Neighborhood greenspace as a social determinant of health and how associations with brain health outcomes may differ by race/ethnicity

Abstract

AbstractBackgroundResidential greenspaces such a parks and other areas of natural vegetation are social determinants of health that have been associated with brain health outcomes including Alzheimer’s disease and related disorders (ADRD). Greenspace access is associated with reduced risk of ADRD‐related comorbidities and increased participation in risk‐reducing behaviors such as physical activity. Therefore, exposure to greenspace may present an ideal opportunity to encourage risk‐reducing behaviors while intervening on the impact of comorbidities on brain health. Although structural determinants of health such as residential segregation and the built environment may influence these outcomes, racial/ethnic minoritized groups are less likely to live in neighborhoods where physical activity is feasible. Additionally, such groups have elevated risk for comorbidities that may increase risk for ADRD. Yet few known studies have investigated greenspace and brain health by racial/ethnic group.MethodWe will include papers previously identified in a published rapid scoping review on greenspace and brain health outcomes (Besser, 2020; n = 22), and will employ the same review methods from that paper to identify additional papers published since February 13, 2020. For each article, we will catalog the racial/ethnic composition of the sample, observed differences between racial/ethnic groups, methods employed, other related findings, as well as guiding theories, conceptual frameworks, and causal mechanisms.ResultWe will: 1) examine the extent to which the current literature investigates racial/ethnic differences in greenspace and brain health associations; 2) cover the potential mechanisms relating greenspace to brain health and how these mechanisms may differentially impact individuals based on race/ethnicity; and 3) discuss the methodological issues surrounding the study of racial/ethnic disparities in greenspace‐brain health associations. Lastly, we will describe greenspace characteristics for select existing datasets and cohorts by race/ethnicity to provide context for future investigations using these and similar resources.ConclusionThe goal of this review is to provide a foundation for understanding and a starting point for studies of racial/ethnic differences in greenspace‐brain health associations.