An ecosystem service perspective on urban nature, physical activity, and health

Abstract

Nature underpins human well-being in critical ways, especially in health. Nature provides pollination of nutritious crops, purification of drinking water, protection from floods, and climate security, among other well-studied health benefits. A crucial, yet challenging, research frontier is clarifying how nature promotes physical activity for its many mental and physical health benefits, particularly in densely populated cities with scarce and dwindling access to nature. Here we frame this frontier by conceptually developing a spatial decision-support tool that shows where, how, and for whom urban nature promotes physical activity, to inform urban greening efforts and broader health assessments. We synthesize what is known, present a model framework, and detail the model steps and data needs that can yield generalizable spatial models and an effective tool for assessing the urban nature-physical activity relationship. Current knowledge supports an initial model that can distinguish broad trends and enrich urban planning, spatial policy, and public health decisions. New, iterative research and application will reveal the importance of different types of urban nature, the different subpopulations who will benefit from it, and nature's potential contribution to creating more equitable, green, livable cities with active inhabitants.

Keywords: decision-support tools; equity in access; green space; public health; urban sustainability.

Fig. 1.

Conceptual model of the relationships among urban nature (as part of the urban system), PA (quantity and quality), and health, aligned with an ecosystem service approach. Numbers correspond with The Current State of Knowledge points 1 and 2.

Fig. 2.

Detailed conceptual model of relationship between urban nature and PA where exposure to nature and the two factors determining it (access and choice to use) mediate the role of urban nature in stimulating PA, modified by external moderators.

Fig. 3.

An illustration of a hypothetical model application for Amsterdam, The Netherlands based on the presented model framework. Step 1 shows urban nature data for the current situation and a scenario with increased and improved city parks (see ref. for details). Step 2 shows neighborhood-level data that moderates exposure to nature, assumed to remain constant between the two scenarios (88). Step 3 applies the relationship between park availability and PA to quantify the change in physically active time between scenarios at the population level (11), or for individual groups (hypothetical). Step 4 uses the relationship between PA and health outcomes to quantify health benefits at population level or for groups, with examples for relative risk of all-cause mortality and hazard ratio of cardiovascular disease mortality based on metabolic-equivalent task-hours per week and hours of sitting per day (4). The arrows show how data from each step feed into the next step and the model output. Sets of output maps for the initial situation and the applied scenarios result from step 3 (PA output) and step 4 (health benefits output).