How does the presence of greenspace related to physical health issues in Indonesia?

[[abstract]]There have been many studies associating various aspects of greenspaces with physical health. Very few of these investigations are available for developing countries such as Indonesia. Our study focused on evaluating the association between greenspace and the incidence rate of non-communicable diseases (NCDs) in terms of ischemic heart disease (IHD), diabetes mellitus (DM), rheumatoid arthritis (RA), and chronic kidney disease (CKD). Greenspace was presented by satellite-derived normalized difference vegetation index (NDVI) and forest -related green cover datasets to define exposures to the resolution of 250-m. The Institute for Health Metrics and Evaluation provided age and gender incident data of NCDs at the province level. A generalized additive mixed model coupled with sensitivity test was used to evaluate the exposure-outcome association. Stratified analyses were also employed. After adjusting for covariates, there was a significant negative association for incidence of NCDs and greenspace. We found that an interquartile unit increase of NDVI, and a percentage of forest were closely related to a decrease in the risk of NCDs by 0.3-9.4% and 0.6-6.2%, respectively. Stratified by exposure level, a greater effect of greenspace on reducing NCDs risk occurred in high exposure areas. Considering the socioeconomic factors, greenspace could influence on reducing NCD risks in high urbanization, low-high poverty, and low-high literacy areas. An increment unit of greenspace was associated with a decreased risk of NCDs. This study underscores important health benefits associated with exposures to nature supporting efforts to preserve greenspaces in Indonesia