The King’s Fund brings together a wide range of evidence-based interventions on ‘what works’ in improving public health and reducing health inequalities. The business case includes access to green and open spaces and leisure. Key findings are set out below:
The health benefits of access to green space:
- A study in the Netherlands showed that every 10 per cent increase in exposure to green space translated into a reduction of five years in age in terms of expected health problems (Groenewegen et al 2003) with similar benefits found by studies in Canada (Villenveuve et al 2012) and Japan (Takano et al 2002).
- Green space has been linked with reduced levels of obesity in children and young people in America (Liu et al 2007). There is also strong evidence that access to open spaces and sports facilities is associated with higher levels of physical activity (Coombes et al 2010; Lee and Maheswaran 2010) and reductions in a number of long-term conditions such as heart disease, cancer, and musculoskeletal conditions (Department of Health 2012).
- The proportion of green and open space is linked to self-reported levels of health and mental health (Barton and Pretty 2010) for all ages and socio-economic groups (Maas et al 2006), through improving companionship, sense of identity and belonging (Pinder et al 2009) and happiness (White 2013).
- Living in areas with green spaces is associated with significantly less income-related health inequality, weakening the effect of deprivation on health (Mitchell and Popham 2008). In greener areas, all-cause mortality rates are only 43 per cent higher for deprived groups, compared to 93 per cent higher in less green areas.
- However, people from more deprived areas have less access; children in deprived areas are nine times less likely to have access to green space and places to play (National Children’s Bureau 2013).
- Dr Mathew White and colleagues from the European Centre for the Environment and Human Health found that (2013) 94% of people who took part in outdoors ‘green exercise’ said it benefited their mental health and can have huge impacts on physical health. Individuals reported less mental distress and higher life satisfaction when they were living in greener areas.
The Business Case:
- Parks and public gardens are associated with health and wellbeing at the community level, including satisfaction with ‘place’, increased social cohesion and interaction (Commission for Architecture and the Built Environment 2005), increases in volunteering, and opportunities for more creative ‘play’ among children, as well as better educational performance.
- Increasing access to parks and open spaces could reduce NHS costs of treating obesity by more than £2 billion (Groundwork 2011). Access to green space can reduce mental health admissions too, resulting in additional savings for the NHS (Wheater et al 2007a, b).
- Increasing access to leisure and sports facilities for local residents can also have much wider impacts. Analysis of Birmingham’s city-wide Be Active programme suggests that up to £23 is recouped for every £1 spent, in terms of better quality of life, reduced NHS use, productivity gains, and other gains to local authorities (Marsh et al 2011). Economic modelling suggests this kind of intervention is a more cost-effective way of improving health through physical activity when compared with most medical interventions (Frew et al 2012). Other pricing initiatives, such as free swimming (Audrey et al 2012), also attract a high proportion of people from disadvantaged backgrounds, supporting health inequality reduction