Effect of exposure to natural environment on health inequalities: an observational population study

Mitchell, R. and Popham, F. (2008) Effect of exposure to natural environment on health inequalities: an observational population study. Lancet, 372(9650), pp. 1655-1660. (doi:10.1016/S0140-6736(08)61689-X)

[img]
Preview
Text
4767.pdf

185kB

Publisher's URL: http://dx.doi.org/10.1016/S0140-6736(08)61689-X

Abstract

<b>Background:</b> Studies have shown that exposure to the natural environment, or so-called green space, has an independent effect on health and health-related behaviours. We postulated that income-related inequality in health would be less pronounced in populations with greater exposure to green space, since access to such areas can modify pathways through which low socio-economic position can lead to disease.<p></p> <b>Methods:</b> We classified the population of England at younger than retirement age (n=40 813 236) into groups on the basis of income deprivation and exposure to green space. We obtained individual mortality records (n=366 348) to establish whether the association between income deprivation, all-cause mortality, and cause-specific mortality (circulatory disease, lung cancer, and intentional self-harm) in 2001—05, varied by exposure to green space measured in 2001, with control for potential confounding factors. We used stratified models to identify the nature of this variation.<p></p> <b>Findings:</b> The association between income deprivation and mortality differed significantly across the groups of exposure to green space for mortality from all causes (p<0·0001) and circulatory disease (p=0·0212), but not from lung cancer or intentional self-harm. Health inequalities related to income deprivation in all-cause mortality and mortality from circulatory diseases were lower in populations living in the greenest areas. The incidence rate ratio (IRR) for all-cause mortality for the most income deprived quartile compared with the least deprived was 1·93 (95% CI 1·86—2·01) in the least green areas, whereas it was 1·43 (1·34—1·53) in the most green. For circulatory diseases, the IRR was 2·19 (2·04—2·34) in the least green areas and 1·54 (1·38—1·73) in the most green. There was no effect for causes of death unlikely to be affected by green space, such as lung cancer and intentional self-harm.<p></p> <b>Interpretation:</b> Populations that are exposed to the greenest environments also have lowest levels of health inequality related to income deprivation. Physical environments that promote good health might be important to reduce socio-economic health inequalities.<p></p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Popham, Dr Timothy and Mitchell, Professor Richard
Authors: Mitchell, R., and Popham, F.
Subjects:R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Centre for Population and Health Sciences
Journal Name:Lancet
Publisher:The Lancet Publishing Group
ISSN:0140-6736
ISSN (Online):1474-547X
Copyright Holders:Copyright © 2008 Elsevier
First Published:First published in The Lancet 372(9650):1655-1660
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher
Related URLs:

University Staff: Request a correction | Enlighten Editors: Update this record