Does green-blue space visibility improve physical activities and human health a systematic review

Abstract

Background Research suggests that exposure to green and blue space (GBS) is significantly associated with improved health and wellbeing; however, the relationship between GBS visibility and health is still poorly understood. Objectives Conduct a systematic review to understand the strength and adequacy of the associations between GBS visibility and health. Identify the strengths and limitations of different approaches for measuring GBS visibility. Methods Following the PRISMA protocol, three databases (PubMed, Web of Science, and Scopus) were searched systematically to identify relevant studies published up to August 15, 2019. Based on a critical selection process and carefully selected eligibility and exclusion criteria, 17 studies were included in the review and synthesised. Results The reviewed studies showed strong, significant positive relationships between GBS visibility and health and wellbeing. Increasing GBS visibility improved mental health (e.g., reduced depression) and wellbeing (e.g., increased happiness). Physical health evidence was mixed, as visibility did not significantly reduce body mass index values for males and children, but visibility did significantly increase physical activities in adults and reduce body mass index values in females. Few studies identified associations between the variables based on age, gender, and socioeconomic conditions. The review indicated heterogeneity in the measurement of health outcomes and visibility (e.g., viewshed, street-view-image analysis). No single method of measuring visibility showed absolute strengths over the other methods. Conclusion The association between visibility and improved health and wellbeing is positive and significant, but the evidence was inadequate. Future studies should focus on (i) associations between GBS visibility and health in diverse populations and different geographic locations, (ii) the development of better visibility measurement methods, (iii) the use of a more objective measurement for health outcomes.