Abstract
BackgroundThere is a growing recognition of the health benefits of the natural environment. Whilst domestic gardens account for a significant proportion of greenspace in urban areas, few studies, and no population level studies, have investigated their potential health benefits. With gardens offering immediate interaction with nature on our doorsteps, we hypothesise that garden size will affect general health—with smaller domestic gardens associated with poorer health.MethodsA small area ecological design was undertaken using two separate analyses based on data from the 2001 and 2011 UK census. The urban population of England was classified into ‘quintiles’ based on deprivation (Index of Multiple Deprivation) and average garden size (Generalised Land Use Database). Self-reported general health was obtained from the UK population census. We controlled for greenspace exposure, population density, air pollution, house prices, smoking, and geographic location. Models were stratified to explore the associations.ResultsSmaller domestic gardens were associated with a higher prevalence of self-reported poor health. The adjusted prevalence ratio of poor self-reported general health for the quintile with smallest average garden size was 1.13 (95% CI 1.12–1.14) relative to the quintile with the largest gardens. Additionally, the analysis suggested that income-related inequalities in health were greater in areas with smaller gardens. The adjusted prevalence ratio for poor self-reported general health for the most income deprived quintile compared against the least deprived was 1.72 (95% CI 1.64–1.79) in the areas with the smallest gardens, compared to 1.31 (95% CI 1.21–1.42) in areas with the largest gardens.ConclusionsResidents of areas with small domestic gardens have the highest levels of poor health/health inequality related to income deprivation. Although causality needs to be confirmed, the implications for new housing are that adequate garden sizes may be an important means of reducing socioeconomic health inequalities. These findings suggest that the trend for continued urban densification and new housing with minimal gardens could have adverse impacts on health.
Highlights
There is a growing recognition of the health benefits of the natural environment
In addition to the main analysis described above, we explored whether the association between poor selfreported general health and deprivation varied by average garden size
The adjusted prevalence ratio for poor health in Model One was 1.13 for the quintile with the smallest average garden sizes compared against the quintile with the largest average gardens, when accounting for deprivation and confounders
Summary
There is a growing recognition of the health benefits of the natural environment. Whilst domestic gardens account for a significant proportion of greenspace in urban areas, few studies, and no population level studies, have investigated their potential health benefits. In contrast and despite their prevalence, the role of domestic gardens remains unclear, with relatively few studies, and no population level studies, Domestic gardens contribute a large proportion of the total urban area (for example, 23% in Sheffield, UK [1] and 36% in Dunedin, New Zealand [2]). Coupled with this is the trend over time which has seen increases in the development of garden space into domestic and other uses (e.g. house extensions and new dwellings). Private gardens are either aggregated with all other greenspace measures [5, 6]; combined within an urban category [7, 8]; or excluded from analysis entirely [9,10,11,12]
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