Health promoting green infrastructure associated with green space visitation

Background: With rapid urbanization globally, people in cities tend to have fewer opportunities to interact with nature. Some health-promoting green infrastructure may support increased visitation. Objective: To investigate associations between green space visitation and a range of health promoting green infrastructure. Methods: From November 2019 to January 2020, we conducted a population-based cross-sectional study in Shenzhen, China. Patients diagnosed with hypertension aged 35 years or older managed by community health centers for one year were recruited. A stratified multi-stage cluster random sampling method was applied to select a representative sample of 1 158 participants. A well-structured questionnaire was applied to obtain information. Participants were surveyed face-to-face (response rate 96.4 %; n = 1,116 participants) by trained interviewers. Binary logistic regression model was used to analyze the relationship between green space visitation and a range of health promoting green infrastructure. Results: The rate of visiting green space was 87.5 % (976/1,116). The rate of visiting green space for at least 30 min per week was 85.5 % (954/1,116). The rate of visiting green space for at least 120 min per week was 78.2 % (873/1,116). Green space with walking trails [OR(95 %CI): 2.322(1.501,3.591)], group exercise venue [OR(95 %CI): 1.546(1.034,2.312)] mean higher odds of people with hypertension visiting green space. Green space with fitness area availability was positively associated with cumulative green space visitation of 30 min or more a week [OR(95 %CI): 1.652(1.115,2.447)]. Health knowledge promotion area was associated with greater odds of visiting green space at least 120 min per week [OR(95 %CI): 1.529(1.124,2.079)]. Conclusion: Walking trails, health knowledge promotion areas, fitness areas and group exercise venue are associated with higher levels of green space visitation at health-relevant cumulative durations. Our findings have significance for urban greening strategies that aim to maximize population health.