Access to blue/green space in healthcare settings or deprived communities to tackle health inequalities.

There is significant and growing evidence on the physical and mental health benefits of green spaces. Research shows that access to green space is associated with better health outcomes and income-related inequality in health is less pronounced where people have access to green space (PHE 2014).
Access to good quality green space is associated with a range of positive health outcomes including better self-rated health; lower body mass index scores, overweight and obesity levels; improved mental health and wellbeing and increased longevity in older people (Bowler 2010)
Access to green space is not equal across the population of England. People living in the most deprived areas are less likely to live in the greenest areas, and will therefore have less opportunity to gain the health benefits of green space compared with people living in the least deprived areas.
Increasing the use of good quality green space for all social groups is likely to improve health outcomes and reduce health inequalities. It can also bring other benefits such as greater community cohesion and less social isolation.
There is a lack of research evidence with regard to the proximity to, amount, and type of green space that has an impact on specific health benefits. The PHE report of 2014 called for more research to more precisely investigate the links between access to green space and improvements in health outcomes. Importantly, many previous studies did not consider the health equity impact for different social groups across the gradient. Measuring average numbers of users or targeting specific sub groups, misses the opportunity to tackle health inequalities by focusing on improving the provision, quality and accessibility for all. Evaluations of interventions in the past have also failed to follow up outcomes over a longer period of time and have too often relied on survey data or self- reported data. Stronger study designs are needed that gather information over a longer period of time and which measure outcomes in more robust objective ways, such as weight loss, number of visits to the GP, number of minutes and intensity of physical activity. The cost effectiveness of increased use is thus missing from study findings as there is no measurable health outcome (PHE 2014). There is a need to better understand the impact of green spaces around workplaces and schools and places where people spend a significant amount of their daily lives. It will be important to utilise the knowledge and experience of specialists who can evaluate complex public health interventions to further our understanding.