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The health of a nation

  • Published at 05:43 pm June 15th, 2016
  • Last updated at 03:47 pm June 19th, 2016
The health of a nation

Most of the risk factors, when it comes to health care, can be manageable if proper initiatives are taken through multidisciplinary approaches. Simple changes in lifestyle behaviour can bring substantial changes in personal health care costs.

While formulating and strictly implementing anti-smoking regulations, ensuring healthy and fresh food for households in co-operation with public and private organisations at the top level, the government should work with urban planners, architects epidemiologists and mass-media agencies to plan and design a neighbourhood, encourage, make aware, and motivate the population at the bottom level.

Role of urban green spaces in promoting population health

There are a number of risk factors which can be prevented through the usage of urban green spaces. In its most basic form, the term “green space” is an outdoor, unbuilt environment.

Commonly recognised urban green spaces include urban parks, greenways, squares and plazas, botanical gardens, recreational parks, memorial grounds, and community open spaces.

The less commonly recognised urban green spaces are within neighbourhoods, vacant plots, and even less unofficial spaces boiling down to residential gardens or street trees.

• The benefits of urban green space is noticed in mainly three fundamental forms:

• Recreational (active or passive enjoyment)

• Ecological (eg water resource and quality protection, bio-diversity and species protection, storm and flood water control, air purification, natural resource conservation, and so on)

• Aesthetic (offers the value of “substituting gray infrastructure”)

Furthermore, urban green spaces fulfill many functions in an urban context that benefit residents’ quality of life and therefore, these play a crucial role in the health sector too.

There is scientific evidence that health benefits are there from using UGS. Here are some of these benefits:

Physical health

Urban parks and playgrounds provide local opportunities for different types of leisure pursuits and play an important role in encouraging physical activity among various sub-populations (ie, different age and socio-economic groups). And we already know that lack of physical activity is one of the major risk factors to NCDs.

Mental health and well-being

Access to green space improves our mental well-being, reduces stress, and helps psychological restoration. Urban green spaces may influence mental health both directly and indirectly.

It may directly impact mental health via the restorative benefits arising from contact with nature.

Alternatively, it can indirectly influence mental health by providing places for people to meet and socialise, which can yield social contact known to be protective of mental health.

A study conducted by BBC found that “living in an urban area with relatively high levels of green space can have a significantly positive impact on well-being, roughly equal to a third of the impact of being married.”

Access to green space improves our mental well-being, reduces stress, and helps psychological restoration. Urban green spaces may influence mental health both directly and indirectly

Quality of life

The provision and access to green space also positively affects reported stress and quality of life. A large epidemiological study in the Netherlands found a positive correlation between the quantity of urban green space and the perception of general health.

A study at the University of Washington shows quantitative evidence that some mental diseases like attention deficit disorder (ADD), Alzheimer’s, dementia, loss of concentration and distractibility, stress, and depression can be treated with a green touch in their neighbourhood.

Health inequalities

Exposure to green spaces also has an impact on urban socio-economic health inequalities. Several studies of Australia found that inner city and poor populations are less likely to participate in outdoor recreational activities.

Teenagers living in disadvantaged neighbourhoods, for example, lack access to parks they considered safe and are therefore less likely to participate in physical activities than teens in more affluent neighbourhoods.

Quality matters too

Only quantitative supply of UGS will not ensure its usage; appropriate care should be taken to ensure the quality of those UGS. The benefits people desire can directly be linked to a particular recreational activity and to physical, social, and management setting characteristics.

UGSs have to be centred in such a way as to encourage people to stay and enjoy being there. So far, proximity and accessibility are considered to be the main determinants for park usage and physical activity, but now activities encouraging features of parks, safety, places for different age groups etc are also important factors. Viewing from a mental health perspective, the quality of green space within a neighbourhood is evidenced to be more significant.

Conditions and usage pattern of UGS in Dhaka

In Bangladesh, Dhaka is the most urbanised and dense city. Population living in Dhaka are consistently exposed to various kinds of risk factors for NCDs. In terms of UGS provisions and usage also, Dhaka has been acutely suffering. From the Dhaka structure plan (2016-35) report, it is revealed that 48% of the entire RAJUK area under urban use and 52% non-urban use.

Among these only 1142.42 acres (0.30%) of the land is used for recreational activities, which is substantially low (0.07 acre/1000 population) compared to other major cities.

The situation is worse for Dhaka, where even after an optimistic calculation, the area of urban green space per capita is found to be only 0.56 square metres, compared with the WHO recommendation of nine square metres per capita.

The situation  will be more critical in 2035 where the population will become 8.83 million in the core area, requiring 25.3% of the area (ie 135.67 sq-km) to be preserved as open space following DAP standards. There is also the WHO standard of accessibility to nearest urban green spaces, that is a 15-minute walking distance. However, there is no study found yet that could show the average walking distance to the nearest green space in Dhaka city.   

Apart from the quantitative inequity, the qualities are not in attractive situations either to pull the neighbouring population to use it. Newspapers have been regularly reporting on the dilapidated situations of parks/open spaces/playground around the city.

A number of studies (eg one recently published by Work for Better Bangladesh) can be found that has already adequately figured out the quantitative and qualitative deficiencies of urban green spaces within Dhaka.

This article does not aim to elaborate more on those issues. Rather, it leaves the urge to the concerned authorities to engage more in enhancing the accessibility and usability of urban green spaces in Dhaka.

Local government bodies should work in co-operation with higher educational institutes in this regard to get more research-based feedback into formulating and implementing policies.

Focusing on green space-health interrelationships

According to WHO, five of the 10 leading causes of worldwide disability and premature death are psychiatric conditions, while depression is predicted to be the second-leading cause of global disease burden by 2020.

To date, the research on UGS-health interrelationships is mainly found in developed and western societies.

One of the main reasons for this could be the prevalence of NCDs in those countries for several decades. To ensure rational usage of a limited resource, developing countries like Bangladesh only focus on fighting communicable diseases while ignoring the foreseeable epidemic of NCDs.

It is high time to reorient the focus on the use of UGS not only from recreational perspectives but also as a “population strategy” for preventing health risk factors.