Assessment of mediators in the associations between urban green spaces and self-reported health

Abstract

Although urban green spaces (UGS) are widely known to confer health benefits, evidence of the specific mechanisms that mediate the pathways from UGS provision and exposure to health outcomes remains limited. In particular, the question of whether exposure to UGS is an independent variable or a mediator in UGS-health linkages remains inadequately addressed. Using a nationally representative household survey in Singapore, this study investigated two models of the pathways linking UGS provision, UGS exposure, three mediators (emotional regulation, social interaction, and physical activities conducted in UGS) and self-reported mental and general health. The first model regarded both UGS provision and exposure as the independent variables and the second treated UGS exposure as the intermediate variable. Path analysis and structural equation modelling were employed to measure the theorised pathways. Good model fit for both models were found. Emotional regulation mediated 52% of the associations of perceived UGS provision and UGS exposure with mental health. Social interaction mediated 100% of the association of UGS with general health. However, green physical activities did not show any significant mediating effect. UGS exposure mediated only 11.5% of the pathways linking perceived UGS provision to other three mediators. Direct use of UGS is not a requisite for obtaining health benefits from UGS, as UGS provision independent of direct use is a significant variable. The use of UGS, however, provides undeniable benefits as UGS exposure was related to both health outcomes with full mediating effects. This study contributes to the understanding of underlying mechanisms in UGS-health associations.