article published yes Dengkai Chi author Gabriele Manoli author Jun Yang author Daniel Richards author Amy Hahs author Brenda Lin author Mark J. McDonnell author Ye Zhang author Yue Zhu author Yeshan Qiu author Jing Wang author Xing Zheng author Paolo Burlando author Simone Fatichi author cf8e546b-a9b0-11f0-a43b-aa89ed1b56d6 Puay Yok Tan author Background: The spatial distribution of tree canopies influences ecological functions and residents’ exposure to green spaces. Although several studies have examined green space configuration at neighborhood scales, evidence on tree canopy configuration at the municipal scale, an operational unit for urban planning, remains limited. Methods: We conducted a nationwide ecological study of 2,136 Swiss municipalities. Tree canopy coverage (PLAND), aggregation (AI, reflecting how tightly green patches are grouped together), patch density (PD, a measure of fragmentation), and area-weighted mean shape index (SHAPE_AM, a measure of shape complexity) were derived from 1-m canopy maps within municipality-specific populated areas. Natural-cause, cardiovascular, and cancer mortality (2017–2019) were obtained from the Swiss National Cohort. Fully adjusted negative binomial regression models estimated associations between canopy metric and mortality for each IQR increase in the metrics. Results: Holding configuration constant, each IQR increase in canopy coverage (∼18%) was associated with a 3.6% [B: −0.036; 95% CI: −0.078 – 0.005] reduction in cardiovascular mortality. Higher aggregation corresponded to a 4.3% [B: 0.043; 95% CI: 0.026–0.061], an 8.9% [B: 0.089; 95% CI: 0.059–0.119], and a 2.1% [B: 0.021; 95% CI: 0–0.042] higher number of natural-cause, cardiovascular, and cancer deaths respectively. Higher fragmentation was associated with a 3.3% [B: 0.033; 95% CI: 0.016–0.050], a 4.9% [B: 0.049; 95% CI: 0.020–0.078], and a 2.2% [B: 0.022; 95% CI: 0.001–0.043] increase in these causes respectively. No meaningful associations were observed between shape complexity and any mortality outcomes. Associations for aggregation and fragmentation were generally stronger in highly urbanized municipalities. Conclusions: At the municipal scale, mortality was lower where tree canopy was distributed across several moderately sized, spatially balanced patches rather than highly aggregated or highly fragmented structures. These findings suggest that urban greening strategies should optimize its spatial configuration to maximize health benefits. Elsevier2026 eng AggregationFragmentationGreen space exposureGreen space morphologyGreen space structureLandscape metricsShape complexity 0160-4120 1873-6750 4181234810.1016/j.envint.2026.110188 209 yes Chi, Dengkai, et al. “Tree Canopy Configuration and Swiss Adult Mortality at the Municipal Level: A Nationwide Ecological Study.” <i>Environment International</i>, vol. 209, 110188, Elsevier, 2026, doi:<a href="https://doi.org/10.1016/j.envint.2026.110188">10.1016/j.envint.2026.110188</a>. D. Chi <i>et al.</i>, “Tree canopy configuration and Swiss adult mortality at the municipal level: A nationwide ecological study,” <i>Environment International</i>, vol. 209. Elsevier, 2026. Chi, Dengkai, Gabriele Manoli, Jun Yang, Daniel Richards, Amy Hahs, Brenda Lin, Mark J. McDonnell, et al. “Tree Canopy Configuration and Swiss Adult Mortality at the Municipal Level: A Nationwide Ecological Study.” <i>Environment International</i>. Elsevier, 2026. <a href="https://doi.org/10.1016/j.envint.2026.110188">https://doi.org/10.1016/j.envint.2026.110188</a>. Chi, D., Manoli, G., Yang, J., Richards, D., Hahs, A., Lin, B., … Tan, P. Y. (2026). Tree canopy configuration and Swiss adult mortality at the municipal level: A nationwide ecological study. <i>Environment International</i>. Elsevier. <a href="https://doi.org/10.1016/j.envint.2026.110188">https://doi.org/10.1016/j.envint.2026.110188</a> D. Chi, G. Manoli, J. Yang, D. Richards, A. Hahs, B. Lin, M.J. McDonnell, Y. Zhang, Y. Zhu, Y. Qiu, J. Wang, X. Zheng, P. Burlando, S. Fatichi, P.Y. Tan, Environment International 209 (2026). Chi D, Manoli G, Yang J, Richards D, Hahs A, Lin B, McDonnell MJ, Zhang Y, Zhu Y, Qiu Y, Wang J, Zheng X, Burlando P, Fatichi S, Tan PY. 2026. Tree canopy configuration and Swiss adult mortality at the municipal level: A nationwide ecological study. Environment International. 209, 110188. Chi D, Manoli G, Yang J, et al. Tree canopy configuration and Swiss adult mortality at the municipal level: A nationwide ecological study. <i>Environment International</i>. 2026;209. doi:<a href="https://doi.org/10.1016/j.envint.2026.110188">10.1016/j.envint.2026.110188</a> 224802026-07-27T12:30:23Z2026-08-03T14:17:29Z