Urban residential greenspace and mental health in youth: Different approaches to testing multiple pathways yield different conclusions

被引:213
作者
Dzhambov, Angel [1 ]
Hartig, Terry [2 ,3 ]
Markevych, Iana [4 ,5 ]
Tilov, Boris [6 ,7 ]
Dimitrova, Donka [8 ]
机构
[1] Med Univ Plovdiv, Fac Publ Hlth, Dept Hyg & Ecomed, Plovdiv, Bulgaria
[2] Uppsala Univ, Inst Housing & Urban Res, Uppsala, Sweden
[3] Uppsala Univ, Dept Psychol, Uppsala, Sweden
[4] Ludwig Maximilians Univ Munchen, Univ Hosp, Inst & Clin Occupat Social & Environm Med, Munich, Germany
[5] German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Epidemiol 1, Neuherberg, Germany
[6] Med Univ Plovdiv, Med Coll, Plovdiv, Bulgaria
[7] Univ Agribusiness & Rural Dev, Fac Econ & Management, Dept Management, Plovdiv, Bulgaria
[8] Med Univ Plovdiv, Fac Publ Hlth, Dept Hlth Management & Healthcare Econ, Plovdiv, Bulgaria
关键词
Air pollution; Greenness; Green space; Mediation analysis; Noise; Physical activity; Restoration; Social cohesion; Stress; NATURAL OUTDOOR ENVIRONMENTS; PHYSICAL-ACTIVITY; NOISE ANNOYANCE; NEIGHBORHOOD GREENSPACE; SHORT QUESTIONNAIRE; VEGETATION INDEX; SOCIAL COHESION; AIR-POLLUTION; OLDER-PEOPLE; BLUE SPACES;
D O I
10.1016/j.envres.2017.09.015
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
Background: Urban greenspace can benefit mental health through multiple mechanisms. They may work together, but previous studies have treated them as independent. Objectives: We aimed to compare single and parallel mediation models, which estimate the independent contributions of different paths, to several models that posit serial mediation components in the pathway from greenspace to mental health. Methods: We collected cross-sectional survey data from 399 participants (15-25 years of age) in the city of Plovdiv, Bulgaria. Objective "exposure" to urban residential greenspace was defined by the Normalized Difference Vegetation Index (NDVI), Soil Adjusted Vegetation Index, tree cover density within the 500-m buffer, and Euclidean distance to the nearest urban greenspace. Self-reported measures of availability, access, quality, and usage of greenspace were also used. Mental health was measured with the General Health Questionnaire. The following potential mediators were considered in single and parallel mediation models: restorative quality of the neighborhood, neighborhood social cohesion, commuting and leisure time physical activity, road traffic noise annoyance, and perceived air pollution. Four models were tested with the following serial mediation components: (1) restorative quality -> social cohesion; (2) restorative quality -> physical activity; (3) perceived traffic pollution -> restorative quality; (4) and noise annoyance -> physical activity. Results: There was no direct association between objectively-measured greenspace and mental health. For the 500-m buffer, the tests of the single mediator models suggested that restorative quality mediated the relationship between NDVI and mental health. Tests of parallel mediation models did not find any significant indirect effects. In line with theory, tests of the serial mediation models showed that higher restorative quality was associated with more physical activity and more social cohesion, and in turn with better mental health. As for self-reported greenspace measures, single mediation through restorative quality was significant only for time in greenspace, and there was no mediation though restorative quality in the parallel mediation models; however, serial mediation through restorative quality and social cohesion/physical activity was indicated for all self-reported measures except for greenspace quality. Conclusions: Statistical models should adequately address the theoretically indicated interdependencies between mechanisms underlying association between greenspace and mental health. If such causal relationships hold, testing mediators alone or in parallel may lead to incorrect inferences about the relative contribution of specific paths, and thus to inappropriate intervention strategies.
引用
收藏
页码:47 / 59
页数:13
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