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Green qualities in the neighbourhood and mental health - results from a longitudinal cohort study in Southern Sweden

Annerstedt, Matilda; Östergren, Per-Olof LU ; Björk, Jonas LU ; Grahn, Patrik; Skarback, Erik and Wahrborg, Peter (2012) In BMC Public Health 12.
Abstract
Background: Poor mental health is a major issue worldwide and causality is complex. For diseases with multifactorial background synergistic effects of person-and place-factors can potentially be preventive. Nature is suggested as one such positive place-factor. In this cohort study we tested the effect of defined green qualities (Serene, Space, Wild, Culture, Lush) in the environment at baseline on mental health at follow-up. We also studied interaction effects on mental health of those place factors and varied person factors (financial stress, living conditions, and physical activity). Methods: Data on person factors were extracted from a longitudinal (years 1999/2000 and 2005) population health survey (n = 24945). The participants were... (More)
Background: Poor mental health is a major issue worldwide and causality is complex. For diseases with multifactorial background synergistic effects of person-and place-factors can potentially be preventive. Nature is suggested as one such positive place-factor. In this cohort study we tested the effect of defined green qualities (Serene, Space, Wild, Culture, Lush) in the environment at baseline on mental health at follow-up. We also studied interaction effects on mental health of those place factors and varied person factors (financial stress, living conditions, and physical activity). Methods: Data on person factors were extracted from a longitudinal (years 1999/2000 and 2005) population health survey (n = 24945). The participants were geocoded and linked to data on green qualities from landscape assessments, and stored in the Geographical Information System (GIS). Crude odds ratios (OR) and 95% confidence intervals (CI) were calculated, and multivariate logistic analyses were performed. Results: Mental health was not affected by access to the chosen green qualities, neither in terms of amount nor in terms of any specific quality. However, we found a reduced risk for poor mental health at follow-up among women, through a significant interaction effect between physical activity and access to the qualities Serene or Space. For men the tendencies were similar, though not significant. Regarding the other three green qualities, as well as amount of qualities, no statistically certain synergistic effects were found. Likewise, no significant synergies were detected between green qualities and the other person-factors. Only advanced exercise significantly reduced the risk for poor mental health among women, but not for men, compared to physical inactivity. Conclusions: The results do not directly support the hypothesis of a preventive mental health effect by access to the green qualities. However, the additive effect of serene nature to physical activity contributed to better mental health at follow-up. This tendency was equal for both sexes, but statistically significant only for women. Objective landscape assessments may be important in detangling geographic determinants of health. This study stresses the importance of considering interaction effects when dealing with disorders of multifactorial background. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Environment, Population health, Stress, Salutogenic, GIS, Landscape, assessment, Synergistic effect, Physical activity, GHQ12
in
BMC Public Health
volume
12
publisher
BioMed Central
external identifiers
  • wos:000308921000001
  • scopus:84860649490
ISSN
1471-2458
DOI
10.1186/1471-2458-12-337
language
English
LU publication?
yes
id
e3fa46d7-d4a0-4924-a839-e0506fcb31bf (old id 3135802)
date added to LUP
2012-11-01 16:32:33
date last changed
2017-11-12 03:38:38
@article{e3fa46d7-d4a0-4924-a839-e0506fcb31bf,
  abstract     = {Background: Poor mental health is a major issue worldwide and causality is complex. For diseases with multifactorial background synergistic effects of person-and place-factors can potentially be preventive. Nature is suggested as one such positive place-factor. In this cohort study we tested the effect of defined green qualities (Serene, Space, Wild, Culture, Lush) in the environment at baseline on mental health at follow-up. We also studied interaction effects on mental health of those place factors and varied person factors (financial stress, living conditions, and physical activity). Methods: Data on person factors were extracted from a longitudinal (years 1999/2000 and 2005) population health survey (n = 24945). The participants were geocoded and linked to data on green qualities from landscape assessments, and stored in the Geographical Information System (GIS). Crude odds ratios (OR) and 95% confidence intervals (CI) were calculated, and multivariate logistic analyses were performed. Results: Mental health was not affected by access to the chosen green qualities, neither in terms of amount nor in terms of any specific quality. However, we found a reduced risk for poor mental health at follow-up among women, through a significant interaction effect between physical activity and access to the qualities Serene or Space. For men the tendencies were similar, though not significant. Regarding the other three green qualities, as well as amount of qualities, no statistically certain synergistic effects were found. Likewise, no significant synergies were detected between green qualities and the other person-factors. Only advanced exercise significantly reduced the risk for poor mental health among women, but not for men, compared to physical inactivity. Conclusions: The results do not directly support the hypothesis of a preventive mental health effect by access to the green qualities. However, the additive effect of serene nature to physical activity contributed to better mental health at follow-up. This tendency was equal for both sexes, but statistically significant only for women. Objective landscape assessments may be important in detangling geographic determinants of health. This study stresses the importance of considering interaction effects when dealing with disorders of multifactorial background.},
  author       = {Annerstedt, Matilda and Östergren, Per-Olof and Björk, Jonas and Grahn, Patrik and Skarback, Erik and Wahrborg, Peter},
  issn         = {1471-2458},
  keyword      = {Environment,Population health,Stress,Salutogenic,GIS,Landscape,assessment,Synergistic effect,Physical activity,GHQ12},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Public Health},
  title        = {Green qualities in the neighbourhood and mental health - results from a longitudinal cohort study in Southern Sweden},
  url          = {http://dx.doi.org/10.1186/1471-2458-12-337},
  volume       = {12},
  year         = {2012},
}