Coping with post-hurricane mental distress: The role of neighborhood green space

Climate Change and Aging: Implications for Psychiatric Care

PURPOSE OF REVIEW

We reviewed recent evidence regarding the impact of climate change (specifically, high ambient temperatures, heatwaves, weather-related disasters, and air pollution) on older adults' mental health. We also summarized evidence regarding other medical problems that can occur in aging adults in connection with climate change, resulting in psychiatric manifestations or influencing psychopharmacological management.

RECENT FINDINGS

Older adults can experience anxiety, depressive, and/or posttraumatic stress symptoms, as well as sleep disturbances in the aftermath of climate disasters. Cognitive deficits may occur with exposure to air pollutants, heatwaves, or post-disaster. Individuals with major neurocognitive disorders and/or preexisting psychiatric illness have a higher risk of psychiatric hospitalizations after exposure to high temperatures and air pollution. There is a growing body of research regarding psychiatric clinical presentations associated with climate change in older adults. However, there is a paucity of evidence on management strategies. Future research should investigate culturally appropriate, cost-effective psychosocial and pharmacological interventions.

NPCC4: Climate change and New York City's health risk

This chapter of the New York City Panel on Climate Change 4 (NPCC4) report considers climate health risks, vulnerabilities, and resilience strategies in New York City's unique urban context. It updates evidence since the last health assessment in 2015 as part of NPCC2 and addresses climate health risks and vulnerabilities that have emerged as especially salient to NYC since 2015. Climate health risks from heat and flooding are emphasized. In addition, other climate-sensitive exposures harmful to human health are considered, including outdoor and indoor air pollution, including aeroallergens; insect vectors of human illness; waterborne infectious and chemical contaminants; and compounding of climate health risks with other public health emergencies, such as the COVID-19 pandemic. Evidence-informed strategies for reducing future climate risks to health are considered.

Adventure and mental health: an ecological perspective

In this paper, we explore the concept of outdoor adventure in the context of mental health, proposing an ecological perspective to redefine adventure beyond its traditional associations with risk and physical challenge. We critically examine current frameworks and definitions of adventure, which often emphasise specific activities and natural environments yet overlook the individual's experience and potential mental health benefits. From an ecological perspective, we emphasise the dynamic interplay between the individual, the activity, and the environment. This approach, grounded in ecological psychology, considers the multi-dimensional nature of adventure, including social, psychological, physical, and spiritual aspects. The paper challenges the traditional risk-focused view of adventure, advocating for a broader definition that includes diverse experiences and interactions, as well as the transformative potential of adventure in various environments, including urban settings. We highlight the changing demographics and motivations of adventure participants, moving away from the stereotypical young male risk-seeker, to more diverse and inclusive participant profiles. We argue that adventure facilitates the realisation of fundamental human affordances, often untapped in daily life, thereby enhancing mental health and wellbeing. This ecological perspective opens new avenues for understanding the role of adventure in mental health and wellbeing, offering a more comprehensive and inclusive approach to adventure activities as therapeutic interventions. This redefined understanding of adventure emphasises its potential as a powerful tool for enhancing human wellbeing, harmonising the relationship between people, tasks, and the environment, and offering profound implications for mental health contexts.

Neighborhood Resources Associated With Psychological Trajectories and Neural Reactivity to Reward After Trauma

Importance

Research on resilience after trauma has often focused on individual-level factors (eg, ability to cope with adversity) and overlooked influential neighborhood-level factors that may help mitigate the development of posttraumatic stress disorder (PTSD).

Objective

To investigate whether an interaction between residential greenspace and self-reported individual resources was associated with a resilient PTSD trajectory (ie, low/no symptoms) and to test if the association between greenspace and PTSD trajectory was mediated by neural reactivity to reward.

Design, Setting, and Participants

As part of a longitudinal cohort study, trauma survivors were recruited from emergency departments across the US. Two weeks after trauma, a subset of participants underwent functional magnetic resonance imaging during a monetary reward task. Study data were analyzed from January to November 2023.

Exposures

Residential greenspace within a 100-m buffer of each participant's home address was derived from satellite imagery and quantified using the Normalized Difference Vegetation Index and perceived individual resources measured by the Connor-Davidson Resilience Scale (CD-RISC).

Main Outcome and Measures

PTSD symptom severity measured at 2 weeks, 8 weeks, 3 months, and 6 months after trauma. Neural responses to monetary reward in reward-related regions (ie, amygdala, nucleus accumbens, orbitofrontal cortex) was a secondary outcome. Covariates included both geocoded (eg, area deprivation index) and self-reported characteristics (eg, childhood maltreatment, income).

Results

In 2597 trauma survivors (mean [SD] age, 36.5 [13.4] years; 1637 female [63%]; 1304 non-Hispanic Black [50.2%], 289 Hispanic [11.1%], 901 non-Hispanic White [34.7%], 93 non-Hispanic other race [3.6%], and 10 missing/unreported [0.4%]), 6 PTSD trajectories (resilient, nonremitting high, nonremitting moderate, slow recovery, rapid recovery, delayed) were identified through latent-class mixed-effect modeling. Multinominal logistic regressions revealed that for individuals with higher CD-RISC scores, greenspace was associated with a greater likelihood of assignment in a resilient trajectory compared with nonremitting high (Wald z test = -3.92; P < .001), nonremitting moderate (Wald z test = -2.24; P = .03), or slow recovery (Wald z test = -2.27; P = .02) classes. Greenspace was also associated with greater neural reactivity to reward in the amygdala (n = 288; t277 = 2.83; adjusted P value = 0.02); however, reward reactivity did not differ by PTSD trajectory.

Conclusions and Relevance

In this cohort study, greenspace and self-reported individual resources were significantly associated with PTSD trajectories. These findings suggest that factors at multiple ecological levels may contribute to the likelihood of resiliency to PTSD after trauma.

The impact of nature-led recovery initiatives for individual and community health post disaster: a systematic literature review

OBJECTIVES

The impact of disasters on individual and community health can be extensive. As such, there exists the need to establish recovery measures that provides support psychologically and with additional mental health services and resilience building for affected people and their communities. Nature-led recovery is one such approach that has the ability to positively impact the mental health of people and their communities after a disaster. Nature-led recovery focuses on the social, economic and environmental recovery through activities that connect people and their communities to nature and the natural environment with the aim to foster recovery after a disaster. Nature-led recovery initiatives support the connection of people with nature and the natural environment to support such recovery processes. This review considers both community and government-led responses pertaining to nature-led recovery. The aim of this review is to systematically explore the literature on the impact of nature-led recovery initiatives on individual and community health following a disaster.

CONTENT

This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) following a three-step process of planning, conducting and reporting the review. At least three authors reviewed all eligible articles.

SUMMARY

There was significant methodological heterogeneity between the sources identified (n=9). A narrative synthesis identified five key themes; A symbol of loss; Nature: the provider; Fostering community connectedness; Spiritual and emotional nourishment; and Regeneration leads to recovery.

OUTLOOK

The positive benefits from nature-led recovery initiatives provide an opportunity to promote community connectedness and resilience following a disaster. Further research is needed to explore the implementation and evaluation of these initiatives for community recovery.

The impact of residential greenness on psychological distress among Hurricane Katrina survivors

Residential greenness may support mental health among disaster-affected populations; however, changes in residential greenness may disrupt survivors' sense of place. We obtained one pre- and three post-disaster psychological distress scores (Kessler [K]-6) from a cohort (n = 229) of low-income mothers who survived Hurricane Katrina in New Orleans, Louisiana, USA. Greenness was assessed using average growing season Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) in the 300 m around participants' homes at each time point. We used multivariable logistic regressions to evaluate two hypotheses: 1) that cross-sectional greenness (above vs. below median) was associated with reduced psychological distress (K6≥5); and 2) that changes in residential greenness were associated with adverse mental health. When using EVI, we found that a change in level of greenness (i.e., from high to low [high-low], or from low to high [low-high] greenness, comparing pre- and post-Katrina neighborhoods) was associated with increased odds of distress at the first post-storm survey, compared to moving between or staying within low greenness neighborhoods (low-high odds ratio [OR] = 3.48; 95% confidence interval [CI] = 1.40, 8.62 and high-low OR = 2.60; 95% CI: 1.05, 6.42). Results for NDVI were not statistically significant. More research is needed to characterize how residential greenness may impact the health of disaster survivors, and how these associations may change over time.

The Economic Value of Health Benefits Associated with Urban Park Investment

The allocation of resources towards the development and enhancement of urban parks offers an effective strategy for promoting and improving the health and well-being of urban populations. Investments in urban parks can result in a multitude of health benefits. The increased usage of greenspace by park users has been linked to positive physical and mental health outcomes. Additionally, the expansion of greenspace in urban areas can mitigate harmful impacts from air pollutants, heat, noise, and climate-related health risks. While the health benefits attributed to urban parks and greenspaces are well documented, few studies have measured the economic value of these benefits. This study applied a novel ecohealth economic valuation framework to quantify and estimate the potential economic value of health benefits attributed to the development of a proposed park in the downtown core of Peterborough, Canada. The results indicated that development of the small urban park will result in annual benefits of CAD 133,000 per year, including CAD 109,877 in the avoided economic burden of physical inactivity, CAD 23,084 in health savings associated with improved mental health, and CAD 127 in health savings attributed to better air quality. When including the economic value of higher life satisfaction, the economic benefit is more than CAD 4 million per year. The study demonstrates the value of developing and enhancing urban parks as a strategy to improve population health and well-being, and as a means of cost savings to the medical system.

Park Characteristics and Changes in Park Visitation before, during, and after COVID-19 Shelter-in-Place Order

The COVID-19 pandemic has limited people’s visitation to public places because of social distancing and shelter-in-place orders. According to Google’s community mobility reports, some countries showed a decrease in park visitation during the pandemic, while others showed an increase. Although government responses played a significant role in this variation, little is known about park visitation changes and the park attributes that are associated with these changes. Therefore, we aimed to examine the associations between park characteristics and percent changes in park visitation in Harris County, TX, for three time periods: before, during, and after the shelter-in-place order of Harris County. We utilized SafeGraph’s point-of-interest data to extract weekly park visitation counts for the Harris County area. This dataset included the size of each park and its weekly number of visits from 2 March to 31 May 2020. In addition, we measured park characteristics, including greenness density, using the normalized difference vegetation index; park type (mini, neighborhood, community, regional/metropolitan); presence of sidewalks and bikeways; sidewalk and bikeway quantity; and bikeway quality. Results showed that park visitation decreased after issuing the shelter-in-place order and increased after this order was lifted. Results from linear regression models indicated that the higher the greenness density of the park, the smaller the decrease in park visitation during the shelter-in-place period compared to before the shelter-in-place order. This relationship also appeared after the shelter-in-place order. The presence of more sidewalks was related to less visitation increase after the shelter-in-place order. These findings can guide planners and designers to implement parks that promote public visitation during pandemics and potentially benefit people’s physical and mental health.