Can health-related ecosystem services actually increase health inequality? What does the uneven distribution and varying quality of urban green spaces say about social justice in urban environments? Not all park spaces and green spaces are created equal. As urbanization marches forward, steps have to be taken to address inequalities and prevent this pattern from continuing.
Health, urbanization, and parks: what we know
Nature is good for your physical and psychological health and wellbeing. The benefits of spending time in nature is a subject that continues to gain traction, both in research and among the public sphere. However, as more and more of the population moves towards urban living, spending time in nature has increasingly become something of a luxury. Although access to healthcare and health resources has increased, urban living itself can lead to more sedentary behaviours and increased exposure to pollution. In addition, there are mental and emotional aspects of city life that impact public health. Of particular note are the trends in psychological well-being associated with cities.
Consider the CAMH Monitor survey in Toronto, which finds that reports of fair or poor mental health increased from 7.1% to 10.1% between 2016 and 2017. Furthermore, reports of suicidal thoughts have almost doubled in the same timeframe, and visits to the CAMH Emergency Department have increased by 70% between 2012 and 2017. Are there within city trends that we should be paying attention to? One of the most studied risk factors affecting urban mental health is socio-economic status (SES). Its association with mental health has been consistent—a 2017 literature review observed that mood disorders were more frequent among residents of large cities in Germany (Gruebner et al., 2017). There are several reasons for this, from the heightened difficulty in building and sustaining supportive social relationships in disadvantaged areas to the possibility that people with poor health or life difficulties move to more “deprived” areas due to lower rent costs.
A greenspace planning workshop in Victoria, BC. Retrieved from: https://www.oala.ca/ground_articles/the-powers-in-the-process/
What role do urban parks and associated greenspace play? The list is long. At its most basic, urban parks provide space for citizens to participate in physical activities, such as running and exercising. These spaces provide more opportunities for people to engage in an active, healthy lifestyle. While physical activity in urban green spaces is no doubt essential, its increasing noted that the psychological benefits of urban park space should are of equal importance. In addition to being a place where physical activities can occur, parks can act as a space for relaxation and reprieve from noise. As urban lifestyles becomes more stressful, having a place to distance oneself from that aspect of modern life can help in preventing emotional distress and crisis. These spaces can also foster community and relationship building. The positive mental health values of park space can be broadly described as “psychological ecosystem services”.
What we know but don’t admit: park space quality is not equal
Socio-economic status doesn’t just directly affect health. It plays a role in the quality of park-space, especially in the context of a city. For park space to provide the psychological ecosystem services they are touted to have, they must be maintained and cared for (Branas et al., 2011; Hunter et al., 2019). Park spaces that are available to low-income communities are often poorly maintained, vandalized, or even unsafe. Some parks even become hotspots for drug use, sometimes acting as a gateway to substance abuse and associated health risks. In light of this, access to the positive psychological ecosystem services that urban green spaces provide are inequitably distributed through many cities around the world.
|A used needle found in a park in Lawrence, Massachusetts. Retrieved from: https://www.citylab.com/equity/2019/02/opioid-epidemic-data-drug-addiction-deaths-urban-rural/582502/|
The issue is more complex than mere park space availability. Whether or not disadvantaged groups have more or less access to park space is less clear—these neighbourhoods tend to be in less developed spaces, meaning that they might have more access to forested park space than people living in typically higher income city centres. However, the quality of park space has a more predictable trend—it’s typically of poor quality in disadvantaged communities, and access tends to be negatively associated with average income. For example, a study in Portugal found that, although the majority of neighbourhoods had accessible greenspace, distance to them increased with neighbourhood deprivation (Hoffimann et al., 2017).
Yet, the group of people who could most benefit from the health aspects of park space are the disadvantaged, and good access to park space and associated green space can reduce observed socio-economic and mental health inequalities between advantaged and disadvantaged groups. Having good park space puts people living in cities on a more even playing field health-wise (Mitchell et al., 2015). However, although this pattern is known, issues with the quality of park space make it hard to believe that planners are taking the potential health benefits of park space seriously.
Although findings are mixed regarding geographic access to greenspace and socio-economic status, the aspect of park quality is less ambiguous. City planners need to consider both proximity and quality if they wish to address inequality in access to park space, and the associated health-related ecosystem services they should to provide to everyone.
|A conceptual rendering of Rail Deck Park in Downtown Toronto. Retrieved from: https://www.toronto.ca/city-government/planning-development/planning-studies-initiatives/rail-deck-park/|
When ecosystem services are not for everyone: the cracks we fall through
Urban park spaces provide health-related ecosystem services, and their quality tends to not be distributed equally across cities. Put the two together and it becomes clear that socio-economic factors are leading to park spaces not benefitting all urban citizens equally. Of course, there is the issue of “which came first”: are disadvantaged neighbourhoods provided with poor quality park space, or does the installation of quality green space lead to housing prices increasing, making them only affordable to the advantaged population? Fundamentally, what led to what is less important than taking action to prevent and remove this trend.
Urban planning and design can and must do better if it wishes to utilize park space in a way that doesn’t amplify health inequalities that already exist. Ecosystem services that are not spread equitably across a populace do a disservice to the communities that need them the most.
Branas, C. C., Cheney, R. A., MacDonald, J. M., Tam, V. W., Jackson, T. D., & Ten Have, T. R. (2011). A Difference-in-Differences Analysis of Health, Safety, and Greening Vacant Urban Space. American Journal of Epidemiology, 174(11), 1296–1306. https://doi.org/10.1093/aje/kwr273
Gruebner, O., A. Rapp, M., Adli, M., Kluge, U., Galea, S., & Heinz, A. (2017). Cities and Mental Health. Deutsches Ärzteblatt International, 114(8), 121–127. https://doi.org/10.3238/arztebl.2017.0121
Hoffimann, E., Barros, H., & Ribeiro, A. I. (2017). Socioeconomic Inequalities in Green Space Quality and Accessibility—Evidence from a Southern European City. International Journal of Environmental Research and Public Health, 14(8). https://doi.org/10.3390/ijerph14080916
Hunter, R. F., Cleary, A., & Braubach, M. (2019). Environmental, Health and Equity Effects of Urban Green Space Interventions. In M. R. Marselle, J. Stadler, H. Korn, K. N. Irvine, & A. Bonn (Eds.), Biodiversity and Health in the Face of Climate Change (pp. 381–409). Springer International Publishing. https://doi.org/10.1007/978-3-030-02318-8_17
Mitchell, R. J., Richardson, E. A., Shortt, N. K., & Pearce, J. R. (2015). Neighborhood Environments and Socioeconomic Inequalities in Mental Well-Being. American Journal of Preventive Medicine, 49(1), 80–84. https://doi.org/10.1016/j.amepre.2015.01.017