Abstract
Evidence concerning the link between park access, use, programming and health has continued to grow. However, government funding for parks and recreation is highly susceptible to the ebbs and flows of the national economy. Given this, the purpose of this study was to test the relationship between county area spending on parks and recreation operations and all-cause mortality in the United States from the years 1980–2010. Using data from 1980 to 2010 collected from the U.S. Census Bureau and the Institute for Health Metrics and Evaluation, we analyzed the relationship between per capita county area spending on parks and recreation and county-level all-cause age-standardized female, male, and overall mortality using county and year fixed effects as well as relevant time-variant controls. The study was conducted during 2017 and 2018. County area spending on parks and recreation was negatively associated with overall and female-specific mortality from 1980 to 2010. According to our models for female and overall all-cause age-standardized mortality, when holding all else equal, a hundred-dollar increase in 2010 dollars in per capita parks and recreation operational expenditures was associated with an average decrease in morality of 3.9 and 3.4 deaths per 100,000, respectively. Although not commonly viewed as a form of healthcare spending, increased government funding for parks and recreation services had a significant association with decreased county level mortality. Our results suggest higher levels of per capita spending on parks and recreation may lead to lower levels of mortality.
Highlights
It is predicted that by the year 2025 the United States will spend 19.9% of its gross domestic product (GDP) on healthcare (Centers for Medicare and Medicaid Services, 2017)
The data for our analysis were collected from four sources for the years of 1980, 1990, 2000, and 2010: the State and Local Government Finance Survey (SLGFS), the Decennial U.S Census, the American Community Survey (ACS), and the age-standardized county level mortality rate estimates provided by the Institute for Health Metrics and Evaluation (IHME) (Historic County Area Finance Data, 2011; 2007 County Area Finance Data, 2018; 2012 County Area Finance Data, 2018; Manson et al, 2017; Institute for Health Metrics and Evaluation (IHME), 2016)
We have demonstrated that as county areas spent more per capita on parks and recreation, mortality decreased
Summary
It is predicted that by the year 2025 the United States will spend 19.9% of its gross domestic product (GDP) on healthcare (Centers for Medicare and Medicaid Services, 2017). United States spending on healthcare has experienced a constant increase during the period of 1960–2016, even during the Great Recession where it increased by 4.5%, while the GDP declined by 2.1% (National Health Expenditure Historical Data, n.d.). There have been mounting concerns among researchers and the public regarding the possibly diminishing returns of increased spending on public health, as well as interest in other, possibly more effective ways, of improving health outcomes (Murphy and Topel, 2003). Considering the large economic value attributed to even modest decreases in mortality, a robust understanding of the impacts of indirect forms of healthcare spending, such as parks and recreation, on mortality is necessary for informing future policy (Murphy and Topel, 2006)
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