Abstract
Though sex/gender is an important social determinant of health, sex/gender inequalities have not been considered comprehensively in environmental health research thus far. The aim of this systematic review was to clarify whether sex/gender theoretical concepts were addressed in studies on the impact of residential green space on self-rated health and whether effect modification by sex/gender was observed. Three electronic databases were searched to identify epidemiological studies on perceived or objective residential green/blue space and self-rated health. Necessary for study inclusion was mentioning at least one keyword for sex/gender in title or abstract, adult study participants and data on self-rated health and on availability and/or use of green/blue spaces. Decisive for study inclusion was consideration of sex/gender differences in the impact of perceived or objective residential green/blue spaces on self-rated health in the analysis and presentation of results. Seven studies were included. They presented an overall positive impact of green space on self-rated health. No consistent sex/gender differences in the impact of green space on self-rated health were found in these studies. However, all studies used a binary operationalization male/female without further theoretical foundation. Research quality could be enhanced by integrating sex/gender-theoretical concepts into study design and interpretation of results.
Highlights
Sex/gender is a ubiquitous but often ignored social determinant of health [1]
Seven of the studies were included in the analysis of this systematic review and no further studies were found studies were included in the analysis of thispresented systematicresults review andthe no PHENOTYPE
The seven included studies gave no consistent pattern of sex/gender differences in the association of subjectively perceived or objectively measured residential green space and self-rated health
Summary
Sex/gender is a ubiquitous but often ignored social determinant of health [1]. Though there is a growing awareness of the importance of sex/gender perspectives in several areas of health research, there is still a need to clarify the use of central sex/gender theoretical concepts [3]. In research on environmental health, sex/gender inequalities have far not been considered comprehensively [5,6]. The mechanisms linking green or blue spaces with health are currently a matter of debate [8,12]. Whereas on the one hand health benefits linked with access to green space may be more pronounced among groups with
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