Environmental health impacts and inequalities in green space and air pollution exposures in six European cities

Abstract

BACKGROUND The GoGreenRoutes project (Horizon 2020/869764) aims to introduce co-created nature-based solutions (NBS) as interventions to enhance access to green space in six medium-sized European cities (Burgas, Lahti, Limerick, Tallinn, Umea, and Versailles). We analyzed the spatial distribution and health impacts associated with unequal exposure to air pollution and green space prior to the implementation of these NBS interventions in each city. METHODS We retrieved air pollution (NO₂ and PM₂.₅) and green space (NDVI and % Green Area proxies) data at a 250m x 250m grid-cell level for each city, in addition to population and mortality data for 2015. We compared baseline exposures to WHO guidelines and calculated the exposure differences at the grid-cell level. We applied a comparative risk assessment methodology to estimate the mortality burden attributable to not achieving the WHO guidelines. We evaluated exposures and attributable mortality distributions and their associations to understand current urban environmental inequalities. RESULTS We found high variability in air pollution and green spaces levels between and within all six cities. Around 60% of the population lacked green space and 90% of the population were exposed to air pollution above WHO guidelines. Overall, we estimated a city range between 3-37 and 2-71 deaths/100,000 persons were attributable to exceedances in WHO NO₂ and PM₂.₅ limit values, respectively; 4-13 deaths/100,000 persons were associated with lack of Green Area; and 18-35 deaths/100,000 persons were linked to NDVI levels below the city target. Green space and air pollution were highly spatially correlated, likewise their attributable burdens. CONCLUSIONS Our results suggest that urban populations in the analyzed cities are affected simultaneously by lack of green space and increased air pollution. We expect NBS interventions will contribute to reducing the environmental health burden and inequalities in the GoGreenRoutes cities. KEYWORDS Health impact assessment; urban health; health equity; nature-based solutions.