The association between green space and depressive symptoms in pregnant women: moderating roles of socioeconomic status and physical activity

Abstract

BackgroundThe current study explored the association between green space and depression in a deprived, multiethnic sample of pregnant women, and examined moderating and mediating variables.Method7547 women recruited to the ‘Born in Bradford’ cohort completed a questionnaire during pregnancy. A binary measure of depressive symptoms was calculated using a validated survey. Two green space measures were used: quintiles of residential greenness calculated using the normalised difference vegetation index for three neighbourhood sizes (100, 300 and 500 m buffer zones around participant addresses); access to major green spaces estimated as straight line distance between participant address and nearest green space (>0.5 hectares). Logistic regression analyses examined relationships between green space and depressive symptoms, controlling for ethnicity, demographics, socioeconomic status (SES) and health behaviours. Multiplicative interactions explored variations by ethnic group, SES or activity levels. Mediation analysis assessed indirect effects via physical activity.ResultsPregnant women in the greener quintiles were 18–23% less likely to report depressive symptoms than those in the least green quintile (for within 100 m of green space buffer zone). The green space-depressive symptoms association was significant for women with lower education or who were active. Physical activity partially mediated the association of green space, but explained only a small portion of the direct effect.ConclusionsHigher residential greenness was associated with a reduced likelihood of depressive symptoms. Associations may be stronger for more disadvantaged groups and for those who are already physically active. Improving green space is a promising intervention to reduce risk of depression in disadvantaged groups.

Residential greenness: current perspectives on its impact on maternal health and pregnancy outcomes

“…For example, McEachan et al tested whether the relationship between NDVI and peripartum depression differed by physical activity level, and found that the beneficial effect of greenness was stronger in those who were physically active, only in the 300 m buffer 9. There was no evidence of effect modification by physical activity in their analysis concerning proximity to a major green space.…”

A Review of Epidemiologic Studies on Greenness and Health: Updated Literature Through 2017

“…For example, in a prospective study of individuals with diabetes, NDVI was associated with a lower risk of depression, however, density of parks/recreational space did not influence depression [39]. In another study of pregnant women in Bradford, United Kingdom, those who resided in the 3 rd or higher quintiles of greenness were 18–23% less likely to report depressive symptoms [27]. Moreover, stronger effect for greenness were estimated among those who were disadvantaged and physically inactive.…”

Green Infrastructure, Green Stormwater Infrastructure, and Human Health: A Review

“…Thus, designers and planners should work with GI researchers to find the optimal types and sizes of GI to implement for both ecological and human health purposes. Finally, because GI benefits several population types, designers should infuse urban areas with trees, green spaces, and other forms of GI so that workers [19], students [13], mothers [90], and people who have mental issues [32] have easy access to GI.…”