Exposure to eye-level greenspace reduces health inequalities of high blood pressure: A gender difference perspective

Existing evidence suggests that exposure to greenspace reduces the risk of high blood pressure (e.g., hypertension). In addition, greenspace may also narrow the socioeconomic and gender inequities of various health outcomes. However, exposure to greenspace was often defined from an over-head perspective. The effect of eye-level greenspace exposure, which may better represent people's actual exposure to greenspace, was not explored yet. Furthermore, it remains unclear whether exposure to greenspace may reduce the socioeconomic and gender inequities of high blood pressure. In this study, the blood pressure data of 24,845 adult participants were retrieved from the 33 Chinese Community Health Study in China. We quantified participants’ exposure to eye-level greenspace via street view images and machine learning technique. Multilevel linear and logistic regressions were applied. While controlling for confounders, we found that exposure to eye-level greenspace was both related to gender and socioeconomic status (SES). More specifically, greenspace exposure was inversely associated with the risk of hypertension for females, but not for males. We observed that greenspace-hypertension associations are more pronounced for SES disadvantaged groups (those uneducated and/ or with low household income). This study provides profound insights into how exposure to eye-level greenspace reduces the gender and socioeconomic inequities in terms of high blood pressure, which suggests that policy makers and urban planners should pay close attention to the equalizing effect of urban greenspace on residents’ health outcomes in the long run.