Population health status and green urban areas: impact on health outcomes in two Italian regions

Abstract Background Living in urban areas has been linked to a rise in noncommunicable diseases. Nevertheless, there is scarcity of evidence emphasizing the combined impacts of certain urban attributes (e.g. pollution, excessive soil sealing, urban temperatures) and the existence of green spaces on health outcomes. Further studies are imperative to evaluate the association between chronic illnesses such as dementia and ischemic heart disease, and the presence of urban green areas. Methods We conducted an ecological study in two Italian regions. Prevalence of chronic diseases in Tuscany and Latium were obtained at the municipality level from public health databases available online and Normalized Difference Vegetation Index (NDVI) was calculated for 2023. Descriptive analyses and Poisson regression models were run to assess the association between green space and chronic diseases prevalence, adjusting for age, sex, education, employment, foreign residents, income, urbanicity and spatial correlation. Results Preliminary analyses were conducted on 273 municipalities in Tuscany. Mean prevalence per 1000 inhabitants of dementia and ischemic heart disease were 15.75 (SD = 5.3) and 48.25 (SD = 11.06), respectively. Mean NDVI across municipalities was 0.37 (SD = 0.04). Higher green exposure is associated with lower prevalence of ischemic heart disease (β= -0.21; p < 0.05) and dementia (β=-0.3, p < 0.05). Analyses will be executed for the Latium region and complete results will be available by mid-June. Conclusions The presence of urban greenery appears to be associated with a reduction in chronic illnesses. While further studies are warranted, it is crucial to adopt urban policies focused on green spaces and citizens’ health outcomes. Generating evidence for decision-makers is essential for shaping urban environments in ways that promote both health and overall human wellbeing. Key messages • Living in green urban areas appears to positively impact human health, reducing chronic disease prevalence. • Greenery serve as a tool for mitigating and adapting to the climate crisis, promoting health.