Science and Solutions for a Changing Planet NERC DTP, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; University of Kent, School of Architecture and Planning, UK.
MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London W2 1PG, UK; MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, the Gambia.
Environ Int. 2024 Oct;192:109036. doi: 10.1016/j.envint.2024.109036. Epub 2024 Sep 30.
Living in an area with good availability and accessibility of residential green spaces such as parks, woodlands, and residential gardens can improve mental health and reduce the global disease burden. Unlike for physical health, it is not well understood if mental health and green space associations might be modified by local area deprivation. Existing evidence for this association comes from cross-sectional studies, widely considered vulnerable to confounding and bias. Individual time-invariant mental health status, personality, and other factors may result in positive effect modification on green space and mental health associations in more deprived areas. We use fixed-effects models that remove time-invariant confounding by calculating differences within-persons to eliminate this bias and add to the existing evidence. We modelled changes in mental health status, green space, and deprivation (relative to the within-person mean) within 54,666 individuals with a combined total of 300,710 mental health scores from one of the world's largest panel surveys: "Understanding Society" in the UK. We found a positive effect of increasing residential green space on mental health and this was positively modified and intensified by area deprivation before and after adjusting for confounding. Our results support providing green space to protect against the negative impact of socioeconomic deprivation on health, particularly for those moving from a less deprived to a more deprived area.
居住在一个有良好可达性和可用性的住宅绿地的地区，如公园、林地和住宅花园，可以改善心理健康，减少全球疾病负担。与身体健康不同，如果心理健康和绿地之间的关联可能受到当地贫困程度的影响，那么这一点还不是很清楚。这一关联的现有证据来自横断面研究，这些研究被广泛认为容易受到混杂和偏倚的影响。个体不变的心理健康状况、个性和其他因素可能导致在更贫困地区，绿地和心理健康关联产生积极的效应修正。我们使用固定效应模型，通过计算个体内的差异来消除时间不变的混杂，从而消除这种偏差，并为现有证据增添新的内容。我们对来自世界上最大的面板调查之一的英国“理解社会”中的 54666 个人的心理健康状况、绿地和贫困程度（相对于个体内的平均值）进行建模，这些个体的总心理健康评分达到 300710 次。我们发现，居住绿地的增加对心理健康有积极影响，而在调整混杂因素之前和之后，这种影响受到地区贫困程度的正向修正和强化。我们的研究结果支持提供绿地，以保护人们免受社会经济贫困对健康的负面影响，特别是对那些从较贫困地区迁往较贫困地区的人。
