Greenness and mortality in an industrialized area in Southern Italy: a health impact assessment study

Abstract Background In Taranto the effects of industrial installations have been studied, but less attention has been placed on the impacts of green-oriented policies. The “3-30-300” rule states that every citizen should have 30% tree-canopy-cover in their neighborhood and not live more than 300m away from the nearest green space. In this Health Impact Assessment (HIA) study, we aimed to quantify the deaths that could be prevented in population aged ≥20 years by implementing this policy in Taranto. Methods Population weighted exposures (PWE) to green spaces (10m) were estimated using the 2022 greenest season NDVI from Sentinel-2 and the 2021 ESA WorldCover within a 300m (WHO 2016) buffer. We set a tree-cover optimal target of 30% and interim targets from 10% to 25%. For each tree-cover target, we set the counterfactual exposure (CE) as the corresponding PWE to NDVI. Age-specific preventable deaths (PD) were calculated by multiplying the baseline deaths (ISTAT) by the preventable fractions (PF). Preventable years of life lost (PYLL) were calculated by multiplying the PD by the specific life expectancy. To compute the 95%CI, we ran 100,000 Monte Carlo simulations to propagate the uncertainties of both CE and ERF to the final estimates. Results The PWEs to NDVI and tree-cover-proportion were 0.19 and 8.0%, respectively. For the 30% tree-cover target (currently achieved by the 1.5% of population), the CE (NDVI) and PF (%) were 0.33 (0.32-0.33) and 5.4% (4.1%-6.2%). A total of 126 (97-146) PD and 1270 (976-1474) PYLL were estimated. Three-cover, shrubland and grassland were associated to higher NDVI values, while built-up and deprivation-index were associated to lower greenness. NDVI and summer temperature showed an inverse relationship. Conclusions This study as a pioneering effort in Southern Italy. Providing more green space could prevent a substantial number of premature deaths in Taranto, potentially up to 5.4% by achieving a 30% tree-cover. Key messages • Providing more green space could prevent a substantial number of premature deaths in Taranto, potentially up to 5.4% by achieving a 30% tree-cover. • Built-up and deprivation-index were associated to lower greenness. NDVI and summer temperature showed an inverse relationship.