Abstract
While there is evidence that access to nature and parks benefits pediatric health, it is unclear how low-income families living in an urban center acknowledge or prioritize access to parks. Methods: We conducted a study about access to parks by pediatric patients in a health system serving low-income families. Adult caregivers of pediatric patients completed a survey to identify and prioritize unmet social and economic needs, including access to parks. Univariate and multivariate analyses were conducted to explore associations between lack of access to parks and sociodemographic variables. We also explored the extent to which access to parks competed with other needs. Results: The survey was completed by 890 caregivers; 151 (17%) identified “access to green spaces/parks/playgrounds” as an unmet need, compared to 397 (45%) who endorsed “running out of food before you had money or food stamps to buy more”. Being at or below the poverty line doubled the odds (Odds ratio 1.96, 95% CI 1.16–3.31) of lacking access to a park (reference group: above the poverty line), and lacking a high school degree nearly doubled the odds. Thirty-three of the 151 (22%) caregivers who identified access to parks as an unmet need prioritized it as one of three top unmet needs. Families who faced competing needs of housing, food, and employment insecurity were less likely to prioritize park access (p < 0.001). Conclusion: Clinical interventions to increase park access would benefit from an understanding of the social and economic adversity faced by patients.
Highlights
There is a growing recognition within healthcare that access to and quality of care are not enough to produce health [1]
Lack of park access was more frequent among families living below the poverty line (p = 0.005), among caregivers ages 25 to 44 years old (p = 0.013), and among caregivers with lower caregiver education level (p = 0.016) (Table 1)
While many families expressed that they had park access, poverty and lower parental education were significantly associated with access to parks being an unmet need
Summary
There is a growing recognition within healthcare that access to and quality of care are not enough to produce health [1]. Increasing awareness of the role of parks in shaping health has led to collective and interdisciplinary actions to increase access to these community resources for health. Public parks and recreational resources promote active living, physical and mental health, and overall well-being across diverse communities [2]. Public parks offer open spaces and facilities such as playgrounds for individuals to participate in physical activity [3], as well as added benefits such as stress reduction, [4] increased social interaction, and social cohesion among neighbors [5,6]. Res. Public Health 2020, 17, 2777; doi:10.3390/ijerph17082777 www.mdpi.com/journal/ijerph
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