Citywide park renovations and changes in perceived stress: a quasi-experimental study among low-income communities in New York City.

Background: Quality parks have the potential to promote well-being and health equity in urban communities through reduced stress, yet high-quality epidemiological evidence is limited. This quasi-experimental study measured associations between park renovation and changes in perceived stress among low-income adults in New York City.

Methods: Pre- and post-renovation data on the Perceived Stress Scale and park use from 162 adults living near (< 0.3 miles) 31 renovated parks and 151 adults living near 21 sociodemographically matched control parks were analyzed. Linear mixed-effects difference-in-difference (DID) regression measured the association between park renovation and change in perceived stress (post-pre) in the overall sample and stratified by baseline sociodemographics. Additional models explored the interaction of post-renovation park use frequency [high (≥ once/week), low (< once/week)] and intervention status on changes in perceived stress.

Results: Overall, changes in perceived stress were similar between intervention and control groups [DID = 0.28 (95% CI -1.48, 2.03)]. However, park renovation was associated with a significant decrease in perceived stress among divorced/separated/widowed participants [DID = -4.22 (95% CI -7.92, -0.53)] and middle-aged participants (35-49y) with high park use [DID = -4.46 (95% CI -8.28, -0.64)]. Among intervention but not control participants, those with high park use experienced a significantly larger decrease in perceived stress compared to those with low park use [DID = -2.92 (95% CI -5.36, -0.47)].

Conclusions: In one of the first and largest studies on park quality improvement and mental health, park renovation near one's home was associated with decreased perceived stress among divorced/separated/widowed adults and middle-aged frequent park users. Frequent users of renovated parks experienced a larger drop in perceived stress than infrequent users, suggesting that high-quality parks may be an important pre-condition to the benefits of frequent park use on stress reduction.