ArticleEnvironmental research2024
The paradox of high greenness and poor health in rural Central Appalachia.
Article in Environmental research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Designing communication strategies to increase rural participation in clinical trials using the Health Belief Model and strategic communication.Contemporary clinical trials communications · 2026Article
- Expert perspectives on exposure-response functions for urban health policy: Lessons from a UBDPolicy workshop.Environmental research · 2026Review
- Neighborhood green space and diabetes mellitus in Brazil.iScience · 2025Article
- Expression of dementia biomarkers in Appalachian and non-Appalachian ELVO patients during thrombectomy.Frontiers in neuroscience · 2025Article
- Factors influencing likelihood of participation in green social prescriptions in an international sample.Journal of healthy eating and active living · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
While many studies have found positive correlations between greenness and human health, rural Central Appalachia is an exception. The region has high greenness levels but poor health. The purpose of this commentary is to provide a possible explanation for this paradox: three sets of factors overwhelming or attenuating the health benefits of greenness. These include environmental (e.g., steep typography and limited access to green space used for outdoor recreation), social (e.g., chronic poverty, declining coal industry, and limited access to healthcare), and psychological and behavioral factors (e.g., perceptions about health behaviors, healthcare, and greenness). The influence of these factors on the expected health benefits of greenness should be considered as working hypotheses for future research. Policymakers and public health officials need to ensure that greenness-based interventions account for contextual factors and other determinants of health to ensure these interventions have the expected health benefits.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.