Page - 272 - in Biodiversity and Health in the Face of Climate Change

272 11.5 Use of  Biodiverse Natural Environments to  Reduce Inequalities in  Health A major drawback in using greenspace to improve public health is that those who are socially disadvantaged are least likely to have access to good quality greens- pace. The health benefits from biodiverse environments tend to be disproportion- ately experienced by the most advantaged sectors of society (Diaz et  al. 2006). This is a social justice issue: the wealthy have less need of the health benefit; they tend to already possess greenspace by having the financial resources to live in greener areas and to own private greenspace; they may travel more extensively to areas of natural beauty; they are more likely to exercise/make use of the greenspace; and finally, they are more likely to displace less advantaged communities from newly greened, previously brownfield sites (i.e. in a process of gentrification). Estimates of health impacts due to SES can be made at a geographical area level, where for a given area the average SES status is known and health data are available. At such geographical areas (carried out at the neighbourhood level, approximately 1,500 persons), it is also possible to measure aspects of the natural environment using geographical information system databases. These area-level analyses show that greenspace is positively associated with health, even after accounting for SES, e.g. in Holland (de Vries et  al. 2003) and the UK (Mitchell and Popham 2008; Dennis et  al. 2018). Indeed, the impact of greenspace on health is greater for those in the most deprived neighbourhoods (de Vries et  al. 2003; Mitchell and Popham 2008). Specifically, Mitchell and Popham (2008) demonstrated that proximity to greenspace reduced health inequalities, and that this effect was stronger in the neighbourhoods with the lowest SES (Fig.  11.8). Good access to greenspace in the local environment can disrupt the expected link between relative poverty and ill health (Mitchell et  al. 2015). However, Wolch et  al. (2014) warn that policies promoting greening of areas for those community areas most in need of such a disruption of health inequality may lead to gentrification and a displacement of the very people most in need. They advocate a balance of green- ing “just enough” to provide benefits without too great a disruption to planning and development. More research will be needed to determine whether this is appropri- ate, feasible and at what level it should be implemented. Residing near to greenspace may not guarantee the full benefits of the natural environment, and in areas where greenspace is more fragmented a more targeted approach might be needed to bring people into contact with nature. This is where the nature, health and well-being sector could target those in socially-deprived neighbourhoods (by using social prescriptions for nature-based interventions) to fit within a public health strategy that aims to reduce inequalities in health. P. A. Cook et al.