Exploring Indirect Links between Green Space Use and Health in the Urban Context: Is There More to It than Meets the Eye?

Abstract

[Abstract]: Urban green spaces are increasingly recognized for their potential role in promoting public health although empirical evidence regarding their direct impact remains inconclusive. Beyond mere proximity, the aesthetic quality and subjective valuation of green areas may substantially influence how they contribute to health outcomes. Addressing a gap in the existing literature, this study establishes an explanatory model of the relationship between green spaces and health based on survey data from the city of Pontevedra (Spain). The model integrates sociodemographic variables, healthy behaviors, and aesthetic evaluations while using a health index that combines subjective perceptions of well-being with objective indicators such as medication use and medical consultations. Results show that the direct relationship between green space use and health is modest; however, green spaces are associated with increased physical activity, particularly sports practice, which in turn relates positively to health outcomes. The findings also reveal evidence of reverse causality as individuals in better health are more likely to engage in sports activities. Notably, aesthetic perceptions—especially favorable evaluations of sustainable garden designs—significantly affect the frequency and intensity of green space use. These results highlight the importance of not only expanding green spaces in urban environments but also enhancing their perceived quality to foster healthier behaviors and contribute indirectly to public health.