Could severe mobility and park use restrictions during the COVID-19 pandemic aggravate health inequalities? Insights and challenges from Latin America

Abstract

Parks are important for local populations, especially during the pandemic and shelter-in-place orders. The coronavirus disease (COVID-19) reached Latin America at the end of February 2020, about a month later than Europe and around two months after Asia. Latin America is among the most urbanized and unequal world regions and, as such, the policies implemented to contain the pandemic, such as mobility restrictions and park closures, may affect health-enhancing behaviors of the wealthy and poor differently. Such unintended consequences deserve a closer examination when confinement and future deconfinement measures are considered and planned. Parks and "green spaces" offer psychological restoration and ease mental health challenges (stress, anxiety, and depression), which are currently rising due to the pandemic and quarantine policies 1. Parks also provide opportunities for physical activity practices in social distancing, which can increase resilience to the COVID-19 by preventing and controlling chronic conditions such as obesity, hypertension, and cardiovascular diseases 2,3. However, parks can also provide hubs for community transmissions. This duality, in which parks are protective spaces, but also a potential source of risk, is mirrored in the variety of different (and sometimes opposing) park-related lockdown policies adopted by governments worldwide. In several Northern countries, during stay-at-home orders, people were encouraged to visit parks for exercise while social distancing, and leading health agencies (World Health Organization and U.S. Centers for Disease Control and Prevention) recommended park use during the pandemic for several health benefits. However, restrictions in park use were often implemented. For example, in New York City, which was most strongly affected from COVID-19 in the United States, playgrounds use was suspended, and the number of park visitors was monitored in early May 2020 to prevent overcrowding 4. While these are examples from one city, such strategies were used in other cities across the United States and Canada 5,6. In Latin America, however, no recommendations for safe park use were provided and restrictions on parks were generally more severe. For example, parks were closed to the public as lockdown was imposed in Peru, Colombia, Chile, and some Brazilian districts, and mobility restrictions excluded opportunities for minimal activity, such as walking outdoors in Chile,

Associations between movement behaviors and emotional changes in toddlers and preschoolers during early stages of the COVID-19 pandemic in Chile

“…Thus, to compensate for the lack of this protective effect, strategies in urban contexts should provide opportunities to access green spaces or open spaces to play while considering physical distancing due to the pandemic. This is particularly relevant in countries like Chile in which the opening of public and national parks has been postponed for months during the pandemic, whereas commercial areas have remained opened (50). Evidence has shown that green spaces enhance wellbeing, overall health and cognitive development in children (51-54).…”

Perceived Health Impact and Usage of Public Green Spaces in Brussels' Metropolitan Area During the COVID-19 Epidemic

“…The uneven access to PGSs and the resulting uneven access to their health-improving qualities could therefore result in increasing health inequalities during and after the epidemic (Cortinez-O'Ryan et al, 2020;Honey-Rosés et al, 2020).…”

Sociodemographic Predictors of Changes in Physical Activity, Screen Time, and Sleep Among Toddlers and Pre-Schoolers in Chile During the COVID-19 Pandemic

“…Nevertheless, the lockdown measures did not allow people to participate in physical activity outdoors and most public parks were still closed during the period included in our study, [3] with few councils prioritizing pedestrian zones to favour physical distancing. [18] These opposing strategies where on one hand PA is promoted indoors while at the same time it is severely restricted outdoors need to be periodically revised and aligned with the latest evidence so health impairing over-restrictions are prevented.…”

“…As These low-cost initiatives have been positively received by the general public and policymakers, [31,32] so once adapted to local needs they could be implemented in other contexts and countries, including Chile, and could help to alleviate the inactivity crisis. [3] The detrimental effects of the COVID-19 pandemic in toddlers and pre-schoolers are still further how the pandemic is affecting movement behaviours of people from other ages, locations and social groups. This may guide the allocation of resources where it is more critical.…”

“…On March 17th, all national parks were closed, and on March 26th some districts enforced lockdowns and curfews. [3] These restrictions likely had a negative impact on young children's movement behaviours, (physical activity, sedentary behaviour -including screen time, and sleep). [4,5] Global guidelines recommend that children aged 1 to 5 should accumulate at least 180 min of physical activity, engage in no more than 1 h sedentary screen time (none for 1-year olds), and have between 11-14 h (1-to 2-year olds) and 10 to 13 h (3-to 5-year olds) good-quality sleep per night.…”