Implications for health promotion, physical activity and well-being

The proportion of people living in densely built up areas is gradually increasing, forcing cities to generate new land to build homes upon. In this process there is a risk for an inexplicit decrease of green space. The green features of neighbourhoods help to create a supportive environment for health and physical activity, thus a reduction of greenness may reduce the general well-being in the population. The overall aim of this thesis was to study how green neighbourhood environments are related to physical activity, health and well-being, to better understand the implications for public health. Separate data was used for each paper in the thesis. Objectively measured physical activity in children was used to assess the association with neighbourhood resources. Longitudinal survey data on general and mental health in prognostic groups was related to survey data on qualities in the green neighbourhood. These qualities was also related to cross-sectional data on physical activity and moderated by safety and social coherence. A qualitative interview study using content analysis is also included in the thesis. An association between access to neighbourhood resources and objectively measured physical activity was seen in children aged 4-11 years. Neighbourhood greenness was weakly associated with general health, but not mental health, and a beneficial effect of increased neighbourhood greenness on general health was indicated only in the most vulnerable subgroup. Access to high quality green areas promotes physical activity only among individuals who perceive their neighbourhood as being safe. The size of the study samples and the extensive and partly longitudinal survey data used in two of the papers in this thesis provided unique possibilities to adjust for confounders and avoid single source bias, while at the same time provide new insights on causality. There is rich variety in potential pathways through which greenness may promote well-being. Hence, there is a need to consider the green neighbourhood environment from multiple perspectives when densifying cities or planning for other changes.