Greener living environment healthier people? Exploring green space, physical activity and health in the Doetinchem Cohort Study

Background: Evidence is emerging that more green space in the living environment is associated with better health, partly via the pathway of physical activity. Objectives: We explored the cross-sectional and longitudinal associations between green space and physical activity and several health indicators in the Doetinchem Cohort Study. Methods: A random sample of men and women aged 20-59 years at baseline was measured max 5 times with 5 year-intervals in the period 1987-2012. Data of round 3-5 were used. Measurements were based on examinations (height, weight, blood pressure) or questionnaires (physical activity, perceived health, depressive symptoms, chronic conditions). The percentage of green space (mainly urban and agricultural green) around the home address (125 m and 1 km) was calculated using satellite data. Results: More agricultural green was associated with less time spent on bicycling (β1 km = - 0.15, 95%CL - 0.13; - 0.04) and sports (β1 km = - 0.04, 95%CL - 0.07; - 0.01) and more time spent on gardening (β1 km = 0.16, 95%CL 0.12; 0.19) and odd jobs (β1 km = 0.10, 95%CL 0.05; 0.15), and this was in the other direction for urban green. For only a few of the many health indicators a positive association with green was found, and mainly for total green within 1 km radius. Longstanding green or a transition to more green did not show more pronounced associations with health. Conclusions: For the green space range of the Doetinchem area the findings do not strongly support the hypothesis that the percentage of green in the living environment affects health positively. The distinction by type of green may, however, be relevant for physical activity.