Environment and Health Research Unit, South African Medical Research Council, 491 Peter Mokaba Ridge, Morningside, 4091, Durban, South Africa.
Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Corner Siemert and Beit Street, Doornfontein, 2028, Johannesburg, South Africa.
BMC Public Health. 2024 Mar 29;24(1):925. doi: 10.1186/s12889-024-18385-1.
Exposure to green spaces has been suggested to improve mental health and may reduce the risk of depression. However, there is generally limited evidence on the association between green spaces and depression originating from low-and middle-income countries and Africa in particular. Here, we investigate the association between proximity to public green spaces and depressive symptoms among residents of Gauteng Province, South Africa.
We used data from the 2017/2018 Gauteng quality of life survey. We included all individuals aged 18 years or older residing in the nine municipalities of Gauteng Province that completed the survey (n = 24,341). Depressive symptoms were assessed using the Patient Health Questionnaire-2. Proximity to public green spaces was defined as self-reported walking time (either less or greater than 15 min) from individuals' homes to the nearest public green space. To assess the association between access to public green spaces and depressive symptoms, we used mixed-effects models, adjusted for age, sex, population group (African, Indian/Asian, Coloured (mixed race), and White), educational attainment, and municipality. We additionally performed stratified analyses by age, sex, educational attainment, and population group to evaluate whether associations differed within subgroups. Associations are expressed as prevalence ratios (PR) and their 95% confidence intervals (95% CI).
We observed a 6% (PR = 0.94, 95%CI = 0.92-0.96) prevalence reduction in depressive symptoms for individuals who reported that the nearest public green space was less than 15 min from their homes as compared to those who reported > 15 min. After stratification, this inverse association was stronger among females, individuals aged 35-59 years,those with higher levels of educational attainment, and Coloured individuals as compared to their counterparts.
Our findings suggest that public green spaces close to residential homes may be associated with a reduction in the occurrence of depressive symptoms among urban populations in resource-constrained settings like South Africa.
有研究表明，接触绿地有益于改善心理健康，还可能降低抑郁风险。然而，来自中低收入国家，特别是非洲国家的相关研究证据十分有限。本研究旨在调查南非豪登省居民居住地与公共绿地的距离与抑郁症状之间的关系。
我们使用了 2017/2018 年豪登省生活质量调查的数据。研究对象为居住在豪登省 9 个城市、年龄在 18 岁及以上并完成调查的所有人（n=24341）。抑郁症状使用患者健康问卷-2 进行评估。公共绿地的接近程度定义为个体从家到最近的公共绿地的自述步行时间（<15 分钟或>15 分钟）。为了评估接近公共绿地与抑郁症状之间的关系，我们使用了混合效应模型，调整了年龄、性别、人群（非洲人、印度/亚洲人、有色人种（混血）和白人）、教育程度和城市。我们还按年龄、性别、教育程度和人群进行了分层分析，以评估在亚组内关联是否存在差异。关联以患病率比（PR）及其 95%置信区间（95%CI）表示。
与自述居住地与最近的公共绿地的距离>15 分钟的个体相比，报告距离最近的公共绿地<15 分钟的个体抑郁症状的发生率降低了 6%（PR=0.94，95%CI=0.92-0.96）。分层后，在女性、35-59 岁的个体、受教育程度较高的个体以及有色人种中，这种负相关关系比相应的对照人群更强。
我们的研究结果表明，在资源有限的环境中，如南非，居住房屋附近的公共绿地可能与城市人群抑郁症状的减少有关。
