Susan Booher

Ohio State University

Abstract

Nature is deficient in our communities, especially in urban and senior living. Typically, these neighborhoods have no access to nearby green spaces and may not have plants or natural materials within their interior environments. It is important to make nature accessible to everyone to promote healthy living. The EDRA 50 conference is a big milestone and discussions will include reflection on the past 50 years while planning for the future of environmental design. Because this conference will have many key players (e.g., architects, city planners, interior designers, and facility managers) in attendance, it is important to address today’s nature deficit problem; then, have plans in place to continue to support the presence of nature in our environments. In consideration of the past, the Silent and Baby Boomer generations are retiring and moving to communities for the aging or may receive at-home care while participating in daily activities provided by a local community center. Coincidently, there is a concern of greater divides within our socioeconomic classes that could place more families into government‑funded and low‑income housing in urban neighborhoods. Intergenerational community centers are being constructed in urban neighborhoods for aging adults, young children, and youth to work together and excel in wellness, health and knowledge across all generations. There is a need to bring nature into these community spaces and improve the health and wellness for all the generations. Nature could be used for learning and community building while providing attentional restorativeness to the community to reduce stress and promote health. We need to ensure the health of our communities is maintained by including nature in our environments or at least accessibility to nearby green spaces. It is our responsibility as professionals and community members to provide these experiences to our future communities.

Introduction

Nature is deficient in our communities, especially in urban and senior living. These communities typically have few accessible and safe nearby green spaces and may not have plants or natural materials within their interior environments. It is important to make nature accessible to everyone to promote healthy living and wellbeing.

It is important to address today’s nature deficit problem; then, have plans in place to continue to support the presence of nature in our environments. In consideration of the past, the Silent and Baby Boomer generations are retiring and moving to communities for the aging or may receive at-home care while participating in daily activities provided by a local community center. Coincidently, there is a concern of greater divides within our socioeconomic classes that could place more families into government-funded and low-income housing in urban neighborhoods.

Nature could be used for learning and community building while providing attentional restorativeness to the community to reduce stress and promote health. We need to ensure the health of our communities is maintained by including nature in our environments or at least accessibility to nearby green spaces. It is our responsibility as professionals and community members to provide these experiences to our future communities.

Benefits of Greenspace

Research studies have evaluated the relation of mental health to the proximity to urban parks and greens spaces. In a study by Wells, Sturm, Sherbourne and Meredith, ten parks were studied in urban neighborhoods with high household poverty and high percentage of ethnic minorities compared to the national average. Data was collected from the park users through observations, surveys and interviews as well as from household surveys of neighborhood residents. There were four strata that the nearby park residents were classified into, which are identified as living within 400m, 400-800m, 800m-1.6 km and more than 1.6 km from the parks in the study. The surveys included a 5-item mental health measure (MHI-5) from the Medical Outcomes Study from Caring for Depression created by authors Wells, Sturm, Sherbourne and Meredith. Sturm, R.& Cohen, D. (2014, March 17). Proximity to Urban Parks and Mental Health. Sturm, R.& Cohen, D. (2014, March 17). Proximity to Urban Parks and Mental Health. The Journal of Mental Health Policy and Economics, 1,19-24.

The results indicated that mental health, frequency of use of the park, and probability of weekly exercise declined with the distance from the parks. The decline in mental health was indicated in the first three distances 400m, 400-800m, 800m-1.6 kmfrom the parks; distances beyond 1.6 km showed “no statistically significant difference”. As distance increased from the study parks, mental health declined. Residents living beyond 800m from the study park had a decline in their mental health by 4.5 points while individuals living within 400m of the study park had highest scores of mental health (Table 1). Sturm, R.& Cohen, D. (2014, March 17). Proximity to Urban Parks and Mental Health. The Journal of Mental Health Policy and Economics, 1, 19-24.

Table 1 Descriptive Statistics: Residents by Distance from Study Parks

Chiesura’s study focused on the reasons local residents visitedVondelpark , Amsterdam’s most popular park. Seven hundred fifty questionnaires were distributed to the park visitors during a variety of times and days through the week and in different areas of the park. Four hundred sixty-seven (62.3%) of the questionnaires were returned along with additional comments and positive words. The responses were represented by 52.7% female and the ages ranged from 15 to 65 years. Chiesura, A. (2004) The role of urban parks for the sustainable city. Landscape and Urban Planning, 68, pp. 129-138

Figure 1 Motives for nature: frequency distribution. that

Table 2

Note: Extraction method: principal component analysis. Rotationmethods: varimax with Kaiser normalization. No factor restriction. All factors loading >0.40 are included.

The responses showed that 73% of people’s primary reasons for visiting the park were “to relax”; “to be in nature” was the next highest ranked motive (54.4%). The respondents mentioned “to escape from the city” as another motive for visiting the park. This indicates the respondents were trying to get to a refuge away from the city’s attributes (traffic, noise and pollution). Twenty percent of the respondents visited the park “to be with the children”. This indicates that families include activities in nature to strengthen their family ties and fulfill social functions. The youngest aged respondents used the park for sport activities and meeting other people while adults and elderly preferred other activities that promoted relaxing, staying with children and experiencing nature (Figure 1). Emotions experienced in the park were assessed via frequency analysis. The two most used words were “Freedom” 299 times and “Unity with nature” 199 while “Happiness” accounted for 163. Other identified feelings from the respondents included positive descriptions of tranquility (Table 2). Chiesura, A. (2004) The role of urban parks for the sustainable city. Landscape and Urban Planning, 68, pp. 129-138

Thompson, Roe, Aspinall, Mitchell, Clow and Miller explored the connection between green spaces in deprived communities and stress in astudy of 25 participants living in Dundee, UK with socio-economic adversity the majority of whom were unemployed. Of the approached 75 individuals, only 33% agreed to participate in this study. Dundee has 31 CAS wards (geographical units) and a mean green space value of 33.89%. The level of stress or patterns of cortisol secretion was measured over the course of the day to study the effects of the presence of green space around people’s homes in deprived urban areas. Self-reported scales were also used by individuals to measure their wellbeing and stress. Thompson, C. W., Roe, J., Aspinall, P., Mitchell, R., Clow, A., &Miller, D. (2012). More green space was linked to stress in deprived communities: Evidence from salivary cortisol patterns, Landscape and Urban Planning, 105, 221-229.

The samples of salivary cortisol secretion were gathered over two days by the participants within the comfort of their own home, with the first one of each day to be swabbed as soon as waking up; then, there were samples gathered 4 more times: every 3 hours for the next 12 hours of the day. After the samples were gathered, they were stored in a sealed bag within the refrigerator or freezer until the samples were collected by the researchers. The secondary measure was the Perceived Stress Scale (Cohen, Kamarck, &Mermelstein,1983) that consisted of ten items that are indicators of wellbeing to include feeling stressed, feeling in-control, etc. Thompson, C. W., Roe, J., Aspinall, P., Mitchell, R., Clow, A., & Miller, D. (2012). More green space is linked to stress in deprived communities: Evidence from salivary cortisol patterns, Landscape and Urban Planning, 105, 221-229.

The results from the self-report showed negative association of green space and the percentage of stress. For every 1% increase of green space, self-reported stress decreased by .14 units (Table 3) and vice versa: stress level perceptions increased with the decline amount of green space in the environment. The cortisol measurements also indicated that the greater presence of green space, the greater the diurnal decline in the cortisol. Thompson, C. W., Roe, J., Aspinall, P., Mitchell, R., Clow, A., & Miller, D. (2012). More green space is linked to stress in deprived communities: Evidence from salivary cortisol patterns, Landscape and Urban Planning, 105, 221-229.

Many researchers have studied human connections to nature andthe effects of cognitive behavior. Attention Restoration Theory (ART) suggests that being in nature, promotes the attentional functions and promotes recovery from mental fatigue that allow the mind to relax and reflect with mild (effortless) attention captivated by nature. Taylor, Kuo and Sullivan’s study was conducted to examine the effect of children diagnosed with Attention Deficit Disorder (ADD) playing outdoors. The study explores “Hypothesis 1, attention deficit symptoms will be more manageable after activities in green settings than after activities in other settings; Hypothesis, 2 the greener a child’s everyday environment, the more manageable their attention deficit symptoms will be in general” (59). The study was conducted with a questionnaire and qualitative data collection from interviews of children diagnosed with ADD, their parents and practitioners. Taylor, A. F., Kuo, F. E., &Sullivan, W. C., (2001, January). Coping with ADD: The surprise connection to green play settings, Environment and Behavior, 33(1), 54-77.

Hypothesis 1 was tested by evaluating the activities the children’s parents suggested as positively (best) or negatively (worst) affecting their attention deficit symptoms. There were 113 best and 106 worst activities nominated. Three categories of activities were identified as Green, Ambiguous, and Not Green by an independent coder. There were 20 Green activities, 17 were nominated as best and 3 were nominated as worst. The Not Green category was identified as 43 activities nominated as best while 57; worst (Table 3). Taylor, A. F., Kuo, F. E., & Sullivan, W. C., (2001, January). Coping with ADD: The surprise connection to green play settings, Environment and Behavior, 33 (1), 54-77.

TABLE 3

Activities Nominated as Best and Worst for

Attention Deficit Disorder Symptoms, Classified by Likely Setting

Likely Setting Best Worst

NOTE: Numbers in parentheses are ns for each group.

Figure 2: Mean Postactivity Attentional Functioning Ratings for Indoor, Built Outdoor, and Green Outdoor Activities

Postactivity Attentional Functioning (PAAF) was measured on the aftereffects of activities that were presented on a list to the participants’ families. The aftereffects of these activities were measured on a Likert-type scale with a rating system of 1 (much worse) to 5 (much better), with 3 indicating no change. Of the 113 participants, the results showed the PAAF ratings measured higher 3.5 with Green outdoor activities than activities within built outdoor 3.2 and indoor environments 3.2 (Figure 2). PAAF measures a person’s amount of attention (ability to focus, complete tasks, follow directions, and minimally distracted) after an activity is performed. In fact, there were no reports the activities in green outdoor that negatively affected their child’s attention. The results of Hypothesis 2 indicated the means of severity of ADD symptoms reduced with activities in “greenness” compared amongst 5 different play settings. However, indoor play with windows resulted in lower severity than indoor without windows.The parents of this focus group reported their children with ADD “function better both during the activity and for some time afterward” when they played in green settings. This study’s results encouraged the application of vegetation in children’s surroundings (home, school and playgrounds) to promote attentional functions.

Taylor, A. F., Kuo, F. E., & Sullivan, W. C., (2001, January). Coping with ADD: The surprise connection to green play settings, Environment and Behavior, 33 (1), 54-77.

Additional research has been conducted on the relationship between nature and physical health. Many studies have aimed at physical activity and obesity. Petraviciene, Grazuleviciene, Andrusaityte, Dedele, and Nieuwenhuijsen’s study was focused on the relationship of greenspace and early childhood obesity of 4 to 6-year-old children in Kaunas, Lithuania in 2012-2013. Through postal letter invitations, 1,489 mothers agreed to fill out the postal questionnaires on their children’s health and other data. The Normalized Difference Vegetation Index (NDVI) was used to aid in measuring the greenness of the land. It ranged between -1 and 1. There’s usually a large presence of water with “-1” and ample green vegetation is measured at “1”. “The prevalence of overweight/obesity among children residing in areas with higher greenness (NDVI-100 m > median) was 5.9%, while in the areas with lower greenness (<median), the prevalence was 9.0%” (Table 4).Petraviciene, I., Grazuleviciene, R., Andrusaityte, S., Dedele, A., & Nieuwenhuijsen, M., (2018, March 5). Impact of the Social and Natural Environment on Preschool-Age Children Weight. International Journal of Environmental Research and Public Health, 449(15), 1-14.

This study also showed young child obesity is impacted by the distance to a city park. The rate of obesity was 5.5% with a distance less than 300 meters and a rate of 8.1% with any distance beyond the 300 meters to the city park. The article concludes “the green spaces exposures for psychosocial stress reduction has been recommended as a measure to prevent overweight / obesity among children.” International Journal of Environmental Research and Public Health, 449(15), 1-14.

Edward O. Wilson’s research interests have led to review biophilia explaining our innate connection with nature. Frumkin’s article reviewed the positive effects of nature that could improve the health of various individuals that are ill or overcoming addictions. Frumkin, H. (2001). Beyond Toxicity: Human Health and the Natural Environment, American Journal of Preventative Medicinevol. 20(3), 234-240.

Frumkin discussed various studies that successfully showed the application and presence of animals and plants to improve health and reduce stress. Frumkin mentions Allen’s study showed a reduction in high blood pressure and stress with the adoption of dogs; cats didn’t cause the same results. Katcher, Segal, and Beck studied the presence of a fish aquarium in dental office waiting rooms promoted relaxation of patients, patients’ blood pressure measured lower than other patients that didn’t view an aquarium.

Table 4

Now on to the review of research of plants and humans. In Shoemaker and Geller’s study, referenced in Frumkin’s literature review, ninety-nine percent of residents of retirement communities reported “living within pleasant landscaped grounds” were important and 95% found importance of windows facing landscapes. Views of landscapes with tree resulted in reduced hospital stays by 8.5% and needs of pain medications in a 10-year study reviewed by Betz. Betz, K. (2016). Healthcare design gets back to nature: Natural elements dramatically influence patient and staff psychological and physiological response to spaces. Commercial Architecture. Retrieved from https://www.commercialarchitecturemagazine.com/healthcare-design-gets-back-to-nature/.

While another study showed 90% of 700 individuals experienced “an increased sense of aliveness, well-being, and energy” while on a 14-28-day wilderness excursion trying to break an addiction. Frumkin, H. (2001). Beyond Toxicity: Human Health and the Natural Environment, American Journal of Preventative Medicinevol. 20(3), 234-240.

Frumkin identified three areas of implications: research, collaboration and intervention. “Is there an association between exposure and outcome?” (238) is the question to ponder in clinical and epidemiologic research. Frumkin concluded that collaboration with various environmental specialists and professionals should be utilized to consider enhancing our health. Through intervention, we need to apply or implement environmental components or featureswhen evidence reveals the health benefits of them in our presence. Frumkin, H. (2001). Beyond Toxicity: Human Health and the Natural Environment, American Journal of Preventative Medicinevol. 20(3), 234-240.

Public Use of Greenspace

Building designs have explored the implementation of biophilic design elements that include daylighting, natural ventilation, etc. Research conducted by Fei Xue and Zhoghua Gou (2018) studied outdoor spaces near offices in Singapore and Hong Kong because both cities are dense. They conducted a case study to assess the physical environment of 14 locations in Singapore and Hong Kong. They also collected the data from questionnaires that measured the physical environment of the location (temperature and humidity) and the individual’s that worked in the nearby offices completed questionnaires to self-evaluate their health. Xue, F. & Gou, Z. (2018). Chapter 21: Healing Space in High-Density Urban Contexts: Case Studies and Design Strategies, Handbook of research on perception-driven approaches to urban assessment and design, IGI Global, Hershey, PA., 489-507.

The respondents that worked in offices with openable windows were less likely to travel to the shared green space in the building complex while the air-conditioned office workers socialized more in the green spaces. The proximity of site locations and access also influenced the respondent’s decision to walk to the public park or garden; if the green spacewas within walking distance of 300-400m from the individual, they were likely to visit the natural habitat. Xue, F. & Gou, Z. (2018). Chapter 21: Healing Space in High-Density Urban Contexts: Case Studies and Design Strategies, Handbook of research on perception-driven approaches to urban assessment and design, IGI Global, Hershey, PA., 489-507.

The results of Xue and Gou’s study indicate the occupants of undesirable buildings visited green spaces to compensate for their negative experience with their built environment. This is an opportunity to draw people outside to participate in activities of sports, music, live entertainment. Providing seating and tables for breaks and socializing amongst trees and plants may promote mental restoration while improving mood and wellbeing. The successful application of greenspaces should attract people and increase the intentional visit to be more than a passive one. Xue, F. & Gou, Z. (2018). Chapter 21: Healing Space in High-Density Urban Contexts: Case Studies and Design Strategies, Handbook of research on perception-driven approaches to urban assessment and design, IGI Global, Hershey, PA., 489-507.

Neighborhood and Community Enhancement

Other researchers have studied the influence of green space to promote community interaction and socialization. The study conducted in 2004 by Sullivan, W., Frances, E., & DePooter, S was conducted at Ida B. Wells, inner-city Chicago housing development that provides housing for 5,700 individuals with 93% of them unemployed. The study consisted of 758 observations at 59 nearby common spaces of the residential development to explore the relationship of social activity to the presence of greenness. Of these outdoor spaces, 32 were considered barren without trees and grass. The research for thisstudy strategically designed the observations for consistency with weather and days/times and used thorough documentation. The detailed coding sheets included a table for entering information about the people observed and a map of the courtyardsto record the observations adequately. Activities were also recorded in six general categories: (a) eating, (b) doing chores/repairs, (c)socializing, (d) entertaining, (e) resting/thinking, and (f) playing. Sullivan, W. C., Kuo, F. E., & DePooter, S. F., (2004), The Fruit of Urban nature: Vital neighborhood spaces, Environment and Behavior, 36 (5), 678-700.

Results suggested green spaces averaged 90% more people than barren spaces. Green spaces had 125% more individuals (alone) users and 82% more individuals in groups. This indicates that green spaces were used more than barren ones. Sullivan, W. C., Kuo, F. E., & DePooter, S. F., (2004), The Fruit of Urban nature: Vital neighborhood spaces, Environment and Behavior, 36 (5), 678-700.

There are still some negative perceptions that vegetation hides criminals and perpetrators in residential areas. Therefore, Kuo and Sullivan conducted a study in 98 Ida B. Wells public housing building developments in Chicago in 1995. This development provides housing for about 5,700 individuals, the majority of whom receive Aid to Families with Dependent Children (Chicago Housing Authority). This study chose Ida B. Wells because of the similarities in the buildings but the amount of nature outside the buildings range from low to high. Results of this study indicate that vegetation reduced the amount of police-reported crime (Figure 3). Kuo, F. E. & Sullivan, W. C. (2001), Environment and crime in the inner city: Does vegetation reduce crime?, Environment and Behavior, 33(3), 343-367.

Figure 3: Kuo, Sullivan Environment and crime in the inner city: Does vegetation reduce crime?

Mean Number of Crimes Reported Per Building for Apartment Buildings With Different Amounts of Vegetation (each icon represents one reported crime)

The comparison shows there was 40-44% reduction of crime in buildings with low vs medium level vegetation while the comparison of medium vs high level of vegetation equates to 48-56% fewer crimes.

The study’s outcome suggests that planting a few trees in inner-city neighborhoods could inhibit crime while increasing safety in poor neighborhoods. Kuo, F. E. & Sullivan, W. C. (2001), Environment and crime in the inner city: Does vegetation reduce crime?, Environment and Behavior, 33(3), 343-367.

Mooney and Nicell (1992) researched the relationship between violence and vegetation by comparing the number of assaults by residents of Alzheimer care facilities with and without gardens. As the mental faculties decline over time with Alzheimer patients, the assaults typically increase; however, the 1992 study showed the same number or fewer assaults within the facilities that had gardens. The comparison study suggests that the presence of gardens may reduce the incidence of Alzheimer patients assaulting others. Kuo, F. E. & Sullivan, W. C. (2001), Environment and crime in the inner city: Does vegetation reduce crime?, Environment and Behavior, 33(3), 343-367.

The Importance of Making Parks Accessible for the Aging Population

There are research studies that continue to explore how to promote physical activity for the Aging population. Loukaitou-Sideris, Storms, Chen, and Brozen explored the preferences of parks to Los Angeles seniors in low-income areas. Their housing is typically public-funded and small in size; therefore, seniors may find an interest to visit nearby public parks. Five focus groups were formed by recruiting 39 members at the local senior center operated by St. Barnabas Senior Services (SBSS). These participants were ethnically diverse with the majority of them identifying as Latinos. Loukaitou-Sideris, A., Levy-Storms, L., Chen, L., Brozen, M., (2016). Parks for an Aging Population: Needs and preferences of low-income seniors in Los Angeles, Journal of the American Planning Association, 23(3), 236-251.

Although the nearby park was large, the focus group members didn’t visit it. The members provided reasons for not visiting the park that were identified as safety issues with tripping, falling, being run-over by youth and security against crime and violence. They voiced their preference of having a park to call their own that didn’t allow access to other generations. Loukaitou-Sideris, A., Levy-Storms, L., Chen, L., Brozen, M., (2016). Parks for an Aging Population: Needs and preferences of low-income seniors in Los Angeles, Journal of the American Planning Association, 23(3), 236-251.

In the focus group meetings, there were six park preferences or characteristics identified as the following: 1. Security from threats and environment hazards, 2. Accessibility, 3. Natural elements present, 4. Senior-friendly park design and programming, 5. Walking and physical activity opportunities, 6. Social interaction promoted through the settings and programs. The group participants also recommended gardening spaces where they could grow flowers to enhance aesthetics, provide produce for themselves and to share with the community, and allow themselves to engage in social and therapeutic activities. Loukaitou-Sideris, A., Levy-Storms, L., Chen, L., Brozen, M., (2016). Parks for an Aging Population: Needs and preferences of low-income seniors in Los Angeles, Journal of the American Planning Association, 23(3), 236-251.

Future parks could be planned to be more supportive of various generational physical activities such as the ‘layering and separation” concept by Cooper Marcus and Francis (1990). This would allow different activities to be conducted in designated activity zones without the overlap of youth and senior physical activities. It is in the best interest of the communities to support “aging-in-place” since more of the aging population is choosing this option as opposed to retirement communities. Loukaitou-Sideris, A., Levy-Storms, L., Chen, L., Brozen, M., (2016). Parks for an Aging Population: Needs and preferences of low-income seniors in Los Angeles, Journal of the American Planning Association, 23(3), 236-251.

Takano, Yushima, Watanabeconducted a cohort study and analyzed five years of survival of individuals born 1903, 1908, 1913 and 1918 that reside in the west and east sides of Tokyo, Japan. The study’s 3,144 participants were originally contacted in 1989 to begin the study in 1992 with a follow up study in 1997. There were 2,211 survivors to participate in the follow up study, 85.7% were 73 years of age in the baseline year and 43.7% was comprised of 88 years of age in the baseline year. The questionnaire was analyzed with the survival report to determine that men that didn’t experience automobile noise had a higher rate of survival. Additional results included women had a higher survival rate if they reported themselves as actively communicating with their neighbors (Table 5). The overall results showed that senior citizens’ longevity was influenced by access to nearby walkable green space. Takano, T., Yushima, K., Watanabe, M., (2002), Urban residential environments and senior citizens’ longevity in megacity areas: the importance of walkable green spaces, J Epidemiol Community Health, 56, 913-918.

Table 5 Five-year survival percentages of the older people by selected characteristics of residential environment.

Conclusion

With the increase of the world’s Aging population (65 years and up), this generation should be aided with accessible greenspace to support their wellbeing. Wellbeing was defined by Martin Seligman to include elements of positive emotion, engagement, meaning, accomplishment and positive relationships (PERMA). Aging adults may achieve many of these elements by actively using nearby greenspace, e.g., participate in a scheduled Tai-Chi activity outside with neighbors. The aforementioned research studies provide results that nature positively affects physical and mental health that extend to include the aging population. Improving accessibility to nearby parks and greenspaces should entice the elderly to participate in outdoor activities and promote their health and longevity, regardless of where they choose to age-in-place in their home or in Continuing Care Retirement Communities (CCRC). Not just their health would be positively be affected but their dignity as well because they can continue to do this independently.

References:

Betz, K. (2016). Healthcare design gets back to nature: Natural elements dramatically influence patient and staff psychological and physiological response to spaces. Commercial Architecture. Retrieved from https://www.commercialarchitecturemagazine.com/healthcare-design-gets-back-to-nature/.

Chiesura, A. (2004). The role of urban parks for the sustainable city. Landscape and Urban Planning, 68, 129-138.

Frumkin, H. (2001). Beyond toxicity: Human health and the natural environment. American Journal of Preventative Medicine, 20(3), 234-240.

Loukaitou-Sideris, A., Levy-Storms, L., Chen, L., Brozen, M., (2016). Parks for an aging population: Needsand preferences of low-income seniors in Los Angeles. Journal of the American PlanningAssociation, 23(3), 236-251.

Petraviciene, I., Grazuleviciene, R., Andrusaityte, S., Dedele, A., & Nieuwenhuijsen, M., (2018, March5).Impact of the social and natural environment on preschool-age children weight. InternationalJournal of Environmental Research and Public Health, 449 (15), 1-14.

Seligman, Martin E. P. (2011). Flourish: A Visionary new understanding of happiness and well-being. Atria Paperback, New York, NY.

Sullivan, W. C., Kuo, F. E., & DePooter, S. F., (2004). The fruit of urban nature: Vital neighborhood spaces. Environment and Behavior, 36 (5), 678-700.

Takano, T., Yushima, K., Watanabe, M. (2002). Urban residential environments and senior citizens’ longevity in megacity areas: The importance of walkable green spaces. J Epidemiol Community Health, 56, 913-918.

Taylor, A. F., Kuo, F. E., & Sullivan, W. C., (2001). Coping with ADD: The surprise connection to green playsettings. Environment and Behavior, 33 (1), 54-77.

Thompson, C. W., Roe, J., Aspinall, P., Mitchell, R., Clow, A., & Miller, D. (2012). More green space waslinked to stress in deprived communities: Evidence from salivary cortisol patterns. Landscape and Urban Planning, 105, 221-229.

Xue, F. & Gou, Z. (2018). Chapter 21: Healing space in high-density urban contexts: Case studies and design strategies. Handbook of research on perception-driven approaches to urban assessment and design, IGI Global, Hershey, PA., 489-507.

Wells, Sturm, Sherbourne and Meredith. Sturm, R.& Cohen, D. (2014). Proximity to urban parks and mental health. The Journal of Mental Health Policy and Economics, 1, 19-24.