Participatory Design of Urban Green Spaces to Improve Residents' Health

Urban green space (UGS) has important impacts on human health, but an integrated participatory approach to UGS design for improved residents' health has been lacking to date. The aim of our study was to develop and evaluate such a novel approach to address this gap. The approach was developed following guiding principles from the literature and tested with groups of children and elderly as participants in two neighborhoods of Maastricht (The Netherlands) with a low score in economic and health indicators. The novel aspects of the approach are the inclusion of both positive and negative health effects, the combination of resident self-assessment and model-based assessment of the health effects of UGS designs, and the use of maps to visualize UGS designs and health effects. The participant-generated UGS designs resulted in a considerable (up to fourfold) self-assessed increase in the use of the UGSs for meeting, stress reduction, and leisure-based physical activity as compared to the current situation. The model-assessed positive and negative health effects of the participant-generated UGS designs were limited: heat stress slightly decreased (by 0.1 degrees C), active transport slightly increased (by 30 m per day), and the perceived unsafety slightly increased (8%). The effects on unattractive views, air pollution, tick bite risk, and traffic unsafety were negligible. The major strength of this approach is that it combines active participation of residents in UGS (re)design with assessment of the health effects of these UGS designs. While in other participatory approaches to UGS design, it often remains unclear whether the resulting designs represent an improvement in terms of health, our combination of computer model-based assessment and a participatory process produced clear outcomes regarding the health benefits and use of UGS designs. A major recommendation for improvement is to involve decision makers already in the initial steps of the approach.