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Werder E, Lawrence K, Deng X, Braxton Jackson W, Christenbury K, Buller I, Engel L, Sandler D. Residential air pollution, greenspace, and adverse mental health outcomes in the U.S. Gulf Long-term Follow-up Study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 946:174434. [PMID: 38960154 PMCID: PMC11332601 DOI: 10.1016/j.scitotenv.2024.174434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 06/06/2024] [Accepted: 06/30/2024] [Indexed: 07/05/2024]
Abstract
Air pollution and greenness are environmental determinants of mental health, though existing evidence typically considers each exposure in isolation. We evaluated relationships between co-occurring air pollution and greenspace levels and depression and anxiety. We estimated cross-sectional associations among 9015 Gulf Long-term Follow-up Study participants living in the southeastern U.S. who completed the Patient Health Questionnaire-9 (depression: score ≥ 10) and Generalized Anxiety Disorder Questionnaire-7 (anxiety: score ≥ 10). Participant residential addresses were linked to annual average concentrations of particulate matter (1 km PM2.5) and nitrogen dioxide (1 km NO2), as well as satellite-based greenness (2 km Enhanced Vegetation Index (EVI)). We used adjusted log-binomial regression to estimate prevalence ratios (PR) and 95 % confidence intervals (CI) for associations between exposures (quartiles) and depression and anxiety. In mutually adjusted models (simultaneously modeling PM2.5, NO2, and EVI), the highest quartile of PM2.5 was associated with increased prevalence of depression (PR = 1.17, 95 % CI: 1.06-1.29), whereas the highest quartile of greenness was inversely associated with depression (PR = 0.89, 95 % CI: 0.80-0.99). Joint exposure to greenness mitigated the impact of PM2.5 on depression (PRPM only = 1.20, 95 % CI: 1.06-1.36; PRPM+green = 0.98, 95 % CI: 0.83-1.16) and anxiety (PRPM only = 1.10, 95 % CI: 1.00-1.22; PRPM+green = 0.95, 95 % CI: 0.83-1.09) overall and in subgroup analyses. Observed associations were stronger in urbanized areas and among nonwhite participants, and varied by neighborhood deprivation. NO2 exposure was not independently associated with depression or anxiety in this population. Relationships between PM2.5, greenness, and depression were strongest in the presence of characteristics that are highly correlated with lower socioeconomic status, underscoring the need to consider mental health as an environmental justice issue.
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Affiliation(s)
| | | | | | - W Braxton Jackson
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA
| | - Kate Christenbury
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA
| | - Ian Buller
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA
| | - Lawrence Engel
- Epidemiology Branch, NIEHS, NC, USA; Department of Epidemiology, UNC Gillings School of Public Health, NC, USA
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Runkle JD, Sugg MM, Berry A, Reed C, Cowan K, Wertis L, Ryan S. Association of Psychiatric Emergency Visits and Warm Ambient Temperature during Pregnancy: A Time-Stratified Case-Crossover Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:67001. [PMID: 38829735 PMCID: PMC11166382 DOI: 10.1289/ehp13293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Acute exposure to high ambient temperature and heat waves during the warm season has been linked with psychiatric disorders. Emerging research has shown that pregnant people, due to physiological and psychological changes, may be more sensitive to extreme heat, and acute exposure has been linked to increased risk of pregnancy complications; however, few studies have examined psychiatric complications. OBJECTIVE Our objective was to examine the association between acute exposure to warm ambient temperatures and emergency department (ED) visits for mental disorders during pregnancy. METHODS A time-stratified case-crossover design with conditional logistic regression was performed on ∼ 206,000 psychiatric ED visits for pregnant patients in North Carolina, from May to September 2016 to 2019. Daily average ambient temperature was the main exposure and was linked to daily visits by maternal zip code of residence for prenatal mood and anxiety disorders (PMAD), severe mental illness (SMI), mental disorder of pregnancy (MDP), suicidal thoughts (SUIC), and any psychiatric disorder (Any). Effect modification by trimester, residential segregation, economic segregation, urbanicity, and availability of greenspace was also investigated. RESULTS Each 5 ° C increase in same-day exposure to warm ambient temperature on case days was associated with an increase in incidence rate ratio (IRR) for any psychiatric disorder [IRR = 1.07; 95% confidence interval (CI): 1.01, 1.14] including anxiety (IRR = 1.14; 95% CI: 1.00, 1.30), bipolar disorder (IRR = 1.28; 95% CI: 0.98, 1.67), and suicidal thoughts (IRR = 1.28; 95% CI: 1.00, 1.65) compared to control days. In general, the associations were strongest for warm season temperatures on the same day of exposure or for temperatures averaged over the 3 or 6 d preceding the ED visit. The greatest risk of an incident ED admission for PMAD (RR = 1.20; 95% CI: 1.04, 1.39), particularly for anxiety (RR = 1.30; 95% CI: 1.07, 1.59), and any psychiatric disorder (RR = 1.17; 95% CI: 1.07, 1.28) occurred following cumulative exposure to hot temperatures the week before admission. Higher psychiatric burden from temperature was observed in urban areas and on extreme heat days. CONCLUSIONS For this pregnant population in the southeastern United States, short-term exposure to high ambient temperatures during the warm season was associated with a greater risk of ED visits for an array of psychiatric disorders. Findings show that climate-related increases in ambient temperature may contribute to psychiatric morbidity in pregnant people. https://doi.org/10.1289/EHP13293.
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Affiliation(s)
- Jennifer D. Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Margaret M. Sugg
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
| | - Anne Berry
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Charlie Reed
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Kristen Cowan
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Luke Wertis
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
| | - Sophie Ryan
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
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Patwary MM, Bardhan M, İnan HE, Browning MHEM, Disha AS, Haque MZ, Helmy M, Ashraf S, Dzhambov AM, Shuvo FK, Alam MA, Billah SM, Kabir MP, Hossain MR, Azam MG, Rahman MM, Swed S, Sah R, Montenegro-Idrogo JJ, Bonilla-Aldana DK, Rodriguez-Morales AJ. Exposure to urban green spaces and mental health during the COVID-19 pandemic: evidence from two low and lower-middle-income countries. Front Public Health 2024; 12:1334425. [PMID: 38496388 PMCID: PMC10940342 DOI: 10.3389/fpubh.2024.1334425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/12/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction The COVID-19 pandemic has had a significant impact on mental health globally, with limited access to mental health care affecting low- and middle-income countries (LMICs) the most. In response, alternative strategies to support mental health have been necessary, with access to green spaces being a potential solution. While studies have highlighted the role of green spaces in promoting mental health during pandemic lockdowns, few studies have focused on the role of green spaces in mental health recovery after lockdowns. This study investigated changes in green space access and associations with mental health recovery in Bangladesh and Egypt across the pandemic. Methods An online survey was conducted between January and April 2021 after the first lockdown was lifted in Bangladesh (n = 556) and Egypt (n = 660). We evaluated indoor and outdoor greenery, including the number of household plants, window views, and duration of outdoor visits. The quantity of greenness was estimated using the normalized difference vegetation index (NDVI). This index was estimated using satellite images with a resolution of 10x10m during the survey period (January-April 2021) with Sentinel-2 satellite in the Google Earth Engine platform. We calculated averages within 250m, 300m, 500m and 1000m buffers of the survey check-in locations using ArcGIS 10.3. Multiple linear regression models were used to evaluate relationships between changes in natural exposure and changes in mental health. Results The results showed that mental health improved in both countries after the lockdown period. People in both countries increased their time spent outdoors in green spaces after the lockdown period, and these increases in time outdoors were associated with improved mental health. Unexpectedly, changes in the number of indoor plants after the lockdown period were associated with contrasting mental health outcomes; more plants translated to increased anxiety and decreased depression. Refocusing lives after the pandemic on areas other than maintaining indoor plants may assist with worrying and feeling panicked. Still, indoor plants may assist with depressive symptoms for people remaining isolated. Conclusion These findings have important implications for policymakers and urban planners in LMICs, highlighting the need to increase access to natural environments in urban areas to improve mental health and well-being in public health emergencies.
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Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Mondira Bardhan
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC, United States
| | - Hüseyin Ertan İnan
- Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC, United States
- Department of Tourism Management, Faculty of Tourism, Ondokuz Mayıs University, Samsun, Türkiye
| | - Matthew H. E. M. Browning
- Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC, United States
| | - Asma Safia Disha
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Department of Environmental Science and Management, North South University, Dhaka, Bangladesh
| | - Md. Zahidul Haque
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Mai Helmy
- Psychology Department, College of Education, Sultan Qaboos University, Muscat, Oman
- Psychology Department, Faculty of Arts, Menoufia University, Shibin el Kom, Egypt
| | - Sadia Ashraf
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Angel M. Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
- Research Group “Health and Quality of Life in a Green and Sustainable Environment”, SRIPD, Medical University of Plovdiv, Plovdiv, Bulgaria
- Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria
- Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | | | - Md. Ashraful Alam
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Sharif Mutasim Billah
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Md. Pervez Kabir
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Department of Civil Engineering, University of Ottawa, Ottawa, ON, Canada
| | - Md. Riad Hossain
- Institute of Disaster Management, Khulna University Engineering & Technology, Khulna, Bangladesh
| | - Md. Golam Azam
- Remote Sensing, Center for Environmental and Geographic Information Services (CEGIS), Dhaka, Bangladesh
| | - Md. Mijanur Rahman
- Department of Geography and Environment, Jagannath University, Dhaka, Bangladesh
| | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | - Ranjit Sah
- Green City Hospital, Kathmandu, Nepal
- Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Juan J. Montenegro-Idrogo
- Faculty of Health Sciences, Universidad Cientifica del Sur, Lima, Peru
- Infectious and Tropical Diseases Service, Hospital Nacional Dos de Mayo, Lima, Peru
| | | | - Alfonso J. Rodriguez-Morales
- Faculty of Health Sciences, Universidad Cientifica del Sur, Lima, Peru
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas-Institución Universitaria Visión de las Américas, Pereira, Colombia
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
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Goldblatt R, Holz N, Tate G, Sherman K, Ghebremicael S, Bhuyan SS, Al-Ajlouni Y, Santillanes S, Araya G, Abad S, Herting MM, Thompson W, Thapaliya B, Sapkota R, Xu J, Liu J, Schumann G, Calhoun VD. "Urban-Satellite" estimates in the ABCD Study: Linking Neuroimaging and Mental Health to Satellite Imagery Measurements of Macro Environmental Factors. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.11.06.23298044. [PMID: 37986844 PMCID: PMC10659457 DOI: 10.1101/2023.11.06.23298044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
While numerous studies over the last decade have highlighted the important influence of environmental factors on mental health, globally applicable data on physical surroundings are still limited. Access to such data and the possibility to link them to epidemiological studies is critical to unlocking the relationship of environment, brain and behaviour and promoting positive future mental health outcomes. The Adolescent Brain Cognitive Development (ABCD) Study is the largest ongoing longitudinal and observational study exploring brain development and child health among children from 21 sites across the United States. Here we describe the linking of the ABCD study data with satellite-based "Urban-Satellite" (UrbanSat) variables consisting of 11 satellite-data derived environmental indicators associated with each subject's residential address at their baseline visit, including land cover and land use, nighttime lights, and population characteristics. We present these UrbanSat variables and provide a review of the current literature that links environmental indicators with mental health, as well as key aspects that must be considered when using satellite data for mental health research. We also highlight and discuss significant links of the satellite data variables to the default mode network clustering coefficient and cognition. This comprehensive dataset provides the foundation for large-scale environmental epidemiology research.
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Affiliation(s)
| | - Nathalie Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
| | - Garrett Tate
- New Light Technologies, Inc., Washington, DC 20012
| | - Kari Sherman
- New Light Technologies, Inc., Washington, DC 20012
| | | | - Soumitra S Bhuyan
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University- New Brunswick
| | - Yazan Al-Ajlouni
- New York Medical College School of Medicine, Valhalla, NY 10595, USA
| | | | | | - Shermaine Abad
- Department of Radiology, University of California, San Diego, 92093
| | - Megan M. Herting
- University of Southern California, Keck School of Medicine of USC, Los Angeles, CA, 90089
| | - Wesley Thompson
- Laureate Institute for Brain Research, Tulsa, Oklahoma, 74136, USA
| | - Bishal Thapaliya
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA 30303
| | - Ram Sapkota
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA 30303
| | - Jiayuan Xu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Jingyu Liu
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA 30303
| | | | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), ISTBI, Fudan University Shanghai, P.R. China
- PONS Centre, Dept. of Psychiatry and Neuroscience, CCM, Charite University Medicine Berlin, Germany
| | - Vince D. Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA 30303
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5
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Mouly TA, Mishra GD, Hystad P, Nieuwenhuijsen M, Knibbs LD. Residential greenspace and anxiety symptoms among Australian women living in major cities: A longitudinal analysis. ENVIRONMENT INTERNATIONAL 2023; 179:108110. [PMID: 37607424 DOI: 10.1016/j.envint.2023.108110] [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: 12/06/2022] [Revised: 07/08/2023] [Accepted: 07/20/2023] [Indexed: 08/24/2023]
Abstract
Despite an increasing number of studies demonstrating the potential mental health benefits of greenspace, few longitudinal studies have been reported. We aimed to assess associations between two metrics of residential greenspace exposure and anxiety symptoms in a cohort of Australian women living in major cities. Our study comprised 3,938 women, born between 1973 and 78. Anxiety symptoms in the previous month were assessed at follow-up every three years during 2003-2018, using the anxiety subscale of the Goldberg Anxiety and Depression Scale. The three-month seasonal average normalized difference vegetation index (NDVI) was estimated from 30 m Landsat satellite images in a 500 m buffer (NDVI500m) around participants' address at each survey (higher NDVI indicates more green vegetation). The annual fractional cover of non-photosynthesising vegetation was estimated (fNPV500m, with higher values indicating greater levels of dead leaf litter or dry grass). A generalised estimating equation assessed associations between greenspace measures and anxiety symptoms (as odds ratios [ORs]), adjusting for repeated outcomes and individual-level covariates. Additional analyses focused on women experiencing substantial changes in between-survey exposure due to moving, and adjusting for nitrogen dioxide (NO2) and fine particulate matter (PM2.5) exposure, among others. A standard deviation (SD) (0.12 units) increase in NDVI500m was significantly associated with lower odds of anxiety symptoms (OR: 0.96, 95% CI: 0.93-0.99) in the adjusted model. An SD (5.2%) increase in annual fNPV500m was consistent with the direction expected for that exposure, but not significant in the adjusted model (OR: 1.03, 95% CI: 0.99-1.07). NDVI500m was modestly attenuated when air pollutants were adjusted for, while fNPV500m only became significant when PM2.5 was adjusted for. Between-survey contrasts had no clear effect for NDVI500m. Moving to a higher fNPV500m area, compared with a similar fNPV500m area, was consistently associated with anxiety symptoms (OR: 1.15, 95% CI: 1.02-1.31). NDVI500m was generally associated with lower odds of anxiety symptoms, while fNPV500m was generally associated with higher odds of anxiety, depending on the covariates considered.
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Affiliation(s)
- Tafzila A Mouly
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - Gita D Mishra
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis Oregon, USA.
| | - Mark Nieuwenhuijsen
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, New South Wales, Australia; Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, New South Wales, Australia.
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6
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Riedel-Heller SG, Reininghaus U, Schomerus G. [Public mental health: Core component or side issue of public health?]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:356-362. [PMID: 36867193 PMCID: PMC9983529 DOI: 10.1007/s00103-023-03670-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/01/2023] [Indexed: 03/04/2023]
Abstract
This article provides an overview of the self-conception, research, and fields of action of public mental health. It is becoming clear that mental health is a central element of public health and that a relevant knowledge base exists on this topic. In addition, lines of development of this field, which is gaining in importance in Germany, are shown. Although there are important current initiatives in the field of public mental health, such as the establishment of a Mental Health Surveillance (MHS) and the Mental Health Offensive, the positioning in the field does not correspond to the relevance of mental illness in population medicine.
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Affiliation(s)
- Steffi G. Riedel-Heller
- grid.9647.c0000 0004 7669 9786Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Deutschland
| | - Ulrich Reininghaus
- grid.7700.00000 0001 2190 4373Abteilung Public Mental Health, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland ,grid.13097.3c0000 0001 2322 6764Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, Großbritannien ,grid.13097.3c0000 0001 2322 6764ESRC Centre for Society and Mental Health, King’s College London, London, Großbritannien
| | - Georg Schomerus
- grid.9647.c0000 0004 7669 9786Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Leipzig, Leipzig, Deutschland
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7
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Torres Toda M, Estarlich M, Ballester F, De Castro M, Fernández-Somoano A, Ibarluzea J, Iñiguez C, Lertxundi A, Subiza-Perez M, Sunyer J, Tardón A, Foraster M, Dadvand P. Associations of residential greenspace exposure and fetal growth across four areas in Spain. Health Place 2022; 78:102912. [DOI: 10.1016/j.healthplace.2022.102912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/14/2022] [Accepted: 09/12/2022] [Indexed: 12/01/2022]
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Runkle JD, Matthews JL, Sparks L, McNicholas L, Sugg MM. Racial and ethnic disparities in pregnancy complications and the protective role of greenspace: A retrospective birth cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 808:152145. [PMID: 34871679 DOI: 10.1016/j.scitotenv.2021.152145] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/17/2021] [Accepted: 11/29/2021] [Indexed: 06/13/2023]
Abstract
Greenspace may positively impact pregnancy health for racially and economically minoritized populations; few studies have examined local availability and accessibility of green/park space in reducing maternal morbidity. The objective of this retrospective birth cohort study was to examine the association between residential exposure to greenspace and adverse pregnancy health outcomes in a Southern US state characterized by high poverty and racial disparities in maternal health (2013-2017). National data from the Protected Area database - United States (PAD-US) and ParkServe estimated three publicly available and accessible residential greenspace measures-a more direct proxy than using remotely-sensed greenness indicators (e.g., normalized difference vegetation index (NDVI))-(a) percent area of greenspace (M1), (b) area of available greenspace per person (M2), (c) total population within a 10-minute walk (M3). Generalized Estimating Equations with logistic regression were used to examine the association between individual greenspace metrics and South Carolina hospital deliveries (n = 238,922 deliveries) for women with correlated maternal health outcomes for gestational hypertension (GHTN), gestational diabetes (GD), severe maternal morbidity (SMM), preeclampsia (PRE), mental disorders (MD), depressive disorders (DD), and preterm birth (PTB). Lowest compared to highest tertiles of all three metrics were associated with increased risk for MD, DD, and a monotonic increase in GD, particularly for black women. Women with the lowest access to M2 and M3 were more at risk for PRE, PTB, and MD. We observed that women in low-income, majority-black communities in the lowest versus highest tertile of M2 were more likely to experience a DD, MD, SMM, or PTB compared to primarily high-income majority-white communities. Available and accessible green/park space may present as an effective nature-based intervention to reduce maternal complications, particularly for gestational diabetes and other pregnancy health risks for which there are currently few known evidence-based primary prevention strategies.
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Affiliation(s)
- Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, 151 Patton Avenue, Asheville, NC 28801, USA.
| | - Jessica L Matthews
- NOAA's National Centers for Environmental Information (NCEI), 151 Patton Avenue, Asheville, NC 28801, USA.
| | - Laurel Sparks
- Department of Geosciences, Georgia State University, Atlanta, GA 30303, USA
| | - Leo McNicholas
- Department of Statistics and Operations Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, P.O. Box 32066, Boone, NC 28608, USA.
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9
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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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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: 14] [Impact Index Per Article: 4.7] [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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Knobel P, Maneja R, Bartoll X, Alonso L, Bauwelinck M, Valentin A, Zijlema W, Borrell C, Nieuwenhuijsen M, Dadvand P. Quality of urban green spaces influences residents' use of these spaces, physical activity, and overweight/obesity. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 271:116393. [PMID: 33388678 DOI: 10.1016/j.envpol.2020.116393] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 06/12/2023]
Abstract
The quality characteristics of urban green spaces (UGS) have been suggested to play a critical role in their use and their potentials to exert health effects. However, epidemiological studies evaluating such a role are scarce. These studies have generally focused on a limited number of quality dimensions. We studied the association between 10 UGS quality dimensions, assessed through a comprehensive multidimensional tool, and physical activity, overweight/obesity, and UGS use. Our study was based on 2053 adults participating in the Barcelona Health Survey (2016) and the quality of 149 UGS located in Barcelona, Spain. For each participant, we abstracted the average and maximum quality score separately for each of the 10 quality dimensions and an overall quality score for the UGS within 300 m of the participant's residential address. Data on the study outcomes were obtained through face-to-face interviews. We developed logistic regression and negative binomial models to assess our evaluated associations and conducted mediation analyses between the different outcomes. We observed that the overall quality of UGS was associated with higher likelihood of engaging in moderate-to-vigorous physical activity (OR:1.13; 95% CI:1.00-1.27), lower risk of overweight/obesity (OR: 0.88; 95% CI: 0.79-0.98), and increased use of UGS (exponentiated regression coefficient: 1.08; 95% CI:1.01-1.15). For the quality dimensions, we observed different patterns of associations depending on the outcome; however, bird biodiversity and amenities seem to be relevant to all of our evaluated outcomes. The mediation analysis suggested that UGS use mediate the association between quality and physical activity, while physical activity mediates the association between quality and overweight/obesity. The novel results from this study will allow decision-makers better design UGS and directly pinpoint relevant quality dimensions to promote physical activity, reduce the risk of overweight/obesity and boost the use of UGS amongst citizens.
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Affiliation(s)
- Pablo Knobel
- Environment and Human Health Lab (EH2 Lab), Universitat Autònoma de Barcelona, Barcelona, Spain; Environmental Science and Technology Institute (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain; Forest Science and Technology Centre of Catalonia (CTFC), Solsona, Spain
| | - Roser Maneja
- Environment and Human Health Lab (EH2 Lab), Universitat Autònoma de Barcelona, Barcelona, Spain; Geography Department, Universitat Autònoma de Barcelona, Barcelona, Spain; Forest Science and Technology Centre of Catalonia (CTFC), Solsona, Spain.
| | - Xavier Bartoll
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
| | | | - Mariska Bauwelinck
- ISGlobal, Barcelona, Spain; Interface Demography (ID), Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; Research Foundation - Flanders (FWO), Egmontstraat 5, 1000 Brussels, Belgium
| | | | | | - Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona, Spain; Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
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