The role of social and natural environments in health geography: a case for wellbeing and greenspace during the COVID-19 pandemic

Health geography examines how health and place relate. The overarching aim of this thesis was to investigate the role of the environment, and more specifically greenspace use, in support of wellbeing. The specific context of the COVID-19 pandemic provided a unique opportunity of research as it was a major stressful crisis across populations and subgroups and as restrictions affected social and natural environments over a substantial duration.
Two research aims and thrusts drive the thesis. First, it examines the specific context of university students across the pandemic and their experience of greenspace, social connectedness and wellbeing using novel survey data; then it analyses the general pattern at the population level using secondary data sources.
First we conducted a systematic review of longitudinal wellbeing studies among university students during the pandemic. It confirmed that early in the pandemic, when restrictions included lockdowns, students experienced significant reductions in wellbeing in comparison to pre-pandemic. Later, however, studies did not demonstrate this consistent worsening of wellbeing and mixed findings were reported across the late 2020 and 2021. We noted a lack of longitudinal studies with more than 2 measurement points, a lack of work documenting later pandemic stages, and no research on the role of environmental settings on student wellbeing. We then designed a longitudinal three-time point online questionnaire study to document wellbeing changes in university students in England during the pandemic in relation to experiences of greenspace use and social connectedness. The study took place across four universities (Oxford Brookes University, University of Oxford, University of Southampton and Solent University) one year into the pandemic, in the spring of 2021 (n = 424), the autumn of 2021 (n = 161) and the spring of 2022 (n = 97). The mean age of the longitudinal sample was 22.5 years old. We found significant wellbeing improvements over one-full year between the spring of 2021 and the spring of 2022. Social support was a critical protective factor for mental wellbeing throughout time. We also found that at various time points greenspace use varied across the pandemic, and correlated differently with physical activity and social connectedness. Our regression analyses showed that greenspace use contributed more substantially to wellbeing when restrictions were high and socialization was limited. In light of our findings, we further examined the patterns of greenspace use and the role of the COVID-19 restrictions at the population level across lower level regions of England. Specifically, we linked the open source daily park visitation data from the Google COVID-19 Community Mobility Reports with daily weather (temperature and rainfall) data from the MET office and the Oxford COVID-19 Stringency Index of restrictions. We statistically controlled for sociodemographic and regional variations by using a panel fixed effect regression model, comparing each region to itself across 22 months of data points, from February 2020 to December 2021. We found a significant reduction in greenspace use at the beginning of the pandemic once restrictions were imposed, followed by a sustained and elevated use of greenspace with a seasonal pattern. Most strikingly an interaction effect emerged showing that park use was moderated by the stringency of pandemic countermeasures.
Findings from this thesis can be used to inform health promotion strategies in times of crisis and beyond. Strategies to alleviate the unintended consequences of the COVID-19 pandemic restrictions, such as the mental health and wellbeing tolls, are important. Such strategies should emphasize the role greenspace play in support of wellbeing.
Future research should continue to explore the role of greenspace in support of wellbeing and the manner in which it interacts with other protective factors such as physical activity and social connectedness.

Keywords: longitudinal study
wellbeing
human mobility study
university students
greenspace
COVID-19
Advisor: Messina, J