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Open Access 01-12-2024 | Climate Change | Research

How do urban green spaces influence heat-related mortality in elderly? A realist synthesis

Authors: Tom Cornu, Bruno Marchal, Dimitri Renmans

Published in: BMC Public Health | Issue 1/2024

Abstract

Background

An important consequence of climate change for urban health is heat-related mortality. Vulnerable groups, especially elderly, will be the most affected. A solution put forward in many reports and policy documents is the introduction or expansion of urban green spaces. While they have a proven effect in decreasing the ambient temperature and reducing heat related mortality, the causal pathways are far from clear. Moreover, results vary for different contexts, population types and characteristics of green spaces as they are ‘complex systems thrusted into complex systems’. To our knowledge, there is no systematic synthesis of the literature that examines the mechanisms by which and the circumstances under which green spaces work to decrease heat-related mortality for elderly.

Methods

We performed a realist synthesis– a theory-driven review method– to develop a complexity- and context-sensitive program theory. As a first step, a causal loop diagram was constructed which describes the possible pathways through which urban green spaces influence heat-related mortality in elderly. In a second step, one of the pathways - how they may lead to a reduction of heat-related mortality by increasing social capital - was further explored for underlying mechanisms, the context in which they work and the differentiated patterns of outcomes they generate. Literature was searched for evidence supporting or contradicting the initial programme theory, resulting in a refined theory.

Results

Results show how urban green space can impact on heat-related mortality in elderly by its influence on their exposure to outdoor and indoor heat, by improving their resilience as well as by affecting their access to treatment. Urban green spaces and their interactions with social capital affect the access to health information, social support, and the capacity for effective lobbying. Several mechanisms help to explain these observed demi-regularities, among others perceived behavioural control, perceived usefulness, receptiveness, ontological security, and self-interest. If and how they are triggered depends on the characteristics of the urban green space, the population, and other contextual factors.

Conclusion

Looking into the impact of urban green spaces on heat-related mortality in elderly, researchers and policy makers should take interest in the role of social capital.

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‘Rough’ in the sense that it was constructed to serve as a conceptual framework and that, in this stage no loops were identified yet.

‘Constructed’ means they labelled observations of behaviour and responses (of a care-recipient unable to communicate) as supportive actions.

According to self-determination theory, internalization of norms occurs at different levels, whereby norms shaped the type of motivation over a continuum from external to internal motivation.

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Title: How do urban green spaces influence heat-related mortality in elderly? A realist synthesis
Authors: Tom Cornu
Bruno Marchal
Dimitri Renmans
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Climate Change
Published in: BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-024-17973-5

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How do urban green spaces influence heat-related mortality in elderly? A realist synthesis

Abstract

Background

Methods

Results

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Abstract

Background

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