Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
Department of Health Sciences, Northeastern University, Boston, MA 02115, United States of America.
Sci Total Environ. 2019 Mar 25;658:854-860. doi: 10.1016/j.scitotenv.2018.12.221. Epub 2018 Dec 15.
Evidence for the association between built environment and mental ill health, especially in older population where mental ill health is common, remains inconclusive. We examined the association of roadway distance and urbanicity, measured as percentage of urban land use within 1 km from participants' residence, with mental ill-health in a longitudinal study of community-dwelling older adults in the United States between 2005 and 2006 and 2011-2012. We evaluated perceived stress, depression and anxiety symptoms using the Cohen's Perceived Stress Scale, the Center for Epidemiological Studies - Depression, and the Hospital Anxiety and Depression Scale - anxiety subscale, respectively. Increment in roadway distance was significantly associated with -0.03 point (95% CI: -0.05, -0.01) change in depressive score, with loneliness and PM partially mediating the observed associations. Age, gender, race/ethnicity, and physical activity significantly modified the distance-depression association. Anxiety was inversely associated with roadway distance (-0.02; 95% CI: -0.03, 0.00), though the associations became insignificant upon adjusting for road traffic or noise. Urbanicity was significantly associated with 0.29 (95% CI: 0.10, 0.57) point increase in depressive symptoms in multivariable model; the association was partly mediated by loneliness, physical activity, social support and air pollution. No association was found between roadway distance and perceived stress, and between urbanicity, and anxiety and perceived stress. Built environment was associated with mental ill health, partially through pathways related to air pollution and certain individual characteristics (e.g. loneliness). Our study warrants further examination of the mediation and interaction of the built environment-mental health association.
证据表明，建筑环境与心理健康之间存在关联，尤其是在心理健康问题较为普遍的老年人群体中，这种关联仍然存在争议。我们在美国进行了一项针对社区居住的老年人的纵向研究，在 2005 年至 2006 年和 2011 年至 2012 年期间，研究了居住在距参与者住所 1 公里范围内的道路距离和城市化程度（以城市土地利用百分比表示）与心理健康不良之间的关系。我们使用 Cohen 的感知压力量表、流行病学研究中心抑郁量表和医院焦虑和抑郁量表-焦虑分量表，分别评估了感知压力、抑郁和焦虑症状。道路距离的增量与抑郁评分的变化呈显著负相关，差值为 -0.03 点（95%CI：-0.05，-0.01），孤独感和 PM 部分介导了观察到的关联。年龄、性别、种族/民族和体力活动显著改变了距离与抑郁之间的关联。焦虑与道路距离呈负相关（-0.02；95%CI：-0.03，0.00），但在调整道路交通或噪音后，关联变得不显著。在多变量模型中，城市化程度与抑郁症状增加 0.29 点（95%CI：0.10，0.57）显著相关；孤独感、体力活动、社会支持和空气污染在一定程度上介导了这种关联。道路距离与感知压力之间，以及城市化程度与焦虑和感知压力之间均无关联。建筑环境与心理健康之间存在关联，部分通过与空气污染和某些个体特征（如孤独感）相关的途径。我们的研究需要进一步探讨建筑环境与心理健康之间关联的中介和交互作用。
