The Association of Active Living Environments and Mental Health: A Canadian Epidemiological Analysis

Abstract

Environments that promote use of active transport (walking, biking, and public transport use) are known as “active living environments” (ALE). Using a Canadian national sample, our aim was to determine if ALEs were associated with mental health outcomes, including depressive symptoms, and mood and anxiety disorders. Data from the Canadian Community Health Survey from 2015–2016 was used for demographic characteristics and mental health outcomes (n ≈ 110,000). This data was linked to datasets from the Canadian Urban Environmental Health Research Consortium, reporting ALE and social and material deprivation. Depressive symptoms were evaluated using standard dichotomized scores of 5+ (mild) and 10+ (moderate/severe) from the Patient Health Questionnaire-9. Self-reported diagnosed mood and anxiety disorders were also included. Logistic regression was used to determine the association of mental health outcomes with four classes of ALE. The analysis included adjustments for social and material deprivation, age, sex, chronic conditions, marital status, education, employment, income, BMI, and immigrant status. No association between any mental health outcome and ALE were observed. While the benefits of ALE to physical health are known, these results do not support the hypothesis that more favorable ALE and increased use of active transport is associated with better mental health outcomes.

Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population

“…While geospatial measures of population dependency have been widely related elsewhere to chronic physical health problems [36], we found few stable associations, likely reflecting age-specific patterns of mental service contacts. A recent Canadian study found no association between mental health outcomes and physical activity-friendliness of built environments [42]. A lack of statistical significance in certain hypothesized prediction patterns may be related to narrower between-neighbourhood sociodemographic differences within less-populated jurisdictions, e.g., small proportions of minority ethnic groups [25].…”

Individual physical activity, neighbourhood active living environment and mental illness hospitalisation among adults with cardiometabolic disease: a Canadian population-based cohort analysis

“…Walking itself has been identified as Canadians’ leading activity to stay fit; it is inexpensive and generally possible for individuals of all ages 27. While growing evidence indicates that walking also has benefits to mental health and well-being, recent studies note that the research remains limited and incomplete for associations between individuals’ physical activity and their residential built environments with selected mental health outcomes 28 29. A small body of literature has found that adults with diabetes residing in poorer or more materially deprived neighbourhoods experience worse mental health outcomes compared with those residing in more affluent neighbourhoods 30 31.…”

“…We use multiple types of linked data from national survey, administrative and socioenvironmental sources, acquired through Statistics Canada’s Social Data Linkage Environment. Previous studies have used linked data to examine associations between individual-level and residential measures of active living with use of active transportation, self-reported mood and anxiety disorders, and premature cardiometabolic mortality 26 29 32. We aim to address the question: do adults 35 years and above with a pre-existing cardiometabolic condition residing in neighbourhoods that are less activity-supportive have higher risk of hospitalisation for mental health and substance use disorders, independently of their physical activity level?…”