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Heal h & Place
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Indi idual and en i onmen al ac o s associa ed wi h g een exe cise in
u ban and subu ban a eas
Rii a Pyky
a,b,⁎,1
, Ma jo Neu onen
a
, Ka ja Kangas
a
, Ann Ojala
a
, Timo Lanki
c,d
, Ka ja Bo odulin
e
,
Liisa Ty äinen
a
a
Na u al Resou ces Ins i u e Finland, La oka anonkaa i 9, 00790 Helsinki, Finland
b
Oulu Deaconess Ins i u e, Depa men o Spo s and Exe cise Medicine, Albe inka u 18A, 90100 Oulu, Finland
c
Na ional Ins i u e o Heal h and Wel a e, Depa men o Heal h Secu i y, P.O. Box 95, 70701 Kuopio, Finland
d
Ins i u e o Public Heal h and Clinical Nu i ion, Uni e si y o Eas e n Finland, P.O. 1627, 70211 Kuopio, Finland
e
Na ional Ins i u e o Heal h and Wel a e, Depa men o Public Heal h Solu ions, P.O. Box 30, 00271 Helsinki, Finland
ARTICLE INFO
Keywo ds:
Physical ac i i y
Subu ban
Adul s
Heal h
G een a ea
ABSTRACT
In his s udy, we mainly aimed o explo e he associa ions o pe sonal and socio-demog aphic ac o s, and he
supply o g een a eas and buil spo s acili ies wi h g een exe cise (GE). We also compa ed he esiden s o he
co e u ban a ea and subu ban a eas acco ding o he le el o leisu e ime physical ac i i y (LTPA) hey had.
A popula ion-based sample o 3730 adul s (aged 25–101 y) om Finland, illed ou a ques ionnai e in 2015.
Va iables desc ibing he supply o g een a eas and buil spo s acili ies we e objec i ely calcula ed. The g een
a eas we e classi ied in o small (< 25 ha), middle-sized (25–150 ha) and la ge (> 150 ha) a eas o e lec hei
quali ies o GE. The da a analysis me hods included mul inomial logis ic eg ession, -, and Chi Squa e es s.
Ou esul s indica e ha ha ing a sho dis ance o a leas a middle-sized g een a ea and high na u e e-
la edness a e impo an o pa icipa ion in GE, bo h in co e u ban and subu ban a eas. Mo e ac o s we e ound
o be ela ed o GE in he subu ban a eas compa ed o co e u ban a eas and among he low LTPA compa ed o
he high LTPA g oup.
1. In oduc ion
Physical ac i i y (PA) educes public heal h cos s by p e en ing
many physical and men al diseases, such as co ona y hea disease, ype
2 diabe es, dep ession, and b eas and colon cance s (Lee e al., 2012;
Teychenne e al., 2008). Popula ion-le el PA may be p omo ed ia in-
o ma ional, beha io al, social, policy, and en i onmen al app oaches
(Hea h e al., 2012). One possible en i onmen al app oach o p omo e
PA is o enhance g een exe cise (GE) in o he wo ds PA ha akes place
in na u al en i onmen s, such as in o es s, pa ks and along sho es. I
has been p oposed ha GE has addi ional heal h bene i s compa ed o
PA indoo s (Thompson Coon e al., 2011), and ha he bene i s include
s ess educ ion and cogni i e es o a ion (James e al., 2015; Pie ilä
e al., 2015; Pasanen e al., 2014). In addi ion, exposu e o g een a eas
has been sugges ed o encou age PA (James e al., 2015; Dad and e al.,
2016).
Easy access o g een in as uc u e may p omo e PA (Pie ilä e al.,
2015; Neu onen e al., 2007). P e iously, he numbe o pa ks wi hin a
0.5 km dis ance om home was ound o posi i ely associa e wi h ob-
jec i ely measu ed PA in a la ge s udy om 14 ci ies in en coun ies on
i e con inen s (Sallis e al., 2016). The p esence and numbe o pa ks
and g een spaces ha e also been ound o be posi i ely associa ed wi h
sel - a ed PA (As ell-Bu e al., 2014a, 2014b; McMo is e al., 2015;
Liu e al., 2017). Despi e some s udies which did no ind a di ec link
(T igue o-Mas e al., 2015; Calogiu i and Ch oni, 2014; O d e al.,
2013), a posi i e associa ion be ween exposu e o g een spaces and PA
le els is gene ally iden i ied in p e ious s udies (Bowle e al., 2010).
F om a esiden s’ pe spec i e, a ele an issue o GE is no only he
accessibili y o na u e, bu also he en i onmen al quali y and di e si y
o oppo uni ies o ac i i ies and na u e expe iences o e ed by e -
e yday li ing en i onmen s (Flowe s e al., 2016; Ty äinen e al.,
2007). Pe cei ed quali ies o g een spaces, such as he a ac i eness o
he landscape, peace and quie , species ichness and cul u al ea u es
ha e been posi i ely associa ed wi h PA (Ty äinen e al., 2007; Bjo k
h ps://doi.o g/10.1016/j.heal hplace.2018.11.001
Recei ed 18 Ap il 2018; Recei ed in e ised o m 18 Oc obe 2018; Accep ed 6 No embe 2018
⁎
Co esponding au ho a : Na u al Resou ces Ins i u e Finland, La oka anonkaa i 9, 00790 Helsinki, Finland.
E-mail add esses: [email p o ec ed] (R. Pyky), [email p o ec ed] (M. Neu onen), [email p o ec ed] (K. Kangas), [email p o ec ed] (A. Ojala),
[email p o ec ed] (T. Lanki), [email p o ec ed] (K. Bo odulin), [email p o ec ed] (L. Ty äinen).
1
P esen add ess: Oulu Deaconess Ins i u e, Depa men o Spo and Exe cise Medicine, Albe inka u 18A, 90100 Oulu, Finland.
Heal h and Place xxx (xxxx) xxx–xxx
1353-8292/ © 2018 The Au ho s. Published by Else ie L d. This is an open access a icle unde he CC BY license
(h p://c ea i ecommons.o g/licenses/BY/4.0/).
Please ci e his a icle as: Pyky, R., Heal h and Place, h ps://doi.o g/10.1016/j.heal hplace.2018.11.001
e al., 2008; de Jong e al., 2012). In addi ion, se e al quali y ac o s
posi i ely a ec he amoun o PA ha people engage in. These ac o s
include, o example, he size and he connec i i y o g een a eas, he
a ac i eness and di e si y o he landscape, as well as e sa ile ou -
doo ec ea ion possibili ies and se ices (i.e. pa king lo s, ligh ing, and
ou doo ec ea ion ails) (Ty äinen e al., 2007; Kaczynski e al.,
2014). Mo eo e , o e -c owding in a g een a ea may p e en people
om isi ing he a ea (A nbe ge and Mann, 2008). PA may also be
highe among esiden s li ing closes o a well-main ained pa k wi h an
o ganized layou and s uc u ed pa h ne wo k (Coombes e al., 2010)
emphasizing he impo ance o pa k ea u es. The p esence o enjoyable
places and being nea o wa e cou ses ha e also been ound o be po-
si i ely associa ed wi h PA (Ka usisi e al., 2012).
In addi ion, socio-demog aphic ac o s may be associa ed bo h wi h
PA beha io and he p e e ed en i onmen s o i , bu he e idence on
his associa ion is mixed. The associa ion be ween u ban g eenness and
PA was he s onges in highe income g oups and young adul s in a
Canadian s udy (McMo is e al., 2015). Howe e , con o e sial non-
signi ican associa ions a e epo ed be ween income and GE (O d e al.,
2013) and be ween age, gende and u ban g eenspace isi s (Dallime
e al., 2014). In Finland, young people, u ban esiden s and highly
educa ed people ha e been sugges ed o p e e indoo spo s se ices
and o he buil spo acili ies in hei ac i i ies (Husu e al., 2011).
Al hough socio-demog aphic ac o s may no gene ally de ine isi s o
g een a eas, i has been sugges ed ha olde people especially p e e o
exe cise in na u e (Husu e al., 2011; Calogiu i e al., 2016).
An indi idual's ela ionship wi h na u e has also ecen ly been
ound o enhance physical ac i i y in g een a eas. Na u e ela edness
may be o g ea signi icance o GE and could help in mee ing PA e-
commenda ions (Flowe s e al., 2016). Ano he s udy has sugges ed
ha people who me PA a ge s and had a highe deg ee o na u e e-
la edness han a e age, engaged mo e in ou doo PA (Law on e al.,
2017). In addi ion, o he pe sonal ac o s, such as con enience, s ess
elie and educing eelings o anxie y may mo i a e people o isi local
g een spaces (James e al., 2015; Calogiu i and Ellio , 2017). Mo e-
o e , good pe cei ed heal h can acili a e GE while poo pe cei ed may
heal h es ic i (James e al., 2015).
In Finland, he g een in as uc u e p o ides an impo an esou ce
o hose who wish o be physically ac i e, and i has been s udied ha
36% o he physical leisu e ime ac i i y o adul s occu s in na u al
en i onmen s (Husu e al., 2011). Impo an ly, Finns li e, on a e age,
app oxima ely 600 m om he o es closes o hei homes, and 96% o
Finnish adul s pa icipa e in ou doo ec ea ion in many di e en o ms
(Sie änen and Neu onen, 2011). In Finland, ci ies and owns a e s ill
ela i ely g een compa ed o many o he Eu opean coun ies
(Ty äinen e al., 2005). Howe e , in in e na ional s udies close
p oximi y and a high p opo ion o g een space has no always been
ound o associa e wi h PA (Mäki-Opas e al., 2016). The e o e, mo e
accu a e measu emen s including he size and he ype o g een space
and he use 's pe spec i es ha e been sugges ed o be used s udies in
ela i ely g een ci ies. Acco ding o Ty äinen e al. (2007), u ban
na u e and daily ou doo ec ea ion a e impo an o people li ing in
he subu bs o ci ies in Finland, whe e hey seem o especially ap-
p ecia e anquili y, he eeling o being in he o es and na u alness.
Howe e , he ele ance o na u e o people can a y by he esiden ial
a ea. Easy accessibili y o he ci y cen e o u ban se ices a e app e-
cia ed mo e by people li ing in compac u ban a eas, while easy access
o na u e is o en mo e app ecia ed by people li ing in subu ban a eas
(Faehnle e al., 2011). Howe e , g een a eas a e only one place which
p o ides oppo uni ies o PA o occu . Acco ding o a Finnish s udy o
6874 adul s, 14% o he sel - epo ed leisu e ime PA akes place in
indoo spo s acili ies (Husu e al., 2011).
The e is only a li le esea ch ha akes in o accoun all he socio-
demog aphic, pe sonal and en i onmen al ac o s associa ed wi h g een
exe cise o he pa icipan s. We had wo aims in his popula ion-based
s udy: 1) We aimed o comp ehensi ely explo e how pe sonal and
socio-demog aphic ac o s and supply o g een a eas and buil spo s
acili ies a e associa ed wi h he amoun o GE. 2) We also compa ed
he co e u ban and subu ban esiden s and he high/low leisu e ime PA
g oups acco ding o he di e ences in supply o g een a eas and o he
ac o s ela ed o g een exe cise. The heo e ical amewo k o he s udy
is p esen ed in Fig. 1.
2. Ma e ial and me hods
2.1. S udy design
We used he esponses om he Helsinki Capi al Region
En i onmen al Heal h Su ey da a measu ing he heal h, heal h beha-
io and en i onmen al ac o s in Helsinki, which is a ci y o 620,000
inhabi an s and he capi al o Finland. App oxima ely 40% o Helsinki
consis s o g een and ec ea ional a eas, while he o es accoun s o
abou one i h o he a ea (Jaakkola e al., 2013). Mos o he g een
a eas a e loca ed in he subu bs, while he majo i y o indoo spo s
acili ies a e loca ed in co e u ban a eas (Fig. 2).
The Helsinki Capi al Region En i onmen al Heal h Su ey da a was
collec ed in 2015 using bo h mailed and elec onic ques ionnai es. A
andom sample o 8000 Helsinki esiden s aged 25 yea s o mo e was
d awn om he Popula ion Regis e . O hese, 3730 (47%) people
pa icipa ed in his su ey. The esponden s we e sligh ly o e p e-
sen ed by he emale gende 59% (53% among Helsinki esiden s aged
25–100) and by age g oups o 55–64 yea s 18% (15%) and a leas 65
Fig. 1. Theo e ical amewo k o he ac o s hypo hesized o a ec g een exe cise.
R. Pyky e al. Heal h and Place xxx (xxxx) xxx–xxx
2
yea s 34% (22%) (Table 1). The p opo ion o esponden s wi h a basic
o middle school le el o educa ion was lowe , and was 16% compa ed
o he Helsinki popula ion (24%). (S a is ics Finland.) The esiden ial
a eas o he pa icipan s we e di ided in o co e u ban and subu ban
a eas acco ding o he pos al code a eas (Ty äinen e al., 2016;
Lönnqwis , 2015).
2.2. Measu es o physical ac i i y
The amoun o g een exe cise and leisu e ime physical ac i i y we e
sel - epo ed. Pa icipan s epo ed how o en hey exe cised ou doo s
(e.g. in pa ks, o es s, o ields) du ing he wa m season (May o
Sep embe ) and in he cold season (Oc obe o Ap il) wi h al e na i es:
1) Ne e (0 poin s), 2) Less o en han once a week (1 poin ), 3) 1–2
imes a week (2 poin s), 4) 3–4 imes a week (3 poin s), and 5) 5 imes
weekly o mo e (4 poin s). The sum o he poin s (0–8 poin s) was used
as he GE sco e and classi ied in o ou le els in a mul inomial eg es-
sion analysis: 1) e e o a ely (0–2 poin s), 2) ela i ely o en (3–4
poin s), 3) o en (5–6 poin s) and 4) e y o en (7–8).
The amoun o LTPA ha he pa icipan s engaged in was ob ained
ia he ques ion: How o en a e you physically ac i e du ing you lei-
su e ime o a minimum o 20 min a a ime so ha you ge a leas
sligh ly winded and ha you swea (excluding ac i e commu ing o
wo k o school)? F om he answe op ions 1) Ne e , 2) Less o en han
once a week, 3) 1–2 imes a week, 4) 3–4 imes a week, and 5) 5 imes
weekly o mo e, op ions 1–3 we e ca ego ized as low LTPA and op ions
4–5 as high LTPA. The ins umen o igina es om he Na ional FINRISK
S udy (Bo odulin e al., 2017). Due o i s old his o y, alida ion s udies
we e no ou inely included in he 1970's, ye ai ly simila physical
ac i i y ins umen s ha e la e been alida ed, showing modes alidi y
agains objec i ely measu ed physical ac i i y (Helme ho s e al.,
2012).
The pa icipan s also epo ed whe he hey walked o cycled o
wo k o school in wa m (1 poin ) and cold seasons (1 poin ) and i hey
walked o cycled o example o g oce y s o e in wa m season (1 poin ).
The ac i e commu ing sco e was a sum o hese poin s.
2.3. Socio-demog aphic and pe sonal-le el a iables
In addi ion o hei age and gende , pa icipan s epo ed hei
highes le el o educa ion om he al e na i es: basic school educa ion,
middle school, oca ional uppe seconda y school, gene al uppe sec-
onda y school, o me pos -seconda y le el, poly echnic deg ee o
uni e si y g adua e. They we e also asked i hey ha e mino s a home.
The pa icipan s a ed hei cu en heal h s a us as e y good, qui e
good, mode a e, qui e poo o poo (Rasanen e al., 2015) and a 2-le el
a iable was used ( e y good/p e y good s. mode a e/p e y poo /
poo ) in he analysis. In addi ion, pa icipan s epo ed (in a single
ques ion) whe he hey had su e ed om s ess du ing he las mon h
and he measu e used was a dicho omous a iable (qui e o en/con-
inually s. ne e /seldom/occasionally). They also epo ed i hey own
a dog and hei body mass index (BMI) was calcula ed om sel - e-
po ed heigh and weigh (BMI = kg/m
2
).
To measu e he connec ion he esponden s o ou su ey had o
na u e, we used he b ie measu e o na u e ela edness (NR6) (Nisbe
e al., 2009; Nisbe and Zelenski, 2013), which is a scale designed o
Fig. 2. Loca ion o he indoo and he ou doo spo acili ies, small (< 25 ha), middle-sized (25–150 ha) and la ge (> 150 ha) g een a eas and he co e u ban a ea in
Helsinki.
R. Pyky e al. Heal h and Place xxx (xxxx) xxx–xxx
3
b ie ly assess people's le el o ela edness o na u e. The scale has six
i ems and he pa icipan s answe ed ques ions such as “I ake no ice o
wildli e whe e e I am,” and, “My ela ionship o na u e is an impo an
pa o who I am.” The pa icipan s esponded wi h a i e-poin Like
scale anging om s ongly disag ee o s ongly ag ee.
The pa icipan s also e alua ed hei sa is ac ion wi h he quali y o
he g een a eas in hei esiden ial en i onmen on a Like scale, and
his was used as a dicho omous a iable ( e y sa is ied o qui e sa is ied
s. no sa is ied/dissa is ied o qui e/ e y dissa is ied) in he analysis. I
was e alua ed wi h a single ques ion: “How sa is ied a e you wi h he
quali y o he g een a eas in you li ing en i onmen ”.
2.4. Supply o g een a eas and buil spo s acili ies
To calcula e he supply o g een a eas in Helsinki, as a s a ing
poin , we used spa ial da a o g een a eas in Helsinki om he yea
2003 used in a p e ious s udy on na u e a eas and heal h in u ban and
subu ban a eas in Helsinki (Ty äinen e al., 2016). The da a was
cons uc ed using he g een a ea da abase o he Ci y o Helsinki Public
Wo ks Depa men , ae ial pho og aphs o he ci y and annually pub-
lished Seu uCD 2003, desc ibing ea u es such as oad ne wo k and
land-use wi hin he Helsinki Me opoli an A ea. The da a was upda ed
o his s udy aking in o accoun ecen land-use changes such as new
esiden ial and indus ial a eas based on da a om The Na ional Land
Su ey om 2014 and 2016. G een a eas in Helsinki included: o es s,
we lands, pa ks, ag icul u al lands, communi y ga dens, and all o he
ege a ed a eas excluding buil -up spo a eas wi h acili ies and gol -
cou ses. The g een a eas we e classi ied in o small (< 25 ha), middle-
sized (25–150 ha) and la ge (> 150 ha) g een a eas o e lec hei
quali ies and he oppo uni ies hey p o ide o a ious ypes o uses. A
leas in he Helsinki a ea he size o he a ea co ela es wi h he acil-
i ies and se ices p o ided o g een exe cise. Fo example he la ges
a eas ha e he c oss-coun y skiing oppo uni ies p o ided du ing he
win e ime. The o he quali y aspec s include he landscape, eeling o
being in he o es , silence – many o hese issues a e app ecia ed by
Finns. The a ea size co ela es o en posi i ely wi h hese i ems. In he
classi ica ion, hose a eas ha we e connec ed ia cycle o walking
pa hs we e conside ed con inuous g een a eas. The dis ances o he
closes small, middle-sized and la ge g een a eas om he pa icipan 's
home add ess we e calcula ed wi h he Ne wo k analys ex ension in
he ESRI A cGIS so wa e package ( e sion 10.3.1). Dis ance was cal-
cula ed using p ima ily walkways and cycle pa hs, and using bigge
Table 1
Cha ac e is ics o he s udy pa icipan s acco ding o he leisu e ime physical ac i i y s a us (LTPA) and he compa ison be ween he su ey esponden s and he
Helsinki popula ion. The alues a e means (s anda d de ia ion, SD) o p opo ions (%).
Va iable All (N = 3730) Low LTPA, n = 1947 High LTPA, n = 1692 p
a
Aged 25+ popula ion
in Helsinki
b
, %
Mean age, yea s 54.9 (17.1) 54.6 (17.0) 54.2 (16.8) 0.441
Age, yea s 0.147
25–34, N (%) 646 (17.3) 325(16.7) 316 (18.7) 26
35–44, N (%) 521 (14.0) 284 (14.6) 233 (13.8) 19
45–54, N (%) 602 (16.1) 331 (17.0) 270 (16.0) 18
55–64, N (%) 683 (18.3) 380 (19.5) 298 (17.6) 15
65–100, N (%) 1278 (34.3) 627 (32.2) 575 (34.0) 22
Gende , N (%) 0.149
Female 2210 (59.2) 1169 (60.0) 976 (57.7) 53
Male 1520 (40.8) 778 (40.0) 716 (42.3) 47
Educa ion, N (%) 0.001
c
Basic school educa ion, middle school 574 (15.7) 305 (15.8) 232 (13.9) 24
Voca ional o gene al uppe seconda y school, pos -seconda y le el (old) 1456 (39.6) 808 (42.1) 617 (36.9) 30
Poly echnic deg ee o uni e si y g adua e 1647 (44.7) 808 (42.1) 502 (49.2) 46
Mino s a home ( s. no), N (%) 619 (16.8) 380 (19.8) 304 (18.2) 0.224
Median household income 30,001–50,000€ 30,001–50,000€ 30,001–50,000€ 35 160 €
d
Mean na u e ela edness sco e 3.5 (0.8) 3.4 (0.8) 3.5 (0.8) 0.002
BMI, kg/m2 25.7 (4.7) 26.2 (5.1) 25.0 (4.0) < 0.001
Li ing in co e u ban a ea ( s. subu ban a ea), N (%) 1027 (27.5) 551 (28.3) 450 (26.6) 0.251
LTPA, 20 min a a ime, N (%)
Less han once a week 742 (20.4)
1–2 imes a week 1205 (33.1)
A leas 3 imes a week 1692 (46.5)
Ac i e commu ing, N (%) < 0.001
None 795 (27.4) 467 (30.1) 327 (24.3)
Regula ly walking o wo k OR walking o do e ands 901 (31.0) 489 (31.5) 410 (30.5)
Regula ly walking o wo k in he wa m season AND walking o do e ands 440 (15.2) 231 (14.9) 208 (15.5)
Regula ac i e wo k commu ing h oughou he yea and walking o do
e ands
767 (26.4) 364 (23.5) 398 (29.6)
G een exe cise sco e (poin s 0–8) 4.6 (2.0) 4.0 (1.9) 5.4 (1.9) < 0.001
Su e s om s ess o en o con inually ( s. ne e /occasionally), N (%) 623 (17.2) 362 (19.0) 256 (15.6) 0.008
A leas qui e good pe cei ed heal h ( s. poo o mode a e), N (%) 2463 (67.0) 1145 (59.7) 1286 (76.7) < 0.001
Owns a dog ( s. no), N (%) 516 (14.0) 263 (13.6) 244 (14.6) 0.400
Dis ance o a leas a middle-sized g een a ea (m) 420 (360) 420 (360) 410 (350) 0.240
Dis ance o he nea es g oup o buil ou doo spo s acili ies (m) 680 (430) 680 (430) 680 (430) 0.937
Dis ance o he nea es g oup o buil indoo spo s acili ies (m) 790 (650) 780 (650) 800 (650) 0.400
A leas qui e sa is ied wi h he quali y o he g een a ea nea by ( s. no
sa is ied), N (%)
3023 (82.6) 1556 (81.2) 1408 (84.3) 0.015
a
p = chi-squa e es o he independen samples - es o he di e ence be ween he low and high LTPA g oups.
b
=Da a sou ce: S a is ics Finland.
c
=aged 15+ y s.
d
=Da a sou ce: S a is ics Finland, Open da a by pos al code a ea.
R. Pyky e al. Heal h and Place xxx (xxxx) xxx–xxx
4
oads only i he be o e men ioned we e absen . Based on ou p e-
limina y analysis, he sho es dis ance o a leas a middle-sized g een
a ea was used in he u he analysis. In o he wo ds, wi h his a iable,
he dis ance was no mally measu ed o he nea es middle-sized g een
a ea, bu i a la ge g een a ea was nea e pa icipan 's home add ess
han he middle-sized a ea, we used he dis ance o he la ge a ea in
he analysis. We also calcula ed he dis ance o he nea es body o
wa e , bu his was no associa ed wi h g een exe cise and he e o e no
included in he main analyses.
In addi ion, we measu ed dis ances o he nea es clus e o buil
ou doo and indoo spo s acili ies. The ou doo and indoo acili ies
o he 20 mos popula Finnish ypes o spo s (The Finnish Olympic
Commi ee, 2010) we e selec ed om he spa ial da a o na ional
spo s acili ies (Uni e si y o Jy äskylä, LIPAS da abase, 26 h o May
2017). The indoo spo s acili ies included gyms, spo s halls, i ness
cen e s, dance ooms, swimming pools, skiing unnels, indoo ice inks,
iding s ables, and o he s. The buil ou doo spo s acili ies included
cou s o di e en ball games, s adiums, ska ing pa ks, gol cou ses,
beaches and ou doo pools. Clus e s we e o med by c ea ing a 150-m
bu e zone a ound each spo s acili y and combining he o e lapping
bu e s in o connec ed a eas. The a eas which included a leas ou
indoo /ou doo spo s acili ies we e used as a clus e o indoo /ou -
doo spo s acili ies in he analysis.
The supply o spo s acili ies and g een a eas o di e en sizes, and
he co e u ban a ea a e p esen ed in Fig. 2.
2.5. S a is ical analysis
The sel - a ed g een exe cise sco e was used as a dependen a iable
in he analyses and he s a is ical signi icance was se a p < 0.05. As a
p elimina y analysis, we s udied he associa ion be ween GE and di -
e en sizes o g een a eas wi h a Pea son co ela ion. Di e ences in
pa icipan cha ac e is ics be ween he low and high LTPA g oups we e
analyzed using a chi-squa e es o he ca ego ical a iables and an
independen samples - es o he con inuous a iables.
To e alua e he ac o s associa ed wi h GE among all pa icipan s as
well as among he low and he high LTPA g oups acco ding o he e-
siden ial a ea (co e u ban/subu ban a eas), sepa a e mul inomial lo-
gis ic eg ession (MLR) analyses using he o wa d en y me hod we e
ca ied ou using he IBM SPSS S a is ics o Windows, Ve sion 22.0
compu e so wa e. The a iables we e en e ed in he model all a once
and MLR analysis was done sepa a ely o all six g oups: 1) co e u ban
esiden s, 2) subu ban esiden s, 3) low LTPA co e u ban esiden s, 4)
low LTPA subu ban esiden s, 5) high LTPA co e u ban esiden s, and 6)
high LTPA subu ban esiden s. Va iables associa ed wi h GE acco ding
o he heo e ical amewo k (age, gende , BMI, educa ion, na u e e-
la edness, ac i e commu ing, dis ance o g een a ea/indoo spo s a-
cili y/ou doo spo s acili y, pe cei ed s ess and heal h, mino s a
home, owning a dog and sa is ac ion wi h he quali y o he g een a ea)
we e en e ed in he eg ession analysis. The esul s a e p esen ed as
odds a ios (OR) wi h 95% con idence in e als (CI).
3. Resul s
In he p elimina y analyses on he co ela ion be ween he g een
exe cise and he supply o g een a ea among all he s udy pa icipan s
(N = 3609), he s onges co ela ion was de ec ed be ween he amoun
o g een exe cise and he dis ance o a leas a middle-sized (25–150 ha)
g een a ea (Pea son co ela ion = −0.151; p- alue < 0.001). A leas
means ha he dis ance was no mally measu ed o he nea es middle-
sized g een a ea, bu i a la ge g een a ea was nea e han he middle-
sized a ea, we used he dis ance o he la ge a ea. The associa ions
wi h he la ges (> 150 ha) and he smalles a eas (< 25 ha) we e non-
signi ican (−0.022, p = 0.184; −0.022, p = 0.190, espec i ely). The
co ela ion be ween he GE and middle-sized g een a eas was −0.040
(p = 0.016) and wi h he nea es g een a ea ega dless o he size was
−0.105 (p < 0.001).
The cha ac e is ics o he s udy pa icipan s a e p esen ed in
Table 1. Mo e han hal o he pa icipan s we e ca ego ized as ha ing a
low le el o LTPA wi h 20 min o exe cise no mo e han wice a week,
and 46.5% ell in o he high LTPA g oup wi h 20 min o exe cise a leas
h ee imes a week. Pa icipan s in he low LTPA g oup had highe BMI
alues (p < 0.001) and a lowe le el o educa ion (p < 0.001) han he
pa icipan s in he high LTPA g oup. Pa icipan s wi h high LTPA had
highe le el o ac i e commu ing (p < 0.001), mo e g een exe cise
(p < 0.001), hey su e ed less o en om s ess (p = 0.008) and pe -
cei ed heal h be e (p < 0.001) compa ed o people wi h lowe LTPA.
Pa icipan wi h low LTPA also had lowe na u e ela edness sco e
(p = 0.002) and we e less sa is ied wi h he quali y o he g een a eas in
hei neighbo hoods (p = 0.015) compa ed o he high LTPA g oup, bu
he e we e no s a is ical di e ences in he objec i ely measu ed cha -
ac e is ics o hei li ing en i onmen s. Al oge he 27.5% li ed in he
co e u ban a ea o Helsinki and he es in he subu bs.
Resul s o he mul inomial logis ic eg ession analysis showed mo e
s a is ically signi ican associa ions o GE in he subu ban a ea com-
pa ed o co e u ban a ea and in he low LTPA compa ed o high LTPA
g oup (Table 2). When highe GE le els 3 (o en) and 4 ( e y o en)
we e compa ed o le el 1 (ne e o a ely), na u e ela edness was
posi i ely associa ed wi h GE despi e he le el o LTPA and li ing en-
i onmen . In gene al, he e we e mo e s a is ically signi ican asso-
cia ions when le el 1 (ne e o a ely) was compa ed o highe GE le-
els 3 (o en) and 4 ( e y o en) han o le el 2 ( ela i ely o en), and
hus he esul s o he compa ison o highe le els (3 and 4) a e e-
po ed mo e p ecisely below. Mo eo e , in Le el 2 he amoun o GE is
qui e low.
When all s udy pa icipan s whe e conside ed, all socio-demog aphic
and pe sonal ac o s we e signi ican ly associa ed o GE among sub-
u ban esiden s (Table 2). Olde age, emale gende , highe educa ion,
ha ing mino s a home, na u e ela edness, ac i e commu ing, good
pe cei ed heal h and ha ing a dog a home we e all posi i ely asso-
cia ed wi h GE. On he o he hand, BMI and pe cei ed s ess we e ne-
ga i ely ela ed o GE among subu ban adul s. Conside ing ac o s in-
dica ing supply o spo acili ies, being sa is ied wi h he quali y o he
g een a ea nea by we e associa ed wi h GE in bo h li ing en i onmen s
when compa ing le el 1 o le el 3, bu only in subu ban a ea when le el
1 compa ed o le el 4 (Table 2). A sho dis ance o a leas a middle-
sized g een a ea was associa ed wi h g een exe cise, bo h in he co e
u ban a ea and he subu ban a ea when highes le el o GE was com-
pa ed o lowes le el o GE (4 s 1), and in subu ban a ea when le el 3
compa ed 1. In co e u ban a ea also he dis ance o he nea es ou doo
spo s acili y was associa ed wi h GE (Table 2).
Conside ing low leisu e ime physical ac i i y g oup, among subu ban
adul s he esul s showed gene ally simila ends on he associa ion o
socio-demog aphic and pe sonal ac o s on GE as when subu ban adul s
o all pa icipan s we e conside ed. None o he ac o s indica ing he
supply o spo acili y in ei he o he esiden ial a eas we e ela ed o
GE when le el 2 o 3 was compa ed o le el 1, bu while compa ing
4–1, sho dis ance o g een a ea and quali y o g een a eas we e as-
socia ed wi h GE in he subu bs and sho dis ance o build ou doo
acili y in co e u ban a ea.
In he high leisu e ime physical ac i i y g oup, only ew socio-demo-
g aphic and pe sonal ac o s we e associa ed wi h GE in bo h e-
siden ial a eas. Na u e ela edness was posi i ely associa ed in bo h
li ing en i onmen s, and ac i e commu ing in subu ban a ea. Ha ing a
dog a home we e also associa ed o GE, bu only when le el one was
compa e o highes GE le el (1 s 4). O he ac o s indica ing he
supply o spo acili y, he dis ance o a g een a ea was nega i ely
ela ed o GE when he highes le el was compa ed o le el 1 (1 s 4) in
he subu ban g oup (Table 2). The quali y o g een a eas we e posi-
i ely associa ed wi h GE in bo h esiden ial a eas when le el 1 was
compa ed o le el 3, bu only in subu ban when compa ed o highes
le el (1 s 4).
R. Pyky e al. Heal h and Place xxx (xxxx) xxx–xxx
5

Table 2
Mul inomial logis ic eg ession o ac o s ela ed o he 4-le el g een exe cise sco e acco ding o he le el o leisu e ime physical ac i i y and he esiden ial a ea.
ALL LOW LTPA HIGH LTPA
G een exe cise sco e, 4-le el Co e u ban, n = 785,
2 = 0.315
Subu ban, n = 1893,
2 = 0.335
Co e u ban, n = 432,
2 = 0.312
Subu ban, n = 999,
2 = 0.376
Co e u ban, n = 353,
2 = 0.380
Subu ban, n = 892,
2 = 0.333
OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI)
2 s 1
a
Age, yea s 0.97 (0.96–0.99) 1.00 (0.99–1.01) 0.98 (0.96–0.99) 1.00 (0.99–1.01) 0.97 (0.94–1.00) 0.99 (0.97–1.02)
Gende , emale ( s. male) 0.84 (0.55–1.29) 1.04 (0.77–1.41) 0.88 (0.53–1.46) 1.11 (0.78–1.59) 1.11 (0.48–2.59) 0.90 (0.49–1.67)
Highe educa ion ( s. no ) 1.22 (0.78–1.90) 1.48 (1.06–2.05) 1.23 (0.74–2.06) 1.37 (0.93–2.02) 1.39 (0.55–3.53) 1.62 (0.84–3.10)
Mino s a home ( s. no) 1.33 (0.68–2.58) 1.90 (1.28–2.82) 1.36 (0.62–2.96) 2.15 (1.34–3.44) 1.36 (0.33–5.52) 1.55 (0.73–3.32)
Na u e ela edness sco e 1.61 (1.21–2.13) 1.39 (1.15–1.68) 1.53 (1.09–2.16) 1.47 (1.17–1.84) 2.06 (1.20–3.54) 1.21 (0.83–1.78)
BMI, kg/m2 0.97 (0.92–1.02) 0.98 (0.95–1.01) 0.94 (0.89–1.00) 0.98 (0.94–1.01) 1.09 (0.97–1.21) 1.00 (0.93–1.08)
Ac i e commu ing sco e 1.02 (0.85–1.24) 1.29 (1.12–1.49) 1.01 (0.80–1.28) 1.20 (1.02–1.42) 0.94 (0.65–1.37) 1.46 (1.06–2.00)
Su e s om s ess o en o con inually ( s. ne e /occasionally) 0.86 (0.53–1.39) 0.76 (0.53–1.10) 0.99 (0.56–1.75) 0.62 (0.40–0.95) 0.57 (0.22–1.46) 1.36 (0.61–3.03)
A leas qui e good pe cei ed heal h ( s. poo o mode a e) 1.06 (0.66–1.72) 2.15 (1.54–3.00) 0.95 (0.55–1.65) 2.07 (1.42–3.02) 1.26 (0.41–3.89) 2.00 (0.91–4.39)
Owns a dog ( s. no) 1.23 (0.50–3.04) 0.94 (0.53–1.66) 1.92 (0.67–5.54) 0.99 (0.52–1.91) 0.30 (0.05–1.99) 0.88 (0.25–3.05)
Dis ance o a leas middle-sized g een a ea, km 0.89 (0.55–1.43) 0.78 (0.47–1.30) 0.96 (0.54–1.70) 0.75 (0.41–1.39) 0.63 (0.23–1.71) 0.82 (0.31–2.22)
Dis ance o he nea es g oup o buil ou doo spo s acili ies, km 0.64 (0.38–1.06) 0.89 (0.59–1.34) 0.55 (0.30–1.01) 0.78 (0.48–1.26) 1.12 (0.37–3.35) 1.04 (0.47–2.29)
Dis ance o he nea es g oup o buil indoo spo s acili ies, km 1.03 ( 0.62–1.73) 1.12 (0.86–1.47) 0.93 (0.51–1.71) 1.26 (0.91–1.74) 2.40 (0.68–8.42) 0.93 (0.55–1.57)
A leas qui e sa is ied wi h he quali y o he g een a ea nea by ( s.
no sa is ied)
1.45 (0.92–2.29) 1.25 (0.86–1.82) 1.20 (0.69–2.10) 1.12 (0.71–1.76) 1.81 (0.75–4.38) 1.66 (0.82–3.36)
3 s 1 Age, yea s 0.99 (0.97–1.00) 1.01 (1.00–1.03) 0.99 (0.96–1.01) 1.01 (0.99–1.03) 0.99 (0.97–1.02) 1.02 (1.00–1.04)
Gende , emale ( s. male) 1.45 (0.9–2.33) 1.41 (1.03–1.94) 2.11 (1.06–4.24) 2.14 (1.41–3.26) 1.73 (0.75–3.97) 1.02 (0.56–1.85)
Highe educa ion ( s. no ) 1.05 (0.65–1.71) 1.58 (1.12–2.22) 1.05 (0.54–2.06) 1.66 (1.06–2.60) 1.22 (0.50–2.98) 1.24 (0.66–2.33)
Mino s a home ( s. no) 1.82 (0.89–3.72) 2.01 (1.33–3.03) 2.11 (0.82–5.40) 2.60 (1.53–4.41) 2.05 (0.52–8.16) 1.78 (0.84–3.76)
Na u e ela edness sco e 2.28 (1.66–3.12) 1.70 (1.39–2.07) 2.24 (1.41–3.55) 1.59 (1.22–2.07) 2.88 (1.69–4.90) 1.96 (1.34–2.85)
BMI, kg/m2 0.95 (0.89–1.00) 0.92 (0.89–0.95) 0.91 (0.84–0.99) 0.92 (0.88–0.96) 1.06 (0.95–1.18) 0.95 (0.88–1.02)
Ac i e commu ing sco e 1.24 (1.01–1.53) 1.46 (1.26–1.70) 1.43 (1.04–1.96) 1.35 (1.11–1.63) 1.07 (0.74–1.54) 1.54 (1.14–2.09)
Su e s om s ess o en o con inually ( s. ne e /occasionally) 0.41 (0.23–0.72) 0.50 (0.34–0.75) 0.41 (0.18–0.92) 0.48 (0.29–0.81) 0.39 (0.15–1.02) 0.70 (0.32–1.57)
A leas qui e good pe cei ed heal h ( s. poo o mode a e) 1.60 (0.92–2.79) 2.31 (1.63–3.28) 1.15 (0.55–2.43) 1.96 (1.25–3.07) 1.22 (0.41–3.59) 1.39 (0.67–2.90)
Owns a dog ( s. no) 1.59 (0.61–4.15) 2.14 (1.23–3.74) 3.50 (1.03–11.96) 2.16 (1.07–4.36) 0.62 (0.11–3.39) 2.51 (0.81–7.79)
Dis ance o a leas middle-sized g een a ea, km 0.70 (0.41–1.21) 0.57 (0.33–0.97) 0.66 (0.30–1.44) 0.49 (0.23–1.03) 0.55 (0.20–1.49) 0.50 (0.19–1.33)
Dis ance o he nea es g oup o buil ou doo spo s acili ies, km 0.52 (0.29–0.93) 1.09 (0.72 (1.65) 0.44 (0.19–1.04) 1.11 (0.63–1.93) 0.82 (0.27–2.45) 0.95 (0.44–2.04)
Dis ance o he nea es g oup o buil indoo spo s acili ies, km 0.84 (0.46–1.56) 1.14 (0.87–1.51) 1.09 (0.46–2.56) 1.15 (0.79–1.66) 1.41 (0.39–5.10) 1.15 (0.69–1.90)
A leas qui e sa is ied wi h he quali y o he g een a ea nea by ( s.
no sa is ied)
2.29 (1.34–3.92) 2.04 (1.35–3.10) 2.24 (0.98–5.13) 1.71 (0.95–3.08) 2.64 (1.10–6.36) 3.26 (1.63–6.53)
4 s 1 Age, yea s 1.00 (0.98–1.02) 1.01 (1.00–1.03) 0.99 (0.96–1.02) 0.99 (0.97–1.01) 1.02 (0.98–1.06) 1.03 (1.01–1.06)
Gende , emale ( s. male) 1.38 (0.75–2.55) 1.53 (1.06–2.22) 1.91 (0.78–4.66) 2.74 (1.56–4.83) 1.59 (0.59–4.31) 1.03 (0.54–1.96)
Highe educa ion ( s. no ) 0.98 (0.53–1.82) 1.55 (1.05–2.30) 1.70 (0.68–4.25) 1.52 (0.85–2.71) 0.71 (0.25–2.01) 1.28 (0.65–2.52)
Mino s a home ( s. no) 1.89 (0.77–4.63) 2.04 (1.29–3.23) 2.51 (0.78–8.13) 2.05 (1.08–3.92) 2.31 (0.46–11.72) 2.14 (0.96–4.76)
Na u e ela edness sco e 2.43 (1.62–3.64) 2.18 (1.72–2.76) 2.42 (1.35–4.34) 1.70 (1.19–2.41) 2.98 (1.57–5.65) 2.79 (1.85–4.20)
BMI, kg/m2 0.93 (0.86–1.00) 0.92 (0.88–0.95) 0.93 (0.84–1.04) 0.93 (0.88–0.99) 1.02 (0.89–1.16) 0.93 (0.86–1.01)
Ac i e commu ing sco e 1.44 (1.09–1.91) 1.72 (1.45–2.05) 1.39 (0.92–2.10) 1.35 (1.05–1.75) 1.34 (0.85–2.11) 1.93 (1.39–2.67)
Su e s om s ess o en o con inually ( s. ne e /occasionally) 0.51 (0.24–1.06) 0.46 (0.29–0.75) 0.51 (0.19–1.40) 0.46 (0.24–0.90) 0.50 (0.15–1.71) 0.64 (0.26–1.53)
A leas qui e good pe cei ed heal h ( s. poo o mode a e) 1.74 (0.83–3.62) 2.99 (1.95–4.59) 1.41 (0.51–3.88) 2.52 (1.36–4.65) 1.54 (0.41–5.81) 1.77 (0.79–3.98)
Owns a dog ( s. no) 22.03 (8.80–55.19) 23.24 (13.36–40.43) 33.63 (10.02–112.87) 34.67 (17.29–69.53) 15.30 (2.97–78.72) 23.40 (7.49–73.11)
Dis ance o a leas middle-sized g een a ea, km 0.48 (0.23–0.99) 0.30 (0.15–0.57) 0.50 (0.17–1.50) 0.31 (0.12–0.82) 0.31 (0.09–1.04) 0.22 (0.08–0.67)
Dis ance o he nea es g oup o buil ou doo spo s acili ies, km 0.33 (0.14–0.74) 1.03 (0.63–1.67) 0.30 (0.09–0.99) 1.14 (0.55–2.36) 0.49 (0.13–1.89) 0.85 (0.37–1.95)
Dis ance o he nea es g oup o buil indoo spo s acili ies, km 1.25 (0.55–2.85) 0.97 (0.70–1.34) 0.98 (0.31–3.07) 0.85 (0.52–1.40) 3.45 (0.76–15.64) 1.05 (0.61–1.82)
A leas qui e sa is ied wi h he quali y o he g een a ea nea by ( s.
no sa is ied)
1.43 (0.72–2.84) 2.25 (1.35–3.74) 0.70 (0.27–1.82) 2.59 (1.11–6.02) 2.14 (0.68–6.70) 3.29 (1.50–7.20)
Adjus ed o all he a iables p esen ed in his able.
S a is ically signi ican associa ions a e in bold ex . Missing da a was excluded lis wise.
OR = Odds a io, CI = Con idence in e al,
2
= Nagelke ke eg ession coe icien o he model.
Colo ing: Ligh g ey = socio-demog aphic ac o s, mode a e g ey = pe sonal ac o s, da k g ey = he supply o spo s acili ies (Fig. 1).
a
GE le els = 1 “ne e o a ely”, 2 “ ela i ely o en”, 3 “o en”, and 4 “ e y o en”.
R. Pyky e al. Heal h and Place xxx (xxxx) xxx–xxx
6
4. Discussion
In his adul -popula ion-based s udy, a sho dis ance o a leas a
middle-sized g een a ea was associa ed wi h g een exe cise, bo h in he
co e u ban a ea and subu ban a ea among all s udy pa icipan s. This
associa ion, howe e , was ound only in he subu ban a ea a e he
pa icipan s we e di ided in o low and high LTPA g oups. Mo e ac o s
we e ound o be ela ed o GE in he subu ban a ea compa ed o he
co e u ban a ea as well as o he low LTPA compa ed o he high LTPA
g oup. A sho dis ance o build ou doo spo s acili ies was ela ed o
highe le els o GE only among co e u ban esiden s. Na u e ela edness
was posi i ely associa ed wi h GE despi e he LTPA le el o he li ing
en i onmen . In addi ion, a good le el o pe cei ed heal h, emale
gende , age, BMI, pe cei ed s ess and quali y o he g een a ea as well
as a high deg ee o ac i e commu ing we e associa ed wi h GE.
Acco ding o p e ious s udies, he e is s ong e idence o a posi i e
associa ion be ween he a ailabili y and p oximi y o g een a eas and
GE (Calogiu i and Ch oni, 2014) which is consis en wi h ou s udy.
Fewe s udies ha e aken in o accoun he size and he connec i i y o
he g een a eas as we ha e done in his s udy. Ea lie s udies ha e
mainly used g een a eas wi h a minimum size o 1.5 o 2 ha (Mäki-Opas
e al., 2016; Fos e e al., 2009) and ha e no s udied how he size o he
a ea a ec s i s use o PA. The quali y o na u e a eas including he size,
he habi a di e si y and he ype o he g een a ea (e.g. pa k, o es ,
wa e elemen included) seem o be good indica o s o p edic ing he
usabili y o g een a eas o PA (Ty äinen e al., 2016; Ko pela e al.,
2010; Keskinen e al., 2018). In a ecen Finnish s udy, howe e , he
associa ion be ween he supply o g een a eas and physical commu ing
ac i i y was no de ec ed (Mäki-Opas e al., 2016), bu la ge g een
a eas we e no included as hey we e in ou s udy.
Mo e g een a eas exis ou side he co e u ban a ea and he oppo -
uni ies o GE a e be e in subu ban Helsinki, and hus mo e co ela es
o GE we e p obably ound in he subu bs o his eason. A p e ious
Finnish s udy also sugges ed ha es o a i e expe iences a e s onge in
people's a o i e places in u ban woodlands and ou doo ac i i y a eas
in na u e compa ed o buil acili ies in u ban se ings (Ko pela e al.,
2010). Fu he mo e, sho e dis ance o buil ou doo spo s acili ies
we e ela ed o highe le els o GE in he co e u ban a ea. This may be
pa ly because buil ou doo spo s acili ies a e o en loca ed in
p oximi y o g een a eas o because he pa icipan s may ha e epo ed
hei physical ac i i y in buil ou doo spo s acili ies as GE.
The ac i a ion o physically inac i e people is a global conce n.
Fewe ac o s we e associa ed wi h GE o he high LTPA compa ed o
he low LTPA g oup. These esul s sugges , ha physically ac i e people
a e mo i a ed o ake exe cise in all en i onmen s and g een a eas do
no need o be loca ed nea hei homes. Acco ding o ou s udy, people
wi h highe le els o na u e ela edness, who engage in ac i e com-
mu ing, ha e a lowe BMI, and ha e lowe le els o pe cei ed s ess
engaged in highe le els o GE, al hough hey did no speci ically epo
high LTPA. Thus ou indings sugges ha g een a eas may p o ide an
oppo uni y o engage in PA o hose wi h lowe le el o leisu e ime
physical ac i i y. Cus omizing GE se ices o di e en g oups may be
necessa y.
Consis en wi h ou s udy, na u e ela edness has been ound o be
associa ed wi h GE in p e ious s udies in he UK and Aus alia (Flowe s
e al., 2016; Lin e al., 2014). In addi ion, hese s udies (Flowe s e al.,
2016; Lin e al., 2014) sugges ha na u e ela edness is e en a s onge
p edic o o pa k use han he objec i ely measu ed a ailabili y o
g een a eas. In he UK s udy, he quan i y o local g een space was
assessed by c oss- e e encing esponden s’ home pos codes wi h gene al
land use da abases, and in he Aus alian s udy bu e s we e used in he
calcula ion o g een a eas. This di e s om he GIS me hods used in ou
s udy because we also ook in o accoun he use 's pe spec i e
(connec i i y o he a eas ia cycle o walking pa hs) and he size o he
g een a ea in he calcula ion. The pe cei ed quali y o g een a eas has
been also ound o p edic GE in p e ious s udies (Flowe s e al., 2016).
The ound associa ion be ween aking g een exe cise and pe cei ed
heal h in his s udy co esponds wi h p e ious s udies in ha heal h
s a us is a s ong co ela e o gene al physical ac i i y (Bauman e al.,
2012).
The s eng h o ou s udy is i s popula ion-based s udy sample and
he use o GIS me hods in he de e mina ion o he a ailabili y o g een
a eas and buil spo s acili ies. In addi ion, he quali ies, such as he
size and he connec i i y o he g een a eas we e comp ehensi ely
aken in o accoun . The a iables desc ibing he supply o g een a eas
we e measu ed in an a emp o ollow he ac ual ways ha people seek
access o g een a eas (by walking and using cycle pa hs).
Ou s udy is limi ed because he ques ions on GE and LTPA may
pa ly be o e lapping and may su e om o e epo ing due o sel -
epo ing me hods. We expec ha ecalling he equencies o isi ing
na u e a eas may cause bias o da a, especially o g een exe cise sco e.
To educe he bias esponden s we e asked he equency o isi s on
summe and win e ime in sepa a e ques ions. The da a we e collec ed
a one poin in ime, and hus he esul s canno be in e p e ed in e ms
o causali ies. Al hough he su ey pa icipa ion was based on he
andom sample o Helsinki esiden s (aged 25+), he esponse a e was
less han 50%. Howe e , he gene al heme o he su ey was no only
ocussed on he g een exe cise, and i implies ha da a co e s also he
in equen isi o s o na u e. Ou s udy, wi h a la ge sample size, has
su icien s a is ical powe o iden i y he ac o s in luencing he ou -
come a iable; howe e , in he s a i ied modelling (e.g. co e u ban
esiden s wi h low leisu e ime physical g oups o subu ban esiden s
wi h high leisu e ime physical ac i i y) he inc eased numbe o e-
sponden s in hese g oups migh ha e enhanced he s a is ical sig-
ni icance o he a iables. Wi hou GPS we would no know whe e he
esponden s a e usually physically ac i e and his may bias ou esul s.
The odds a ios o owning a dog we e qui e high in he eg ession
analysis (Hosme and Lemeshow, 2000) and because o his, he ORs
and hei 95% CIs o his a iable a e in e p e ed o be only allusi e.
High ORs may be due o small numbe s o dog owne s in he le el 4 GE
g oup. We also conduc ed he mul inomial eg ession analysis wi hou
he a iable “owning a dog” and he esul s emained oughly he same.
Because o he p e ious esea ch on he posi i e associa ion be ween
dog owne ship and PA (Ch is ian e al., 2013), we s ill wan ed o in-
clude he a iable in he analysis.
In his s udy, pe sonal and socio-demog aphic ac o s associa ed
wi h GE e.g. heal h s a us, s ess le els, na u e ela edness and LTPA
we e mainly sel - epo ed, and we e no objec i e measu es. This may
sugges ha an indi idual's own expe iences a e ele an o GE.
The e o e i will also be impo an o include subjec i e ac o s besides
objec i e ones in he u u e s udies.
Globally and in Helsinki, he signi ican po en ial o inc easing PA
migh be in he c ea ion o suppo i e policies in sec o s ou side heal h
such as anspo a ion, communica ion, u ban planning and ha ing a
good supply o g een spaces (P a e al., 2012). Conside ing he hec ic
e e yday li e and he inc easing amoun o heal h p oblems linked o
mode n li es yles, na u al a eas seem o be a aluable esou ce o
public heal h p omo ion, and he ole and impo ance o na u al a eas
a he popula ion le el needs o be be e unde s ood.
5. Conclusion
Based on ou s udy, a sho dis ance o a leas a middle-sized g een
a ea and a high deg ee na u e ela edness a e o g ea impo ance o
g een exe cise despi e he li ing en i onmen . In addi ion, ac i e
commu ing and being sa is ied wi h he quali y o g een a eas nea by
R. Pyky e al. Heal h and Place xxx (xxxx) xxx–xxx
7
inc eases he odds o people exe cising in g een a eas. The g een en-
i onmen may p o ide an oppo uni y o engage in physical ac i i y
especially o subu ban esiden s and hose wi h lowe le el o leisu e
ime physical ac i i y.
Acknowledgemen s
We would like o hank Vesa Ni ala and Tuija Sie änen om
Na u al Resou ces Ins i u e Finland and Pekka Tii anen om Na ional
Ins i u e o Heal h and Wel a e o hei co-ope a ion in his s udy.
Decla a ions o in e es
None.
Funding
This s udy was unded by he Minis y o Educa ion and Cul u e
(OKM/84/626/2015, OKM/24/626/2016, OKM/75/626/2017) and
Na u al Resou ces Ins i u e Finland (P ojec no. 41007-00073400). The
unding sou ces had no ole in he s udy implemen a ion.
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