Cause and context: place-based approaches to investigate how environments affect mental health

Abstract

Our surroundings affect our mood, our recovery from stress, our behavior, and, ultimately, our mental health. Understanding how our surroundings influence mental health is central to creating healthy cities. However, the traditional observational analyses now dominant in the psychiatric epidemiology literature are not sufficient to garner such an understanding. Alternative strategies, such as randomizing people to place, randomizing places to change, or harnessing natural experiments that mimic randomized experiments each have their strengths and weaknesses. We discuss these strengths and weaknesses with respect to (1) defining the most relevant scale and characteristics of context, (2) disentangling the effects of context from the effects of individuals' preferences and prior health, and (3) generalizing causal effects beyond the study setting. Promising alternative strategies include creating many small-scale randomized place-based trials, using the deployment of place-based changes over time as natural experiments, and using fluctuations in the changes in our surroundings in combination with emerging data collection technologies to better understand how surroundings influence mood, behavior, and mental health. Improving existing research strategies will require interdisciplinary partnerships between those specialized in mental health, those advancing new methods for place effects on health, and those who seek to optimize the design of local environments.

Are Rurality, Area Deprivation, Access to Outside Space, and Green Space Associated with Mental Health during the COVID-19 Pandemic? A Cross Sectional Study (CHARIS-E)

“…Related to this point, we did not examine mechanisms to explain environmental differences and mental health. Future research should consider measuring proposed potential mechanisms such as the effect of environment on mood and recovery from stress [ 61 ] and environment effects on social support and interpersonal relationships [ 62 , 63 ]. Both of these potential mechanisms may be pertinent in pandemics due to the effects of communicable disease on stress and on restrictions on social interactions to reduce transmission of the infection.…”

Road Traffic Noise Exposure and Depression/Anxiety: An Updated Systematic Review and Meta-Analysis

“…Further, the variation through major differences in contextual factors [88], which are known moderators or potential mediators like the built environment [89,90], green space [91,92,93], and social capital [94,95] could not be evaluated.…”

Comparisons of depression, anxiety, well-being, and perceptions of the built environment amongst adults seeking social, intermediate and market-rent accommodation in the former London Olympic Athletes’ Village

“…Mental health problems are common amongst those with lower SES ( Goldman, 2001 ), and those with low SES are less likely to be able to afford to move into a neighbourhood that has lower crime rates and where one feels safe ( Lovasi et al, 2016 ). The Examining Neighbourhood Activities in Built Living Environments in London (ENABLE London) study, is a natural experiment evaluating the extent to which health behaviours change amongst adults with differing socio-economic backgrounds, who are seeking to move into social, intermediate (affordable rent / shared ownership), and market-rent (private rent) housing in East Village (formerly, the London 2012 Olympic Athletes’ Village), which was specifically designed to encourage positive health behaviours.…”