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Polemiti E, Hese S, Schepanski K, Yuan J, Schumann G. How does the macroenvironment influence brain and behaviour-a review of current status and future perspectives. Mol Psychiatry 2024:10.1038/s41380-024-02557-x. [PMID: 38658771 DOI: 10.1038/s41380-024-02557-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
The environment influences brain and mental health, both detrimentally and beneficially. Existing research has emphasised the individual psychosocial 'microenvironment'. Less attention has been paid to 'macroenvironmental' challenges, including climate change, pollution, urbanicity, and socioeconomic disparity. Notably, the implications of climate and pollution on brain and mental health have only recently gained prominence. With the advent of large-scale big-data cohorts and an increasingly dense mapping of macroenvironmental parameters, we are now in a position to characterise the relation between macroenvironment, brain, and behaviour across different geographic and cultural locations globally. This review synthesises findings from recent epidemiological and neuroimaging studies, aiming to provide a comprehensive overview of the existing evidence between the macroenvironment and the structure and functions of the brain, with a particular emphasis on its implications for mental illness. We discuss putative underlying mechanisms and address the most common exposures of the macroenvironment. Finally, we identify critical areas for future research to enhance our understanding of the aetiology of mental illness and to inform effective interventions for healthier environments and mental health promotion.
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Affiliation(s)
- Elli Polemiti
- Centre of Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Clinical Neuroscience CCM, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Sören Hese
- Institute of Geography, Friedrich Schiller University Jena, Jena, Germany
| | | | - Jiacan Yuan
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology & IRDR-ICOE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Gunter Schumann
- Centre of Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Clinical Neuroscience CCM, Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Centre for Population Neuroscience and Stratified Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China.
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Zhang Y, Wu T, Yu H, Fu J, Xu J, Liu L, Tang C, Li Z. Green spaces exposure and the risk of common psychiatric disorders: A meta-analysis. SSM Popul Health 2024; 25:101630. [PMID: 38405164 PMCID: PMC10885792 DOI: 10.1016/j.ssmph.2024.101630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024] Open
Abstract
Objective To explore the effects of green spaces exposure on common psychiatric disorders. Methods PubMed, Embase, Web of Science and MEDLINE were screened and articles published prior to November 15, 2023 were included. Analyses were performed on common psychiatric disorders, categorized into depression, anxiety, dementia, schizophrenia, and attention deficit hyperactivity disorder (ADHD). And the subgroup analyses were conducted for depression, anxiety, dementia, and schizophrenia. Results In total, 2,0064 studies were retrieved, 59 of which were included in our study; 37 for depression, 14 for anxiety, 8 for dementia, 7 for schizophrenia and 5 for ADHD. Green spaces were found to benefit the moderation of psychiatric disorders (OR = 0.91, 95% CI: 0.89 to 0.92). Green spaces positively influence depression (OR = 0.89, 95% CI: 0.86 to 0.93), regardless of the cross-sectional or cohort studies. Green spaces can also help mitigate the risk of anxiety (OR = 0.94, 95%CI:0.92 to 0.96). As an important index for measuring green spaces, a higher normalized difference vegetation index (NDVI) level related to a lower level of depression (OR = 0.95, 95%CI:0.91 to 0.98) and anxiety (OR = 0.95, 95%:0.92 to 0.98). The protection was also found in dementia (OR = 0.95, 95% CI: 0.93 to 0.96), schizophrenia (OR = 0.74, 95% CI: 0.67 to 0.82), and ADHD (OR = 0.89, 95% CI: 0.86 to 0.92) results. Conclusion Green spaces decrease the risk of psychiatric disorders, including depression, anxiety, dementia, schizophrenia, and ADHD. Further studies on green spaces and psychiatric disorders are needed, and more green spaces should be considered in city planning.
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Affiliation(s)
- Yimin Zhang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Tongyan Wu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Hao Yu
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Urology, The Second Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Jianfei Fu
- Department of Medical Records and Statistics, Ningbo First Hospital, Ningbo, China
| | - Jin Xu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Liya Liu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Chunlan Tang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Zhen Li
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
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Spano G, Nobile F, Giannico V, Elia M, Michelozzi P, Bosco A, Dadvand P, Sanesi G, Stafoggia M. Two- and three-dimensional indicators of green and grey space exposure and psychiatric conditions and medicine use: A longitudinal study in a large population-based Italian cohort. ENVIRONMENT INTERNATIONAL 2023; 182:108320. [PMID: 37976839 DOI: 10.1016/j.envint.2023.108320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Evidence available on the associations between urban greenness and mental health is mainly based on cross-sectional studies and has relied on 2D indicators of greenness. This longitudinal study aimed at investigating the association between 2D and 3D indicators of green and grey spaces and incident mental health-related outcomes in a large population-based cohort. METHODS Our study used data from 593,894 Italian adults (≥30 years) from the Rome Longitudinal Study. Mental health outcomes were defined using either drug prescriptions (antidepressants, antipsychotics, lithium and other mood stabilisers, and anxiolytics, hypnotics and sedatives), or hospitalisation records (for schizophrenia spectrum disorder, depression, anxiety, stress-related and somatoform, or substance use disorders). We obtained 2D and 3D indicators of green and grey exposures including Normalized Difference Vegetation Index (NDVI), green volume, grey volume, number of trees, and Normalized Difference Green-Grey Volume Index around participants' homes. Cox proportional hazards regression models were developed to estimate the association of green and grey space exposure and psychiatric conditions and medicine use, adjusted for relevant covariates. RESULTS We found beneficial associations of NDVI and the number of trees with antipsychotic and lithium and other mood stabiliser drugs. We also observed detrimental associations between grey volume and lithium and other mood stabilisers and anxiolytic, hypnotic and sedative drugs. Finally, we found a protective association of the NDGG with lithium and other mood stabilisers (HR: 0.977; 95% CI: 0.965-0.990) and anxiolytic, hypnotic and sedative drugs (HR: 0.851; 95% CI: 0.762-0.950). The associations for hospitalisation for psychiatric conditions were less consistent and generally not statistically significant. CONCLUSIONS Findings suggested that higher greenness areas around residential addresses are associated with reduced use of drugs for psychiatric conditions, while the opposite is true for higher grey space exposure. The study highlights the importance of accurately characterising green and grey spaces, using novel exposure indicators.
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Affiliation(s)
- Giuseppina Spano
- Department of Education, Psychology, Communication Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Federica Nobile
- Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy
| | - Vincenzo Giannico
- Department of Education, Psychology, Communication Sciences, University of Bari Aldo Moro, Bari, Italy.
| | - Mario Elia
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy
| | - Andrea Bosco
- Department of Education, Psychology, Communication Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Payam Dadvand
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain
| | - Giovanni Sanesi
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy
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Polemiti E, Hese S, Schepanski K, Yuan J, Schumann G. How does the macroenvironment influence brain and behaviour - a review of current status and future perspectives. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.09.23296785. [PMID: 37873310 PMCID: PMC10593044 DOI: 10.1101/2023.10.09.23296785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
The environment influences mental health, both detrimentally and beneficially. Current research has emphasized the individual psychosocial 'microenvironment'. Less attention has been paid to 'macro-environmental' challenges including climate change, pollution, urbanicity and socioeconomic disparity. With the advent of large-scale big-data cohorts and an increasingly dense mapping of macroenvironmental parameters, we are now in a position to characterise the relation between macroenvironment, brain, and behaviour across different geographic and cultural locations globally. This review synthesises findings from recent epidemiological and neuroimaging studies, aiming to provide a comprehensive overview of the existing evidence between the macroenvironment and the structure and functions of the brain, with a particular emphasis on its implications for mental illness. We discuss putative underlying mechanisms and address the most common exposures of the macroenvironment. Finally, we identify critical areas for future research to enhance our understanding of the aetiology of mental illness and to inform effective interventions for healthier environments and mental health promotion.
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Affiliation(s)
- Elli Polemiti
- Centre of Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Clinical Neuroscience, Charité, Universitätsmedizin Berlin, Germany
| | - Soeren Hese
- Institute of Geography, Friedrich Schiller University Jena, Germany
| | | | - Jiacan Yuan
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology & IRDR-ICOE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Gunter Schumann
- Centre of Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Clinical Neuroscience, Charité, Universitätsmedizin Berlin, Germany
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
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Mayagoitia-Novales L, Cerda-Molina AL, Mendoza-Mojica SA, Borráz-León JI, Hernández-Melesio MA, Saldívar-Hernández GJ. Psychopathology, cortisol and testosterone responses to traumatic images: differences between urban and suburban citizens in a middle-income country. Front Psychol 2023; 14:1187248. [PMID: 37484079 PMCID: PMC10360937 DOI: 10.3389/fpsyg.2023.1187248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
Background Living in urban places has been associated with a higher risk of psychopathology as well as with altered hypothalamus-pituitary-adrenal (HPA) axis and consequently altered cortisol response, but studies have concentrated mainly in high-income countries population. The role of other hormones such as testosterone, implicated in stress response and with human social behaviors, have not yet been investigated. The aim of this study was to compare symptoms of psychopathology as well as cortisol and testosterone in response to traumatic images between urban and suburban people in a middle-income country. Methods A sample of 67 women and 55 men (N = 122, 18-45 years) from urban and suburban places of Mexico participated in the study. We quantified salivary cortisol and testosterone in response to images with traumatic and violent content (basal, 15, 30, and 45 min after images). Participants answered a general information questionnaire and the Symptom Checklist-90-R to assess their psychopathological traits. We performed Generalized Estimating Equation Models to analyze hormonal levels and MANOVAs to compare differences in participants' psychopathology symptoms. Area under the curve respect to ground (AUCG) of hormonal levels and sex differences were also compared. Results Suburban citizens showed no cortisol response, whereas urban people showed a cortisol peak 15 min after the image's exposure; however, suburban people had higher AUCG and basal levels compared to urban ones. Contrastingly, testosterone levels declined in all participants excepting the urban women, who showed no testosterone response. Although similar testosterone profile, AUCG levels were higher in urban than suburban men. Participants living in suburban areas had higher scores of somatizations, obsessive-compulsive, and interpersonal sensitivity, as well as more sleep disorders than participants living in urban areas. Conclusion This study offers novel evidence about differences in cortisol and testosterone responses to a social stressor and in mental health indicators between a population of urban and suburban citizens, highlighting the impact of urbanization process on physiological and psychological outcomes in a middle-income country.
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Affiliation(s)
- Lilian Mayagoitia-Novales
- Departamento de Etología, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de Mexico, Mexico
| | - Ana Lilia Cerda-Molina
- Departamento de Etología, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de Mexico, Mexico
| | | | - Javier I. Borráz-León
- Departamento de Etología, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de Mexico, Mexico
- Institute for Mind and Biology, The University of Chicago, Chicago, IL, United States
| | - M. Alejandra Hernández-Melesio
- Departamento de Etología, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de Mexico, Mexico
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Winnicki MH, Dunn RR, Winther-Jensen M, Jess T, Allin KH, Bruun HH. Does childhood exposure to biodiverse greenspace reduce the risk of developing asthma? THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 850:157853. [PMID: 35940273 DOI: 10.1016/j.scitotenv.2022.157853] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/13/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
The prevalence of inflammatory diseases is increasing in populations throughout the industrialized world. An increasing proportion of human populations grow up and live in urban areas, probably with reduced exposure to biodiversity, including diverse soil biotas. Decreased exposure to microorganisms from natural environments, in particular in early childhood, has been hypothesized to hamper development of the human immune system and lead to increasing risks of inflammatory diseases, such as asthma. We investigated 40,249 Danish individuals born 1995-2015. Percentage greenspace was assessed in a 2 km buffer around home addresses of individuals. The Danish Biodiversity Map, charting occurrence density of red-listed animals, plants and macrofungi, was used as a proxy for multi-taxon biodiversity. For asthma defined broadly, we found no evidence of decreasing risk of developing asthma with higher levels of biodiversity, while greenspace exposure was associated with higher risk of asthma. In contrast, exposure to total and biodiverse greenspace was associated with reduced risk of developing severe asthma. Exposure to farmland, which in Denmark is heavily industrialized cropland, also showed association with elevated risk of developing asthma, even at relatively low agricultural landcover. In the subset of children growing up in highly urbanized settings, we found high exposures to urban greenspace to be associated with reduced risk of developing asthma. Our results lend limited support to the hypothesis that childhood exposure to biodiverse environments reduces the risk of acquiring inflammatory diseases later in life. However, access to urban greenspace, such as parks, which typically harbour low levels of biodiversity, seems to reduce asthma risk, potentially through exposure to common soil microbiota. Our results suggest that effects of biodiversity exposure on human health is set by a balance between ecosystem services and disservices and that biodiversity conservation is best motivated with other arguments than reduction of risks from inflammatory diseases.
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Affiliation(s)
- Martin Holm Winnicki
- Department of Biology, University of Copenhagen, Universitetsparken 15, 2100 Copenhagen, Denmark; Section for Data, Biostatistics and Pharmacoepidemiology, Center for Clinical Research and Prevention, Bispebjerg Frederiksberg Hospital, Copenhagen, Denmark
| | - Robert R Dunn
- Department of Applied Ecology, North Carolina State University, Raleigh, NC, USA
| | - Matilde Winther-Jensen
- Section for Data, Biostatistics and Pharmacoepidemiology, Center for Clinical Research and Prevention, Bispebjerg Frederiksberg Hospital, Copenhagen, Denmark
| | - Tine Jess
- Center for Molecular Prediction of Inflammatory Bowel Disease, Department of Clinical Medicine, Aalborg University, A.C. Meyers Vænge 15A, 2450 Copenhagen, Denmark; Department of Gastroenterology & Hepatology, Aalborg University Hospital, 9100 Aalborg, Denmark
| | - Kristine Højgaard Allin
- Center for Molecular Prediction of Inflammatory Bowel Disease, Department of Clinical Medicine, Aalborg University, A.C. Meyers Vænge 15A, 2450 Copenhagen, Denmark; Department of Gastroenterology & Hepatology, Aalborg University Hospital, 9100 Aalborg, Denmark
| | - Hans Henrik Bruun
- Department of Biology, University of Copenhagen, Universitetsparken 15, 2100 Copenhagen, Denmark.
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Milne BJ, D'Souza S, Andersen SH, Richmond-Rakerd LS. Use of Population-Level Administrative Data in Developmental Science. ANNUAL REVIEW OF DEVELOPMENTAL PSYCHOLOGY 2022; 4:447-468. [PMID: 37284522 PMCID: PMC10241456 DOI: 10.1146/annurev-devpsych-120920-023709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Population-level administrative data-data on individuals' interactions with administrative systems (e.g., health, criminal justice, and education)-have substantially advanced our understanding of life-course development. In this review, we focus on five areas where research using these data has made significant contributions to developmental science: (a) understanding small or difficult-to-study populations, (b) evaluating intergenerational and family influences, (c) enabling estimation of causal effects through natural experiments and regional comparisons, (d) identifying individuals at risk for negative developmental outcomes, and (e) assessing neighborhood and environmental influences. Further advances will be made by linking prospective surveys to administrative data to expand the range of developmental questions that can be tested; supporting efforts to establish new linked administrative data resources, including in developing countries; and conducting cross-national comparisons to test findings' generalizability. New administrative data initiatives should involve consultation with population subgroups including vulnerable groups, efforts to obtain social license, and strong ethical oversight and governance arrangements.
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Affiliation(s)
- Barry J Milne
- School of Social Sciences and Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
| | - Stephanie D'Souza
- School of Social Sciences and Centre of Methods and Policy Application in the Social Sciences (COMPASS), University of Auckland, Auckland, New Zealand
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Buckley RC, Cooper MA. Tourism as a Tool in Nature-Based Mental Health: Progress and Prospects Post-Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013112. [PMID: 36293691 PMCID: PMC9602562 DOI: 10.3390/ijerph192013112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 05/26/2023]
Abstract
The healthcare sector recognises the role of nature in mental health. The tourism sector is equipped to take people to national parks. The conservation sector gains support from visitors. Theoretical frameworks for mental health benefits from nature tourism include: tourism destinations and activities; tourist personalities and life histories; sensory and emotional components of tourist experiences; and intensity and duration of memories. Mental health deteriorated worldwide during the COVID-19 pandemic. Recovery of global economic productivity requires immediate, accessible, affordable mental health measures at national scales, and nature-based approaches provide the best option. Different countries have adopted a variety of public, private, or voluntary mechanisms. Some focus on design of activities, others on provision of facilities. Costs and implementation depend on key research questions: marginal benefits of nature tour guides or psychologists compared to self-guided nature experiences; comparisons between repeated brief visits and one-off nature holidays; effects of biodiversity, flagship species, and scenic or wilderness quality; and differences between individuals, depending on personalities, life histories, and mental health status and symptoms.
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Affiliation(s)
- Ralf C. Buckley
- School of Environment & Sciences, Griffith University, Southport, QLD 4215, Australia
| | - Mary-Ann Cooper
- Instituto Profesional de la Fundacion Duoc UC de la Pontificia, Universidad Católica, Viña del Mar 2336, Chile
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Sprague NL, Bancalari P, Karim W, Siddiq S. Growing up green: a systematic review of the influence of greenspace on youth development and health outcomes. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:660-681. [PMID: 35614136 PMCID: PMC9482936 DOI: 10.1038/s41370-022-00445-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 05/05/2023]
Abstract
Youth growing up in places with more greenspaces have better developmental outcomes. The literature on greenspace and youth development is largely cross-sectional, thus limited in terms of measuring development and establishing causal inference. We conducted a systematic review of prospective, longitudinal studies measuring the association between greenspace exposure and youth development outcomes measured between ages two and eighteen. We searched Cochrane, PubMed, CINAHL, Scopus, and Environment Complete, and included prospective cohort, quasi-experimental, and experimental studies on greenspace and youth development. Study quality was assessed using a 10-item checklist adapted from a previously published review on greenspace and health. Twenty-eight studies met criteria for review and were grouped into five thematic categories based on reported outcomes: cognitive and brain development, mental health and wellbeing, attention and behavior, allergy and respiratory, and obesity and weight. Seventy-nine percent of studies suggest an association between greenspace and improved youth development. Most studies were concentrated in wealthy, Western European countries, limiting generalizability of findings. Key opportunities for future research include: (1) improved uniformity of standards in measuring greenspace, (2) improved measures to account for large latency periods between greenspace exposure and developmental outcomes, and (3) more diverse study settings and populations.
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Affiliation(s)
- Nadav L Sprague
- Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Pilar Bancalari
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Wasie Karim
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Shabnaz Siddiq
- Columbia University Mailman School of Public Health, New York, NY, USA
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Aerts R, Vanlessen N, Dujardin S, Nemery B, Van Nieuwenhuyse A, Bauwelinck M, Casas L, Demoury C, Plusquin M, Nawrot TS. Residential green space and mental health-related prescription medication sales: An ecological study in Belgium. ENVIRONMENTAL RESEARCH 2022; 211:113056. [PMID: 35248565 DOI: 10.1016/j.envres.2022.113056] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/18/2022] [Accepted: 02/27/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Residential green space has been associated with mental health benefits, but how such associations vary with green space types is insufficiently known. OBJECTIVE We aimed to investigate associations between types and quantities of green space and sales of mood disorder medication in Belgium. METHODS We used aggregated sales data of psycholeptics and psychoanaleptics prescribed to adults from 2006 to 2014. Generalized mixed effects models were used to investigate associations between relative covers of woodland, low-green, grassland, and garden, and average annual medication sales. Models were adjusted for socio-economic background variables, urban-rural differences, and administrative region, and included random effects of latitude and longitude. RESULTS Urban census tracts were associated with 9-10% higher medication sales. In nationwide models, a 10% increase in relative cover of woodland, garden, and grass was associated with a 1-2% decrease in medication sales. The same association was found for low green but only for men. In stratified models, a 10% increase in relative cover of any green space type in urban census tracts was associated with a decrease of medication sales by 1-3%. In rural census tracts, no protective associations between green space and mood disorder medication sales were observed, with the exception of relative woodland cover for women (-1%), and low green was associated with higher medication sales (+6-7%). CONCLUSIONS Taken together, these results suggest that living in green environments may be beneficial for adult mental health. Woodland exposure seemed the most beneficial, but the amount of green space was more important than the type. Results underline the importance of conserving green space in our living environment, for the conservation of biodiversity and for human health.
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Affiliation(s)
- Raf Aerts
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium; Division Ecology, Evolution and Biodiversity Conservation, University of Leuven (KU Leuven), Kasteelpark Arenberg 31-2435, BE-3001, Leuven, Belgium; Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Diepenbeek, Hasselt, Belgium.
| | - Naomi Vanlessen
- Division Ecology, Evolution and Biodiversity Conservation, University of Leuven (KU Leuven), Kasteelpark Arenberg 31-2435, BE-3001, Leuven, Belgium.
| | - Sebastien Dujardin
- Department of Geography, Institute of Life Earth and Environment (ILEE), University of Namur, Namur, Belgium.
| | - Benoit Nemery
- Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000, Leuven, Belgium.
| | - An Van Nieuwenhuyse
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium; Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000, Leuven, Belgium.
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 5, BE-1050, Brussels, Belgium.
| | - Lidia Casas
- Epidemiology and Social Medicine, University of Antwerp, Universiteitsplein 1-R.232, BE-2610, Wilrijk, Antwerp, Belgium.
| | - Claire Demoury
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium.
| | - Michelle Plusquin
- Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Diepenbeek, Hasselt, Belgium.
| | - Tim S Nawrot
- Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Diepenbeek, Hasselt, Belgium; Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000, Leuven, Belgium.
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Bereziartua A, Chen J, de Hoogh K, Rodopoulou S, Andersen ZJ, Bellander T, Brandt J, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Arthur Hvidtfeldt U, Verschuren WMM, Jöckel KH, Jørgensen JT, Katsouyanni K, Ketzel M, Hjertager Krog N, Brynedal B, Leander K, Liu S, Ljungman P, Faure E, Magnusson PKE, Nagel G, Pershagen G, Peters A, Raaschou-Nielsen O, Renzi M, Rizzuto D, Samoli E, van der Schouw YT, Schramm S, Severi G, Stafoggia M, Strak M, Sørensen M, Tjønneland A, Weinmayr G, Wolf K, Zitt E, Brunekreef B, Hoek G. Exposure to surrounding greenness and natural-cause and cause-specific mortality in the ELAPSE pooled cohort. ENVIRONMENT INTERNATIONAL 2022; 166:107341. [PMID: 35717714 DOI: 10.1016/j.envint.2022.107341] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/28/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The majority of studies have shown higher greenness exposure associated with reduced mortality risks, but few controlled for spatially correlated air pollution and traffic noise exposures. We aim to address this research gap in the ELAPSE pooled cohort. METHODS Mean Normalized Difference Vegetation Index (NDVI) in a 300-m grid cell and 1-km radius were assigned to participants' baseline home addresses as a measure of surrounding greenness exposure. We used Cox proportional hazards models to estimate the association of NDVI exposure with natural-cause and cause-specific mortality, adjusting for a number of potential confounders including socioeconomic status and lifestyle factors at individual and area-levels. We further assessed the associations between greenness exposure and mortality after adjusting for fine particulate matter (PM2.5), nitrogen dioxide (NO2) and road traffic noise. RESULTS The pooled study population comprised 327,388 individuals who experienced 47,179 natural-cause deaths during 6,374,370 person-years of follow-up. The mean NDVI in the pooled cohort was 0.33 (SD 0.1) and 0.34 (SD 0.1) in the 300-m grid and 1-km buffer. In the main fully adjusted model, 0.1 unit increment of NDVI inside 300-m grid was associated with 5% lower risk of natural-cause mortality (Hazard Ratio (HR) 0.95 (95% CI: 0.94, 0.96)). The associations attenuated after adjustment for air pollution [HR (95% CI): 0.97 (0.96, 0.98) adjusted for PM2.5; 0.98 (0.96, 0.99) adjusted for NO2]. Additional adjustment for traffic noise hardly affected the associations. Consistent results were observed for NDVI within 1-km buffer. After adjustment for air pollution, NDVI was inversely associated with diabetes, respiratory and lung cancer mortality, yet with wider 95% confidence intervals. No association with cardiovascular mortality was found. CONCLUSIONS We found a significant inverse association between surrounding greenness and natural-cause mortality, which remained after adjusting for spatially correlated air pollution and traffic noise.
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Affiliation(s)
- Ainhoa Bereziartua
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Zorana J Andersen
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate - interdisciplinary Center for Climate Change, Aarhus University, Denmark.
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy; School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
| | - John Gulliver
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, UK.
| | - Ole Hertel
- Department of Ecoscience, Aarhus University, Roskilde, Denmark.
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Germany.
| | | | - W M Monique Verschuren
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany.
| | - Jeanette T Jørgensen
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Environmental Research Group, School of Public Health, Imperial College London, London, UK.
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford GU2 7XH, United Kingdom.
| | - Norun Hjertager Krog
- Section of Air Pollution and Noise, Norwegian Institute of Public Health, Norway.
| | - Boel Brynedal
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Shuo Liu
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden.
| | - Elodie Faure
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP UMR1018, 94805 Villejuif, France.
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Chair of Epidemiology, Ludwig Maximilians Universität München, Munich, Germany.
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark.
| | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy.
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - Sara Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Germany.
| | - Gianluca Severi
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP UMR1018, 94805 Villejuif, France; Department of Statistics, Computer Science and Applications "G. Parenti" (DISIA), University of Florence, Italy.
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy.
| | - Maciej Strak
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark.
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark; Diet, Genes and Environment (DGE), Denmark.
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
| | - Emanuel Zitt
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria; Department of Internal Medicine 3, LKH Feldkirch, Feldkirch, Austria.
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
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A population-based retrospective study of the modifying effect of urban blue space on the impact of socioeconomic deprivation on mental health, 2009-2018. Sci Rep 2022; 12:13040. [PMID: 35906285 PMCID: PMC9338232 DOI: 10.1038/s41598-022-17089-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022] Open
Abstract
The incidence of mental health disorders in urban areas is increasing and there is a growing interest in using urban blue spaces (urban waterways, canals, lakes, ponds, coasts, etc.) as a tool to manage and mitigate mental health inequalities in the population. However, there is a dearth of longitudinal evidence of the mechanisms and impact of blue spaces on clinical markers of mental health to support and inform such interventions. We conducted a 10-year retrospective study, following STROBE guidelines, using routinely collected population primary care health data within the National Health Service (NHS) administrative area of Greater Glasgow and Clyde for the North of Glasgow city area. We explored whether living near blue space modifies the negative effect of socio-economic deprivation on mental health during the regeneration of an urban blue space (canal) from complete dereliction and closure. A total of 132,788 people (65,351 female) fulfilling the inclusion criteria were entered in the analysis. We established a base model estimating the effect of deprivation on the risk of mental health disorders using a Cox proportional hazards model, adjusted for age, sex and pre-existing comorbidities. We then investigated the modifying effect of living near blue space by computing a second model which included distance to blue space as an additional predicting variable and compared the results to the base model. Living near blue space modified the risk of mental health disorders deriving from socio-economic deprivation by 6% (hazard ratio 2.48, 95% confidence interval 2.39–2.57) for those living in the most deprived tertile (T1) and by 4% (hazard ratio 1.66, 95% confidence interval 1.60–1.72) for those in the medium deprivation tertile (T2). Our findings support the notion that living near blue space could play an important role in reducing the burden of mental health inequalities in urban populations.
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Upscaling Local Adaptive Heritage Practices to Internationally Designated Heritage Sites. CLIMATE 2022. [DOI: 10.3390/cli10070102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
World Heritage Sites can face an onslaught of risks from high tourist numbers, climate changes, the impacts of conflict and war, and static management practices. These sites have been ascribed a value that is considered both outstanding and universal (OUV) and as such they are placed at a higher prioritisation than all other heritage sites. The aim of this listing is to ensure their protection for future generations. Yet, the management practices enacted under this preservation mandate can be reactive rather than proactive and reflective, overly concerned with maintaining the status quo, and restricted by a complexity of national and international regulations and stakeholders. We here introduce a local-scale, community-driven heritage project, called CHICC, that offers, we argue, a useful insight into management practices that may be upscaled to internationally designated sites. Although this is not a blueprint to fit all heritage needs, some of the fundamental intentions embedded within CHICC can and perhaps should be adopted in the approaches to internationally designated site management. These include inclusivity with the local community as a priority stakeholder, a deeper understanding of the site including its future risks, consideration of the wider heritage landscape, and greater incorporation of heritage dynamism. Through analysing and evaluating the case study project, this conceptual chapter argues that adaptive heritage practices are underway in some local-scale contexts, and this can be a useful template for advancing the management of World Heritage Sites.
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Association of environmental and socioeconomic indicators with serious mental illness diagnoses identified from general practitioner practice data in England: A spatial Bayesian modelling study. PLoS Med 2022; 19:e1004043. [PMID: 35771888 PMCID: PMC9286217 DOI: 10.1371/journal.pmed.1004043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 07/15/2022] [Accepted: 06/03/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The evidence is sparse regarding the associations between serious mental illnesses (SMIs) prevalence and environmental factors in adulthood as well as the geographic distribution and variability of these associations. In this study, we evaluated the association between availability and proximity of green and blue space with SMI prevalence in England as a whole and in its major conurbations (Greater London, Birmingham, Liverpool and Manchester, Leeds, and Newcastle). METHODS AND FINDINGS We carried out a retrospective analysis of routinely collected adult population (≥18 years) data at General Practitioner Practice (GPP) level. We used data from the Quality and Outcomes Framework (QOF) on the prevalence of a diagnosis of SMI (schizophrenia, bipolar affective disorder and other psychoses, and other patients on lithium therapy) at the level of GPP over the financial year April 2014 to March 2018. The number of GPPs included ranged between 7,492 (April 2017 to March 2018) to 7,997 (April 2014 to March 2015) and the number of patients ranged from 56,413,719 (April 2014 to March 2015) to 58,270,354 (April 2017 to March 2018). Data at GPP level were converted to the geographic hierarchy unit Lower Layer Super Output Area (LSOA) level for analysis. LSOAs are a geographic unit for reporting small area statistics and have an average population of around 1,500 people. We employed a Bayesian spatial regression model to explore the association of SMI prevalence in England and its major conurbations (greater London, Birmingham, Liverpool and Manchester, Leeds, and Newcastle) with environmental characteristics (green and blue space, flood risk areas, and air and noise pollution) and socioeconomic characteristics (age, ethnicity, and index of multiple deprivation (IMD)). We incorporated spatial random effects in our modelling to account for variation at multiple scales. Across England, the environmental characteristics associated with higher SMI prevalence at LSOA level were distance to public green space with a lake (prevalence ratio [95% credible interval]): 1.002 [1.001 to 1.003]), annual mean concentration of PM2.5 (1.014 [1.01 to 1.019]), and closeness to roads with noise levels above 75 dB (0.993 [0.992 to 0.995]). Higher SMI prevalence was also associated with a higher percentage of people above 24 years old (1.002 [1.002 to 1.003]), a higher percentage of ethnic minorities (1.002 [1.001 to 1.002]), and more deprived areas. Mean SMI prevalence at LSOA level in major conurbations mirrored the national associations with a few exceptions. In Birmingham, higher average SMI prevalence at LSOA level was positively associated with proximity to an urban green space with a lake (0.992 [0.99 to 0.998]). In Liverpool and Manchester, lower SMI prevalence was positively associated with road traffic noise ≥75 dB (1.012 [1.003 to 1.022]). In Birmingham, Liverpool, and Manchester, there was a positive association of SMI prevalence with distance to flood zone 3 (land within flood zone 3 has ≥1% chance of flooding annually from rivers or ≥0.5% chance of flooding annually from the sea, when flood defences are ignored): Birmingham: 1.012 [1.000 to 1.023]; Liverpool and Manchester: 1.016 [1.006 to 1.026]. In contrast, in Leeds, there was a negative association between SMI prevalence and distance to flood zone 3 (0.959 [0.944 to 0.975]). A limitation of this study was because we used a cross-sectional approach, we are unable to make causal inferences about our findings or investigate the temporal relationship between outcome and risk factors. Another limitation was that individuals who are exclusively treated under specialist mental health care and not seen in primary care at all were not included in this analysis. CONCLUSIONS Our study provides further evidence on the significance of socioeconomic associations in patterns of SMI but emphasises the additional importance of considering environmental characteristics alongside socioeconomic variables in understanding these patterns. In this study, we did not observe a significant association between green space and SMI prevalence, but we did identify an apparent association between green spaces with a lake and SMI prevalence. Deprivation, higher concentrations of air pollution, and higher proportion of ethnic minorities were associated with higher SMI prevalence, supporting a social-ecological approach to public health prevention. It also provides evidence of the significance of spatial analysis in revealing the importance of place and context in influencing area-based patterns of SMI.
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15
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Jarvis I, Sbihi H, Davis Z, Brauer M, Czekajlo A, Davies HW, Gergel SE, Guhn M, Jerrett M, Koehoorn M, Nesbitt L, Oberlander TF, Su J, van den Bosch M. The influence of early-life residential exposure to different vegetation types and paved surfaces on early childhood development: A population-based birth cohort study. ENVIRONMENT INTERNATIONAL 2022; 163:107196. [PMID: 35339041 DOI: 10.1016/j.envint.2022.107196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/23/2022] [Accepted: 03/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Growing evidence suggests that exposure to green space is associated with improved childhood health and development, but the influence of different green space types remains relatively unexplored. In the present study, we investigated the association between early-life residential exposure to vegetation and early childhood development and evaluated whether associations differed according to land cover types, including paved land. METHODS Early childhood development was assessed via kindergarten teacher-ratings on the Early Development Instrument (EDI) in a large population-based birth cohort (n = 27,539) in Metro Vancouver, Canada. The residential surrounding environment was characterized using a high spatial resolution land cover map that was linked to children by six-digit residential postal codes. Early-life residential exposure (from birth to time of EDI assessment, mean age = 5.6 years) was calculated as the mean of annual percentage values of different land cover classes (i.e., total vegetation, tree cover, grass cover, paved surfaces) within a 250 m buffer zone of postal code centroids. Multilevel models were used to analyze associations between respective land cover classes and early childhood development. RESULTS In adjusted models, one interquartile range increase in total vegetation percentage was associated with a 0.33 increase in total EDI score (95% CI: 0.21, 0.45). Similar positive associations were observed for tree cover (β-coefficient: 0.26, 95% CI: 0.15, 0.37) and grass cover (β-coefficient: 0.12, 95% CI: 0.02, 0.22), while negative associations were observed for paved surfaces (β-coefficient: -0.35, 95% CI: -0.47, -0.23). CONCLUSIONS Our findings indicate that increased early-life residential exposure to vegetation is positively associated with early childhood developmental outcomes, and that associations may be stronger for residential exposure to tree cover relative to grass cover. Our results further indicate that childhood development may be negatively associated with residential exposure to paved surfaces. These findings can inform urban planning to support early childhood developmental health.
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Affiliation(s)
- Ingrid Jarvis
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, British Columbia, Canada
| | - Hind Sbihi
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; BC Centre for Disease Control, 655 West 12(th) Avenue, Vancouver, British Columbia, Canada
| | - Zoë Davis
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, British Columbia, Canada
| | - Michael Brauer
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Agatha Czekajlo
- Department of Forest Resources Management, Faculty of Forestry, The University of British Columbia, 2424 Mail Mall, Vancouver, British Columbia, Canada
| | - Hugh W Davies
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Sarah E Gergel
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, British Columbia, Canada
| | - Martin Guhn
- Human Early Learning Partnership, School of Population and Public Health, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California at Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA, the United States; Center for Occupational and Environmental Health, Fielding School of Public Health, University of California at Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA, the United States
| | - Mieke Koehoorn
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Lorien Nesbitt
- Department of Forest Resources Management, Faculty of Forestry, The University of British Columbia, 2424 Mail Mall, Vancouver, British Columbia, Canada
| | - Tim F Oberlander
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; Department of Pediatrics, Faculty of Medicine, The University of British Columbia, 4480 Oak Street, Vancouver, British Columbia, Canada
| | - Jason Su
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, 2121 Berkeley Way West, Berkeley, CA, the United States
| | - Matilda van den Bosch
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, British Columbia, Canada; School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; ISGlobal, Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader 88 08003 Barcelona, Spain; Universitat Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain; Centro de Investigación Biomédica en Red Instituto de Salud Carlos III, Calle de Melchor, Fernández Almagro, 3, 28029 Madrid, Spain.
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16
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From Childhood Residential Green space to Adult Mental Wellbeing: A Pathway Analysis among Chinese Adults. Behav Sci (Basel) 2022; 12:bs12030084. [PMID: 35323403 PMCID: PMC8945553 DOI: 10.3390/bs12030084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/02/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
Residential green spaces, arguably the most accessible type of urban green space, may have lasting impacts on children and even change their lives later in adulthood. However, the potential pathways from childhood residential green space to adulthood mental wellbeing are not well understood. Therefore, we conducted a questionnaire survey among Chinese adults (N = 770) in September 2021 to capture data on subjective measures of residential green space and nature contact during childhood, and nature connectedness, nature contact, and mental wellbeing during adulthood. Structural equation modeling (SEM) was employed to examine theoretical pathways between childhood residential green space and adult mental wellbeing. The results suggest that childhood residential green space positively predicts childhood nature contact and also has direct and indirect positive impacts on nature contact, nature connectedness, and mental wellbeing during adulthood. These findings advance understanding of the long-term impacts of childhood residential green space. Policymakers are advised to prioritize residential greening as well as other recreational facilities for children when planning health-promoting environments in urban spaces. Due to limitations in our study design, we also advise future studies to re-examine and extend the framework documented here.
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17
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Engemann K, Svenning JC, Arge L, Brandt J, Bruun MT, Didriksen M, Erikstrup C, Geels C, Hertel O, Horsdal HT, Kaspersen KA, Mikkelsen S, Mortensen PB, Nielsen KR, Ostrowski SR, Pedersen OB, Tsirogiannis C, Sabel CE, Sigsgaard T, Ullum H, Pedersen CB. A life course approach to understanding associations between natural environments and mental well-being for the Danish blood donor cohort. Health Place 2021; 72:102678. [PMID: 34610547 DOI: 10.1016/j.healthplace.2021.102678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 01/28/2023]
Abstract
Natural environments have been associated with mental health benefits, but globally access to these benefits is threatened by urban development and densification. However, it remains unclear how natural environments relate to mental health and how consistent the association is across populations. Here we use a life-course approach with a population consisting of 66 194 individuals from the Danish Blood Donor Study (DBDS) to investigate the association between green and blue space (e.g. parks and lakes) and self-evaluated mental well-being. Green and blue space was identified from remotely-sensed images from the Landsat program, while mental well-being was based on the mental component score (MCS) calculated using the 12-item short form health survey. We use multivariate linear regression models and logistic regression models to quantify the associations. We adjust for additional environmental (urbanization, and air pollution) and lifestyle factors (smoking, body mass index, socioeconomic status, and physical activity) and specifically evaluate the role of physical activity and air pollution as possible mediating factors. We found a positive association between the MCS and current and childhood green space, and a non-significant association for current and childhood blue space. Adjusting for environmental and the other factors attenuated the effect sizes indicating that a broad range of factors determine mental well-being. Physical activity and air pollution were both associated with the MCS as possible mediators of green space associations. In addition, the odds for successfully completing tasks', seeing others, and feeling less downhearted increased with higher levels of green space, and the odds of feeling calm increased with higher levels of blue space. In conclusion, we found support for an association between green and, to less degree, blue space and mental well-being throughout different life stages. In addition, we found a positive association with individual indicators of mental well-being such as being productive, feeling less downhearted and calmer, and being social. The healthy blood donor effect and the bias towards urban residency may explain why we found smaller effect sizes between green and blue space and mental well-being for this generally healthy and resourceful cohort compared to previous studies.
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Affiliation(s)
- Kristine Engemann
- Section for Ecoinformatics & Biodiversity, Department of Biology, Aarhus University, 8000, Aarhus C, Denmark; Center for Biodiversity Dynamics in a Changing World (BIOCHANGE), Department of Biology, Aarhus University, 8000, Aarhus C, Denmark; Centre for Integrated Register-based Research (CIRRAU), Aarhus University, 8210, Aarhus V, Denmark; Big Data Centre for Environment and Health (BERTHA), Aarhus University, 4000, Roskilde, Denmark.
| | - Jens-Christian Svenning
- Section for Ecoinformatics & Biodiversity, Department of Biology, Aarhus University, 8000, Aarhus C, Denmark; Center for Biodiversity Dynamics in a Changing World (BIOCHANGE), Department of Biology, Aarhus University, 8000, Aarhus C, Denmark.
| | - Lars Arge
- Center for Massive Data Algorithmics (MADALGO), Aarhus University, Department of Computer Science, Aarhus University, 8200, Aarhus N, Denmark.
| | - Jørgen Brandt
- Department of Bioscience, Aarhus University, 4000, Roskilde, Denmark; IClimate, Interdisciplinary Centre for Climate Change, Aarhus University, 4000, Roskilde, Denmark.
| | - Mie T Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark.
| | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Christian Erikstrup
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, 4000, Roskilde, Denmark; Department of Clinical Immunology, Aarhus University Hospital, Aarhus N, Denmark.
| | - Camilla Geels
- Department of Bioscience, Aarhus University, 4000, Roskilde, Denmark.
| | - Ole Hertel
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, 4000, Roskilde, Denmark; Department of Bioscience, Aarhus University, 8000, Aarhus C, Denmark.
| | - Henriette Thisted Horsdal
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, 4000, Roskilde, Denmark; National Centre for Register-based Research, Aarhus BSS, Department of Economics and Business Economics, Aarhus University, 8210, Aarhus V, Denmark.
| | - Kathrine A Kaspersen
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, 4000, Roskilde, Denmark; Department of Clinical Immunology, Aarhus University Hospital, Aarhus N, Denmark.
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus N, Denmark.
| | - Preben Bo Mortensen
- National Centre for Register-based Research, Aarhus BSS, Department of Economics and Business Economics, Aarhus University, 8210, Aarhus V, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, 8210, Aarhus V, Denmark.
| | - Kaspar R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark.
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Ole B Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark.
| | - Constantinos Tsirogiannis
- Center for Massive Data Algorithmics (MADALGO), Aarhus University, Department of Computer Science, Aarhus University, 8200, Aarhus N, Denmark.
| | - Clive E Sabel
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, 4000, Roskilde, Denmark; Department of Bioscience, Aarhus University, 4000, Roskilde, Denmark.
| | - Torben Sigsgaard
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, 4000, Roskilde, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark.
| | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Carsten Bøcker Pedersen
- Centre for Integrated Register-based Research (CIRRAU), Aarhus University, 8210, Aarhus V, Denmark; Big Data Centre for Environment and Health (BERTHA), Aarhus University, 4000, Roskilde, Denmark; National Centre for Register-based Research, Aarhus BSS, Department of Economics and Business Economics, Aarhus University, 8210, Aarhus V, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, 8210, Aarhus V, Denmark.
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18
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Jarvis I, Davis Z, Sbihi H, Brauer M, Czekajlo A, Davies HW, Gergel SE, Guhn M, Jerrett M, Koehoorn M, Oberlander TF, Su J, van den Bosch M. Assessing the association between lifetime exposure to greenspace and early childhood development and the mediation effects of air pollution and noise in Canada: a population-based birth cohort study. Lancet Planet Health 2021; 5:e709-e717. [PMID: 34627475 DOI: 10.1016/s2542-5196(21)00235-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Exposure to greenspace is associated with improved childhood development, but the pathways behind this relationship are insufficiently understood. Therefore, we aimed to investigate the association between lifetime residential exposure to greenspace and early childhood development and evaluate the extent to which this association is mediated by reductions in traffic-related air pollution and noise. METHODS This population-based birth cohort study comprised singleton births in Metro Vancouver, BC, Canada, between April 1, 2000, and Dec 31, 2005. Children and mothers had to be registered with the mandatory provincial health insurance programme, Medical Services Plan, and have lived within the study area from the child's birth to the time of outcome assessment. Early childhood development was assessed via teacher ratings on the Early Development Instrument (EDI), and we used the total EDI score as the primary outcome variable. We estimated greenspace using percentage vegetation derived from spectral unmixing of annual Landsat satellite image composites. Lifetime residential exposure to greenspace was estimated as the mean of annual percentage vegetation values within 250 m of participants' residential postal codes. Multilevel modelling, adjusted for eight covariates, was used to investigate associations between greenspace exposure and EDI scores. We estimated the mediation effects of nitrogen dioxide (NO2), fine particulate matter (PM2·5), and noise levels using causal mediation analyses. FINDINGS Of the 37 745 children born in Metro Vancouver between April 1, 2000, and Dec 31, 2005, 27 372 were included in our final study sample. In the adjusted model, 1 IQR increase in percentage vegetation was associated with a 0·16 (95% CI 0·04-0·28; p=0·0073) increase in total EDI score, indicating small improvements in early childhood development. We estimated that 97·1% (95% CI 43·0-396·0), 29·5% (12·0-117·0), and 35·2% (17·9-139·0) of the association was mediated through reductions in NO2, PM2·5, and noise, respectively. INTERPRETATION Increased exposure to residential greenspace might improve childhood development by reducing the adverse developmental effects of traffic-related exposures, especially NO2 air pollution. Our study supports the implementation of healthy urban planning and green infrastructure interventions. FUNDING Canadian Institutes of Health Research.
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Affiliation(s)
- Ingrid Jarvis
- Department of Forest and Conservation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Zoë Davis
- Department of Forest and Conservation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hind Sbihi
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Michael Brauer
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Agatha Czekajlo
- Department of Forest Resources Management, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hugh W Davies
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sarah E Gergel
- Department of Forest and Conservation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Martin Guhn
- Faculty of Forestry, and Human Early Learning Partnership, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA; Center for Occupational and Environmental Health, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA
| | - Mieke Koehoorn
- Department of Forest and Conservation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tim F Oberlander
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jason Su
- Division of Environmental Health Sciences, School of Public Health, University of California at Berkeley, Berkeley, CA, USA
| | - Matilda van den Bosch
- Department of Forest and Conservation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; ISGlobal, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain; Barcelona, Spain; Centro de Investigación Biomédica en Red Instituto de Salud Carlos 3, Madrid, Spain.
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19
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The Environment of Birthplace and Self-Reported Mental Health Conditions: Findings from the American Panel of Life. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2021; 2:256-261. [PMID: 36417224 PMCID: PMC9620909 DOI: 10.3390/epidemiologia2030019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 12/14/2022]
Abstract
Studies from around the globe have found that urbanicity is associated with greater risk for certain psychiatric disorders, though the association has been less evident in the United States. We analyzed data collected in 2019 from the RAND American Life Panel (n = 2554), which were representative of the general adult population of the United States. Using multivariable logistic regression, we examined the associations between environment of birthplace (large urban, small urban, suburban, rural) and psychiatric disorders, adjusting for sociodemographic characteristics. We found that being born in a large urban area was associated with greater odds of having any psychiatric disorder when compared with being born in a rural area. However, when looking at specific disorders, we found that being born in a large urban area was only significantly associated greater odds of anxiety disorder and post-traumatic stress disorder (PTSD), but was not associated with bipolar disorder, major depressive disorder, attention deficit/hyperactivity disorder, or alcohol/substance use disorder. Being born in a small urban area was marginally associated with anxiety disorder. Future studies should examine why urban birthplace has only been associated with anxiety disorders and PTSD in the United States, and why urbanicity is associated with mood disorders in other parts of the world but not in the United States.
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20
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Stanhope J, Liddicoat C, Weinstein P. Outdoor artificial light at night: A forgotten factor in green space and health research. ENVIRONMENTAL RESEARCH 2021; 197:111012. [PMID: 33716029 DOI: 10.1016/j.envres.2021.111012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
Exposure to green space has been associated with a range of human health benefits, largely in spatial epidemiological studies. Green space and artificial light at night are both associated with breast and prostate cancer, depressive symptoms, obesity, and sleep problems, and are both influenced by the built environment and urbanisation. We identified a negative correlation between green space diversity and outdoor artificial light at night for Australian major cities. Outdoor artificial light at night is therefore a potential, but overlooked, confounder in spatial epidemiological studies of green space exposure and human health, and should be incorporated into future models.
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Affiliation(s)
- Jessica Stanhope
- School of Allied Health Science and Practice, The University of Adelaide, Australia.
| | - Craig Liddicoat
- School of Public Health, The University of Adelaide, Australia; College of Science and Engineering, Flinders University, Australia
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21
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Li D, Menotti T, Ding Y, Wells NM. Life Course Nature Exposure and Mental Health Outcomes: A Systematic Review and Future Directions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105146. [PMID: 34066287 PMCID: PMC8152056 DOI: 10.3390/ijerph18105146] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 12/18/2022]
Abstract
Recently, an emerging body of literature has examined the relationships between early life nature exposure and mental health in later life; however, no critical synthesis yet exists regarding the extent and strength of these relationships. This study presents the first systematic review of studies in this growing area. Following the PRISMA framework, we searched six databases (i.e., Scopus, Web of Science, MEDLINE, Embase, PsycINFO, and CINAHL); conducted identification, screening, eligibility, and inclusion analyses; and identified a final set of 29 articles. The review set comprises primarily longitudinal studies, with several cross-sectional studies using retrospective measures of childhood nature exposure. The majority of included studies were published between 2016 and 2020 and conducted in Europe and North America. Five domains of mental health outcomes are associated with early-life nature exposure: incidence of mental disorders, psychiatric symptoms and emotions, conduct problems in children, cognitive function, and subjective well-being. The evidence lends support to an overall beneficial role of early nature exposure on mental health, although inconsistencies are reported. Taken together, the evidence does not suggest that exposure at any given life stage is more saliently associated with mental health outcomes than at others. We discuss the validity concerns and methodological remedies and offer directions for future research.
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Affiliation(s)
- Dongying Li
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX 77843, USA; (T.M.); (Y.D.)
- Correspondence:
| | - Tess Menotti
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX 77843, USA; (T.M.); (Y.D.)
| | - Yizhen Ding
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX 77843, USA; (T.M.); (Y.D.)
| | - Nancy M. Wells
- Department of Design and Environmental Analysis, College of Human Ecology, Cornell University, Ithaca, NY 14853, USA;
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22
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Abstract
PURPOSE OF REVIEW This review scoped recent (2019-2020) literature investigating the association between urbanization and eating disorders, and the putative role of urbanization as a direct or indirect risk factor. RECENT FINDINGS There are few epidemiological studies which investigated adequately direct or indirect association between urban domicile and eating disorders. Findings suggest that urbanization is a complex phenomenon and its effects on eating behaviour are indirect, for example, because of other important social and environmental features, such as the amount of 'green' space, 'Western' thin idealization, and poverty. The review also supports others indicating an increase of eating disorders in Africa and Asia. The majority of research includes only adolescent and young woman. SUMMARY It does not seem likely that metropolitan dwelling in itself is a major risk factor for developing an eating disorder. However, when accompanied by other sociodemographic effects, there may well be an increase in eating disorder risk. There are opportunities for planners to design cities to be supportive of peoples' eating and mental health in general. More research investigating moderating and mediating effects on the associations between urban dwelling and eating disorder is needed as well as studies of more sexually and age diverse populations.
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23
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Menculini G, Bernardini F, Attademo L, Balducci PM, Sciarma T, Moretti P, Tortorella A. The Influence of the Urban Environment on Mental Health during the COVID-19 Pandemic: Focus on Air Pollution and Migration-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3920. [PMID: 33917942 PMCID: PMC8068323 DOI: 10.3390/ijerph18083920] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 12/14/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused a crisis worldwide, due to both its public health impact and socio-economic consequences. Mental health was consistently affected by the pandemic, with the emergence of newly diagnosed psychiatric disorders and the exacerbation of pre-existing ones. Urban areas were particularly affected by the virus spread. In this review, we analyze how the urban environment may influence mental health during the COVID-19 pandemic, considering two factors that profoundly characterize urbanization: air pollution and migration. Air pollution serves as a possibly risk factor for higher viral spread and infection severity in the context of urban areas and it has also been demonstrated to play a role in the development of serious mental illnesses and their relapses. The urban environment also represents a complex social context where minorities such as migrants may live in poor hygienic conditions and lack access to adequate mental health care. A global rethinking of the urban environment is thus required to reduce the impact of these factors on mental health. This should include actions aimed at reducing air pollution and combating climate change, promoting at the same time a more inclusive society in a sustainable development perspective.
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Affiliation(s)
- Giulia Menculini
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (P.M.B.); (T.S.); (P.M.)
| | - Francesco Bernardini
- CSM 24 ore Area delle Dolomiti Friulane, Department of Mental Health, AsFO Friuli Occidentale, 33170 Pordenone, Italy;
- Planetary Health Lab, Old Medical School, University of Edinburgh, Edinburgh EH8 9AG, UK;
| | - Luigi Attademo
- Planetary Health Lab, Old Medical School, University of Edinburgh, Edinburgh EH8 9AG, UK;
- SPDC Potenza, Department of Mental Health, ASP Basilicata, Italian National Health Service, 85100 Potenza, Italy
| | - Pierfrancesco Maria Balducci
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (P.M.B.); (T.S.); (P.M.)
- CSM Terni, Department of Mental Health, 05100 Terni, Italy
| | - Tiziana Sciarma
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (P.M.B.); (T.S.); (P.M.)
| | - Patrizia Moretti
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (P.M.B.); (T.S.); (P.M.)
| | - Alfonso Tortorella
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (P.M.B.); (T.S.); (P.M.)
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24
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Simkin J, Ojala A, Tyrväinen L. The Perceived Restorativeness of Differently Managed Forests and Its Association with Forest Qualities and Individual Variables: A Field Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E422. [PMID: 33430350 PMCID: PMC7825791 DOI: 10.3390/ijerph18020422] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/20/2020] [Accepted: 12/31/2020] [Indexed: 11/16/2022]
Abstract
Despite increasing research knowledge about the positive well-being effects forests have on citizens, it is still unclear how the quality of forests and individual variables effect the well-being. This research investigated (1) the differences in restorative experiences (components being away, fascination, compatibility and extent, measured by perceived restorativeness (PRS)), and (2) how people evaluate forest qualities in four differently managed forests. Furthermore, this research studied (3) which individual variables (4) as well as forest qualities, explain the overall restorative experience (PRS-score from all components). Altogether, 66 volunteers were taken in small groups to each of the four forest sites once, after their day at work. The participants viewed the forests for 15 min and then walked inside the forests for 30 min. Their perceived restorativeness and perceptions about forest qualities were measured on-site after each visit. Most of the components of PRS differed between the three older forests compared to the young forest. The three older forests also had more preferred qualities, compared to the young commercial forest. From the individual variables, the nature relatedness positively explained the restorative experiences (PRS-score) in old-growth forest and in mature commercial forest. Beauty was the most important quality that explained PRS-score in all forests. Biodiversity positively explained the PRS-score, except in urban recreation forest. However, not all forest qualities need to be present in order to reach high perceived restorativeness and both a pristine or managed old forest can have high restorative values. Also, decaying wood does not seem to diminish forests' restorative values, but there may be individual differences in its acceptance. Therefore, a greater attention to the overall versatility is needed when managing the forest used for outdooring.
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Affiliation(s)
- Jenni Simkin
- Natural Resources Institute Finland, Latokartanonkaari 9, 00790 Helsinki, Finland; (A.O.); (L.T.)
- Department of Forest Sciences, University of Helsinki, Latokartanonkaari 7, 000790 Helsinki, Finland
| | - Ann Ojala
- Natural Resources Institute Finland, Latokartanonkaari 9, 00790 Helsinki, Finland; (A.O.); (L.T.)
| | - Liisa Tyrväinen
- Natural Resources Institute Finland, Latokartanonkaari 9, 00790 Helsinki, Finland; (A.O.); (L.T.)
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