Written evidence - MRC Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), University of Cambridge (PTC0019)

The MRC Epidemiology Unit is a department at the University of Cambridge. It works to improve the health of people in the UK and around the world through understanding obesity, type 2 diabetes and related metabolic disorders, and finding strategies for their prevention. www.mrc-epid.cam.ac.uk. Within the Unit, the Centre for Diet and Activity Research (CEDAR) studies the population-level influences on what we eat and how much physical activity we do, develops and evaluates public health interventions, and helps shape public health practice and policy. www.cedar.iph.cam.ac.uk.

This response was compiled by Dr Jenna Panter and Dr David Ogilvie of the Unit’s Population Health Interventions Programme. Reflecting our expertise, it focuses on consultation questions relating to green space and public transport rather than housing.


What is the long-term impact of the pandemic likely to be on housing and green spaces in towns and cities?


1.1 Evidence suggests that exposure to green space has a positive influence on health and well-being.[1,2] Green space use is associated with decreased levels of all-cause mortality, loneliness and stress and provides an important source of social interaction and, for many, a source for physical activity. [3,4]

1.2 There is evidence that contact with green space may disproportionately benefit disadvantaged populations, reducing health inequalities and therefore weakening the effects of poverty, known as the ‘equigenic’ effect. [5]

1.3 A study of 2250 UK participants who responded to a YouGov Survey in April - May 2020 [6] has indicated that manual workers were less likely to visit green space than those non-manual workers, both before and after covid restrictions were enforced. Women were more likely than men to agree that green space benefited their mental health more following restrictions. People aged 65 and over were less likely than those aged 25–64 to have visited green space following the restrictions. These results suggest that inequalities in green space use were sustained, and possibly exacerbated, during movement restrictions. The pandemic and associated lockdowns are likely to have exposed existing inequalities in health benefits.

1.4 Current NICE guidance highlights the importance of creating environments that are supportive for walking, cycling and physical activity, such as by enhancing the accessibility, quality and appeal to users of local open spaces to increase their use[7]. The guidance recommends providing facilities that help people of all cultures and backgrounds to feel safe and welcome, lighting, clear signage, shelter and shade, seating, toilets, footpaths and easy access by public transport.

1.5 The quality and accessibility of greenspaces are likely to be even more important in the current context, given that inequalities are likely to have been exacerbated by the pandemic.


What is the long-term impact of the pandemic likely to be on public transport in towns and cities?

1.1 With government guidance to avoid public transport to reduce viral transmission through close contact, levels of public transport use remain comparatively low. In general people are still making fewer journeys than pre-pandemic.[8]

1.2 Public transport provides important access to amenities and services for disadvantaged groups and areas. Public transport is also an important source of physical activity. For example, we have shown that on average 20% of the journey to work for those travelling by bus, park-and-walk or park-and-cycle, is spent in physical activity of at least moderate intensity. [9] The current reductions in public transport use relative to private motor vehicles is unlikely to support increases in physical activity.

1.3 Current NICE guidance also highlights the importance of public transport for health [7]. Against a backdrop of increasing numbers of private motor vehicle trips, it may be important to sustain levels of public transport service and use in order to further reduce dependence on private motor vehicles.

1.4 Some evidence suggests that if public transport is improved more people may use it, particularly if they live nearby. Use could be encouraged by ensuring available services are reliable, particularly in rural commuting hinterlands of towns and cities where public transport may be more limited; making information about public transport services accessible to people with visual and hearing impairments; and making services physically accessible to everyone. Further details are provided in the NICE guidance document.


  1. Barton J, Pretty J. What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environ Sci Technol 2010;44:3947–55.
  2. Douglas O, Lennon M, Scott M. Green space benefits for health and well-being: a life-course approach for urban planning, design and management. Cities 2017;66:53–62.
  3. Twohig-Bennett C, Jones A. The health benefits of the great outdoors: a systematic review and meta-analysis of greenspace exposure and health outcomes. Environ Res 2018;166:628–37.
  4. Maas J, et al. Social contacts as a possible mechanism behind the relation between green space and health. Health Place 2009;15:586–95.
  5. Mitchell R, et al. Neighborhood environments and socioeconomic inequalities in mental well-being. Am J Prev Med 2015;49:80–4.
  6. Burnett H,et al.t. Change in time spent visiting and experiences of green space following restrictions on movement during the COVID-19 pandemic: a nationally representative cross-sectional study of UK adults. BMJ Open, 2021;11:e044067.
  7. NICE, 2018. Physical activity and the environment.  NICE Guidance [NG90] https://www.nice.org.uk/guidance/ng90/ Accessed 28/06/21.
  8. Department for Transport, 2021. Transport use during the coronavirus (COVID-19) pandemic. https://www.gov.uk/government/statistics/transport-use-during-the-coronavirus-covid-19-pandemic Accessed 28/06/21.
  9. Ogilvie D, et al. Health impacts of the Cambridgeshire Guided Busway: a natural experimental study. Public Health Research, 2016; 4 (1) 10.3310/phr04010.

6 July 2021