This doctoral thesis critically examines green space characteristics and their proximity to residents in their ability to help reduce the global disease burden of non-communicable diseases. By dissecting three pivotal pathways of theorized green space health effects through increased physical activity, increased social cohesion, and reduced air pollution, the thesis aims to provide new insights into which green space characteristics drive these relationships and in which distance they occur. To achieve these aims, this thesis develops reporting guidelines for the research field, a QGIS script for automatization of green space indicator development and uses two complementary sources for data collection. It builds on the self-reported data on physical activity, social cohesion, air pollution, health and mental health from the URBiNAT project and its case studies in the four European satellite neighbourhoods Nantes-Nord (France), Porto-Campanhã (Portugal), Sofia-Nadezhda (Bulgaria), and Høje-Taastrup (Denmark) and complements it with a rigorous spatial analysis. This enabled a rigorous sensitivity analysis based on up to 135 structural equation models per pathway. The results of this doctoral research revealed distinct green space characteristics and proximities that drive each pathway, including thresholds where these associations disappear or even change direction. It concludes that interconnected, multi-use green corridors are more beneficial than isolated patches for all analysed health pathways, challenging current municipal green space strategies to shift focus from mere ratios to green mobility infrastructures. Although rooted primarily in European contexts and of a cross-sectional nature, the doctoral research provides new evidence for urban planning and public health. It emphasizes the practical implications of how to design green spaces to address health concerns. The results not only resonate with the WHO's Urban Health Research Agenda but also provide tangible recommendations for a healthier human habitat.

Introduction: In recent decades, there has been a rise in mental illnesses. Community infrastructures are increasingly acknowledged as important for sustaining good mental health. Moreover, green spaces are anticipated to offer advantages for both mental health and social cohesion. However, the mediating pathway between green space, social cohesion and mental health and especially the proximity and characteristics of green spaces that trigger these potential effects remain of interest. Methods: We gathered data from 1365 individuals on self-reported social cohesion and mental health across four satellite districts in European cities: Nantes (France), Porto (Portugal), Sofia (Bulgaria), and Høje-Taastrup (Denmark). Green space data from OpenStreetMap was manually adjusted using the PRIGSHARE guidelines. We used the AID-PRIGSHARE tool to generate 7 indicators about green space characteristics measured in distances from 100–1500 m, every 100 m. This resulted in 105 different green space variables that we tested in a single mediation model with structural equation modelling. Results: Accessible greenness (900–1400 m), accessible green spaces (900–1500 m), accessible green space corridors (300–800 m), accessible total green space (300−800), and mix of green space uses (700–1100 m) were significantly associated with social cohesion and indirectly with mental health. Green corridors also showed negative indirect and direct associations with mental health in larger distances. Surrounding greenness and the quantity of green space uses were not associated with social cohesion nor indirectly with mental health. We also observed no positive direct associations between any green space variable in any distance to mental health. Conclusions: Our results suggest that accessibility, connectivity, mix of use and proximity are key characteristics that drive the relationship between green spaces, social cohesion and mental health. This gives further guidance to urban planners and decision-makers on how to design urban green spaces to foster social cohesion and improve mental health.

Exploring the influence of green space characteristics and proximity on health via air pollution mitigation, our study analysed data from 1,365 participants across Porto, Nantes, Sofia, and Høje-Taastrup. Utilizing OpenStreetMap and the AID-PRIGSHARE tool, we generated nine green space indicators around residential addresses at 15 distances, ranging from 100m to 1500m. We performed a mediation analysis for these 135 green space variables and revealed significant associations between self-rated air pollution and self-rated health for specific green space characteristics. In our study, indirect positive effects on health via air pollution were mainly associated with green corridors in intermediate Euclidean distances (800-1,000m) and the amount of accessible green spaces in larger network distances (1,400–1,500m). Our results suggest that the amount of connected green spaces measured in intermediate surroundings seems to be a prime green space characteristic that could drive the air pollution mitigation pathway to health.

Introduction: Non-communicable diseases are the global disease burden of our time, with physical inactivity identified as one major risk factor. Green spaces are associated with increased physical activity of nearby residents. But there are still gaps in understanding which proximity and what characteristics of green spaces can trigger physical activity. This study aims to unveil these differences with a rigorous sensitivity analysis. Methods: We gathered data on self-reported health and physical activity from 1365 participants in selected neighbourhoods in Porto, Nantes, Sofia, and Høje-Taastrup. Spatial data were retrieved from OpenStreetMap. We followed the PRIGSHARE guidelines to control for bias. Around the residential addresses, we generated seven different green space indicators for 15 distances (100–1500 m) using the AID-PRIGSHARE tool. We then analysed each of these 105 green space indicators together with physical activity and health in 105 adjusted structural equation models. Results: Green space accessibility and green space uses indicators showed a pattern of significant positive associations to physical activity and indirect to health at distances of 1100 m or less, with a peak at 600 m for most indicators. Greenness in close proximity (100 m) had significant positive effects on physical activity and indirect effects on health. Surrounding greenness showed positive direct effects on health at 500–1100 m and so do green corridors in 800 m network distance. In contrast, a high quantity of green space uses, and surrounding greenness measured in a larger radius (1100–1500 m) showed a negative relationship with physical activity and indirect health effects. Conclusions: Our results provide insight into how green space characteristics can influence health at different scales, with important implications for urban planners on how to integrate accessible green spaces into urban structures and public health decision-makers on the ability of green spaces to combat physical inactivity.

The relationship between green spaces and health is attracting more and more societal and research interest. The research field is however still suffering from its differing monodisciplinary origins. Now in a multidisciplinary environment on its way to a truly interdisciplinary field, there is a need for a common understanding, precision in green space indicators, and coherent assessment of the complexity of daily living environments. In several reviews, common protocols and open-source scripts are considered a high priority to advance the field. Realizing these issues, we developed PRIGSHARE (Preferred Reporting Items in Greenspace Health Research). It is accompanied by an open-source script that supports non-spatial disciplines in assessing greenness and green space on different scales and types. The PRIGSHARE checklist contains 21 items that have been identified as a risk of bias and are necessary for understanding and comparison of studies. The checklist is divided into the following topics: objectives (3 items), scope (3 items), spatial assessment (7 items), vegetation assessment (4 items), and context assessment (4 items). For each item, we include a pathway-specific (if relevant) rationale and explanation. The PRIGSHARE guiding principles should be helpful to support a high-quality assessment and synchronize the studies in the field while acknowledging the diversity of study designs.

In the interdisciplinary field of green space health research, there is a demand to reduce the effort to assess green space, especially for non-spatial disciplines. To address this issue, we developed AID-PRIGSHARE, an open-source script that automates over 400 QGIS processes to substantially reduces the time-intensive task of generating green space indicators. AID-PRIGSHARE calculates greenness, public green space, access to green infrastructure, and green space uses within distances of 100–1500 m around geolocations. This substantially reduces the effort for sensitivity analysis and may provide support for research that aims to understand the impact of different green space features and distances on health outcomes.

Current societal challenges like climate change led to a general agreement that our cities need to become greener and our lifestyles more sustainable. This transformation of our daily living environments can also impact the prevalence of non-communicable diseases as a global disease burden of our time. These positive impacts of horizontal green spaces on human health are widely recognized. However, it is still unclear whether the same is true for green walls, as a promising nature-based solution for dense urban spaces which is increasingly applied. To date, the available research on green walls has not been systematically synthesized along the potential impact pathways of reducing environmental stressors (Mitigation), restoring capacities (Restoration), and promoting healthier behavior (Instoration). We conducted a systematic review of 30 reviews to synthesize available evidence on all three pathways and direct health outcomes, following the established strategies of PICOS and PRISMA. We assessed the review quality through AMSTAR. We found strong consistent evidence that green walls can mitigate urban heat island effects (daylight surface temperature: -0.3 °C to -31.9°, daylight air temperature: -0 °C to -8.7 °C), air pollution (PM2.5: -25% to -99%, PM10: -23% to -60%), and noise pollution (sound pressure level: -1dBA to -5dBA). We found some evidence for disaster risk reduction and restoration effects. There were no reviews on the instoration pathway or direct health outcomes. The underlying reviews rated low according to the AMSTAR checklist, which might limit our findings. We recognize a generally young research field and conclude that more in-field studies are needed in all pathways to better understand the relationship between green walls and health.

The Handbook aims to provide decision-makers with a comprehensive NBS impact assessment framework, and a robust set of indicators and methodologies to assess impacts of nature-based solutions across 12 societal challenge areas: Climate Resilience; Water Management; Natural and Climate Hazards; Green Space Management; Biodiversity; Air Quality; Place Regeneration; Knowledge and Social Capacity Building for Sustainable Urban Transformation; Participatory Planning and Governance; Social Justice and Social Cohesion; Health and Well-being; New Economic Opportunities and Green Jobs. Indicators have been developed collaboratively by representatives of 17 individual EU-funded NBS projects and collaborating institutions such as the EEA and JRC, as part of the European Taskforce for NBS Impact Assessment, with the four-fold objective of: serving as a reference for relevant EU policies and activities; orient urban practitioners in developing robust impact evaluation frameworks for nature-based solutions at different scales; expand upon the pioneering work of the EKLIPSE framework by providing a comprehensive set of indicators and methodologies; and build the European evidence base regarding NBS impacts. They reflect the state of the art in current scientific research on impacts of nature-based solutions and valid and standardized methods of assessment, as well as the state of play in urban implementation of evaluation frameworks.

The Handbook aims to provide decision-makers with a comprehensive NBS impact assessment framework, and a robust set of indicators and methodologies to assess impacts of nature-based solutions across 12 societal challenge areas: Climate Resilience; Water Management; Natural and Climate Hazards; Green Space Management; Biodiversity; Air Quality; Place Regeneration; Knowledge and Social Capacity Building for Sustainable Urban Transformation; Participatory Planning and Governance; Social Justice and Social Cohesion; Health and Well-being; New Economic Opportunities and Green Jobs. Indicators have been developed collaboratively by representatives of 17 individual EU-funded NBS projects and collaborating institutions such as the EEA and JRC, as part of the European Taskforce for NBS Impact Assessment, with the four-fold objective of: serving as a reference for relevant EU policies and activities; orient urban practitioners in developing robust impact evaluation frameworks for nature-based solutions at different scales; expand upon the pioneering work of the EKLIPSE framework by providing a comprehensive set of indicators and methodologies; and build the European evidence base regarding NBS impacts. They reflect the state of the art in current scientific research on impacts of nature-based solutions and valid and standardized methods of assessment, as well as the state of play in urban implementation of evaluation frameworks.

Two portraits of European Middle Class Mass Housing. As the experts of their living environment the resident’s explain to us what is: valuable, problematic or desirable. We explore everyday neighbourhoods of Almere Haven and NewBelgrade, using resident’s testimonies as a tool for analysis. This Video and used material is part of two on going PhD projects.

This report describes the variables explored in the first and second stage of the Local Diagnostic. In the first stage, it is requested that the cities provide secondary information of use to framing their specific relevant conditions. Such information will be helpful for further identifying the location and wider context for the implementation of healthy corridors, with the prospect of enabling real improvement of the quality of life for citizens. The Local Diagnostic stage 2 focuses on over the study area were the Healthy corridor will be implemented. This separate report informs mostly on new data, produced especially for URBiNAT and the target area to identify local real needs and expectations to be integrated in the following phases of the project. It included participatory activities, territorial mapping studies, and behavioural mappings. To identify study, mobilize and prepare different actors for the following phases of the project, various participatory methods were applied and reported at this stage – observation, focus groups, face-to-face interviews, culture mapping, walkthrough, and photovoice. The findings from all of the methods applied are summarized in “Baseline for the development of the healthy corridor” that will support all further activities for the development of the Healthy corridor in all target district.