Impact of residential green spaces on health inequalities in the UK: A systematic review and exploratory meta-analysis

Abstract

Residential green spaces - defined here as public or private green environments located within or immediately surrounding places of residence - are recognised as important social determinants of health, yet their potential to reduce health inequalities remains underexplored. This systematic review synthesised evidence on whether access to residential green spaces is associated with health outcomes across socioeconomic groups in the United Kingdom. A total of 20 studies were included that covered mental health, physical health, child development and mortality outcomes. Across studies, green space was generally associated with improved mental wellbeing, lower chronic disease risk and greater child socio-emotional development. Importantly, several studies found stronger health benefits among socioeconomically disadvantaged groups which suggests equigenic effects, although lower-quality or inaccessible green spaces could entrench inequalities. Three studies were included in a pre-specified exploratory random-effects meta-analysis focussed on mental wellbeing outcomes. The pooled odds ratio indicated a modest but non-significant protective association between green space exposure and mental wellbeing (OR 0.91, 95 % CI 0.77–1.07), with very high heterogeneity (I²=99.8 %) and sensitivity analysis showed no single study unduly influenced the results. Although the pooled effect was non-significant, the consistent direction across studies supports the view that more and better residential green space may promote mental health. Findings from the broader review show that equity impacts vary across green space typologies: public parks, neighbourhood vegetation and community spaces tend to deliver more equitable benefits than private gardens, which are unevenly distributed and can reinforce environmental privilege. By embedding a focus on health inequalities, this review provides actionable evidence to enable the provision of green space as a core public health infrastructure.