A-42: Evolving Public Health Patterns in U.S. Cities During the Pandemic: Interactions Between Urban Green Space and Physical Activity

Abstract

Objective: Urban green space is associated with improved mental and physical health; however, it remains unclear whether these relationships shifted during the COVID-19 pandemic. This study examined whether associations among park access, park composition, leisure-time physical activity (LTPA), and population-level mental and physical health outcomes changed across the 100 most populous U.S. cities from 2019 to 2022. We hypothesized that LTPA would remain a stable predictor of health outcomes, while relationships with park characteristics would vary across pandemic years. Method/Data Selection: A repeated-measures, city-level observational design was used. Urban green space metrics were obtained from the Trust for Public Land, and health indicators were derived from Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System estimates. Variables included percent population with no LTPA, depression, frequent mental health distress, and frequent physical health distress. Within-year Pearson correlations, pooled linear regressions, and linear mixed-effects models were conducted to assess associations and temporal moderation. Results/Data Synthesis: Across all years, no LTPA was strongly associated with frequent physical health distress (r = 0.59–0.64, p < .001). No LTPA was also associated with depression in 2019 (r = 0.22, p = .032) and 2021 (r = 0.25, p = .013). Significant walkability-by-year interactions were observed for depression (B = 0.010, p = .009), frequent mental health distress (B = 0.008, p = .002), and frequent physical health distress (B = −0.009, p < .001). Mixed-effects models indicated that no LTPA predicted frequent physical health distress (F(1,386) = 146.38, p < .001), and depression increased over time (F(3,351) = 2.73, p = .045). Conclusions: Leisure-time physical inactivity remained a stable predictor of adverse health outcomes, while associations between urban green space and mental health varied modestly across pandemic years. These findings underscore the importance of behavioral factors in population health and suggest that shifts in environmental and activity patterns may have downstream implications for brain health, including risk trajectories for depression and cognitive decline. Results highlight the need to consider both behavioral and environmental determinants in neuropsychological and public health research.