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

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 ( ≈ 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.