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Counties with more trees and shrubs spend less on Medicare

A new study finds that Medicare costs tend to be lower in counties with more forests and shrublands than in counties dominated by other types of land cover. The relationship persists even when accounting for economic, geographic or other factors that might independently influence health care costs, researchers report.

The analysis included county-level health and environmental data from 3,086 of the 3,103 counties in the continental U.S.

Urban and rural counties with the lowest socioeconomic status appeared to benefit the most from increases in forests and shrubs, said University of Illinois graduate student Douglas A. Becker, who led the new research with Matt Browning, a professor of recreation, sport and tourism at the U. of I.

"At first, I was surprised by this," Becker said. "But then it occurred to me that low-income communities are getting the biggest bang for their buck because they probably have the most to gain."

The findings, reported in the journal Urban Forestry and Urban Greening, are observational and do not prove that having more trees and shrubs directly lowers health care costs, Becker said. But the study adds to a growing body of evidence linking green space -- in particular, forested areas -- to better health outcomes for those living nearby.

"Previous studies have looked at any health outcomes people think might be linked to nature: depression, cardiovascular disease, physical activity levels, even recovery from surgery," Becker said.

Several studies report no association between access to green space and health, he said.

"But there is also a lot of work -- including experimental work, which we consider to be the strongest -- showing a link between exposure to green space and beneficial health effects," Becker said.

Douglas A. Becker, Matthew H.E.M. Browning, Ming Kuo, Stephen K. Van Den Eeden. Is green land cover associated with less health care spending? Promising findings from county-level Medicare spending in the continental United States. Urban Forestry & Urban Greening, 2019; 41: 39 DOI: 10.1016/j.ufug.2019.02.012

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