Associations between green/blue spaces and mental health across 18 countries

Research article originally published in Nature.com in April 2021

Abstract
Living near, recreating in, and feeling psychologically connected to, the natural world are all associated with better mental health, but many exposure-related questions remain. Using data from an 18-country survey we explored associations between multiple measures of mental health (positive well-being, mental distress, depression/anxiety medication use) and: (a) exposures (residential/recreational visits) to different natural settings (green/inland-blue/coastal-blue spaces); and (b) nature connectedness, across season and country.

People who lived in greener/coastal neighbourhoods reported higher positive well-being, but this association largely disappeared when recreational visits were controlled for. Frequency of recreational visits to green, inland-blue, and coastal-blue spaces in the last 4 weeks were all positively associated with positive well-being and negatively associated with mental distress. Associations with green space visits were relatively consistent across seasons and countries but associations with blue space visits showed greater heterogeneity.

Nature connectedness was also positively associated with positive well-being and negatively associated with mental distress and was, along with green space visits, associated with a lower likelihood of using medication for depression. By contrast inland-blue space visits were associated with a greater likelihood of using anxiety medication. Results highlight the benefits of multi-exposure, multi-response, multi-country studies in exploring complexity in nature-health associations.

The research provides significant new insights into the relationships between mental health, residential and recreational exposure to green and blue spaces, and feeling psychologically connected to the natural world. Collecting data in four seasonal waves, across 18 different countries/regions allowed us to make far more nuanced conclusions than are generally possible.

There was little evidence in the current sample that the amount of green, and presence of inland- and coastal-blue space, within 1000 m of the home was directly related to mental health. In models without recreational visits, but controlling for socio-demographic confounders, residents of the greenest and coastal areas did report higher positive well-being, but these effects disappeared when visits were added, suggesting that visit frequency mediated these effects.

In other words, the reason why residents of the greenest and coastal neighbourhoods experienced better positive mental health might be because these neighbourhood qualities encouraged more frequent recreational visits.

Authors
Mathew P. White, Lewis R. Elliott, James Grellier, Theo Economou, Simon Bell, Gregory N. Bratman, Marta Cirach, Mireia Gascon, Maria L. Lima, Mare Lõhmus, Mark Nieuwenhuijsen, Ann Ojala, Anne Roiko, P. Wesley Schultz, Matilda van den Bosch & Lora E. Fleming

Source
Nature.com