Beyond proximity: Green space visitation patterns and physical health outcomes

Urban green spaces (GS) are increasingly recognized for mitigating health risks linked to urbanization, yet most research emphasizes proximity rather than actual use in Mediterranean cities. This study examines how GS visitation patterns, demographic characteristics, and physical health outcomes interact in Chania, Crete, addressing gaps in GS exposure and chronic disease prevention. A cross-sectional survey was conducted among 718 adult residents between June and August 2024. Data included demographics, GS use, physical activity, and self-reported health indicators, including BMI, coronary artery disease (CAD), hypertension, and hypercholesterolemia. Chi-square tests and logistic regression models were applied. Demographics were significantly associated with GS engagement and health. Men more often visited forests and had higher odds of chronic conditions (e.g., OR = 3.194 for CAD, p = 0.004), while older adults visited GS more frequently. Limited GS accessibility (>20-minute walk) was associated with higher odds of hypertension (OR = 1.603, p = 0.024). Garden visits were associated with more frequent GS use (OR = 3.133, p = 0.017), and longer visits (>1 h) were associated with lower odds of CAD, hypercholesterolemia, hypertension and longer physical activity duration. These findings highlight the importance of actual GS engagement alongside availability and support equitable, quality-focused GS planning.