The economics of nature's healing touch: A systematic review and conceptual framework of green space, pharmaceutical prescriptions, and healthcare expenditure associations
Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature...
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Veröffentlicht in: | The Science of the total environment 2024-03, Vol.914, p.169635-169635, Article 169635 |
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creator | Patwary, Muhammad Mainuddin Bardhan, Mondira Browning, Matthew H.E.M. Astell-Burt, Thomas van den Bosch, Matilda Dong, Jiaying Dzhambov, Angel M. Dadvand, Payam Fasolino, Tracy Markevych, Iana McAnirlin, Olivia Nieuwenhuijsen, Mark J. White, Mathew P. Van Den Eeden, Stephen K. |
description | Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature examining green space exposure and its associations with healthcare prescriptions and expenditures. We applied Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to search MEDLINE, Scopus, and Web of Science for observational studies published in English through May 6, 2023. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 26 studies that met the inclusion criteria and were included in our review. Among these, 20 studies (77 % of the total) showed beneficial associations of green space exposure with healthcare prescriptions or expenditures. However, most studies had risks of bias, and the overall strength of evidence for both outcomes was limited. Based on our findings and related bodies of literature, we present a conceptual framework to explain the possible associations and complex mechanisms underlying green space and healthcare outcomes. The framework differs from existing green space and health models by including upstream factors related to healthcare access (i.e., rurality and socioeconomic status), which may flip the direction of associations. Additional research with lower risks of bias is necessary to validate this framework and better understand the potential for green space to reduce healthcare prescriptions and expenditures.
[Display omitted]
•First systematic review on green space exposure and healthcare prescriptions and expenditures.•Twenty-six articles with 242 associations were found through May 2023.•Twenty (77 %) studies reported protected associations of green space on healthcare outcomes.•However, studies showed potential risk of bias for exposure classification.•A new framework shows complexity of associations and influence of other variables. |
doi_str_mv | 10.1016/j.scitotenv.2023.169635 |
format | Article |
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[Display omitted]
•First systematic review on green space exposure and healthcare prescriptions and expenditures.•Twenty-six articles with 242 associations were found through May 2023.•Twenty (77 %) studies reported protected associations of green space on healthcare outcomes.•However, studies showed potential risk of bias for exposure classification.•A new framework shows complexity of associations and influence of other variables.</description><identifier>ISSN: 0048-9697</identifier><identifier>EISSN: 1879-1026</identifier><identifier>DOI: 10.1016/j.scitotenv.2023.169635</identifier><identifier>PMID: 38159779</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><ispartof>The Science of the total environment, 2024-03, Vol.914, p.169635-169635, Article 169635</ispartof><rights>2023 Elsevier B.V.</rights><rights>Copyright © 2023 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c371t-7ea1bc2dd9e9e5f660e0b74d2a1fb485d38c859dfeff972e5c5262a8e937ddb63</citedby><cites>FETCH-LOGICAL-c371t-7ea1bc2dd9e9e5f660e0b74d2a1fb485d38c859dfeff972e5c5262a8e937ddb63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.scitotenv.2023.169635$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38159779$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Patwary, Muhammad Mainuddin</creatorcontrib><creatorcontrib>Bardhan, Mondira</creatorcontrib><creatorcontrib>Browning, Matthew H.E.M.</creatorcontrib><creatorcontrib>Astell-Burt, Thomas</creatorcontrib><creatorcontrib>van den Bosch, Matilda</creatorcontrib><creatorcontrib>Dong, Jiaying</creatorcontrib><creatorcontrib>Dzhambov, Angel M.</creatorcontrib><creatorcontrib>Dadvand, Payam</creatorcontrib><creatorcontrib>Fasolino, Tracy</creatorcontrib><creatorcontrib>Markevych, Iana</creatorcontrib><creatorcontrib>McAnirlin, Olivia</creatorcontrib><creatorcontrib>Nieuwenhuijsen, Mark J.</creatorcontrib><creatorcontrib>White, Mathew P.</creatorcontrib><creatorcontrib>Van Den Eeden, Stephen K.</creatorcontrib><title>The economics of nature's healing touch: A systematic review and conceptual framework of green space, pharmaceutical prescriptions, and healthcare expenditure associations</title><title>The Science of the total environment</title><addtitle>Sci Total Environ</addtitle><description>Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature examining green space exposure and its associations with healthcare prescriptions and expenditures. We applied Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to search MEDLINE, Scopus, and Web of Science for observational studies published in English through May 6, 2023. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 26 studies that met the inclusion criteria and were included in our review. Among these, 20 studies (77 % of the total) showed beneficial associations of green space exposure with healthcare prescriptions or expenditures. However, most studies had risks of bias, and the overall strength of evidence for both outcomes was limited. Based on our findings and related bodies of literature, we present a conceptual framework to explain the possible associations and complex mechanisms underlying green space and healthcare outcomes. The framework differs from existing green space and health models by including upstream factors related to healthcare access (i.e., rurality and socioeconomic status), which may flip the direction of associations. Additional research with lower risks of bias is necessary to validate this framework and better understand the potential for green space to reduce healthcare prescriptions and expenditures.
[Display omitted]
•First systematic review on green space exposure and healthcare prescriptions and expenditures.•Twenty-six articles with 242 associations were found through May 2023.•Twenty (77 %) studies reported protected associations of green space on healthcare outcomes.•However, studies showed potential risk of bias for exposure classification.•A new framework shows complexity of associations and influence of other variables.</description><issn>0048-9697</issn><issn>1879-1026</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkU9z1SAUxRlHxz6rX0HZ6aJ5AnmB4O5NR60znXFT1wyBm4ZnAhFI_3ymfklJX-1WNrD4nXMu9yD0gZItJZR_PmyTcTlk8DdbRli9pVzyunmBNrQVsqKE8ZdoQ8iurSSX4gS9SelAyhEtfY1O6pY2Ugi5QQ9XA2AwwYfJmYRDj73OS4SPCQ-gR-evcQ6LGb7gPU73KcOkszM4wo2DW6y9xUVrYM6LHnEf9QS3If5efa4jgMdp1gbO8DzoOJXXUsQFnCMkE92cXfDp7NFmTcuD0bGMczeDt24dA-uUgnH6EXyLXvV6TPDu6T5Fv759vTq_qC5_fv9xvr-sTC1orgRo2hlmrQQJTc85AdKJnWWa9t2ubWzdmraRtoe-l4JBYxrGmW5B1sLajten6NPRd47hzwIpq8klA-OoPYQlKSaJJC1v6IqKI2piSClCr-boJh3vFSVqbUod1HNTam1KHZsqyvdPIUs3gX3W_aumAPsjAOWrZdtxNYKya-simKxscP8N-QsKZq9Q</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Patwary, Muhammad Mainuddin</creator><creator>Bardhan, Mondira</creator><creator>Browning, Matthew H.E.M.</creator><creator>Astell-Burt, Thomas</creator><creator>van den Bosch, Matilda</creator><creator>Dong, Jiaying</creator><creator>Dzhambov, Angel M.</creator><creator>Dadvand, Payam</creator><creator>Fasolino, Tracy</creator><creator>Markevych, Iana</creator><creator>McAnirlin, Olivia</creator><creator>Nieuwenhuijsen, Mark J.</creator><creator>White, Mathew P.</creator><creator>Van Den Eeden, Stephen K.</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240301</creationdate><title>The economics of nature's healing touch: A systematic review and conceptual framework of green space, pharmaceutical prescriptions, and healthcare expenditure associations</title><author>Patwary, Muhammad Mainuddin ; Bardhan, Mondira ; Browning, Matthew H.E.M. ; Astell-Burt, Thomas ; van den Bosch, Matilda ; Dong, Jiaying ; Dzhambov, Angel M. ; Dadvand, Payam ; Fasolino, Tracy ; Markevych, Iana ; McAnirlin, Olivia ; Nieuwenhuijsen, Mark J. ; White, Mathew P. ; Van Den Eeden, Stephen K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c371t-7ea1bc2dd9e9e5f660e0b74d2a1fb485d38c859dfeff972e5c5262a8e937ddb63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Patwary, Muhammad Mainuddin</creatorcontrib><creatorcontrib>Bardhan, Mondira</creatorcontrib><creatorcontrib>Browning, Matthew H.E.M.</creatorcontrib><creatorcontrib>Astell-Burt, Thomas</creatorcontrib><creatorcontrib>van den Bosch, Matilda</creatorcontrib><creatorcontrib>Dong, Jiaying</creatorcontrib><creatorcontrib>Dzhambov, Angel M.</creatorcontrib><creatorcontrib>Dadvand, Payam</creatorcontrib><creatorcontrib>Fasolino, Tracy</creatorcontrib><creatorcontrib>Markevych, Iana</creatorcontrib><creatorcontrib>McAnirlin, Olivia</creatorcontrib><creatorcontrib>Nieuwenhuijsen, Mark J.</creatorcontrib><creatorcontrib>White, Mathew P.</creatorcontrib><creatorcontrib>Van Den Eeden, Stephen K.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Science of the total environment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Patwary, Muhammad Mainuddin</au><au>Bardhan, Mondira</au><au>Browning, Matthew H.E.M.</au><au>Astell-Burt, Thomas</au><au>van den Bosch, Matilda</au><au>Dong, Jiaying</au><au>Dzhambov, Angel M.</au><au>Dadvand, Payam</au><au>Fasolino, Tracy</au><au>Markevych, Iana</au><au>McAnirlin, Olivia</au><au>Nieuwenhuijsen, Mark J.</au><au>White, Mathew P.</au><au>Van Den Eeden, Stephen K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The economics of nature's healing touch: A systematic review and conceptual framework of green space, pharmaceutical prescriptions, and healthcare expenditure associations</atitle><jtitle>The Science of the total environment</jtitle><addtitle>Sci Total Environ</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>914</volume><spage>169635</spage><epage>169635</epage><pages>169635-169635</pages><artnum>169635</artnum><issn>0048-9697</issn><eissn>1879-1026</eissn><abstract>Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature examining green space exposure and its associations with healthcare prescriptions and expenditures. We applied Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to search MEDLINE, Scopus, and Web of Science for observational studies published in English through May 6, 2023. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 26 studies that met the inclusion criteria and were included in our review. Among these, 20 studies (77 % of the total) showed beneficial associations of green space exposure with healthcare prescriptions or expenditures. However, most studies had risks of bias, and the overall strength of evidence for both outcomes was limited. Based on our findings and related bodies of literature, we present a conceptual framework to explain the possible associations and complex mechanisms underlying green space and healthcare outcomes. The framework differs from existing green space and health models by including upstream factors related to healthcare access (i.e., rurality and socioeconomic status), which may flip the direction of associations. Additional research with lower risks of bias is necessary to validate this framework and better understand the potential for green space to reduce healthcare prescriptions and expenditures.
[Display omitted]
•First systematic review on green space exposure and healthcare prescriptions and expenditures.•Twenty-six articles with 242 associations were found through May 2023.•Twenty (77 %) studies reported protected associations of green space on healthcare outcomes.•However, studies showed potential risk of bias for exposure classification.•A new framework shows complexity of associations and influence of other variables.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>38159779</pmid><doi>10.1016/j.scitotenv.2023.169635</doi><tpages>1</tpages></addata></record> |
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title | The economics of nature's healing touch: A systematic review and conceptual framework of green space, pharmaceutical prescriptions, and healthcare expenditure associations |
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