Health inequality is a fact of American life.  The Eight Americas Study, looking at the whole US population, discovered breathtaking differences in survival.  American Indian males on the reservation barely make it into their late fifties, while Asian American women in metropolitan New York average over 91 years life expectancy.  Trying to fix such health inequality should be a national priority, but also appears daunting.

         Is a disparity of more than 33 years the result of differentials in medical care?  Mainly, no.  The difference in survival comes mostly from lifestyle and environment.  Now Scottish studies are showing the differences between classes might halved simply Ð by making the environment a little greener.

         The research, highlighted by the BBC, studied the survival of 360,000 British city dwellers. Proximity to even small amounts of greenery related to improved survival. If there were a fair sized bit of parkland around, survival differences between the highest and the lowest socio-economic groups declined by half, a result is five to ten times better than what ÒimprovedÓ health care does in many studies. 

Why Greenery Improves Survival

         The British study is not an outlier.  Many recent studies argue that populations living near greenswards live longer and better, with decreased heart attack, stroke, and depression rates. The real question is why.

Physical Activity

         The presumption of many environmental studies is that green areas improve  survival through increased physical activity.  Various studies show that denizens of Òstressful, denseÓ cities like NY live considerably longer than expected, supposedly because they canÕt get everywhere by car and have to walk.  Green areas can encourage walking and exercise, but only when they are safe.  Many an American or British urban dweller will not go near certain parks.  That greenspace increases physical activity might  explain some, but certainly not all of its positive health effects.

Socialization

         Less acknowledged, but well supported, is the idea that green spaces increase social engagement.  ItÕs a lot easier to walk with your family and meet the neighbors when thereÕs a nice park nearby.  Strangers intermingle,  saying hello to dogs, sitting  on the same bench, and talking about the neighborhood.

         Thirty years of study demonstrates social support can markedly decrease heart attacks and strokes.  More recent studies show the marked decreases in the stress response even come with acquaintances and ÔfriendsÕ created in artificial laboratory conditions.  Then there are cultural  factors.

Cultural and Mental Health Effects

         Other British studies show that individuals are much happier walking through a wood than strolling through a mall.  Many a walker, jogger, hiker, or runner will tell you how much sweeter it is to move through a park than crunch down a high school track.

         Greenspaces may exert some healthy effects through Òsocial mixing,Ó bringing together members of  a community who would otherwise not meet.  This type of engagement can improve the sense of community and peopleÕs basic sense of safety.

         The Dutch treat major depression by taking people to work on farms.  In other countries, depressed groups have been taken out for walks in parks, often cleaning up the environment as they go.

Pollution

         Lung cancers are rising worldwide among non-smokers.  For a long time, much of the cause was ascribed to indoor pollution.  However, soot and small particulates are now recognized important lung cancer inducers. 

         Trees and other plants help get rid of such particulates, and by acting as the ÒlungsÓ of a town or city, decrease overall pollution.  Greenspaces make the air cleaner.

Rest

         For a population that runs like Wiley E. Coyote, rushing around like mad until they suddenly ÒcrashÓ and Òdrop deadÓ into a deep sleep they hope turns off like a fast switch on waking, green spaces provide excellent places to slow down and rest.  Walking around with a friend or family members combines physical activity with social and mental rest.  For many, parks are where they reconnect with nature, temporarily escaping from four concrete walls.

Policy Implications

         America will soon try to reform its immense and immensely wasteful health care system.  Yet other means to improve the nationÕs health more rapidly lie at hand.

         Green spaces work.  They reknit communities, and improve individual health.  Rebuilding infrastructure cannot only help the economy through immediately creating jobs, but can create stronger, healthier communities, with greater social cohesion and improved physical and mental health.  ItÕs something to think about when reviewing development along spaces like SarasotaÕs Bayfront.

         Going green means more than producing alternative energy, creating national energy independence, and decreasing global warming.  Adding greenspaces to where we live can also make us healthier, and our nation more equitable.

Dr. Matthew Edlund practices sleep medicine and psychiatry in Sarasota.  His new book, Designed To Last, is available online. He can be reached at 365-4308 and via his Web site at doctoredlund.com.