Exploring the quality of urban green spaces and their association with health: An epidemiological study on obesity using Street View technology.

Objectives: Evidence suggests that access to urban green spaces (UGS) may encourage physical exercise and impact nutritional status and health. Nevertheless, the quality of UGS is an understudied area. Novel digital tools allow the analysis of urban environments. This study aims to explore the quality of UGS and its association with obesity in Córdoba, Argentina, using Google Street View (GSV) images.

Study Design: Population-based cross-sectional study.

Methods: Lifestyle and sociodemographic data were collected in Córdoba, Argentina (n = 1322 adults) during 2020-2022. Anthropometric measurements were obtained. Buffers of 500m were established around dwellings to identify the presence of large-area UGS (≥1ha). The quality of 226 UGS was evaluated across specific dimensions using a multi-dimensional assessment tool adapted for remote monitoring through GSV. Two-level logistic regression models for obesity outcome (yes/no) were fitted using a random intercept to account for spatial variability. Odds ratios (OR) and their 95 % confidence intervals (95 % CI) were estimated as measures of association.

Results: Obesity was present in 25.9 % of participants. The UGS quality dimensions that showed an inverse association with obesity were safety (OR = 0.33; 95 % CI 0.32-0.82), potential usage (OR = 0.42; 95 % CI 0.21-0.81), surroundings (OR = 0.54; 95 % CI 0.31-0.93), access (OR = 0.55; 95 % CI 0.31-0.97), aesthetics (OR = 0.55; 95 % CI 0.34-0.87) and amenities (OR = 0.62; 95 % CI 0.42-0.91). Proximity to UGS was not significantly associated with obesity.

Conclusions: Rather than their proximity, the quality of the UGS might play a key role as a determinant of obesity. In urban areas, digital tools such as GSV are useful to explore these topics.