Introduction

In the last decade, green spaces have received increasing attention as a resource for psychological restoration and health benefits due to increasing recognition of a link between green space exposure and reduced perceived stress (Campagnaro et al., 2020; Garrett et al., 2019; Gatersleben et al., 2020; Geneshka et al., 2021; Georgiou et al., 2021; Hartig et al., 2014; Huang et al., 2020; Yang et al., 2019; Yang et al., 2020; Völker et al., 2018; Völker & Kistemann, 2011; Ward Thompson et al., 2012; Gascon et al., 2017; White et al., 2019; White et al., 2020). Short and long-term mental health outcomes have been identified such as 1) the risk of psychological distress (Høj et al., 2021; Pope et al., 2018; Wang et al., 2019), (2) self-reported physician-diagnosed depression or anxiety (Banay et al., 2019; Hystad et al., 2019; Reece et al., 2021), (3) self-rated fair to poor general health (Furukawa et al., 2003), (4) well-being (WHO-5), and (5) life satisfaction (An et al., 2020; Reyes-Riveros et al., 2021). Associations between life satisfaction, urban green space exposure, and health outcomes are often affected by confounding factors such as socio-economic factors and life habits i.e. physical activity (Chen et al., 2021; Geneshka et al., 2021; Georgiou et al., 2021; Richardson & Mitchell, 2010). Additionally, place attachment is another mediator contributing to psychological restoration (Escolà-Gascón & Houran, 2021; Gatersleben et al., 2020; Liu et al., 2020). Place attachment points to the emotional relationships established by the individuals, groups, or communities toward their physical environment. Studies show that all components of social capital have direct and significant effects on migration and place attachment among these public green spaces (Addas & Rishbeth, 2018; Albers et al., 2021; Behroozeh et al., 2021; Chen et al., 2019; Fu et al., 2022; Žlender & Gemin, 2020). A study conducted in two large cities in Germany showed that not being exposed at a green space is directly associated with decreased life satisfaction, which triggers willingness to migrate (Kley & Dovbishchuk, 2021).

Emigration from Albania has been driven mainly by political and economic considerations (Azzarri & Carletto, 2009; Matoshi & Mulaj, 2021; Sabatini, 1999), lack of individual and political security (Soto, 2002; Shochat et al., 2006), and poor living conditions (Chletsos & Roupakias, 2019). However, it remains important to understand the mechanisms and factors that influence life satisfaction and migration willingness among Albanians. Our objective is first to explore whether exposure to green spaces affects life satisfaction using BMI/ Body fat percentage index and Psychological distress and Well-being index (Fig. 1), and second, to examine whether the mediation between green spaces and life satisfaction is conditioned by migration willingness (Fig. 2). Thus, our three research questions are:

  • RQ1: Is green space exposure affecting life satisfaction?

  • RQ2: Do physical (BMI/Body fat percentage index) and mental health outcomes (Psychological distress index, well-being Index) mediate the association between green space exposure and life satisfaction?

  • RQ3: Is the migration willingness moderating the association between green space exposure and life satisfaction?

Fig. 1
figure 1

Parallel mediation of Green exposure to Life satisfaction

Full size image
Fig. 2
figure 2

The moderating effect of Migration willingness to Life satisfaction

Full size image

Green Spaces in Tirana

Albania has progressed from one of the poorest countries in Europe to an upper-middle-income country (World Bank, 2022) and has been a member of NATO since 2009. Tirana, both the capital and the largest city, is situated in the Western Balkans, close to the Mediterranean coast. The population of the prefecture of Tirana is expected to reach about 954,000 by 2031 (INSTAT, 2019). Despite Tirana's rapid population growth, there has been very little research on its green spaces and their contribution of human health and well-being in the face of increasing urbanization, and the need to design and implement for evidence-based policies to develop greening solutions.

Methods

We conducted a cross-sectional study based on an online survey undertaken in March–April 2021 focused on physical (BMI and Body fat percentage index) and mental health (Psychological distress index and Well-being index) indicators (Fig. 3). The study area was the Grand Park of Tirana City, Albania, due to its location and the frequency with which it is visited by city residents.

Fig. 3
figure 3

Source: Authors’ Elaboration

Flow chart of the data collection procedure.

Full size image

The Grand Park of Tirana occupies an area of about 250 hectares of vegetation and contains a large lake called the Artificial Lake of Tirana, covering 48 hectares, constituting an ecological sanctuary that provides a variety of ecosystem services in the middle of the city. The Grand Park is strategically located merely 1.7 km from the city center, making it easily accessible (Fig. 4). Many services are available as the Grand Park is a popular leisure and sports destination in the city. Several studies have emphasized how vital the park is to the daily lives of Tirana residents (Mesiti et al., 2015; Hamdy & Plaku, 2021). The park's exceptional ecological value, and enormous artificial lake all contribute to its high usage (Fig. 5).

Fig. 4
figure 4

Source: Authors’ elaboration

Location of the Grand Park of Tirana.

Full size image

Tirana's neighborhoods are characterized by a combination of high-rise residential complexes and historic neighborhoods. The expansion of residential superblocks following the Tirana municipality’s implementation of a city center densification policy has led to the disappearance of smaller green areas and open public spaces (Yunitsyna & Shtepani, 2023). The Grand Park of Tirana is currently the only area that remains unaffected by the unplanned urbanization of the city.

Measurement

Our questionnaire was prepared by an interdisciplinary panel of urban planners, geographers, psychologists, and environmentalists to cover six main domains: 1) Socio-demographic characteristics, 2) Life habits, 3) Health and well-being, 4) Green space exposure, 5) Life satisfaction, and 6) Migration willingness. A pilot study with 20 people was conducted to test the survey questions. After the validation and cleaning process, a representative sample of 493 respondents from Tirana was obtained with a 95% confidence level. This survey targeted people over 16 years old and was distributed through social media platforms.

Exposure to urban green space was measured in minutes and coded for the data analysis as follows: 1) 0–30 min, 2) 31–60 min, 3) 61–90 min, 4) 91–120 min, 5) 120–180 min, 6) Over 181 min. Regarding health outcomes, we used participants' self-reports measuring BMI based on height and weight and the body fat percentage index was measured using the Deurenberg formula (Body fat % = (1.20 * BMI) + (0.23 * Age) − (10.8 * gender) – 5.4) (Deurenberg et al., 1991).

We used the Kessler psychological distress scale (K10) to calculate the self-reported psychological distress index. The K10 scale involved ten questions about emotional states, each with a five-level response scale. Each item is scored from one ‘none of the time’ to five ‘all the time.’ Low scores indicate low levels of psychological distress, and high scores indicate high levels of psychological distress. Interpretation of scores is outlined as follows: 10 – 19 likely to be well; 20—24 likely to have a mild disorder; 25–29 likely to have a moderate disorder; 30–50 likely to have a severe disorder.

Well-being was measured through the World Health Organization-Five Well-Being Index (WHO-5) which consists of five statements: 1. "I have felt cheerful and in good spirits;" 2. "I have felt calm and relaxed;" 3. "I have felt active and vigorous;" 4. "I woke up feeling fresh and rested;" 5. "My daily life has been filled with things that interest me." Respondents rate according to the scale: all of the time = 5; most of the time = 4; more than half of the time = 3; less than half of the time = 2; some of the time = 1; at no time = 0. WHO-5 values ≤ 50 are defined as poor well-being, and > 50 as good well-being, while WHO-5 values ≤ 28 are defined as identifying the possible presence of clinical depression (Topp et al., 2015).

Life satisfaction was measured using a one-item scale as follows: All things considered, how satisfied are you with your life as a whole nowadays? 0 = not satisfied at all and 10 = extremely satisfied. As with the World Happiness Report (WHR) and Gallup World, informants were asked to make a general evaluation of their life on a Cantril ladder (1965) scale from 0 to 10, with the worst possible = 0 and the best possible = 10. The one-item life satisfaction measure is a popular method that produces results similar to those of longer scales and with several items (Diener et al., 2013; Veenhoven, 1996). We assessed migration willingness using the question: Are you planning to emigrate to another country? Yes = 1 and no = 2. We measured participants ‘ physical activity with the self-reported daily physical activity: 0–30 min; 31–60 min; 61–90 min; 91–120 min; 150 min; over 150 min. The participants were asked to report their gender, age, income, education, marital status, job status, employment, etc.

Statistical Analysis

A short description is provided on the demographics, health indicators, life satisfaction, and migration willingness with mean and standard deviation. A non-parametric t-test is computed to analyze the differences in demographics, health indicators, migration willingness, and life satisfaction. Also, non-parametric bootstrapping analyses were performed to test the indirect effect of BMI, body fat percentage index, psychological distress index, and well-being index on the relationship between green space exposure and life satisfaction. In these analyses, mediation is significant if the 95% bias is corrected. Two mediation models are hypothesized and explored (Figs. 1 and 2). The first is a parallel mediation model of green space exposure to life satisfaction through BMI, body fat percentage index, psychological distress index, and well-being index, which we use to understand the relationship between green space exposure and life satisfaction through multiple mediators and the role they play in this relationship. In this case, the green space exposure is assumed to have a causal effect on life satisfaction. To understand this relationship, we consider four mediators: BMI, Body Fat Percentage Index, Psychological Distress Index, and Well-being Index.

Our second model is a moderated mediation model, where the relationship between green space exposure and life satisfaction is moderated by migration willingness (Fig. 2). This means that the effect of green space exposure on life satisfaction may vary based on an individual's willingness to migrate (Table 1).

Table 1 Description of variables
Full size table

Before examining this model, we conducted a correlation analysis to understand the relationship among the variables. Other factors, such as gender, income, education, and marital status, were also included as covariates. The analysis was performed using SPSS 24 software and the PROCESS macro. For the parallel mediation model we used model 4, and for the moderated mediation model we used model 15 (Figs. 1 and 2).

Results

Most participants in the survey are women (69%), with the mean age of the respondents is 33 years old, single (55%), and highly educated. About 75% have a university degree and 80.7% are employed. Regarding physical health, about 30% of the participants are overweight, and 22% are likely to have a severe mental health disorder. Also, 45% are characterized by poor well-being (WHO-5 < 50). About 52% of the participants are willing to leave the country, and the mean of life satisfaction is 6.8 from 10 (Table 2).

Table 2 Sociodemographic, green exposure and health-related variables (N: 493)
Full size table

Regarding time spent in the Grand park, 53.1% of respondents spent 31 to 60 min per day, about 17% stayed between 91–120 min, and 4.5% spent more than 120 min, which is the time necessary for positive health effects. Thus average exposure to urban green spaces is 77 min, which is considered too low to positively influence health.

Weekly physical activity is also low; 27.5% of the participants exercise only up to 30 min per week, although about 26% exercise weekly for 150 min or more, which is the World Health Organization’s recommended time of physical activity associated with good health outcomes.

People willing to migrate do more physical activity than those unwilling to move; however, the difference is statistically significant at a p-value < 0.07. All the participants exercise weekly fewer than 60 min. Respondents 18–31 years old are more willing to leave the country than the other age ranges, indicating that increasing age reduces migration willingness (Table 3). Similarly, single unemployed participants indicated greater willingness to leave, as did those with high education levels. Residents living in Tirana for less than ten years are more willing to leave than those that have lived for more than ten years. Regarding the health indicators considered in the study, participants willing to migrate show better physical outcomes but worse mental outcomes than those not willing to migrate.

Table 3 The profile of survey participants willing to migrate
Full size table

Participants willing to migrate show a moderate disorder related to mental health (PDI mean = 25), while those intending to stay show a mild disorder (PDI mean = 20). The same results are obtained on the well-being index. Participants with the intention to leave the country show a lower well-being index (mean = 47), while those without the intention to emigrate show a higher well-being index (mean = 57). Similarly, participants willing to migrate show a lower life satisfaction index than those willing to stay.

Our results show that a life satisfaction mean score of 6.8, the same as Belgium's happiness index for 2021. This score is above the World Happiness Report score of 5.1 in 2021 for Albania and 5.285 in Tirana. The country scores are based on a survey in which respondents evaluate the quality of their current lives on a scale of 0 to 10 on the environment – social, urban, and natural, and include links between happiness and sustainable development. The difference in the score obtained in the present study with the United Nation Report is possibly linked to the characteristics of the respondents participating in our study.

We included migration willingness as a moderator in the relationship between green space exposure and three dependent variables: BMI, body fat percentage index, psychological distress index for mental health and well-being index. The assumption is that a respondent who expresses a willingness to migrate will moderate the effect of green exposure on health outcomes and life satisfaction as they are less attached to the place, in this case the city of Tirana. A correlation between all the variables included in the parallel mediation model is performed to detect the possible pathways and their significance.

There is a significant correlation between life satisfaction, green space exposure, migration willingness, BMI, body fat percentage index and psychological distress index. Higher life satisfaction is associated with low BMI and body fat percentage index. Similarly, a high life satisfaction index is linked with a better psychological disorder index and a high well-being index (Table 4). Migration willingness is not correlated with green space exposure, while life satisfaction is linked negatively. The parallel mediation model shows a significant effect of green space exposure in all the health outcomes except BMI.

Table 4 Pearson correlation coefficients between the variables
Full size table

Also, all the considered health outcomes directly impact life satisfaction (Fig. 4). In our study, the poor scores on the quality and the low exposure to the urban green space are negatively associated with life satisfaction (Fig. 6).

Fig. 5
figure 5

The Grand Park of Tirana view (c) Holistic Backpacker Blog

Full size image

Regarding the indirect effect of green space exposure on life satisfaction, the parallel mediation model shows that body fat percentage index has a significant effect, and the ratio of the indirect effect to the total effect is the lowest among the considered mediators (0.6%). BMI does not moderate the effect of green space exposure on life satisfaction. At the same time, the mental health indicators show a significant indirect effect on life satisfaction. The indirect effect of green space exposure through psychological distress is -0.042, making up 24% of the total effect on the green space exposure-life satisfaction relationship. The negative sign of the coefficients shows that with a one-unit increase in green space exposure, the psychological distress index will drop to 0.042. The well-being index has the highest indirect effect in the total effect on relationship between the green space exposure and life satisfaction, 55% (Table 5).

Table 5 Standardized indirect effects and the ratio of indirect to total effects for the paths on the PMM of green space in life satisfaction
Full size table

Discussion

Around 1.4 million Albanians have emigrated since the fall of the communist system at the end of 1990, largely to neighboring countries such as Italy and Greece, leading to both economic decline and population loss (Azzarri & Carletto, 2009; Carletto et al., 2006; Gedeshi, 2002; Mancellari et al., 1996; Papapanagos & Sanfey, 2001; Matoshi & Mulaj, 2021). A more recent forecast places the population of Albania at 2,745,996 by 2031 (INSTAT, 2019). Compared to Population Projections 2011–2031, the annual forecasts have revealed a bigger decline, reducing projections (INSTAT, 2019). Albania's net migration rate in 2022 was -4.888 per 1000 people, up 0.18% from 2021 (Habitat, 2023).

Fig. 6
figure 6

Source: Authors’ elaboration

The parallel mediation model linking green space exposure with life satisfaction. *Correlation is significant at the 0.05 level (2-tailed). **Correlation is significant at the 0.01 level (2-tailed).

Full size image

Regardless of an overall good life satisfaction index, approximately half of our participants are planning to leave the country. The Gallup World Poll survey for 2015–2017 estimated a desired emigration rate of 60% for Albania, making it 4th in the World behind only Sierra Leone, Liberia, and Haiti (Beine et al., 2021). Also, according to INSTAT (2020), the Albanians living abroad number 1.68 million, equivalent to 59% of the current resident population in the country.

The values of the estimated mediation model show that exposure to green spaces is associated with lower life satisfaction of the respondents. Our findings indicate a strong correlation between green space exposure and life satisfaction among respondents. However, they also highlight that this relationship is negatively impacted by the quality of urban green spaces. Other studies show similar results that quality of neighborhood green spaces contribute to life satisfaction (Ta et al., 2021; Kley & Dovbishchuk, 2021). Therefore, improving the quality of such spaces can enhance the positive effects of green space exposure on individuals' life satisfaction.

Our results also show that out of four considered mediators, three have a significant effect: body fat percentage index, psychological distress index and well-being (Velten et al., 2014; Lachowycz & Jones, 2011) (Fig. 4). The analysis of each pathway shows that green space exposure negatively affects body fat percentage index, similar to the result shown with the life satisfaction index, the parameter (pathway a2 = .364, p-value = 0.01). The results show that the body fat percentage index increased by 0.364 units for one unit of exposure to green space. Nevertheless, we observe a slight positive relationship when considering this effect on life satisfaction (pathway b2 = -0.032). A one-unit decrease in the body fat percentage index will increase the life satisfaction index by 0.032. Indicating the relevance of this indicator. The same results are obtained with the other two mediators. The green space exposure negatively affects psychological distress (pathway a3 = .438, p value = 0.01) and well-being index (pathway a4 = -2.251). The analysis of the pathways a2, a3, and a4 show that green space shows the highest effect on well-being index compared to body fat percentage index and well-being index. These findings also show the possible pathways to explore in the future regarding the best indicator of the urban green space effect. In our study, the highest effect, even though negative, is on the well-being index of the respondent.

Interesting results are observed in the b pathways that measure the direct effect of the mediators in life satisfaction. The lower the body fat percentage index, the better life satisfaction. Also, the lower the psychological distress, the better the life satisfaction (Zayed et al., 2018). Similarly, the higher the well-being index, the higher the life satisfaction index (Caciula et al., 2019). Even in the b pathway, the well-being index is the best predictor of life satisfaction. The application of the mediation analysis shows that the well-being index is the best mediator between green spaces and life satisfaction in the case of Albania within this sample. In conclusion, the body fat percentage index shows a significant effect from physical health mediator indicators. In contrast, the mental health indicators show a significant effect, with the well-being index exhibiting a larger effect.

The moderating effect of migration willingness is shown only in the relationship between psychological distress and life satisfaction. Amongst the individuals without the willingness to migrate, we observe that at -1 standard deviation of psychological Distress, which corresponds to better mental health outcomes (mean = 14.7), life satisfaction is the highest (mean = 7.3). In contrast, at the mean of psychological distress Index = 22.95, individuals willing to migrate have lower Life satisfaction (mean = 6.6) than those no wiling (Life satisfaction Mean = 7.1). As expected, at the highest mental health disorder level (mean = 31.14), individuals willing to migrate have a lower life satisfaction than those who do not (the index of moderating effect = -.072, se = .015; value = -4.705, p value = .000).

Also, the partial moderation of the association between green space exposure and psychological distress shows that green space exposure has a higher effect on the participants not willing to leave Albania. The result also shows that the urban green spaces affect the participants that have self-reported good mental health. Green spaces are a value-added in the mental health situation of those with stable mental health, and migration willingness reduces this effect. Individuals willing to migrate are those being stressed who are less impacted by green exposure.

One of the limitations of our study is the potential influence of the gender disparity of participants on the study's outcomes, emphasizing the need for caution in extending the results to a broader population. Nevertheless, a notable advantage of the research lies in the substantial number of participants, ensuring a representative sample that reflects the broader community. Furthermore, it is important to note that the survey itself was uniquely tailored for the purposes of this study.

From the methodological standpoint, another limitation of this study is our focus on a single park in Tirana, so that extrapolation of our findings to the entire population requires caution. We focused on a single park in Tirana due to its centrality and significance within the urban context. We are aware that Tirana, as the capital, may differ from other regions in terms of population density, lifestyle, and access to green spaces.

Residents of large cities such as Tirana may navigate distinct challenges and opportunities compared to those residing in smaller urban settlements or rural areas. In urban settings, the desire to emigrate could be influenced by factors such as employment opportunities, lifestyle, and social amenities, which may not necessarily correlate directly with exposure to existing green spaces. Conversely, individuals in smaller urban settlements or rural areas might have a unique relationship with their surroundings, where the desire to emigrate could be tied to economic prospects or a perceived lack of amenities rather than green space exposure. Moreover, the correlation between life satisfaction and green space exposure may vary across these settings due to differing perceptions of well-being, community engagement, and environmental preferences.

Conclusions and Recommendations

In conclusion, our study has highlighted intriguing dynamics in the relationship between green spaces, mediators, and life satisfaction. Notably, three of the four considered mediators—namely, the body fat percentage index, psychological distress index, and well-being index—were identified as moderators in the connection between green spaces and life satisfaction. Of these, the well-being index emerged as the most influential, suggesting a robust impact on individuals' overall life satisfaction.

Moreover, a significant revelation emerged regarding the moderating role of migration willingness in the relationship between psychological distress and life satisfaction. Our findings indicate that green spaces exhibit a positive influence on the mental well-being of individuals with stable mental health, while migration willingness attenuates this positive effect. This underscores the complex interplay between environmental factors and personal aspirations, emphasizing the need for a nuanced understanding of the multifaceted impact of green spaces on mental health and life satisfaction.

The overall outcomes affirm a strong correlation between green space exposure and life satisfaction among respondents. However, a noteworthy nuance comes to light—the quality of urban green spaces significantly influences this relationship. Our study underscores the crucial role of urban green space quality as a determinant factor in the overall impact on life satisfaction. Consequently, our findings suggest that enhancing the quality of such spaces could serve as a pivotal solution to amplify the positive effects of green space exposure on individuals' health and, subsequently, life satisfaction. This insight holds potential implications for urban planning and underscores the importance of investing in the quality, accessibility, and design of green spaces to optimize their positive impact on the well-being of individuals within urban environments.