
In response to the growing need for ecosystem services, many cities have adopted nature-based solutions such as tree planting and green corridors to increase biodiversity and improve climate change resilience. However, these efforts may inadvertently increase tick-borne disease risk by attracting wildlife tick hosts. Our study focuses on the city of Glasgow in Scotland and examines both ecological and socioeconomic drivers of deer abundance, tick density, Lyme disease hazard and Lyme disease incidence across the city and its surrounding rural areas. We found that less deprived areas exhibit higher rates of Lyme disease incidence and tend to have greater woodland cover, suggesting that people in these areas may live closer to habitats favourable for both tick and pathogen hosts. To explore ecological processes further, we surveyed 32 greenspaces and woodlands along an urban-rural and deprivation gradient. Using structural equation modelling, we found that tick density and Lyme disease hazard are significantly influenced by woodland cover, built-up cover and deprivation index within a 1000 m radius of surveyed sites. These findings underscore a key challenge for urban planning: while rewilding and greenspace expansion support biodiversity and climate resilience, they may also elevate tick-borne disease risks. Additionally, the influence of socioeconomic factors on Lyme disease incidence calls for deeper research into how behaviour, exposure and access to healthcare may shape risk. Future urban design must carefully balance ecological benefits with public health considerations to minimize unintended consequences of rewilding efforts.