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Ambient greenness, access to local green spaces, and subsequent mental health: a 10-year longitudinal dynamic panel study of 2·3 million adults in Wales

Rebecca S Geary, Daniel Thompson, Amy Mizen Orcid Logo, Ashley Akbari Orcid Logo, Joanne K Garrett, Francis M Rowney, Alan Watkins Orcid Logo, Ronan Lyons Orcid Logo, Gareth Stratton Orcid Logo, Rebecca Lovell, Mark Nieuwenhuijsen, Sarah C Parker, Jiao Song Orcid Logo, Dialechti Tsimpida, James White, Mathew P White, Susan Williams, Benedict W Wheeler, Rich Fry Orcid Logo, Sarah E Rodgers

The Lancet Planetary Health, Volume: 7, Issue: 10, Pages: e809 - e818

Swansea University Authors: Amy Mizen Orcid Logo, Ashley Akbari Orcid Logo, Alan Watkins Orcid Logo, Ronan Lyons Orcid Logo, Gareth Stratton Orcid Logo, Jiao Song Orcid Logo, Rich Fry Orcid Logo

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DOI (Published version): 10.1016/s2542-5196(23)00212-7

Abstract

Background: Evidence suggests living in greener areas, or close to green blue spaces (GBS; parks, lakes, or beaches) benefits mental health, but longitudinal evidence when GBS exposures precede outcomes is limited. We aimed to analyse the impact of living in greener areas, or close to GBS over time...

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Published in: The Lancet Planetary Health
ISSN: 2542-5196
Published: Elsevier BV 2023
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa64000
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Abstract: Background: Evidence suggests living in greener areas, or close to green blue spaces (GBS; parks, lakes, or beaches) benefits mental health, but longitudinal evidence when GBS exposures precede outcomes is limited. We aimed to analyse the impact of living in greener areas, or close to GBS over time on subsequent adult mental health, explicitly considering health inequalities, and disentangling the mental health benefits of potentially accessing GBS from living in greener areas.Methods; A cohort of the adults in Wales, UK (>16 years; n=2,341,591) was constructed from electronic health record (EHR) data sources, 2008-2019, comprising 19,141,896 person-years of follow-up. Household ambient greenness (Enhanced Vegetation Index, EVI), access to GBS (counts, distance to nearest); and common mental health disorders (CMD, based on a validated algorithm combining current diagnoses or symptoms of anxiety or depression (treated or untreated in the preceding one-year period), or treatment of historical diagnosis(es) frombefore the ‘current’ cohort (up to 8 years prior, to 2000), where diagnosis preceded treatment) were record-linked. Cumulative exposure values were created for each adult, censoring for CMD, migration out-of-Wales, death, or end of cohort. Exposure and CMD associations were evaluated using multivariate logistic regression, stratified by area-level deprivation.Findings: After adjustment, exposure to greater ambient greenness over time (+0.1 increased EVI on a 0-1 scale) was associated with lower odds of subsequent CMD (Adjusted Odds Ratio (AOR) = 0.80, 95% CI: 0.80, 0.81), where CMD was based on a combination of current diagnoses or symptoms (treated or untreated in the preceding one-year period), or treatments). Ten percentile points more access to GBS was associated with lower odds of a later CMD (AOR = 0.93 95% CI 0.93, 0.93). Every additional 360m to the nearest GBS was associated with higher odds of CMD (AOR = 1.05, 95% CI 1.04, 1.05). We found differences across deprivation quintiles. Interpretation Ambient exposure is associated with the greatest reduced risk of CMD, particularly for adults who live in deprived communities. Findings support authorities responsible for GBS who are attempting to engage planners and policy makers, to ensure GBS meets resident needs.
Keywords: Green spaces, blue spaces, mental health, health inequalities, Wales
College: Faculty of Medicine, Health and Life Sciences
Funders: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme (Project number 16/07/07). Time for SER to contribute to this project was funded by The National Institute for Health Research Applied Research Collaboration North West Coast (NIHR ARC NWC). We thank Mr Roberto Villegas-Diaz for drawing the Forest plots.
Issue: 10
Start Page: e809
End Page: e818

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