Green space and mental health for vulnerable populations: A conceptual review of the evidence

Introduction: Mental health is an essential component of overall health that is affected by various environmental factors. Research suggests the inclusion of green space and nature settings in built environments is beneficial for mental health, particularly for vulnerable populations such as military Veterans. Inequities exist for certain populations in relation to accessing a high quality and quantity of green space. Methods: This conceptual review offers a broad assessment of peer-reviewed literature examining links between green space and mental health. Results: Many studies have highlighted associations between exposure to green space and the mental health of vulnerable populations, such as Veterans and individuals of relatively low socio-economic status (SES). Evidence points to the importance of contextual features of green space, such as quality and quantity of green space, in relation to mental health benefits. Engagement in nature-based outdoor activities in green space, or other nature settings, appears to offer restorative effects linked to cognitive function and mental health benefits. Discussion: There is an emerging body of evidence on the relationship between mental well-being and accessibility to green space and nature settings, particularly for vulnerable populations. More research should focus on accessibility to green space and nature settings for the Veteran population.

Prevalence of and risk factors for diabetes mellitus in the school-attending adolescent population of the United Arab Emirates: a large cross-sectional study

OBJECTIVES

The prevalence of diabetes has reportedly increased among adolescents in low-income and middle-income countries of the Middle East and may be linked to social, demographic and economic contextual factors. This study aimed: (1) to estimate the prevalence of self-reported diagnosis of diabetes in the adolescent population of the United Arab Emirates (UAE); (2) to assess differences in the prevalence based on gender and (3) to identify other characteristics of those with diabetes including parental marital status, smoking/illegal drug use, quality of life and nationality.

DESIGN

A secondary data analysis was performed on data from the National Study of Population Health in the UAE, conducted between 2007 and 2009.

SETTING

Large cross-sectional population-based survey study.

PARTICIPANTS

Survey was administered to a stratified random sample of 151 public and private schools from the UAE, across 7 emirates. 6365 school-attending adolescents (12-22 years; mean=16 years) participated.

OUTCOMES

Multivariable logistic regression analysis was used to examine the relationships between diabetes diagnosis and characteristics of participants after adjusting for confounding from other predictors.

RESULTS

The overall prevalence of self-reported diabetes was 0.9% (95% CI 0.7% to 1.2%) and was higher in males 1.5% (95% CI 1.0% to 2.1%) than females 0.5% (95% CI 0.3% to 0.8%), (p<0.001). Children of parents who were not currently married had more than twice the odds of self-reporting diabetes (p=0.031) compared with those with married parents. Adolescents who reported ever smoking/using illegal drugs had more than three times the odds of diabetes (p<0.001).

CONCLUSION

We found a positive association between certain characteristics of adolescents and their diabetes status, including male gender, parental marital status and smoking/illegal drug use. The high prevalence of smoking/illegal drug use among those reporting a diagnosis of diabetes suggests the need for behavioural and mental health interventions for adolescents with diabetes, as well as strong parental support and involvement.

Resilience under protracted conflict and siege: a new paradigm shift

This study sought to explore the relationship between resilience as perceived within the Palestinian context, and individual, contextual, and psychosocial factors among adults living in the Gaza Strip. Secondly, this study applies the Connor-Davidson Resilience Scale to the Palestinian population within the context of the challenges they are facing while living under extended sieges, in order to examine the generalizability of the resilience scale. Gender-specific bivariate analyses and multivariate linear regression were conducted to examine links between resilience, and diverse psychosocial and contextual factors. Males scored higher in resilience than females. Consistent predictors of higher resilience included, being male, employed, income, not living in a peaceful area, higher life satisfaction, and the Palestinian idea of resilience (Sumud). For the overall sample and males, hardiness was a positive predictor of higher resilience. For the overall sample and females, post-secondary education was a positive predictor of resilience. Psychosocial factors may act synergistically to foster resilience in the face of adversity, low socioeconomic status, and fear of living in a non-peaceful area. Our findings add to a limited body of literature calling for attention to contextual and psychosocial influences on gender differences in measuring and defining the dynamic nature of resilience.