Green space isn’t ambitious, it’s necessary: how Barcelona is providing access to green space and active transport

COVID-19 fundamentally changed our relationship with the outdoors. With an increase in climate anxiety growing across Europe, how can we better approach our urban planning to benefit our health, the planet, and the economy?

Helping to lower air and noise pollution, reduce heat, whilst providing a space for exercise and social interaction, and having access to green space has been proven to be of great benefit to our health and wellbeing. These benefits are particularly important for children. Interacting in green areas can enhance children's physical and mental wellbeing. But sadly, not everyone has the same equal access to green space. Access differs greatly across Europe, with significant regional variations. Yet by taking steps to address disparities in access, the benefits of nature to health and wellbeing in our cities can be significantly increased for all.

We discuss why green space is an important ally for our health and wellbeing and what steps Barcelona is taking to ensure access for all with Mark Nieuwenhuijsen, from the Barcelona Institute for Global Health, (ISGlobal).

Barcelona has ambitious plans to step-up the city’s approach to green space such as the ‘Eixos Verds’ initative. How does this intervention aim to increase access to green space and lower air and noise pollution to benefit health?

The Eixos Verds programme is part of the overall SuperIllas (Superblock programme) and it aims to reduce the number of cars on the road, promote active and public transportation, while at the same time increase access to green space, with the main goal to make our streets more people-friendly by introducing more increase in vegetation to all of Barcelona's streets. The initial programme targets 30 streets in the Eixample neighbourhood, one of the city's most densely populated areas, with four of the streets now almost complete. This initiative follows a trend that we see in many European cities, whereby decision makers discourage the use of cars in cities and plant more trees and introduce additional greenery

This strategy was created more than 10 years ago, as the brainchild of urban planner Salvador Rueda who had the vision to create over 500 'superblocks' in the city. The 'superblocks' are a Barcelona pioneered urban planning concept that restricts vehicle traffic to the streets on the perimeter of a block with the interior streets used for walking, biking, as well as expanding green space in the city. Mayor Ada Colau and the lead for urbanism, Janet Sanz, implemented this concept when they came into power eight years ago. Together, they wanted to build a fairer and healthier Barcelona for everyone.

Several interventions are already in place as a means to meet a fairer and healthier city. These include a number of new superblocks, the Eixos Verds, a large cycling infrastructure, the creation of a park in Glories created as a result of tearing down a large roundabout in the area, and connecting the tram system, to name a few. Due to the reduction in car traffic, the programme will result in less air and noise pollution and more green space, thereby promoting better physical and mental health. However, in spite of all these developments there is still a lot of work to do.

As new urban models are introduced throughout Europe, just how effective are they in reducing health risks whilst alleviating the effects of climate change?

We have several innovative urban models already in place, such as the Barcelona Superblock, the Paris 15-minute city, the London low traffic neighbourhoods, and the Freiburg car free neighbourhood (Vaughban). These all lead to a reduction in motorised traffic and thereby air pollution, noise and heat island effects, creating more opportunities for green space and active mobility and physical activity.

In Barcelona, we estimate that the city's air pollution levels would drop by at least 25%, noise levels would reduce by a few decibels, and there would be a 20% increase in green space if all 500 superblocks were put into effect in the city. Additionally, it would lower the city's temperature, allowing more people to walk and cycle and engage in physical activity. These effects are all beneficial to your health. It would be able to prevent around 700 premature deaths each year.

Why is there a need to radicalise urban environments to benefit health?

Now, there is good evidence illustrating that visiting green spaces is very beneficial for both mental and physical health. This is particularly important for the next generation. Being exposed to nature can have significant health benefits to children not just now, but also in the future. A study we undertook highlighted that adults who had close contact with nature at a young age could have better mental wellbeing in adult life than those who had less or no contact at all during the early years.

With this in mind, there has been an increase in nature visits via social prescribing schemes. Taking holistic routes via social prescribing is becoming commonly seen as a more effective treatment than prescribing drugs. This also links to the loneliness crisis we are currently facing as a society. Prescribing social activities that take place in natural spaces can reduce feelings of loneliness and improve quality of life in urban contexts.

Besides the health impact, the initiative could also address the economic impact of air and noise pollution. The costs of air and noise pollution are huge but also preventable. The European Commission documentation underlies the new proposed Ambient Air Quality Directive and estimates the following economic impacts:

  • Annual costs of €231-853 billion (bn) in health impacts.
  • €8 bn in lost workdays.
  • €4-12 bn in ecosystems damage.
  • €10-11 bn in crop yield loss.
  • €19 bn in forest damage.
  • €1 bn in damage to buildings.

The question is: what are we waiting for? The whole health system is set up to treat sick people, while the primary aim should be preserving and promoting health. Money should flow to prevention rather than treatment, but currently, only a small percentage of the healthcare budget goes to prevention.

In Barcelona only 20% of the population meet the WHO’s recommendations in terms of accessing green space. How can we ensure we achieve a fair and just green transition? How can green spaces contribute to this and help us adapt to climate change?

It is important that green space is introduced throughout the city and not only in some neighbourhoods or streets. Everyone should be able to enjoy green space. Barcelona is a compact city and the existing infrastructure does not lend itself to much opportunity to increase space.

Therefore, we need to remove, for example, some of the car infrastructure, i.e., asphalt and parking, and plant green space instead. Incredibly, although only 1 out of 4 trips are by car, car infrastructure takes up 60% of public space (including roads). We need green infrastructure that runs throughout the city and is well-connected. It is not only good for people but also for biodiversity and many animal and bird species.

It is estimated that this initative will increase Barcelona’s green space between 5-6%. Can this really make a significant difference in terms of people’s wellbeing?

Besides increasing Barcelona's green space by around 5-6%, implementing the entire Eixos Verds programme would also lead to the estimated prevention of 14% of cases of self-perceived poor mental health, 13% of visits to mental health specialists and cases of antidepressant use, and 8% of cases of tranquilliser/sedative use each year.

As a result of more green space, more than 30,000 people could experience improved mental health. According to a somewhat conservative estimate, these population-wide benefits for mental health and wellbeing would result in annual savings of €45 million in direct and indirect mental health costs.

A recent health impact assessment led by ISGlobal illustrates that increasing vegetation through green corridors (pieces of land that receive coordinated actions to protect biological diversity) could have a significant impact on the environment in which we live and ultimately save lives.

We must break down the silos, and consider what we need to do to plan a society that is more sustainable, liveable, and healthier by default.. Therefore, we need to spread the word about what works, build coalitions of like-minded actors, include health indicators right from the start of urban (and rural) planning projects, co-create healthy urban visions with citizens, and make sure that these efforts are actually put in place.


COVID-19 reinforced the need to better invest in health systems to protect society and the economy. Considering how intrinsically linked the economy and our health are, in what ways can regular visits to greener environments help lower medical costs?

Reports are now demonstrating that those living in urban areas during COVID-19 saw a reduction in physical activity when compared to those living in areas with greater access to greenery. We witnessed the real need and want for green spaces during the pandemic when amenities such as schools and gyms started to close. Consequently visitor numbers to greener areas increased enormously as people generally said it made them feel better. Green space is associated with a large number of health benefits, including: lower premature mortality, longer life expectancy, fewer mental health problems, less cardiovascular disease, better cognitive functioning in children and the elderly, and healthier babies.

The pandemic further highlighted the equity issue surrounding green space. It is often the case that these areas are not close enough to where people live, so many do not gain the health benefits. Yet, the uneven distribution along with the health impacts of green areas is not just an issue between cities across Europe, but also between the various areas within each city. Poorer neighbourhoods often have less access to green space and as a result those residing in these areas do not benefit from them.

In 2022 Europe faced unprecedented heatwaves. In what ways can urban planning, and specifically green spaces, cool high ambient temperatures to alleviate premature deaths?

Yes, we saw a severe heatwave with a high mortality and morbidity burden. But even outside of heatwaves, we see that city centres are hotter than surrounding areas, the so-called 'heat island effects'. We recently estimated that these 'heat island effects' can cause 4% of premature deaths and that a third of these premature deaths could be prevented if we increased the amount of green space coverage in our cities by up to 30%. It is just under half now. However, green spaces can contribute significantly to climate mitigation by reducing these 'heat island effects.' In 2021, we analysed more than 1,000 cities in 31 European countries and found that up to 43,000 premature deaths could be prevented each year if these cities were to achieve the WHO recommendations regarding residential proximity to green space. Our ISGlobal Ranking tool which aims to estimate the health impacts of urban and transport illustrates why green space is needed.

In a recent article published by ISGlobal, you highlighted that electric cars cannot save cities, but rather urban planning can. Could you please explain what is meant by this?

No matter if they have an internal combustion engine or are electric, cars still occupy a lot of public space that could be used much more effectively by providing more infrastructure for walking and cycling and increasing green space to promote better physical and mental health. Also, cars and car infrastructure lead to a lot of community severance while we need more community building. We need to reduce our dependency and plan for alternative, healthier modes of transport. Reducing air pollution levels could prevent thousands of deaths in European cities every year.

Through social prescribing, we can encourage more visits to nature, which are beneficial for health. The question is: what are we waiting for? The whole health system is set up to treat sick people, while the primary aim should be preserving and promoting health. Money should flow to prevention rather than treatment, but currently, only a small percentage of the healthcare budget goes to prevention.


Finally, how can policies and actions help to reinforce the need to implement green space across Europe's urban areas?

We need to implement urban and transportation planning policies that promote healthy living. We now often see what appears to be the opposite. For example, there is a lot of planning for cars, while plans for alternative modes of transport are forgotten.

Many years of this type of planning and lobbying by, among others, the car industry have led to car dependency and car-dominated cities. For many people there are no alternative modes of transport left. We have lost the sensible link between urban planning, transport engineering, and health. People live further and further away from their work and shops, while we should be planning to have people live closer to their work and other destinations such as shops, education, and cultural centres so they can walk or cycle. An interesting approach in this aspect is the 15-Minute City.

We must break down the silos, and consider what we need to do to plan a society that is more sustainable, liveable, and healthier by default. Therefore, we need to spread the word about what works, build coalitions of like-minded actors, include health indicators right from the start of urban (and rural) planning projects, co-create healthy urban visions with citizens, and make sure that these efforts are actually put in place.

Click the orange button to discover more about ISGlobal and the work it does to include '5 keys to healthier cities' and the #CitiesWeWant initiative.

Mark J Nieuwenhuijsen
Research Professor, Director of the Urban Planning, Environment and Health Initiative, and Head of the Air pollution and Urban Environment Programme at ISGlobal | Website

Professor Mark J Nieuwenhuijsen PhD is director of the Urban Planning, Environment and Health initiative and the Climate, Air pollution, Nature and Urban Health research program at ISGlobal Barcelona, Spain. He is a world leading expert in environmental exposure assessment, epidemiology, and health impact assessment with a strong focus and interest on healthy urban living. He has edited 8 books on Environmental Exposure assessment and Epidemiology, and urban and transport planning and health, co-authored 39 book chapters, and has co-authored more than 500 papers published in peer reviewed journals. In 2018, he was awarded the ISEE John Goldsmith Award for Outstanding Contributions to Environmental Epidemiology. Since 2018 he is among the Clarivate 1% Highly cited scientists in the world. In 2021 he was ranked as the number 1 scientist in Urban health. He leads the bi-annual Urban Transitions conference and he is Editor in Chief of Environment International. In 2020 and 2021 he was the President of the International Society of Environmental Epidemiology. He led 5 large EC funded consortia, including currently UBDPolicy, and is involved many more EC funded research consortia as WP or task leader. He leads the European Urban Burden of Disease project (

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