Environmental Effects on Mental Health

Methods:

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Adult samples were drawn from the BHPS (British Household Panel Survey), a nationally representative longitudinal survey of over 5000 UK households that ran annually from 1991 to 2008. The analyses investigated GHQ scores of two subsets of respondents: those who moved to greener urban areas, and those who moved to less green urban areas. We identified two categories of individual: (a) those who relocated to greener areas, and (b) those who relocated to less green areas, and examined the mental health of these groups before and after their moves. For current purposes we defined “green space” as the percentage of land cover accounted for by “green space” and “gardens” combined. Land use is divided into nine categories: green space; domestic gardens; water; domestic buildings; nondomestic buildings; roads; paths; railways; and other. Mental health was measured with the short-form twelve item General Health Questionnaire (GHQ), a self-report instrument used to aid diagnosis of disorders such as anxiety and depression. Respondents report how they have felt in the “past few weeks” compared to “usual” for six positive mood states, such as being able to concentrate and make decisions, and six negative mood states, such as feeling under strain and lacking confidence.

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The samples were based on adults who relocated to greener urban areas compared to relocating to  less green urban areas. The land was divided into categories to determine how green an area was considered. The categories included gardens, water, buildings, roads, etc. The amount of “greenness” is based from the percentage of land covered by “green space.” The GHQ (General Housing Questionnaire) was used to analyse changes in participant mental health by assessing positive and negative moods before and after relocating.

Introduction:

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Unipolar depressive disorders are now the leading cause of disability in middle to high income countries, making mental health and wellbeing a critical modern public health issue. This trend may be related to increased urbanisation with 77.7% of people in the world’s more developed regions now residing in urban areas, and reduced access to “natural” spaces which aid in stress reduction. Support for this possibility comes from epidemiological studies which find that individuals living in the greenest urban areas tend to have better mental health than those in the least green areas.

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The study aims to investigate the differences in mental health between people living in urban areas or cities, and people living in natural open spaces. It highlights the mental health crisis and reports the leading cause of disability is depression, linking it to rapid urbanization of natural areas.

Results:

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Movers to greener areas showed no difference in GHQ at T–1 compared to T–2, but then a significant improvement in mental health for each of the three years post move. Movers to less green areas showed a significant decrease in mental health at T–1 compared to T–2, (b = −0.34, P = 0.031), but no significant differences for the three years post move. That is, people have apparently adapted rapidly to living in a less green area.

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While initially no change occurred immediately post move, participants that moved to greener areas showed improvements in mental health over 3 years. Participants that moved to less green areas showed a decrease almost immediately post move, but became stabilized 3 years later. This indicates that while there was a significant decrease in mental health, the participants were able to adapt to living in a less natural environment.

Discussion:

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This study aimed to explore the longitudinal effects of changes in environmental green space on mental health through examination of the impact of home relocation to a greener (or less green) urban area. Our test of these different possibilities suggested that for movers to greener areas, the shifting baseline hypothesis best fit the data: Mental health improved within a year and stayed approximately the same for the following two years. Results for movers to less green areas were less straightforward: The predicted decline in mental health for this group occurred before the move and was followed by rapid adaptation to the new circumstances. There are at least two possible interpretations. First, the anticipation of moving to a less green area may have negatively impacted mental health. First, the anticipation of moving to a less green area may have negatively impacted mental health. Second, declines in mental wellbeing may have precipitated the moves themselves. For instance, it could be that individuals who were becoming increasingly unhappy in greener areas, perhaps due to fewer facilities or job opportunities, decided to move to less green urban areas and once they had done so their mental health improved again. Further work is needed to examine why these effects occur and just how long they may last, and also why the reverse situation was not observed, that is, people who moved to less green areas did not show enduring negative impacts.

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The initial results concluded that participants that moved to greener areas had an improved mental health over the 3 years. However, it was not expected that participants that had moved to less green areas would adapt as quickly as they did. The study includes that there are many possibilities as to why there was such a decrease in mental health prior to moving to a less green area. The anticipation of moving, of finding a new job, making new friends, are all factors that could affect the results of the study. It also highlights the need for further examination as to how long the effects may last. For example, does the mental health of participants living in a greener area only increase? And does the mental health of participants living in a less green area only decline?

Future Direction

• What future research should follow up on this work?

I do believe that this study should be conducted again. However, the length and the conditions should be slightly different. The age group should be more distinguished to compare people at a similar life stage. Participants that are 25 will have a much different experience with mental health than someone who is 35. I believe the GHQ should be conducted monthly to evaluate not only the impacts but how fast of a change in mental health the participants experience after moving to greener vs less green areas.

Difficult Material

• What did you not understand about this paper that someone else may be able to help you with? Or, if you understood everything, what did you find most challenging to understand?

I found the study very interesting and felt that I had a good grasp on what it was trying to accomplish. However, I found it hard to accept the results because of how difficult it would be to calculate someone’s mental health without including any kind of bias. The age groups for example, would implicate many differences in results. I personally think that having such broad categories of participants would not have concise results. Someone who is 25 is at a completely different life stage than someone who is 35. The study also noted that many of the participants had gotten married, started families, and became financially stable. I find it hard to ignore that those additions would have a significant impact on mental health, and therefore the results of the study.