Natural outdoor environments and adults' health : associations, effect modifiers and mediators

This thesis aims at (a) evaluating the association between natural outdoor environments (NOE) and health in adults and potential effect modifiers of this association, and (b) investigating the possible mechanism of this association. Data was derived from two cross-sectional studies (including a nest...

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Detalles Bibliográficos
Autor: Triguero Mas, Margarita
Tipo de recurso: tesis doctoral
Estado:Versión publicada
Fecha de publicación:2017
País:España
Institución:CBUC, CESCA
Repositorio:TDR. Tesis Doctorales en Red
OAI Identifier:oai:www.tdx.cat:10803/565926
Acceso en línea:http://hdl.handle.net/10803/565926
Access Level:acceso abierto
Palabra clave:Natural outdoor environments
Green space
Physical activity
Stress
Air pollution
Entorns naturals exteriors
Espais verds
Activitat física
Estrés
Contaminació atmosférica
614
Descripción
Sumario:This thesis aims at (a) evaluating the association between natural outdoor environments (NOE) and health in adults and potential effect modifiers of this association, and (b) investigating the possible mechanism of this association. Data was derived from two cross-sectional studies (including a nested one) and one experimental study. Exposure assessment included residential NOE exposure, and contact with NOE (objectively measured with smartphones and event-based exposures). Health outcomes included mainly subjectively mental health. The potential effect modifier of gender, age, socioeconomic status, urbanisation degree/city and exposure time was evaluated. The possible mechanisms investigated were: (NOE) physical activity, stress/restoration, social contacts, noise, and air pollution. Results of the present work suggest that NOE exposure (both residential and contact with NOE) was positively associated with adults’ chronic health, mainly for green space and greenery, and specially for surrounding greenness. Event-based exposure to NOE was also positively associated to adults’ acute health effects. No strong conclusions could be drawn about groups of population that could benefit more from NOE exposure. Physical activity might not be a mediator of the NOE-health associations. Stress reduction/restoration and air pollution might be partial mediators of these associations. The relationship between NOE exposure -NOE physical activity could be modified by various factors. We highlight the limitations of existing studies in the field and provide recommendations for future research. In the meanwhile, urban planners and policy makers should consider all the mechanisms, targeting the entire population, and use “just green enough” strategies supported by anti-gentrification policies.