Green neighbourhood environments in relation to neighbourhood satisfaction, physical activity, BMI, vitality and perceived physical and mental health status

Various empirical studies have shown positive effects of natural environments on general health, feelings of satisfaction and well-being. Biologically this is explained by theories stating that exposure to natural envi-ronments can provide restoration of stress and attentional fatigue. Additionally green neighbourhood envi-ronments could indirectly affect health by increasing levels of social interaction and physical activity. Most studies in this field have used either self-reported or objective assessments of the green environment. Very few studies have used both methods and their results have shown that a mismatch between the objectively assessed and perceived environment is not uncommon. Research is needed to find sufficient predictors for ‘healthy’ neighbourhood environments in future epidemiological research as well as in spatial planning proc-esses. This study aimed at investigating the concordance between self-reported and objectively assessed availability of five preferred green neighbourhood characteristics and secondly to investigate if these assessments relate to neighbourhood satisfaction, physical activity, body mass index, vitality and perceived health status. A large public health survey supplied data about perceived availability of the five preferred green character-istics and various health outcomes for 25029 participants in the age of 18-80 living in the Scania region in Southern Sweden. Geographical information systems (GIS) were used to objectively assess availability of the five preferred green characteristics within 100, 300 or 500 meter from participants’ residences. Agree-ment between the two methods is analysed. The associations between the green neighbourhood environment and various health outcomes were assessed with ordinal regression models and variations between socio-demographic subgroups with the likelihood ratio test. Access to green characteristics within 300 meter from the residence was rare and unequally distributed among population subgroups. Green neighbourhood environments were least favourable for participants born outside Sweden and for participants living in a flat. Perceived availability of green characteristics, adjusted for (less) favourable actual environments, was lower for these subgroups. Agreement between objectively assessed and perceived availability of green characteristics was poor and seems to be influenced by socio-demographic status. Both objectively assessed and perceived availability of green neighbourhood character-istics strongly affects neighbourhood satisfaction and weekly level of moderate physical activity. Perceived availability of green neighbourhood characteristics was associated with self-rated vitality and perceived health status. After adjusting for causality the effect on vitality did not remain significant and the effect on perceived health was somewhat weaker. The association between the green residential environment and health seems to be stronger for people living in flats and in some cases for people born outside Sweden. These are also the subgroups with least access and least perceived access to green characteristics near their residence. Further research is needed to find more accurate assessment methods of both actual and perceived living en-vironments and to find pathways by which the green environments can benefit health.