Associate Professor of Public Health Sciences,Miller School of Medicine,University of Miami,USA.
Professor of Architecture,School of Architecture,University of Miami,USA.
Br J Psychiatry. 2019 Aug;215(2):476-480. doi: 10.1192/bjp.2019.129. Epub 2019 Jun 13.
Neighbourhood greenness or vegetative presence has been associated with indicators of health and well-being, but its relationship to depression in older adults has been less studied. Understanding the role of environmental factors in depression may inform and complement traditional depression interventions, including both prevention and treatment.AimsThis study examines the relationship between neighbourhood greenness and depression diagnoses among older adults in Miami-Dade County, Florida, USA.
Analyses examined 249 405 beneficiaries enrolled in Medicare, a USA federal health insurance programme for older adults. Participants were 65 years and older, living in the same Miami location across 2 years (2010-2011). Multilevel analyses assessed the relationship between neighbourhood greenness, assessed by average block-level normalised difference vegetative index via satellite imagery, and depression diagnosis using USA Medicare claims data. Covariates were individual age, gender, race/ethnicity, number of comorbid health conditions and neighbourhood median household income.
Over 9% of beneficiaries had a depression diagnosis. Higher levels of greenness were associated with lower odds of depression, even after adjusting for demographics and health comorbidities. When compared with individuals residing in the lowest tertile of greenness, individuals from the middle tertile (medium greenness) had 8% lower odds of depression (odds ratio 0.92; 95% CI 0.88, 0.96; P = 0.0004) and those from the high tertile (high greenness) had 16% lower odds of depression (odds ratio 0.84; 95% CI 0.79, 0.88; P < 0.0001).
Higher levels of greenness may reduce depression odds among older adults. Increasing greenery - even to moderate levels - may enhance individual-level approaches to promoting wellness.Declaration of interestNone.
社区绿化或植被的存在与健康和幸福感的指标有关，但它与老年人抑郁的关系研究较少。了解环境因素在抑郁中的作用可能会为传统的抑郁干预措施提供信息和补充，包括预防和治疗。
本研究在美国佛罗里达州迈阿密-戴德县检查了社区绿化与老年人抑郁诊断之间的关系。
分析中检查了 249405 名参加美国联邦医疗保险（Medicare）的受益人，这是一项为美国老年人提供的医疗保险计划。参与者年龄在 65 岁及以上，在两年（2010-2011 年）内在同一迈阿密地点居住。使用美国医疗保险索赔数据，通过卫星图像评估的平均街区归一化差异植被指数评估社区绿化与抑郁诊断之间的关系。协变量为个人年龄、性别、种族/民族、合并健康状况的数量和社区家庭收入中位数。
超过 9%的受益人被诊断患有抑郁症。即使在调整了人口统计学和健康合并症后，较高的绿化水平与较低的抑郁几率相关。与居住在绿化水平最低三分位的个体相比，居住在中三分位（中等绿化）的个体患抑郁症的几率低 8%（优势比 0.92；95%置信区间 0.88，0.96；P = 0.0004），居住在高三分位（高绿化）的个体患抑郁症的几率低 16%（优势比 0.84；95%置信区间 0.79，0.88；P < 0.0001）。
较高的绿化水平可能会降低老年人患抑郁症的几率。增加绿化——即使是适度的绿化——也可能增强促进个体健康的方法。
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