rethink, invest, regenerate
Improving Health by using Parks Agenda item Presented by Welcome and Introductions Hayley Ash and Jane Powell -at 1PM Introduction to Bristol Future Parks – questions and answers Video clip/Hayley Ash Literature review – Parks based activities and interventions Jane Powell and Sanda Ismail for health The Story of Health in our City – Mapping inequality Hayley Ash Questions and answers All Comfort break 10 minutes at 2.10pm Case Studies for mitigating health inequality in Parks Jane Powell and Sanda Ismail – at 2.20pm Discussion - Interventions and activities for improving health Hayley Ash and Jane Powell and wellbeing Planning an approach for Bristol Breakout groups Feedback session and Next Steps Hayley Ash and Jane Powell
Bristol Future Parks:
Bristol Future Parks: Questions and Answers
Literature review: Park-based activities and interventions for health and wellbeing Jane Powell and Sanda Ismail
Introduction Those who spend more time in parks and green spaces have • improved: Physical health – • e.g. lower prevalence of high blood pressure and allergies (Donovan et al., 2018; Shanahan et al., 2016) – Mental health e.g. lower prevalence of depression and anxiety • (Cohen-Cline, Turkheimer and Duncan, 2015; Cox et al., 2017) – Social wellbeing outcomes • e.g. social cohesion (Shanahan et al., 2016) • Dose-response relationship - staying longer in green spaces is better for health and wellbeing (Shanahan et al., 2016)
Introduction: rationale for the literature review Generally, there is reduced engagement with green spaces (Soga and Gaston,2016) Park and green space activities/ interventions can increase engagement Several park-based interventions are being implemented in the UK However, there is paucity of intelligence as to what specific health outcomes park-based interventions might achieve and for whom Limits to leveraging ability of park-based interventions to improve health and wellbeing outcomes Inefficient and ill – targeted investment decisions more likely
• T o identify different forms of park-based interventions in the UK, the potential health and wellbeing outcomes and the target user groups • Rapid, selective literature review • Population – 3 main user groups People who do not use parks (e.g. physically inactive, people living in – deprived neighbourhoods) – People who need to use parks for health and wellbeing (e.g. people with Aim and chronic heath or mental health conditions) Methodology – People who use parks (e.g. regular runners/ walkers) – not talking about this group today Focus on activities and interventions in parks and green-spaces excl. allotment • gardens and interventions that create new green spaces • Focus on UK-based studies and evidence reviews Sources of literature: academic databases (e.g. Scopus), Green Infrastructure • Resource Library, websites (e.g. The Conservation Volunteers, Mind), SROI reports, references from other published work
Review still ongoing but some outputs so far… Number of Year range of Study designs Hea lth and Park and park and publications used in green-space wellbeing green space- evaluations 2004-2020 based outcomes based activities and interventions Cross-sectional studies Physical health interventions identified Case studies Physical activity Programmes for Qualitative studies 59 Mental wellbeing engaging with park (ethnography, focus and green spaces Social capital groups, interviews, observations) Modifying the park infrastructure to Longitudinal studies attract and promote Controlled trials use Mixed methods Health interventions Natural experiments based in natural environment Evidence reviews and meta-analysis
Park-based User group Health and wellbeing outcomes activity Physical activity Running Physical health Fitness, health, weight Non-runners Park-runs Mental wellbeing Running confidence Social capital Sense of community Physical activity Walking Physically inactive Walking Body mass, body fat, blood pressure, Physical health fasting glucose, VO2 max Physical activity People who Physical activity don’t use Mental wellbeing Place-making QoL, safety High deprivation parks Social capital Community trust areas Signposting for health Physical activity Physical activity Children Physical image, fitness, motor skills Physical health Adolescents Forest schools General wellbeing, mood, Mental wellbeing confidence, social skills, motivation, Students concentration, self-esteem Psychological restoration, achievement, Mental wellbeing self-esteem, reduced stress & mental Green gyms Volunteers fatigue Social capital Contribution to community, social contact
Health and wellbeing outcomes User group Park-based activity Park-runs Mental wellbeing Achievement, safe space People with BMI, body fat, blood pressure, fasting chronic health glucose, VO2 max, heart rate, Physical health conditions cholesterol levels, physical functioning, Walking waist circumference Mental wellbeing Depression Physical health Managing chronic conditions Social prescribing Mental wellbeing General wellbeing Sense of achievement Mental wellbeing Park-runs Social capital Inclusivity People who Walking need to use Physical health Body mass index, body fat parks for Adults/ adolescents Mental health recovery, self-esteem, Mental wellbeing Social and therapeutic engagement, enjoyment, self-image, with mental health health and mood, anxiety, depression horticulture (incl. Social capital Social relations wellbeing issues ecotherapy and adventure therapy General physical health Physical health Forest schools Mental wellbeing Mood Signposting for health Mental wellbeing General mental wellbeing Psychological health, tension and stress, Mental wellbeing mood, confidence, motivation Green gym Social capital Sociability, inclusion Engagement, enjoyment, self-image, Mental wellbeing Children with mental emotions, risk-taking Forest schools health difficulties Social capital Social relationships, friendships
Limitations and Conclusions No claim of literature review as exhaustive - work still ongoing • Only UK-based studies and evidence reviews • • No focus on specific types of individuals – adults, older people, adolescents, children Some trends noted: although some common park-based activities • are used for different groups, the achieved outcomes do vary sometimes Could help guide targeted investments in promoting park use • Success of interventions would still depend on matching and • adapting them to community needs and the existing infrastructure (Buchner and Gobster, 2007)
The Story of Health in our City Mapping inequality - Hayley Ash
Not everyone has access to quality open space CABE 2010
Indices of Deprivation 2019 LSOAs in • Lawrence Weston • Henbury Brentry • Lockleaze • Frome Vale • Hillfields • Ashely • Easton • Lawrence Hill • Brislington West • Stockwood • Knowle West • Filwood • Hartcliffe and Withywood • Hengrove and Whitchurch Park
Health Deprivation and Disability 2019
Diabetes Admissions due to diabetes - rate per 10,000 population Source: NHS Digital Hospital Episode Statistics. Emergency hospital admission episodes with the primary diagnosis of diabetes Bristol residents, 2015/16 to 2019/20.
Prevalence of excess weight in year 6 pupils by ward of residence, 2016/17- 2018/19 - Bristol schools only Source: NCMP data collated by Bristol City Council (Public Health)
Wards with highest diabetes hospital admissions and excess weight rates. Bristol residents, 2015/16 to 2019/20 Source: NCMP data collated by Bristol City Council (Public Health), NHS Digital Hospital Episodes Statistics, Bristol Quality of Life Survey 2019
Asthma and COPD emergency admissions - rate per 10,000 population Source: NHS Digital Hospital Episode Statistics. Emergency hospital admission episodes with the primary diagnosis of asthma or COPD Bristol residents, 2015/16 to 2019/20 .
Mental Health and Wellbeing Admissions due to mental health disorder or emergency admissions for self-harm - rate per 10,000 population Source: NHS Digital Hospital Episode Statistics. Emergency hospital admission episodes with the cause code of self-harm, Bristol residents, 2015/16 to 2019/20 .
Premature deaths from cardiovascular disease by ward. Age standardised rate per 100,000 population. Bristol residents, 2015-2019 Source: NHS Digital Primary Care Mortality Database
Areas with highest admissions rates for one or more of the conditions: diabetes, mental health, self- harm, asthma and COPD. Rates per 10,000 population Source: NHS Digital Hospital Episode Statistics. Bristol residents, 2015/16 to 2019/20.
Bristol Future Parks: Questions and answers
Bristol Future Parks: Comfort break
Mitigating health inequalities in parks: Case studies Jane Powell and Sanda Ismail
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