intervention, particularly those amenable to short-and medium-term action. Methods: We estimated a travel mode choice model using data from a survey of 765 commuters who live and work within the municipality of Barcelona. We considered how the decision to commute by bicycle was associated with cycling infrastructure, bike share availability, travel demand incentives, and other environmental attributes (e.g., public transport availability). Self-reported and objective (GIS-based) measures were compared. Point elasticities and marginal effects were calculated to assess the relative explanatory power of the independent variables considered. Results: While both self-reported and objective measures of access to cycling infrastructure were associated with bicycle commuting, self-reported measures had stronger associations. Bicycle commuting had positive associations with access to bike share stations but inverse associations with access to public transport stops. Point elasticities suggested that bicycle commuting has a mild negative correlation with public transport availability (À0.136), bike share availability is more important at the work location (0.077) than at home (0.034), and bicycle lane presence has a relatively small association with bicycle commuting (0.039). Marginal effects suggested that provision of an employer-based incentive not to commute by private vehicle would be associated with an 11.3% decrease in the probability of commuting by bicycle, likely reflecting the typical emphasis of such incentives on public transport. Contents lists available at ScienceDirectTransportation Research Part A j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / t r a public transport, through the presence of public transport stops and the provision of public transport-oriented travel demand incentives. Education and awareness campaigns that influence perceptions of cycling infrastructure availability, travel demand incentives that encourage cycling, and policies that integrate public transport and cycling may be promising and cost-effective strategies to promote cycling in the short to medium term.

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