Abstract
Although previous studies have shown that exposure to nature has a positive impact on physical and mental health, the factors that produce such benefits are still not well established, especially in high- and middle-income countries. In the present study, we implemented a mediation approach between green space exposure and psychological distress, body fat percentage and well-being index in Tirana (Albania), through the mediation of physical activity. The significant direct effects of green space on body fat percentage index (BFPI), psychological distress index (PDI) and well-being index, together with the relatively smaller mediating role of physical activity, offer insightful implications for the design and prioritization of urban green spaces. The differential impact on health outcomes suggests a complex association that is not only mediated by physical activity, but also offers clear benefits by reducing psychological distress (as indicated by PDI scores) and significantly improving overall well-being. This dichotomy highlights the multifaceted role of green spaces in public health, requiring a broad lens that goes beyond physical health metrics to include mental health and subjective well-being. Our findings also confirm the intrinsic value of green spaces in improving well-being and reducing psychological distress, independent of the physical activities they may promote.