Park green spaces, public health and social inequalities: Understanding the interrelationships for policy implications

Abstract

How to reduce neighborhood socioeconomic status- (SES-) related health inequalities has been prioritized in the recent political literature. Park green spaces (PGSs) are essential neighborhood land use assets, as they are beneficial for population health and thus should mitigate SES-related health inequalities. This paper aims to elaborate the knowledge on the complex interrelationships among PGSs, health outcomes and social inequalities through developing a set of mixed indicators in an integrated manner. The data are obtained at the community level (N=8117) for three health outcomes (cardiopathy, chronic pneumonia and hypertension) and five SES variables. The PGS characteristics are described from three dimensions (coverage, quality and accessibility) at two geographical levels (15-minute walking distance (15 WD) neighborhoods and 30-minute walking distance (30 WD) neighborhoods). Spatial regressions reveal the following: 1) socioeconomically disadvantaged communities enjoy fewer PGSs and limited access to parks of high quality; 2) socioeconomically disadvantaged communities present higher incidences of diseases; and 3) PGS coverage within 30 WD neighborhoods and PGS accessibility within 15 WD neighborhoods are related to health outcomes. Structural equation modeling further confirms that PGSs, especially those of higher quality, could mitigate SES-related health inequalities. The findings of this study highlight the necessity of improving the PGS quality within walking distance of socioeconomically disadvantaged communities. We thus argue that land use policy makers should collaborate with social researchers and health professionals; and through health impact assessment, they can translate the professional knowledge into land use planning and consider health promotion into land use policies.