Impact of ecological park restoration on health in low income neighborhoods: A natural experiment

摘要 生活在社会经济贫困的市中心的个人有不成比例的高死亡率 心血管疾病、癌症、2型糖尿病和肥胖症，这些疾病都有压力--和身体上的 与活动相关的病因。此前对城市建成环境的研究表明，公园 可以减轻压力，增加体力活动。然而，因果健康关系一直是 由于依赖横断面设计、粗略的暴露评估、 健康影响数据有限，忽视了绿地的负面方面(例如，垃圾、噪音)。 这项研究将利用即将在五个低收入社区进行的一项自然实验。 在底特律，密歇根州涉及将未经维护的公园生态恢复为草原草甸。 五个控制公园社区在人口统计和建筑特征上进行了匹配。这 纵向研究将包括来自10个干预/对照的参与者(减员后n=590人 公园社区进行基线测量，然后在三年后进行年度测量- 修复。我们的研究将是第一个考察生态环境影响的自然实验 通过视觉/听觉暴露的个体水平测量进行恢复(例如，绿色植物， BirdSong)关于健康的绿色空间。我们将超越通常的客观体力指标 PARK研究中的活动(GPS/加速计)包括有效的压力生物标记物(唾液 皮质醇)和心脏代谢指标(BMI、血压、腰臀比、C反应 蛋白质和A1C)。需要回答的问题是：废弃的生态恢复 公园变成草原草甸和鸟类栖息地，增加了附近居民的体力活动， 减轻他们的压力，改善他们的心脏代谢健康？我们提出了三个目标。目标1： 建立公园生态修复对体力活动的影响 修复后3年，采用非随机设计。目标2：说明压力减轻 修复公园的潜力。目标3：评估生态修复对下游的影响 心脏代谢健康结果。理解生态修复对健康意愿的作用 为城市的可复制性、可扩展性和普及性提供独特的机会 管理低收入社区的公园资源。我们的发现将在 制定必要的政策以缓解肥胖症中普遍存在的社会经济差距，类型 2糖尿病、癌症和心脏代谢健康。

Summary Individuals living in socioeconomically deprived inner cities have disproportionately high rates of cardiovascular disease, cancers, Type 2 diabetes and obesity, which have stress- and physical activity-related etiologies. Previous research on the urban built environment suggests that parks may reduce stress and increase physical activity. Yet, the causal health relationships have been difficult to establish due to reliance on cross-sectional designs, coarse exposure assessment, limited health effects data and neglect of negative aspects of green space (e.g., litter, noise). This study will capitalize on an upcoming natural experiment in five low-income neighborhoods in Detroit, MI involving the ecological restoration of unmaintained parks to grassland meadows. Five control park neighborhoods were matched on demographic and built characteristics. This longitudinal study will include participants (n=590 after attrition) from ten intervention/control park neighborhoods with baseline measurement then annual measurement for three years post- restoration. Our study will be the first natural experiment to examine the impact of ecological restoration with individual-level measurement of visual/auditory exposure (e.g., greenery, birdsong) to green space on health. We will go beyond the usual objective measure of physical activity (GPS/accelerometer) in park studies to include a validated stress biomarker (salivary cortisol) and cardio-metabolic indicators (BMI, blood pressure, hip-to-waist ratio, C-reactive protein and A1C). The question to be answered is: Does ecological restoration of abandoned parks into grassland meadows and bird habitats increase nearby resident’s physical activity, lower their stress, and improve their cardio-metabolic health? We propose three aims. Aim 1: Establish the effect of ecological restoration of parks on physical activity from baseline through 3-years post-restoration, using a non-randomized design. Aim 2: Illuminate the stress reduction potential of restored parks. Aim 3: Evaluate the effect of ecological restoration on downstream cardio-metabolic health outcomes. Understanding the role of ecological restoration on health will provide the unique opportunity to inform replication, scalability and generalizability for cities managing park resources in low-income neighborhoods. Our findings will be vital in the development of policies needed to mitigate pervasive socioeconomic disparities in obesity, Type 2 diabetes, cancer, and cardio-metabolic health.