Why a New Research Agenda on Green Spaces and Health Is Needed in Latin America: Results of a Systematic Review

Abstract

(1) Background: Increasing and improving green spaces have been suggested to enhance health and well-being through different mechanisms. Latin America is experiencing fast population and urbanization growth; with rising demand for interventions to improve public health and mitigate climate change. (2) Aim: This study aimed to review the epidemiological evidence on green spaces and health outcomes in Latin America. (3) Methods: A systematic literature review of green spaces and health outcomes was carried out for studies published in Latin America before 28 September 2020. A search strategy was designed to identify studies published in Medline via PubMed and LILACS. The search strategy included terms related to green spaces combined with keywords related to health and geographical location. No time limit for the publication was chosen. The search was limited to English, Spanish, Portuguese, and French published articles and humans’ studies. (4) Findings: This systematic review found 19 epidemiological studies in Latin America related to green spaces and health outcomes. Nine studies were conducted in Brazil, six in Mexico, three in Colombia, and one in Chile. In terms of study design, 14 were cross-sectional studies, 3 ecological, and 2 cohort studies. The population included among the studies ranged from 120 persons to 103 million. The green space definition used among studies was green density or proximity (eight studies), green presence (five studies), green spaces index (four studies), and green space visit (two studies). The health outcomes included were mental health (six studies), overweight and obesity (three studies), quality of life (three studies), mortality (two studies), cardiorespiratory disease (one study), disability (one study), falls (one study), and life expectancy (one study). Eleven studies found a positive association between green spaces and health, and eight studies found no association. (5) Conclusion: This systematic review identified 19 epidemiological studies associating green spaces and health outcomes in Latin America. Most of the evidence suggests a positive association between green spaces and health in the region. However, most of the evidence was supported by cross-sectional studies. Prioritizing longitudinal studies with harmonized exposure and outcome definitions and including vulnerable and susceptible populations is needed in the region.

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“…In addition, these studies are prone to certain biases. [ 24 ] Therefore, we must be careful to interpret associations and directions of relationships from cross-sectional surveys. Finally, the prevalence of cross-sectional results depends on disease incidence and survival after the results.…”

The effect of living conditions on nature exposure and wellbeing in the Global South

“…Alternately, nature spaces in much of the global south have more complex origins and are not always a product of systematic urban planning and design 21 . In fact, planning for nature provision can be highly fragmented 22 and green space management and maintenance tends to be poorly funded or seen as an expensive luxury rather than a public health priority [23][24][25] . Furthermore, in some cities, rapid urbanization has led to the emergence of informal settlements and urban population levels that exceed governmental capacity to provide basic services 22 .…”