Total area greenness is associated with lower per-capita medicare spending, but blue spaces are not. (August 2021)

• Record Type: Journal Article
• Authors: Becker, Douglas A.; Browning, Matthew H.E.M.
• Is Part Of: City and environment interactions. Volume 11(2021)
• Publication Date: 2021-08
• Subjects: Green space -- Bluespace -- Healthcare costs; Metropolitan areas -- Environmental aspects -- Periodicals; Sustainable urban development -- Periodicals; Urban ecology (Sociology) -- Periodicals; Urban ecology (Biology) -- Periodicals; Land use, Urban -- Environmental aspects -- Periodicals; City planning -- Environmental aspects -- Periodicals; 307.3416
• DOI: 10.1016/j.cacint.2021.100063
• Languages: English
• ISSNs: 2590-2520

Abstract

Highlights: Overall area greenness is associated with per-capita Medicare spending at the county level. The green-spending association is nonlinear and generally negative. Greenness and spending are linked in even the most urban and most rural counties. The results for blue spaces and spending are mixed. Abstract: As evidence continues to mount that areas with more natural spaces also have healthier residents, researchers are beginning to suspect that these benefits extend beyond health to other related factors, such as healthcare spending. If more nature translates to better health, does more nature ultimately reduce the need for and spending on healthcare, and is this especially true for the elderly and disabled, who benefit differently from nature? This study aims to answer that question, employing a cross-sectional, ecological study design on county-level, annual per-capita Medicare spending in the United States. We examine the association between Medicare spending and the amount of total greenness in a county as well as the amount of blue space, or open water, in a county while controlling for demographic, socioeconomic, and healthcare access confounders. Our results show a significant and inverse association between greenness and spending and mixed results in regard to blue spaces and spending. The greenness-spending association persists in varying levels of the urban–rural spectrum, including both the most and least urban counties.