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Peer-reviewedCC BYEnvironmental Science and Ecotechnology

Poverty-modulated tree equity shapes health burdens across U.S. cities

  • Min-Ki Lee1
  • Chang-Bae Lee2
  • Sungyong You
  • Stephen J. Freedland3
  • Michael R. Freeman4
4 affiliations
  1. 1Department of Forest Resources, Kookmin University, Seoul, 02707, Republic of Korea
  2. 2Department of Forest Resources, Kookmin University, Seoul, 02707, Republic of Korea; Department of Climate Convergence Technology, Kookmin University, Seoul, 02707, Republic of Korea; Corresponding author. Department of Forest Resources, Kookmin University, Seoul, 02707, Republic of Korea.
  3. 3Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
  4. 4Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA; Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
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Abstract

Rapid urbanization concentrates both opportunity and health risk across cities worldwide. Although urban green infrastructure is widely promoted for public health, most evidence examines single outcomes or simple area metrics and rarely tests how socioeconomic context modulates the magnitude and pathways of these benefits. Whether tree-canopy equity delivers stronger returns in areas with the highest poverty remains unresolved. Here, we show that poverty-modulated tree equity shapes health burdens across 497 cities in the United States. Socioeconomic disadvantage is the dominant structural driver of eleven physical and mental health outcomes, yet higher Tree Equity Score is consistently associated with lower prevalence; these protective associations are strongest in high-poverty cities, where greening acts partly by mitigating heat and air-pollution hazards, whereas in low-poverty cities direct restorative pathways predominate. Models explain up to 72.6 percent of the variation in poor mental health, and a five-point rise in the Tree Equity Score corresponds to a 2.7–35 percent lower prevalence of multiple conditions. These findings demonstrate that the health returns of urban greening are context-dependent and require equity-focused strategies stratified by city poverty level.

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Cite

BibTeXRIS
BibTeX
@article{lee2026povertymodulated,
  title = {{Poverty-modulated tree equity shapes health burdens across U.S. cities}},
  author = {Min-Ki Lee and Chang-Bae Lee and Sungyong You and Stephen J. Freedland and Michael R. Freeman},
  journal = {Environmental Science and Ecotechnology},
  year = {2026},
  month = sep,
  doi = {10.1016/j.ese.2026.100758},
  url = {https://doi.org/10.1016/j.ese.2026.100758},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Poverty-modulated tree equity shapes health burdens across U.S. cities
AU  - Min-Ki Lee
AU  - Chang-Bae Lee
AU  - Sungyong You
AU  - Stephen J. Freedland
AU  - Michael R. Freeman
PY  - 2026
DA  - 2026/09/01
JO  - Environmental Science and Ecotechnology
DO  - 10.1016/j.ese.2026.100758
UR  - https://doi.org/10.1016/j.ese.2026.100758
AB  - Rapid urbanization concentrates both opportunity and health risk across cities worldwide. Although urban green infrastructure is widely promoted for public health, most evidence examines single outcomes or simple area metrics and rarely tests how socioeconomic context modulates the magnitude and pathways of these benefits. Whether tree-canopy equity delivers stronger returns in areas with the highest poverty remains unresolved. Here, we show that poverty-modulated tree equity shapes health burdens across 497 cities in the United States. Socioeconomic disadvantage is the dominant structural driver of eleven physical and mental health outcomes, yet higher Tree Equity Score is consistently associated with lower prevalence; these protective associations are strongest in high-poverty cities, where greening acts partly by mitigating heat and air-pollution hazards, whereas in low-poverty cities direct restorative pathways predominate. Models explain up to 72.6 percent of the variation in poor mental health, and a five-point rise in the Tree Equity Score corresponds to a 2.7–35 percent lower prevalence of multiple conditions. These findings demonstrate that the health returns of urban greening are context-dependent and require equity-focused strategies stratified by city poverty level.
SN  - 2666-4984
ER  -