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Urban Nature

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Nature and Wellbeing Project
Funded by the Robert Wood Johnson Foundation, Nature Sacred, American Heart Association, and United States Forest Service


Living near and spending time in nature is associated with a host of mental and physical health benefits including lower rates of hypertension, less depression, and improved social cohesion. Green space has been cited as a potential buffer between inequitable neighborhood conditions and poor health.  However, there is limited evidence how to increase how much time people spend in green space to maximize the health benefits. To address these gaps in knowledge, the broad objective of this study is to test two intervention strategies to increase green space use - place-based and person-focused, and to evaluate the impact on individual and community health.
 
We are partnering with The Pennsylvania Horticulture Society, OLIN Studio, and the US Forest Service to design a new urban micro-green space intervention. Our concept is a low-cost “kit of parts” that includes design elements such as a path, bench, community signage, and more, that communities can use to design a personalized green space. We are also developing and testing a Nature Coach intervention. The Nature Coach is a community health worker who serves to connect community residents to nearby green space. They will work with study participants to educate them on the health benefits of nature, find desirable nearby green spaces to visit, and visit these green spaces with participants.
Nurtured in Nature
Leveraging urban greenspace, behavioral economics, and mobile platforms to prevent postpartum depression
Funded by Penn Center for Mental Health Policy (CMHPSR) and Center for Health Incentives and Behavioral Economics (CHIBE) ALACRITY Pilot Program

Living near and spending time in nature has been associated with many mental health benefits, including reduced depression, anxiety, and stress. Despite this growing body of evidence linking nature with improved mental health, spending time in green space is not a standard health promoting tool to address mental illness. The recent ParkRx movement involves physicians prescribing time outside. However, few studies describe what these programs entail or if they are effective. To the best of our knowledge, there is no similar effort taking place in women’s health to address post-partum depression. The broad objective of this study is to fill these gaps in knowledge through the development and testing of a digital health intervention using a behavioral economics framework to increase the amount of time postpartum women spend in nature. ​

This work has been featured in Penn Today: Can spending time in nature prevent or lessen postpartum depression? 

Neighborhood Greening Impact on Emergency Department Utilization
Does a neighborhood greening intervention decrease emergency department visits for violence and stress related complaints?

We are evaluating data from our randomized controlled trial of vacant lot greening to determine if a neighborhood greening intervention has an impact on emergency department utilization for violence and stress related visits. Violence related visits include shootings and assaults. Stress related visits include cardiovascular and mental health visits. Our hypothesis is that because greening was associated with reduced violent crime, the intervention will also indirectly decrease violence related visits to the ED. Additionally, because greening is associated with reduced stress, we anticipate stress related ED visits to decrease in response to greening compared to control. 

Neighborhood Greening Space and Cardiovascular Outcomes in Pregnancy

​Lead by CECPR fellow Max Tiako, this study evaluates the relationship between residential green space and the development of hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia. 

Vacant Lot Greening – Randomized Control Trial

Led by UHL Founder Dr. Charlie Branas, we conducted a citywide cluster randomized trial of vacant lot greening in Philadelphia PA. 541 vacant lots were randomized to received either the greening treatment, a trash-clean up treatment, or no-intervention control. We evaluated police reported crime, and perceptions of safety, social connectedness, and mental health. ​

Publications
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Moyer R, MacDonald JM, Ridgeway G, Branas CC. Effect of Remediating Blighted Vacant Land on Shootings: A Citywide Cluster Randomized Trial. American Journal of Public Health. 2019. 

Branas CC, South EC, Kondo MC, Hohl BC, Bourgois P, Wiebe DJ, MacDonald JM. Citywide cluster randomized trial to restore blighted vacant land and its effects on violence, crime, and fear. Proceedings of the National Academy of Sciences. 2018.

South EC, Hohl BC, Kondo MC, MacDonald JM, Branas CC. Effect of Greening Vacant Land on Mental Health of Community-Dwelling Adults: A Cluster Randomized Trial. JAMA Network Open. 2018. 
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Neighborhood Blight, Stress, and Health
A Walking Trial of Urban Greening and Ambulatory Heart Rate

​We measured dynamic stress responses using ambulatory heart rate monitoring as participants in Philadelphia, Pennsylvania walked past vacant lots before and after a greening remediation treatment of randomly selected lots. Being in view of a greened vacant lot decreased heart rate significantly more than did being in view of a nongreened vacant lot or not in view of any vacant lot. Remediating neighborhood blight may reduce stress and improve health.

Publications

South EC, Kondo MC, Cheney RA, Branas CC. 
Neighborhood Blight, Stress, and Health: A Walking Trial of Urban Greening and Ambulatory Heart Rate. American Journal of Public Health. 2015. 

Nature as a Community Health Tool

This commentary describes the role that providers and health systems can play in promoting nature as a community health tool. “I think changing how people interact with their neighborhood environment, and changing the environment directly, is perceived as being hard, perhaps out of bounds of what is possible from health care. We don’t learn about environmental contributors to health in medical school, and it is not part of traditional biomedical care,” Eugenia South, UHL Faculty Director, said. “And yet, changing the environment, including increasing nature access, has the potential to have a huge health impact on a lot of people. It is worth pursuing.”

South EC, Kondo MC, Razani N. Nature as a Community Health Tool: The Case for Healthcare Providers and Systems. American Journal of Preventative Medicine. 2020. 
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Urban Health Lab at Penn

​​Contact us:  urbanhealth@pennmedicine.upenn.edu