• Samantha Hajna, Vahe Nafilyan, and Steven Cummins.
• Child Health Informatics Group, Great Ormond Street Institute of Child Health, UCL, London, UK; Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK. Electronic address: s.hajna@ucl.ac.uk.
• Lancet. 2022 Nov 1; 400 Suppl 1: S44S44.

BackgroundUrban greenspaces might reduce non-communicable disease risk. The links between greenspaces and mortality related to non-communicable disease remain unclear. We estimated the associations between residential greenspace quantity and access with all-cause, cardiovascular disease, cancer, respiratory, and type 2 diabetes mortality.MethodsWe linked 2011 UK Census data of London-dwelling adults (aged ≥18 years) to data from the UK death registry and the Greenspace Information for Greater London resource (N=4 645 581). We calculated percent greenspace area, access point density (access points per km2), and distance (metres) to the nearest access point for each respondent's residential neighbourhood (defined as 1000-m street network buffers) for greenspaces overall and by park type using a geographic information system. We estimated associations using Cox proportional hazards models, adjusted for a range of confounders. Ethics approval was granted by the London School of Hygiene and Tropical Medicine's Observational/Interventions Research Ethics Committee.FindingsRespondents were followed for 8·4 years (SD 1·4). A one percentage point increase in pocket park area was associated with a 6% decrease in all-cause mortality risk (hazard ratio [HR] 0·94 [95% CI 0·92-0·97]) and an increase of ten pocket park access points per km2 was associated with an 8% decreased respiratory mortality risk (0·92 [0·85-0·99]). Other associations were observed but the estimated effects were 3% or less. For example, all-cause mortality risk for increases of one percentage point in regional park area (0·99 [0·99-1·00]) and increases of ten small open space access points per km2 (1·03 [1·02-1·03]).InterpretationIncreasing pocket park quantity and access might mitigate premature mortality risk. More research is needed to elucidate the mechanisms that could explain these associations.FundingHealth Data Research UK.Copyright © 2022 Elsevier Ltd. All rights reserved.

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