Measures of Greenspace Exposure and Their Association to Health-Related Outcomes for the Periods before and during the 2020 Lockdown: A Cross-Sectional Study in the West of England

Round 1

Reviewer 1 Report

This is a very interesting and well-written paper, I really enjoyed reading it. I especially appreciate the high quality of the presentation of the obtained results as well as the numerous references to the previous studies. I have only one concern and a few small remarks.

My main concern is about the multivariate regression model. I did not find information on whether the multivariate regression models were the linear regression models but I assume they were (as the most popular). If yes, then I have serious doubts if in the case of greenspace exposure measures based on a distance (Euclidean or network) the relationship between greenspace exposure measures and health-related outcomes (esp. visits to greenspaces) is actually linear. In the case of spatial accessibility, and especially when we are talking about respondents who access greenspace by foot, we may expect some kind of diminishing sensitivity i.e. it is not a great difference for a greenspace user if the greenspace is 15km or 17 km away from respondent’s home but it is very important if it is 250 m or 2250 m (in both cases we have 2km difference but the significance of this difference is in both cases completely different). What might be expected is a kind of threshold (radius) that defines the area the respondent perceived as easily accessible. Destinations located further away are perceived as not accessible or less accessible and thus less frequently or never visited (see: information and usage fields proposed by Potter, 1979). For each person (depending on age, physical condition, preferences, car ownership etc.) this threshold may be different but in general, this will disturb linear relationships and create a kind of breaking point (see: segmented regression).

Minor comments:

Basic information about the lockdown restrictions would be useful e.g. were people allowed to leave their homes for recreational purposes without limitations?

In Table 1, it would be easier to read the data about age if they were organized by age group and not by frequency.

Author Response

First of all, thank you for your time and efforts in reviewing this paper and helping us further develop its content. In general, your comments have been of great benefit to help us showcase the data in a more suitable way, for us and for the readers to see the relationship between greenspace exposure measures and health-related outcome.

Thank you for this comment about the linearity of the relationships we are testing. We have clarified in the Methods section that we are using linear regression models. Yet, in response to your comment, we decided to log the distances to greenspaces to bring the values on to a comparable scale and to bring in linearity to the relationships. We did that for the six spatial measures of exposure: Network Distance (m) to nearest greenspace access; Euclidean Distance (m) to nearest greenspace access; Euclidean Distance (m) to nearest 0.5ha doorstep greenspace access; Euclidean Distance (m) to nearest 2ha local greenspace access; Euclidean Distance (m) to nearest 10ha neighbourhood greenspace access; and Euclidean Distance (m) to nearest 20ha wider neighbourhood greenspace access. This is now further explained in the Methods. The updated results helped us to better see the relationships with health-related outcomes. There was no change in any significance compared to the old models (not logged), but the R² and adjusted R² have increased.

In response to your comment on explaining the lockdown restrictions, we added some information in the introduction to specify that non-essential businesses were closed, and greenspaces were one of few outdoor destinations accessible to the public.

Finally, in response to your comment on arranging the age characteristic of the participants by age groups rather than frequency, this was done in table 1 as suggested to facilitate reading the data.

Best regards.

Author Response File: Author Response.docx

Reviewer 2 Report

Dear authors,

I must congratulate you on your contribution because of its originality, interest and transferability to society and its link to environmental issues. However, the text can be implemented in your state of the art, to solve this deficit I leave you some references that you should include as an example of previous works:

https://doi.org/10.3390/ijerph17114140
https://doi.org/10.1016/j.eiar.2022.107013
https://doi.org/10.1016/j.scitotenv.2020.138835
https://doi.org/10.1186/s12955-020-01623-6

In addition to including and citing these works, they should include cartography related to the areas of study indicated, as they talk about the application of the NDVI index with which they detect the areas of work. It is strongly recommended that they also include a map of the location of these areas.

Once these tasks have been completed, you may resubmit this article for a second revision for final acceptance.

However, these formal issues should not detract from your work; they are intended to reinforce it.

Best regards.

Author Response

First of all, thank you for your time and efforts in reviewing this paper and helping us further develop its content. In general, your comments have been of great benefit to help us strengthen out argument through further literature, for us and for the readers to see a wider perspective of this research typology and to further understand the importance of this topic.

We have now included all the suggested literature either in the Introduction section, or later on to support our results in the Discussion section.

In response to your comment on defining the area of the study, we have included figure 1, which is a map of England with the parts (highlighted in red) from which participants were invited.

Best regards.

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

Dear authors,

I very much welcome the changes made to your work. However, it would be necessary to improve figure 1. As you know, all maps must have their basic elements: north, graphic scale, legend, toponymy (including neighbouring territories, the English Channel, the name of the seas...), etc.

Best regards

Author Response

Thank you again for your further comments.

We improved Figure 1 to include a north arrow, a graphic scale, a legend of the different boundaries and toponymy.