Health Disparities in the Relationship of Neighborhood Greenness to Mental Health Outcomes in 249,405 U.S. Medicare Beneficiaries

Abstract

Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence) and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer’s disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer’s disease (by 18%) and depression (by 28%) for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37% lower odds of depression in low-income neighborhoods, compared to 27% and 21% lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation.

Addressing Inequity: Evaluation of an Intervention to Improve Accessibility and Quality of a Green Space

“…The associations between green space, health, and well-being are well described and have been outlined in numerous publications [1][2][3][4][5][6][7][8]. Ensuring that public green spaces are available and accessible for all population groups can promote contact with nature, social interaction and physical activity (e.g., walking, running, and cycling), and have a positive impact on a range of health outcomes [3,4,[9][10][11][12]. However, some studies have also found that not all public green spaces facilitate physical activity [13,14]; thus, it can be argued that public green spaces have the potential to promote physical activity, but certain characteristics are needed for this to be realised.…”

“…Furthermore, living in greener neighbourhoods has been found to create a stronger green space-health association [32,33] as well as lower levels of health inequality related to income deprivation [34]. Studies have also indicated that socioeconomically disadvantaged populations gain particular health benefits from greater contact with and use of green space areas [5,[10][11][12][35][36][37][38], most likely because this group generally has poorer health and lives in areas with more environmental problems [35]. This group also tends to be more dependent on local resources [9,11,12,34,39] since they have fewer opportunities to travel away from their neighbourhoods of residence.…”

“…Studies have also indicated that socioeconomically disadvantaged populations gain particular health benefits from greater contact with and use of green space areas [5,[10][11][12][35][36][37][38], most likely because this group generally has poorer health and lives in areas with more environmental problems [35]. This group also tends to be more dependent on local resources [9,11,12,34,39] since they have fewer opportunities to travel away from their neighbourhoods of residence. Thus, equitable access to local resources, such as green spaces, can be a potential way to moderate health inequalities associated with socioeconomic deprivation [5,[10][11][12]23,36,[40][41][42].…”

“…This group also tends to be more dependent on local resources [9,11,12,34,39] since they have fewer opportunities to travel away from their neighbourhoods of residence. Thus, equitable access to local resources, such as green spaces, can be a potential way to moderate health inequalities associated with socioeconomic deprivation [5,[10][11][12]23,36,[40][41][42]. It is also the case that providing public green spaces that are inaccessible for socioeconomically disadvantaged groups might result in widening both health and social inequalities [12,[41][42][43].…”

Empirical Analysis on the Positive Correlation Between Physical Exercise and the Mental Health of College Students

“…However, it has been rarely studied on how to effectively promote the mental health by a certain aspect of improvement. In literature (Muto, Hayes, & Jeffcoat, 2017;Pickard, Rodriguez, & Lewis et al, 2017), it's proposed to improve mental health problems through music, and the implementation methods were also given, but no more studies on the psychological barriers due to lack of personality communication (Brown, Perrino, Lombard et al, 2018). As an effective means to enhance the physical health and relieve tension, physical exercise can directly affect the human body (Musich, Wang, Hawkins et al, 2016).…”