Green Space and Physical Activity in China: A Systematic Review

Green space may play an essential role in residents' physical activity (PA), but evidence remains scattered in China. This study systematically reviewed scientific evidence regarding the influence of green space on PA among residents in China. Keyword and reference searches were conducted in PubMed, Web of Science, Scopus, EBSCO, and CNKI from the inception of an electronic bibliographic database to May 2021. Eligibility criteria included the following: study designs-observational (e.g., longitudinal or cross-sectional studies) and experimental studies; study subjects-people of all ages; exposures-green space (e.g., parks, vegetation areas, open green fields); outcomes-leisure-time and work/school-related PA (e.g., active commuting); and country-China. All but two studies identified at least one measure of green space to be associated with PA. Street greenness was associated with increased odds of active commuting (e.g., cycling) and walking, and a reduced risk of physical inactivity. Access to green space was associated with increased PA levels and green space usage. Distance to green space was inversely associated with the odds of PA. By contrast, evidence linking overall greenness exposure to PA remains limited. Future studies adopting experimental study design are warranted to establish more robust scientific evidence of causality between green space and PA in China. Future studies are also warranted to examine the underlining mechanisms and the differential impacts of green space on population subgroups in China.