Greenspaces and Cardiovascular Health: Unpacking Urban-Rural Differences

Key Takeaways

• Greenspaces within parks are linked to reduced cardiovascular disease (CVD) risk, while greenspaces outside parks may have negative health associations.
• Urbanicity affects how greenspaces impact health—beneficial effects are seen in highly urbanized areas but not in rural settings.
• Tailored greenspace planning and community-specific interventions are needed to support both urban and rural cardiovascular health.
• The “Landscape Compensation Effect” proposes balancing built and natural greenspaces to maximize health benefits for different communities.

Introduction

Access to greenspaces is often touted as essential for improving health outcomes, particularly cardiovascular health. But what if not all greenspaces are created equal? A recent study published in Landscape and Urban Planning dives into the complex relationships between different types of greenspaces and cardiovascular diseases (CVDs) like coronary heart disease (CHD) and stroke, revealing surprising contrasts based on urban and rural settings.

The Complex Role of Greenspaces in Cardiovascular Health

Cardiovascular diseases, including coronary heart disease and stroke, are the leading causes of death worldwide. While greenspaces have long been associated with improved cardiovascular outcomes, the specifics of how different types of greenspaces influence health—especially across urban and rural areas—remain poorly understood.

This study analyzed data from over 69,000 census tracts in the United States, evaluating four main types of greenspaces: forest and open spaces located inside parks, and those outside parks. By incorporating urbanicity levels, the researchers were able to uncover nuanced relationships between greenspaces and CVD prevalence that are often obscured in broader studies.

Key Findings: Greenspaces Inside vs. Outside Parks

The study found a stark difference in health effects between greenspaces located inside and outside parks:

• Greenspaces Inside Parks: Forested areas and open spaces within parks were associated with a lower prevalence of CHD and stroke. These areas offer structured environments conducive to physical activities like walking, running, or social events, which can benefit cardiovascular health.
• Greenspaces Outside Parks: Surprisingly, greenspaces outside of designated parks, such as unmanaged forest areas, were linked to higher rates of CVDs. The study suggests that these areas, often poorly maintained and lacking in accessibility, may discourage active use or could contribute to stress due to feelings of insecurity. It should be noted that such unmanaged spaces often occured in rural areas, which in general had less access to dedicated recreational parks and activities.

Urbanicity Matters: Differing Impacts Across City and Rural Settings

One of the study’s most significant insights was the impact of urbanicity on greenspace benefits. The researchers found that:

• In highly urbanized areas, greenspaces within parks were associated with significant reductions in CHD and stroke prevalence. These parks, integrated within the urban fabric, provide much-needed green relief for city dwellers who may otherwise experience high levels of pollution and stress.
• In less urbanized or rural areas, the health benefits of greenspaces were far less consistent. In some cases, greenspaces outside parks were even associated with an increased prevalence of CVDs. The lack of infrastructure, accessibility, and supportive amenities in these areas may contribute to their limited health benefits.

Implications for Health Equity and Environmental Justice

The findings of this study have profound implications for health equity and community well-being. Urban communities, often characterized by limited space, stand to benefit significantly from well-designed, accessible greenspaces that facilitate physical activity and social interaction. This is particularly important in marginalized neighborhoods where health disparities, including high rates of CVD, are prevalent due to systemic inequities.

Conversely, rural areas may have an abundance of natural landscapes, but these spaces are frequently underutilized for health benefits. Lack of accessibility, recreational facilities, and safety features makes these greenspaces less effective in promoting cardiovascular health. This highlights a need for targeted interventions that can make rural greenspaces more usable and beneficial for health.

Introducing the Landscape Compensation Effect

The researchers propose a new theoretical concept: the Landscape Compensation Effect. This concept emphasizes the need for a balanced mix of greenspace types to compensate for the different challenges faced by urban and rural residents:

• In urban areas, where people experience higher levels of stress, pollution, and limited physical activity, increasing the availability of accessible, well-designed greenspaces is crucial for improving public health outcomes.
• In rural areas, more emphasis should be placed on creating “built greenspaces” that are accessible and equipped with amenities that encourage active use, compensating for the scattered and less user-friendly natural landscapes.

Public Health Recommendations

1. Prioritize Accessible Greenspaces in Urban Areas

Urban greenspaces should be integrated into neighborhood planning with a focus on easy access and safety. Features like walking paths, playgrounds, and lighting not only encourage physical activity but also improve the perceived safety of these areas, making them more appealing for regular use.

2. Invest in Usable Greenspaces in Rural Areas

Rural greenspaces often lack the infrastructure necessary to promote cardiovascular health. By improving accessibility through better pathways and public transit connections, and by adding features such as picnic areas or sports fields, these greenspaces can become more inviting and supportive of physical activity.

3. Community Engagement and Tailored Solutions

To ensure that greenspace interventions are effective, community engagement is key. Local residents should be involved in planning greenspace features that suit their needs, whether it’s more seating for older adults, playgrounds for children, or quiet areas for mental health respite.

Conclusion

Greenspaces are more than just areas with trees and grass—they are crucial for the health of urban and rural populations alike. However, as this study highlights, not all greenspaces are equally beneficial, and their impact varies significantly based on location and design. For public health practitioners, urban planners, and policymakers, this research offers important insights into how tailored greenspace interventions can promote cardiovascular health and reduce health disparities across different communities.

Investing in thoughtful, accessible greenspaces is essential to creating environments where everyone—regardless of urban or rural residency—can enjoy the physical and mental health benefits of nature. Addressing these disparities is a step toward greater health equity, environmental justice, and community resilience.

For this article, the featured image was gathered from PxHere.