A natural experiment reveals impacts of built environment on suicide rate: Developing an environmental theory of suicide

Jiang, Bin; Shi, Ke; Sullivan, W. C.; Yang, Yiyang; Liu, Xueming; Lü, Yi

doi:10.1016/j.scitotenv.2021.145750

Cited by 25 publications

(15 citation statements)

References 60 publications

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“…Holtan and colleagues also speculated that public green spaces are open spaces with relatively low-cost and easy interventions to increase the strength of social capital among communities and may could reduce the suicide mortality risk ( 36 ). In addition, an environmental theory of suicide proposed by Jiang demonstrated a significant relationship between built environment and suicide mortality ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Examining the Benefits of Greenness on Reducing Suicide Mortality Rate: A Global Ecological Study

Asri

Tsai²,

Wong³

et al. 2022

Front. Public Health

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ObjectiveThis study applied an ecological-based analysis aimed to evaluate on a global scale the association between greenness exposure and suicide mortality.MethodsSuicide mortality data provided by the Institute for Health Metrics and Evaluation and the Normalized Difference Vegetation Index (NDVI) were employed. The generalized additive mixed model was applied to evaluate with an adjustment of covariates the association between greenness and suicide mortality. Sensitivity tests and positive-negative controls also were used to examine less overt insights. Subgroup analyses were then conducted to investigate the effects of greenness on suicide mortality among various conditions.ResultsThe main finding of this study indicates a negative association between greenness exposure and suicide mortality, as greenness significantly decreases the risk of suicide mortality per interquartile unit increment of NDVI (relative risk = 0.69, 95%CI: 0.59–0.81). Further, sensitivity analyses confirmed the robustness of the findings. Subgroup analyses also showed a significant negative association between greenness and suicide mortality for various stratified factors, such as sex, various income levels, urbanization levels, etc.ConclusionsGreenness exposure may contribute to a reduction in suicide mortality. It is recommended that policymakers and communities increase environmental greenness in order to mitigate the global health burden of suicide.

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Section: Discussionmentioning

confidence: 99%

Examining the Benefits of Greenness on Reducing Suicide Mortality Rate: A Global Ecological Study

Asri

Tsai²,

Wong³

et al. 2022

Front. Public Health

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“…It is subjected to ecological fallacy. Future studies can use individual level data or experimental studies to confirm the causal relations and the potential underlying mechanisms (Jiang et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…Exposure to air pollution (Ali & Islam, 2020; Konstantinoudis et al, 2021; Liang et al, 2020), crowded housing (Brandén et al, 2020; Hu, Roberts, Azevedo, & Milner, 2021; van Ingen et al, 2021), and lower average temperature (Ma et al, 2020; Perone, 2021) were found to increase COVID-19 deaths. The relationship between greenspace and COVID-19 mortality rates has received far less attention (Jiang, Yang, et al, 2021; Klompmaker et al, 2021; Lu, Chen, et al, 2021), despite the numerous salutary effects of nature exposure on human health.…”

Section: Introductionmentioning

confidence: 99%

Population-weighted greenspace exposure tied to lower COVID-19 mortality rates: A nationwide dose-response study in the United States

Yang

Lü

Jiang

2022

Preprint

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The COVID-19 outbreak has caused enormous deaths and profound social and economic disruption globally. Accumulating evidence suggests exposure to greenspace may reduce the risk of COVID-19 mortality. Greenspace exposure enhances immune functioning, reduces inflammation, and replenishes gut microbiota may protect against the risk of mortality among those with COVID-19. However, previous studies often fail to distinguish the health effect of different types of greenspace, explore the dose-response association and optimal buffer distance, and consider the spatial dynamics of population distribution and geographic locations of greenspace.This study examined the associations among ratio of different types of greenspaces, population- weighted exposure to different types of greenspaces, and COVID-19 mortality rates using a negative binomial generalized linear mixed effects model across 3,025 counties, adjusted for socioeconomic, demographic, pre-existing chronic disease, policy and regulation, behavioral, and environmental factors. The population-weighted measure gave proportionally greater weight to greenspace near areas of higher population density.Exposure to forest and pasture was negatively associated with COVID-19 mortality rates, while developed open space has insignificant or positive associations with mortality rates. Forest outside park has the largest effect size across all buffer distances, followed by forest inside park. The optimal exposure buffer distance is 1km for forest outside park, with 1 unit of increase in exposure associated with a 9.9% decrease in mortality rates (95% confidence interval: 6.9% -12.8%). The optimal exposure buffer distance of forest inside park is 400m, with 1 unit of increase in exposure, associated with a 4.7% decrease in mortality rates (95% confidence interval: 2.4% - 6.9%).Greenspaces, especially nearby forest, may be effective at lowering the mortality risk of COVID-19 patients. Our findings suggest that policymakers and planners should prioritize forestry within walking distance of residential clusters to mitigate mortality rates during current and future respiratory pandemics.

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“…Still, the notion that exposure to green spaces, and forest in particular, lower infection rates from SARS-CoV-2 is plausible, based on the mechanisms proposed and a wealth of previous research. We suggest more experimental studies, including laboratory or natural experiments, be conducted to fully confirm these casual relationships (Jiang et al, 2021;Tyrvainen et al, 2014).…”

Section: Limitations and Future Research Opportunitiesmentioning

confidence: 91%

Green spaces, especially forest, linked to lower SARS-CoV-2 infection rates: A one-year nationwide study

Jiang

Yang

Chen

et al. 2021

Preprint

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This study examined the associations between green spaces and one–years' worth of SARS–CoV–2 infection rates across all 3,108 counties in the contiguous United States after controlling for multiple categories of confounding factors. We found green spaces at the county level have a significant negative association with infection rates. Among all types of green spaces, forest yields the most consistent and strongest negative association. Sensitivity analyses confirmed the negative association of forest across five urbanicity levels, and the strength of the association increases as disease incidence increases across five time periods. Although forest located in moderately urbanized counties yields the strongest association, the negative pattern of significant associations holds across all five urbanicity levels. A population–weighted analysis revealed that proximity to forest within a moderate walking distance (≤ 1.0–1.4 km) may provide the greatest protection against the risk of infection.

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A natural experiment reveals impacts of built environment on suicide rate: Developing an environmental theory of suicide

Cited by 25 publications

References 60 publications

Examining the Benefits of Greenness on Reducing Suicide Mortality Rate: A Global Ecological Study

Examining the Benefits of Greenness on Reducing Suicide Mortality Rate: A Global Ecological Study

Population-weighted greenspace exposure tied to lower COVID-19 mortality rates: A nationwide dose-response study in the United States

Green spaces, especially forest, linked to lower SARS-CoV-2 infection rates: A one-year nationwide study

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