Understanding public health risk perceptions is essential in efficient environmental health management. In the light of the negative impact of air pollution on health and the direct and indirect mediation of this impact through risk perceptions, it is crucial to better understand the lay perceptions of air pollution. Since qualitative research methods are well suited for this aim, the central objective of this study is to present a review of qualitative research articles in the field of environmental epidemiology that investigate health risk perceptions of ambient air pollution since the 2000s. We followed the PRISMA-guidelines which resulted in a selection of 20 scientific articles published in peer-reviewed academic journals that used qualitative research methods and reported on health risk perceptions about ambient air pollution. Qualitative research in the field of environmental epidemiology is still scarce. Most of the studies included in the review were based on face-to-face interviews and focus group discussions; a minority used a mixed-method approach. Interesting contributions were made with respect to both the perception of exposure to air pollution and the perception of the health effect associated with air pollution. The review suggests that data generated through qualitative research might complement the traditionally quantitative field of environmental epidemiology. Mixed method multidisciplinary research is likely to provide a more holistic explanation of environmental health patterns observed through quantitative research. These explanations are key in managing environmental health and in developing successful prevention, mitigation and communication strategies. Implementing qualitative research methods contribute to the field of environmental epidemiology as it i) allows for triangulation of findings; ii) generates nuanced findings and new research questions; iii) triggers in-depth understandings of quantitatively identified patterns; iv) leads to additional surprising and/or multifaceted responses; v) enhances relationships between researcher and respondent; vi) increases the awareness of important context-dependent dynamics or interactions that may generate biases and vii) grasps the local, contextual, situational and cultural elements that interact with health risk perceptions.

Background: Our living environment impacts on our health and wellbeing. The physical and mental benefits of interaction with nature and the ecosystem are well-established in literature. From a public health perspective, it is thus crucial that people make use of public green spaces (PGSs) in urban areas. Therefore, it is important to understand why they are potentially under-used.Methods: In this research, we identified social barriers that prevent the (full) use of PGSs in the Brussels Capital Region (BCR). We applied a qualitative research methodology. Insights were generated through 51 individual face-to-face in-depth interviews with a group of PGS users diversified in terms of age, gender, migration background, and socioeconomic situation. Questions were open-ended, and the interview guide was semi-structured.Results: Our research identified three social barriers for the use of available and accessible PGSs: (1) perceived dangers due to bad precedents, the presence of socially frightening elements, or a lack of social control, (2) not feeling in place because of the dominance of a specific group of users or because of community perceptions, and (3) not fulfilling one's social needs. These barriers were different in their manifestations (barriers to go—barriers to stay—barriers for integral use) and resulted in a differential degree of PSG-use. We distinguished three different dimensions of the completeness or integrality (understood as full or optimal use) by which PGSs are used; the spatial integrality (using all the different parts of the PGS), the temporal integrality (using PGSs at all moments of the day), and the social integrality of PGS use (without any restriction concerning social interaction).Conclusions: While there are many benefits associated with PGSs, a continuous social evaluation of these physical places might generate social barriers resulting in a decline of their use, a more superficial use, or even in complete avoidance. Both the social context and social needs of individuals result in specific social barriers.

To fight the COVID-19 epidemic, many countries implemented containment measures that made physical distancing the norm and imposed restrictions on the use of public space. In countries where access to public green spaces (PGSs) was safeguarded, they were expected to partially counterbalance the negative health outcomes of these containment measures, as they offered a unique opportunity to meet others, to avoid isolation, and to move, play and relax at a safe distance. Research on PGS use and its objective association with health during the COVID-19 epidemic is rather limited and is based on quantitative research methodologies. Such methodologies are useful to detect objective associations between PGS use and health or between COVID-19 and PGS use, but fall short in explaining the observed associations. This qualitative research filled this gap by examining how PGS users perceived the health advantages of PGSs and how the use of PGSs changed during the epidemic in the Brussels-Capital Region, Belgium. In total, 23 individual face-to-face in-depth interviews were conducted in various PGSs. We found that while PGSs were initially perceived as a possible threat to health in the first period of the epidemic, they gradually became associated in users' minds with both improved physical and mental health. Although the mechanisms behind this association were also present prior to the epidemic, they became more tangible and more universal. We also found that the use of PGSs changed during the epidemic due to measures and restrictions and due to health risk perceptions. We distinguished five different health risk perception profiles in relation to COVID-19: the denier, the fatalist, the negotiator, the conformer and the worrier. These different health risk perceptions impacted on the use of and behaviour within PGSs. This research confirms the importance of PGSs during an epidemic and may inspire further research, offer pointers to policymakers for developing and implementing strategies related to the use of PGSs during epidemics, and assist them in providing available and accessible PGSs and in designing attractive, more epidemic-proof PGSs.