Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia.
JAMA Netw Open. 2019 Jul 3;2(7):e198209. doi: 10.1001/jamanetworkopen.2019.8209.
Recent studies indicate that living near more green space may support mental and general health and may also prevent depression. However, most studies are cross-sectional, and few have considered whether some types of green space matter more for mental health.
To assess whether total green space or specific types of green space are associated with better mental health.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study included a residentially stable, city-dwelling sample of 46 786 participants from Sydney, Wollongong, and Newcastle, Australia, in the baseline of the Sax Institute's 45 and Up Study (data collected from January 1, 2006, to December 31, 2009). Follow-up was conducted from January 1, 2012, to December 31, 2015. Analyses were conducted in January 2019.
Percentage of total green space, tree canopy, grass, and other low-lying vegetation measured within 1.6-km (1-mile) road network distance buffers around residential addresses at baseline.
Three outcome variables were examined at baseline (prevalence) and follow-up (incidence without baseline affirmatives): (1) risk of psychological distress (10-item Kessler Psychological Distress Scale), (2) self-reported physician-diagnosed depression or anxiety, and (3) fair to poor self-rated general health.
This study included 46 786 participants (mean [SD] age, 61.0 [10.2] years; 25 171 [53.8%] female). At baseline, 5.1% of 37 775 reported a high risk of psychological distress, 16.0% of 46 786 reported depression or anxiety, and 9.0% of 45 577 reported fair to poor self-rated health. An additional 3.3% of 32 991 experienced psychological distress incidence, 7.5% of 39 277 experienced depression or anxiety incidence, and 7.3% of 40 741 experienced fair to poor self-rated health incidence by follow-up (mean [SD] of 6.2 [1.62] years later). Odds ratios (ORs) adjusted for age, sex, income, economic status, couple status, and educational level indicated that exposures of 30% or more total green space (OR, 0.46; 95% CI, 0.29-0.69) and tree canopy specifically (OR, 0.69; 95% CI, 0.54-0.88) were associated with lower incidence of psychological distress. Exposure to tree canopy of 30% or more, compared with 0% to 9%, was also associated with lower incidence of fair to poor general health (OR, 0.67; 95% CI, 0.57-0.80). Exposure to grass of 30% or more, compared with 0% to 4%, was associated with higher odds of incident fair to poor general health (OR, 1.47; 95% CI, 1.12-1.91) and prevalent psychological distress (OR, 1.71; 95% CI, 1.25-2.28). Exposure to low-lying vegetation was not consistently associated with any outcome. No green space indicator was associated with prevalent or incident depression or anxiety.
Protection and restoration of urban tree canopy specifically, rather than any urban greening, may be a good option for promotion of community mental health.
最近的研究表明，居住在靠近更多绿地的地方可能有助于改善心理健康和整体健康，并可能预防抑郁。然而，大多数研究是横断面的，很少有研究考虑某些类型的绿地对心理健康是否更为重要。
评估总绿地或特定类型的绿地与更好的心理健康之间的关系。
设计、设置和参与者：本队列研究包括来自澳大利亚悉尼、卧龙岗和纽卡斯尔的一个居住稳定的城市居民样本，共 46786 名参与者，他们是萨克研究所的 45 岁及以上研究的基线人群（数据收集自 2006 年 1 月 1 日至 2009 年 12 月 31 日）。从 2012 年 1 月 1 日至 2015 年 12 月 31 日进行了随访。分析于 2019 年 1 月进行。
在住宅地址的 1.6 公里（1 英里）道路网络缓冲区范围内测量的总绿地、树冠、草地和其他低矮植被的百分比。
在基线（流行率）和随访（无基线肯定的发病率）时检查了三个结果变量：（1）心理困扰风险（10 项凯斯勒心理困扰量表），（2）自我报告的医生诊断的抑郁或焦虑，（3）一般健康状况自评较差。
本研究包括 46786 名参与者（平均[标准差]年龄 61.0[10.2]岁；25171[53.8%]名女性）。在基线时，37775 名中的 5.1%报告有较高的心理困扰风险，46786 名中的 16.0%报告有抑郁或焦虑，45577 名中的 9.0%报告一般健康自评较差。在随访时（平均[标准差]为 6.2[1.62]年后），32991 名中有 3.3%经历了心理困扰发病率，39277 名中有 7.5%经历了抑郁或焦虑发病率，40741 名中有 7.3%经历了一般健康自评较差发病率。经年龄、性别、收入、经济状况、夫妻状况和教育程度调整后的优势比（OR）表明，总绿地 30%或以上（OR，0.46；95%置信区间，0.29-0.69）和树冠（OR，0.69；95%置信区间，0.54-0.88）暴露与较低的心理困扰发病率相关。与 0%至 9%相比，树冠暴露 30%或以上也与一般健康自评较差的发病率较低相关（OR，0.67；95%置信区间，0.57-0.80）。与 0%至 4%相比，草地暴露 30%或以上与一般健康自评较差的发病率较高相关（OR，1.47；95%置信区间，1.12-1.91）和心理困扰流行率较高（OR，1.71；95%置信区间，1.25-2.28）。绿地指标与任何结果均无一致性关联。没有任何绿地指标与抑郁或焦虑的普遍或新发相关。
具体来说，保护和恢复城市树冠可能是促进社区心理健康的一个很好的选择，而不是任何城市绿化。
