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February 12, 2026BMJ Public Health1 citationsOpen Access

Investigating health-related barriers to green space use, chronic health conditions and sociodemographic characteristics: a structural equation modelling approach

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HBHannah BurnettJOJonathan OlsenSRSarah Rodgers

Key Points

  • This study aims to identify health-related barriers to green space use among people with chronic health conditions and to explore how these barriers differ by sociodemographic characteristics.
  • Utilized Natural England’s People and Nature Survey for health-related barriers data.
  • Analyzed data from a nationally representative sample of English adults aged 16+ (n=10,415).
  • Applied structural equation modelling to assess relationships between barriers, chronic conditions, and sociodemographics.
  • Individuals with progressive illnesses or physical disabilities reported multiple health-related barriers more often than those with other conditions like arthritis or diabetes.
  • 32% of respondents with physical disabilities identified lack of disabled facilities as a key barrier.
  • 34% of respondents with progressive illnesses reported having no support as a crucial barrier to using green spaces.

Abstract

Introduction Using green space improves health and well-being. However, there are many barriers to green space use, including poor health. Evidence is lacking on how health-related barriers to green space differ by chronic health condition. This study investigates health-related barriers to green space use, chronic health conditions and sociodemographic characteristics. Methods We assessed health-related barriers to green space use using Natural England’s People and Nature Survey. Data from 5 months of the nationally representative survey of English adults (aged 16+) were used (n=10 415), collected during November 2020–March 2021. To assess relationships between reporting of health-related barriers to using green space, an individual’s chronic health conditions and sociodemographic characteristics, structural equation modelling was used (n=201). Results Respondents with progressive illnesses or physical disabilities had a higher likelihood of reporting multiple (four) health-related barriers as important compared with respondents with arthritis or diabetes (both had no barriers that they were more likely to report). For example, respondents with physical disabilities (32%) and progressive illnesses (31%) had an increased likelihood of reporting lack of disabled facilities as an important barrier to using green space compared with those with other conditions. Those with progressive illnesses (34%) had a particularly higher likelihood of reporting having no one to go with/help as an important barrier to using green space (p=0.001). Both physical health-related (eg, fatigue) and place-based (eg, poorly maintained sites) factors are barriers to green space use for individuals reporting a chronic condition. Conclusions The results suggest that those with physical disabilities and progressive illnesses would benefit most from reducing place-based and support barriers, such as a lack of disabled facilities and no one to go with/help. By improving the suitability of green spaces using this evidence, barriers to green space would be reduced for all users, which may improve the quality of the space.

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Cite This Study

Burnett et al. (2026) studied this question.

synapsesocial.com/papers/698d6eca5be6419ac0d54adbhttps://doi.org/10.1136/bmjph-2025-003077
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