Background

Longitudinal evidence linking urban greenspace to reduced rates of all-cause and cause-specific mortality has mostly been established using greenness measures of limited specificity such as vegetation indices. Evidence on specific green space types, including private residential gardens is less well established.

Methods

We examined associations of greenspace with all-cause, non-injury, cardiovascular disease (CVD) and respiratory disease deaths in UK Biobank – a national prospective cohort of adults with linked Office for National Statistics mortality records. We included private residential gardens and other greenspace types, e.g., public parks, sport facilities, using categories from Ordnance Survey MasterMap™ Greenspace. We used Cox proportional hazards models, adjusted for individual and area-level covariates, and stratified analyses by sex, household income, and area-level deprivation. In sensitivity analyses, we further adjusted for air pollution, road-traffic noise, indirect tobacco smoke exposure, and physical activity, and restricted analyses to non-movers.

Results

In 232,926 participants, we observed 13,586 all-cause, 13,159 non-injury, 2,796 cardiovascular (CVD), and 968 respiratory disease deaths. Private residential garden cover showed inverse associations with all-cause, non-injury, CVD, and chronic respiratory disease mortality, after adjustment for covariates and other types of greenspace, with hazard ratios and 95 % confidence intervals of 0.94 (0.91, 0.97), 0.95 (0.92, 0.97), 0.92 (0.86, 0.98) and 0.87 (0.78, 0.98), respectively, per interquartile range (IQR) increase in private residential garden cover (IQR = 21.6 % increase within 100 m buffer). Other greenspace types showed weaker inverse associations with CVD and chronic respiratory disease mortality than private residential gardens. Sex, household income, and area level deprivation modified associations. Findings were robust to sensitivity analyses.

Conclusion

Our finding that private residential gardens substantially contributed to inverse associations of total greenspace with premature mortality has implications for public health and urban planning. Inequities in access, ownership, views and use of private residential gardens, and potential health inequities, should be addressed.

中文翻译：

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私人住宅花园与其他绿地类型与心血管和呼吸系统疾病死亡率的关联：来自英国生物银行的观察证据

背景

将城市绿地与全因和特定原因死亡率降低联系起来的纵向证据大多是通过植被指数等有限特异性的绿色指标来建立的。关于特定绿色空间类型（包括私人住宅花园）的证据尚不完善。

方法

我们研究了英国生物银行（UK Biobank）中绿地与全因、非伤害、心血管疾病 (CVD) 和呼吸系统疾病死亡的关联。英国生物银行是一个与国家统计局死亡率记录相关的全国成年人前瞻性队列。我们使用 Ordnance Survey MasterMap™ Greenspace 中的类别，将私人住宅花园和其他绿地类型（例如公园、体育设施）纳入其中。我们使用 Cox 比例风险模型，根据个人和地区层面的协变量进行调整，并按性别、家庭收入和地区层面的贫困进行分层分析。在敏感性分析中，我们进一步调整了空气污染、道路交通噪音、间接烟草烟雾暴露和体力活动，并对不运动的人进行了限制性分析。

结果

在 232,926 名参与者中，我们观察到 13,586 例全因死亡、13,159 例非伤害死亡、2,796 例心血管 (CVD) 死亡和 968 例呼吸系统疾病死亡。调整协变量和其他类型的绿地后，私人住宅花园覆盖率与全因、非伤害、CVD 和慢性呼吸道疾病死亡率呈负相关，风险比和 95% 置信区间为 0.94 (0.91, 0.97)，私人住宅花园覆盖率每四分位距 (IQR) 增加分别为 0.95 (0.92, 0.97)、0.92 (0.86, 0.98) 和 0.87 (0.78, 0.98)（IQR = 100 m 缓冲区内增加 21.6%）。与私人住宅花园相比，其他绿地类型与心血管疾病和慢性呼吸道疾病死亡率的负相关性较弱。性别、家庭收入和地区水平的剥夺改变了关联。研究结果对敏感性分析是稳健的。

结论

我们的发现是，私人住宅花园在很大程度上导致了总绿地面积与过早死亡率的负相关，这对公共卫生和城市规划具有影响。应解决私人住宅花园的获取、所有权、景观和使用方面的不平等以及潜在的健康不平等问题。