Spatial Analysis of Greenspace and Mental Health in North Carolina

Abstract

Greenspace positively impacts mental health. Previous research has focused on the greenspace-mental health relationship in urban areas. Yet, little work has looked at rural areas despite rural communities reporting similar rates of poor mental health outcomes and higher rates of suicide mortality compared with urban areas. This ecological research study examined the following research questions: (1) Do public and/or private greenspaces affect the spatial distribution of mental health outcomes in North Carolina? (2) Does this relationship change with rurality? Emergency department data for 6 mental health conditions and suicide mortality data from 2009 to 2018 were included in this analysis. Spatial error and ordinary least squares regressions were used to examine the influence of public and private greenspace quantity on mental health in rural and urban communities. Results suggest greenspace benefits mental health in rural and urban communities. The strength of this relationship varies with urbanity and between public and private greenspaces, suggesting a more complex causal relationship. Given the high case counts and often lower density of mental health care facilities in rural areas, focusing attention on low-cost mental health interventions, such as greenspace, is important when considering rural mental health care.

Advancing Understanding on Greenspace and Mental Health in Young People

“…Recent research corroborates our substance use disorder findings; suggesting greenspace may be associated with lower rates of binge drinking and tobacco-use among adolescents and young adults (Wiley et al, 2022) and the general public (Berry et al, 2021;Ryan et al, 2023). Our analysis highlights the protective role of greenspace quantity for young people's mental health in urban and suburban neighborhoods.…”

“…(Ekkel & de Vries, 2017). Past research suggests that private greenspace may also benefit community mental health (Ryan et al, 2023;Verheij et al, 2008), which could help explain our greenspace quantity findings in micropolitan, small town and rural/isolated communities. Our results indicate that with regards to greenspace interventions, micropolitan areas may benefit more from increased accessibility of greenspace, rather than increased greenspace quantity.…”

“…The greenspace‐mental health association may vary with rurality (Jiang et al., 2021 ; Ryan et al., 2023 ). Rurality was included using Rural‐Urban Commuting Area (RUCA) codes at the ZCTA‐level.…”

Mapping high-risk clusters and identifying place-based risk factors of mental health burden in pregnancy

“…Insurance included Medicaid, other government insurance, self-pay, and commercial insurance. Insurance was used as a proxy for individual socioeconomic status ( Margiotta et al, 2022 ; Ryan et al, 2023 ).…”

“…Availability of greenspace was measured using the proportion of greenspace per person at the ZCTA level using cross-sectional data from PAD-US, following a methodology proposed by Runkle et al, 2022 ). The upper 25th percentile of ZCTAs with the highest proportion of greenspace per person were classified as having a high level of greenspace; the bottom 75th percentile was classified as having low greenspace ( Runkle et al, 2022 ; Ryan et al, 2023 ).…”