Kookmin University team identifies structural links between urban inequality, green-space equity and health burdens

A research team from Kookmin University and Cedars-Sinai Medical Center has mapped how urban poverty, green-space equity and environmental risks combine to shape residents’ health burdens across 497 U.S. cities.

Published in Environmental Science and Ecotechnology, the study examined 11 major health indicators using data from the U.S. Centers for Disease Control and Prevention. The indicators included arthritis, asthma, chronic obstructive pulmonary disease, coronary heart disease, diabetes, hypertension, high cholesterol, chronic kidney disease, obesity, stroke and poor mental health.

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This study is significant because it structurally shows the socioeconomic conditions under which green-space equity connects to health burdens and the pathways through which that connection occurs, going beyond the general understanding that urban forests and green spaces are beneficial to health.

The researchers compared health data with each city’s Tree Equity Score, tree and shrub or grass coverage, poverty rate, access to medical care, racial composition, fine-particle pollution and urban heat-island effects. Their analysis found that health burdens reflected a combination of social, economic and environmental conditions rather than any single factor. Poverty showed particularly strong links to several chronic diseases and mental-health burdens.

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As the climate crisis, urban heat islands, air pollution and socioeconomic inequality intensify simultaneously, future urban-forest and green-space policies need to be designed to reduce residents’ health burdens by expanding urban forests and green spaces on an equity-based foundation, rather than simply increasing their total area.

The study also found lower health burdens in cities with higher Tree Equity Scores, which measure how evenly trees and their benefits are distributed among residents. In cities with higher poverty rates, green space appeared to be connected to health through the mitigation of fine-particle pollution and urban heat. In lower-poverty cities, the researchers said green space may be linked more directly to physical activity, psychological recovery and social interaction.

Kookmin professor Lee Chang-bae said the findings showed how green-space equity connects to health burdens through different socioeconomic pathways. First author Lee Min-ki said addressing urban health inequality would require coordinated policies covering health care, urban planning, green space and environmental justice. The researchers argued that future urban-forest policies should focus not only on expanding green-space areas but also on distributing their benefits more equitably.

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This study suggests that resolving urban health inequality requires integrated policies involving not only health care but also urban planning, green spaces and environmental justice.