Exposure to natural space, sense of community belonging, and adverse mental health outcomes across an urban region

Rugel, Emily J.; Carpiano, Richard M.; Henderson, Sarah B.; Bräuer, Michael

doi:10.1016/j.envres.2019.01.034

Cited by 134 publications

(92 citation statements)

References 61 publications

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“…This ts with earlier data that have shown a clear trend towards higher prevalence rates for psychiatric disorders with increasing urbanization (9). Greenspace in rural counties might be the pivotal protective agens to ameliorate course of mental diseases, as its effect on mental health has been shown by ecological (35) studies and by studies on publicly accessible greenspace in urban living areas (36).…”

Section: Discussionsupporting

confidence: 87%

Stress and the City: Living in Rural Environment has a Protective Effect on Hospital Readmission Rates in Chronic Psychiatric Disorders

Langguth

Frick

2020

Preprint

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Background:Living in urban environment represents a well-known risk factor for the development of mental disorders. Here we aimed to investigate whether urbanicity has also an effect on the trajectories of psychiatric disorders. For this purpose, we analyzed the relationship between urbanization and hospital readmission risk. Method:We analysed the impact of geospatial, demographic, clinical and socioeconomic data on hospital readmission risk in a sample of 17’145 patients observed during a 12 years period starting from 1996 and leading to 37’697 psychiatric hospitalizations by using a frailty model Results:Living in more urbanized regions was related to an increasing risk for earlier rehospitalization. The impact of urbanicity was less pronounced in patients with affective disorders and more pronounced in patients with co-morbid substance abuse disorder. Shorter distance to the hospital and change of residence increased the readmission risk. Population density, proportion of non-german citizens, local population growth tendency, and local unemployment rate were not associated with readmission risk. Conclusion:A clear impact of urban living environment on the course of mental disorders was demonstrated. In metropolitan regions of our sample it took one year till 50% of discharged patients had been readmitted to the psychiatric clinic, whereas this took 6 years in rural regions.

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Section: Discussionsupporting

confidence: 87%

Stress and the City: Living in Rural Environment has a Protective Effect on Hospital Readmission Rates in Chronic Psychiatric Disorders

Langguth

Frick

2020

Preprint

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“…Comparing the associations with general health to those with mental health, larger differences between odds ratios corresponding to different levels of community belonging were observed in the mental health models. The associations between social cohesion with mutual respect and self-esteem have been understood to influence psychological domains: a lack of connectedness acting as a chronic stressor is associated with poorer psychological functioning, more severe depression, and increased distress ( Rugel et al, 2019 , Thoits, 2011 ). Given that one in three Canadians meets the criteria for a mental or substance use disorder at some point in their lifetime, and that this prevalence is rising, the identification of a potentially modifiable determinant of mental health is becoming increasingly relevant and important for Canada's health system ( Pearson et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Relationship between sense of community belonging and self-rated health across life stages

Michalski

Diemert

Helliwell

et al. 2020

SSM - Population Health

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Background Health interventions aimed at facilitating connectedness among seniors have recently gained traction, seeing as social connectedness is increasingly being recognized as an important determinant of health. However, research examining the association between connectedness and health across all age groups is limited, and few studies have focused on community belonging as a tangible aspect of social connectedness. Using a population-based Canadian cohort, this study aims to investigate (1) the associations between community belonging with self-rated general health and self-rated mental health, and (2) how these associations differ across life stages. Methods Data from six cycles of a national population health survey (Canadian Community Health Survey) from 2003 to 2014 were combined. Multinomial logistic regressions were run for both outcomes on the overall study sample, as well as within three age strata: (1) 18–39, (2) 40–59, and (3) ≥ 60 years old. Results Weaker community belonging exhibited an association with both poorer general and mental health, though a stronger association was observed with mental health. These associations were observed across all three age strata. In the fully adjusted model, among those reporting a very weak sense of community belonging, the odds of reporting the poorest versus best level of health were 3.21 (95% CI: 3.11, 3.31) times higher for general health, and 4.95 (95% CI: 4.75, 5.16) times higher for mental health, compared to those reporting a very strong sense of community belonging. The largest effects among those reporting very weak community belonging were observed among those aged between 40 and 59 years old. Conclusion This study contributed to the evidence base supporting life stage differences in the relationship between community belonging and self-perceived health. This is a starting point to identifying how age-graded differences in unmet social needs relate to population health interventions.

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“…However, findings that relate NDVI to health outcomes are not always consistent. For example, while [13] reported beneficial effects of green space on brain development, another study found an insignificant direct effect of residential NDVI extracted from the Moderate Resolution Imaging Spectroradiometer (MODIS) on major depressive disorders and psychological distress [20].…”

Section: Introductionmentioning

confidence: 99%

“…Green space varies naturally over time, but ambiguities can also arise artificially as a result of applied data processing [22]. Despite such temporal variations in NDVI scores, some studies [20,23] defend the application of NDVI data that are misaligned with epidemiological data. However, empirical results supporting such practices are lacking.…”

Section: Introductionmentioning

confidence: 99%

Spatiotemporal Contextual Uncertainties in Green Space Exposure Measures: Exploring a Time Series of the Normalized Difference Vegetation Indices

Helbich

2019

IJERPH

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Environmental health studies on green space may be affected by contextual uncertainties originating from the temporality of environmental exposures and by how the spatial context is delimitated. The Normalized Difference Vegetation Index (NDVI) is frequently used as an outdoor green space metric capturing the chlorophyll content in the vegetation canopy. This study assessed (1) whether residential NDVI exposures vary over time, and (2) how these time series of NDVI scores vary across spatial context delimitations. Multi-temporal NDVI data for the period 2006–2017 for the Netherlands were obtained from the Moderate Resolution Imaging Spectroradiometer (MODIS) satellite platform. Annual NDVI exposures were determined across multiple buffer sizes (i.e., 300, 600, and 1000 m) centered on a random sample of 10,000 Dutch residential addresses. Besides the descriptive statistics, pairwise Wilcoxon tests and Fligner–Killeen tests were used to determine mean and variance differences in annual NDVI scores across buffer widths. Heat maps visualized the correlation matrices. Significance levels were adjusted for multiple hypotheses testing. The results indicated that annual NDVI metrics were significantly correlated but their magnitude varied notably between 0.60 to 0.97. Numerous mean and variance differences in annual NDVI exposures were significant. It seems that the disparate buffers (i.e., 300 and 1000 m) were less strongly correlated, possibly because variance heterogeneity is reduced in larger buffers. These results have been largely consistent over the years and have passed Monte Carlo-based sensitivity tests. In conclusion, besides assessing green space exposures along different buffer sizes, our findings suggest that green space–health studies should employ NDVI data that are well-aligned with epidemiological data. Even an annual temporal incompatibility may obscure or distort green space–health associations. Both strategies may diminish contextual uncertainties in environmental exposure assessments.

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Exposure to natural space, sense of community belonging, and adverse mental health outcomes across an urban region

Cited by 134 publications

References 61 publications

Stress and the City: Living in Rural Environment has a Protective Effect on Hospital Readmission Rates in Chronic Psychiatric Disorders

Stress and the City: Living in Rural Environment has a Protective Effect on Hospital Readmission Rates in Chronic Psychiatric Disorders

Relationship between sense of community belonging and self-rated health across life stages

Spatiotemporal Contextual Uncertainties in Green Space Exposure Measures: Exploring a Time Series of the Normalized Difference Vegetation Indices

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