Center for Health & Nature, Houston Methodist Research Institute, Houston, TX 77030, USA.
Center for Health Data Science and Analytics, Houston Methodist Research Institute, Houston, TX 77030, USA.
Int J Environ Res Public Health. 2024 Feb 1;21(2):168. doi: 10.3390/ijerph21020168.
In this cross-sectional study, we examined the impact of access to nature on mental health utilization in urban neighborhoods using Texas outpatient encounters data merged with NatureScore (0-100; low to high nature levels) and US census data (household income, education, employment, poverty, and insurance coverage) at the zipcode level. Our sample size included 61 million outpatient encounters across 1169 zipcodes, with 63% women and 30% elderly. A total of 369,344 mental health encounters were identified, with anxiety/stress and depression encounters representing 68.3% and 23.6%, respectively. We found that neighborhoods with a NatureScore of 60+ had lower overall mental health utilization than those below 40 (RR 0.51, 95%CI 0.38-0.69). This relationship persisted for depression, bipolar disorder, and anxiety/stress and in neighborhoods with a NatureScore above 80 ( < 0.001). Compared to neighborhoods with a NatureScore below 40, those above 80 had significantly lower depression (aRR 0.68, 95%CI 0.49-0.95) and bipolar (aRR 0.59, 95%CI 0.36-0.99) health encounters after adjusting for demographic and socioeconomic factors. This novel approach, utilizing NatureScore as a proxy for urban greenness, demonstrates the correlation between a higher NatureScore and reduced mental health utilization. Our findings highlight the importance of integrating nature into our healthcare strategies to promote well-being and mental health.
在这项横断面研究中，我们利用德克萨斯州门诊就诊数据与 NatureScore（0-100；低到高自然水平）以及按邮政编码级别汇总的美国人口普查数据（家庭收入、教育、就业、贫困和保险覆盖范围），研究了接近自然对城市社区心理健康利用的影响。我们的样本量包括了 1169 个邮政编码的 6100 万门诊就诊，其中 63%为女性，30%为老年人。共确定了 369344 例心理健康就诊，其中焦虑/压力和抑郁就诊分别占 68.3%和 23.6%。我们发现，NatureScore 为 60+的社区整体心理健康利用率低于 NatureScore 低于 40 的社区（RR 0.51，95%CI 0.38-0.69）。这种关系在 NatureScore 高于 80 的社区中仍然存在，并且持续存在于抑郁、双相情感障碍和焦虑/压力中（<0.001）。与 NatureScore 低于 40 的社区相比，NatureScore 高于 80 的社区的抑郁（aRR 0.68，95%CI 0.49-0.95）和双相（aRR 0.59，95%CI 0.36-0.99）就诊显著降低，调整人口统计学和社会经济因素后。这种利用 NatureScore 作为城市绿化代理的新方法，证明了更高的 NatureScore 与降低心理健康利用率之间存在相关性。我们的研究结果强调了将自然融入我们的医疗保健策略以促进健康和心理健康的重要性。
