An ecological study investigating the association between access to urban green space and mental health
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...2013, New Zealand [23] Ecological >15 y 319521 Health ministry database Anxiety/mood disorder treatment counts Distance to total and useable GS Increasing distance to usable GS ↑ risk of treatment...
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...Author (Year, Country) Study Design Age of the Study Population (Stratifications/Interactions) N Tools to Measure Mental Health Mental Health Item Greenness Data Source Surrounding Greenness Indicator Risk of Mental Health Problems Adults (or population irrespective of age) Triguero-Mas et al. 2015, Spain [14] Cross- sectional 34–64 y (physical activity, gender, degree of urbanization, socioeconomic status and social support) 8793 GHQ-12 SF-36 Perceived mental health NDVI 100 m, 300 m, 500 m and 1 km buffers Increasing greenness ↓ risk of poor mental health (for both tests and all buffers assessed) Van den Berg et al. 2010, The Netherlands [39] Cross- sectional >18 y (stressful life events) 4529 GHQ-12 Perceived mental health Land-cover map % GS in 1 km & 3 km buffers - Weich et al. 2002, The UK [40] Cross- sectional Adults >16 y 1896 CES-D20 Depression BESSC (audit) Number of trees and amount of houses with private garden in the housing area - White et al. 2013, The UK [20] Longitudinal Adults 12818 GHQ-12 Mental health and well-being Land-cover map % GS at CAU Increasing greenness ↓ risk of poor mental health ADHD/DMS-IV: ADHD symptom Criteria of Diagnostic and Statistical Manual of Mental Disorder, 4th Edition; CAU level: Census area unit level; CES-D20: Centre for Epidemiologic Studies Depression scale (20 items); CIS-R: Revised Clinical Interview Schedule; DASS: Depression Anxiety and Stress Scales; GHQ-(12/30): General Health Questionnaire-(number of items included); GS: green space; ICD-10: International Classification of Disease; K(6/10): Kessler Psychological Distress Scale (number of items included); NDVI: Normalized Difference Vegetation Index; PSS: Perceived Stress Scale; SDQ: Strengths and Difficulties Questionnaire; SF-36: Short form health survey (36 items), WEMWBS: Warwick-Edinburgh Mental Well-being Scale; a SDQ measures hyperactivity, emotional symptoms, conduct problems, peer problems, prosocial behaviour and ADHD/DMS-IV measures inattention and hyperactivity-impulsivity symptoms; b A factor was created to define surrounding greenness....
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...Eight cross-sectional studies [14,26–30,41,42] and one ecological study [23] evaluated the mental health benefits of access to green spaces....
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...Author (Year, Country) Study Design Age of the Study Population (Stratifications/Interactions) N Tools to Measure Mental Health Mental Health Item Greenness Data Source Surrounding Greenness Indicator Risk of Mental Health Problems Adults (or population irrespective of age) Francis et al. 2012, Australia [24] Cross- sectional Adults (20–79 y) 911 K6 Psychological distress Land-cover map Size and n° of public open space in a 1600 m buffer - Maas et al. 2009, The Netherlands [35] Cross- sectional 12 to >65 y 4842- 10089 GHQ-12 Propensity to psychiatric morbidity Land-cover map % GS in 1 km & 3 km buffers Increasing greenness in 1 km ↓ propensity to psychiatric morbidity Maas et al. 2009, The Netherlands [25] Cross- sectional All ages (age, socioeconomic status, urbanity degree) 345143 Primary care medical records Mental health morbidity (depression and anxiety) Land-cover map % GS in 1 km & 3 km buffers Increasing greenness in 1 km ↓ depression & anxiety In 3 km ↓ anxiety (stronger associations with depression in children for both buffers) Nutsford et al. 2013, New Zealand [23] Ecological >15 y 319521 Health ministry database Anxiety/mood disorder treatment counts Land-cover map % of total and useable GS of >500 m2 (300 m & 3 km buffers) Increasing total and usable GS in 3 km ↓ risk of treatment Richardson et al. 2013, New Zealand [36] Cross- sectional >15 y (physical activity) 8157 SF-36 Mental health Land-cover map % GS of ≥0.02 ha at CAU Increasing greenness ↓ poor mental health Roe et al. 2013, The UK [37] Cross- sectional 33–55 y of socio-economically deprived areas ~100 PSS WEMWBS (short version) Stress Well-being Land-cover map % GS at CAU Increasing greenness ↓ stressc Sarkar et al. 2013, The UK [38] Cross- sectional 65–84 y 687 GHQ-30 Psychological distress NDVI 500 m buffer - Table 1....
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...Additionally, quite a few studies were at risk of obtaining significant results due to multiple testing, although some of them did not even obtain significant associations after multiple analyses [17,20,21,23,24,26,27,30,34,37,40]....
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"An ecological study investigating t..." refers background in this paper
...Three primary theoretical pathways have been identified through which green space may influence mental health.(13,15) First, recreational physical activity, common in green space, promotes positive moods and reduces stress levels....
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...aesthetic place for social and recreational opportunities, which encourages physical activity, enhances social ties and promotes mental and physical recuperation.(13,15) The majority of green space studies evaluate its influence on physical health or general health as the health outcome....
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...A review of health associations with urban green space concluded that many claims are supported by weak evidence and studies were limited by poor design and failure to exclude confounding factors and bias.(1) Much less established is the investigation of the effects of access to and visualization of green space on mental health....
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...General consensus in existing literature finds green space to be negatively associated with poor mental health,(5,11) however it is met with some contention and the causal pathways remain relatively unexplored.(1,2) Mental health is important as it is often a precursor for other chronic conditions and physical health outcomes....
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