Greenness and Depression Incidence among Older Women

Background: Recent evidence suggests that higher levels of residential greenness may contribute to better mental health. Despite this, few studies have considered its impact on depression, and most are cross-sectional. Objective: The objective of this study was to examine surrounding residential greenness and depression risk prospectively in the Nurses’ Health Study. Methods: A total of 38,947 women (mean age throughout follow-up 70 y [range 54–91 y]) without depression in 2000 were followed to 2010. Residential greenness was measured using the satellite-based Normalized Difference Vegetation Index (NDVI) and defined as the mean greenness value within 250-m and 1,250-m radii of the women’s residences in July of each year. Incidence of depression was defined according to the first self-report of either physician-diagnosed depression or regular antidepressant use. We used Cox proportional hazards models to examine the relationship between greenness and depression incidence and assessed physical activity as a potential effect modifier and mediator. Results: Over 315,548 person-years, 3,612 incident depression cases occurred. In multivariable-adjusted models, living in the highest quintile of residential greenness within 250m was associated with a 13% reduction in depression risk (HR=0.87 [95% confidence interval (CI): 0.78, 0.98]) compared with the lowest quintile. The association between greenness and depression did not appear to be mediated by physical activity, nor was there evidence of effect modification by physical activity. Conclusions: In this population of mostly white women, we estimated an inverse association between the highest level of surrounding summer greenness and the risk of self-reported depression. https://doi.org/10.1289/EHP1229

[1]  Executive Summary.  World Urbanization Prospects: The 2018 Revision , 2019 .

[2]  B. Coull,et al.  The relationship between surrounding greenness in childhood and adolescence and depressive symptoms in adolescence and early adulthood. , 2018, Annals of epidemiology.

[3]  J. Hart,et al.  A Review of Epidemiologic Studies on Greenness and Health: Updated Literature Through 2017 , 2018, Current Environmental Health Reports.

[4]  I. Markevych,et al.  Urban residential greenspace and mental health in youth: Different approaches to testing multiple pathways yield different conclusions , 2018, Environmental research.

[5]  B. Coull,et al.  The Association Between Natural Environments and Depressive Symptoms in Adolescents Living in the United States. , 2018, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[6]  P. Gosselin,et al.  An effective public health program to reduce urban heat islands in Québec, Canada. , 2016, Revista panamericana de salud publica = Pan American journal of public health.

[7]  K. Sowjanya.  A review on Health , 2016 .

[8]  W. Willett,et al.  Origin, Methods, and Evolution of the Three Nurses' Health Studies. , 2016, American journal of public health.

[9]  F. Grodstein,et al.  Greater Adherence to the Alternative Healthy Eating Index Is Associated with Lower Incidence of Physical Function Impairment in the Nurses' Health Study. , 2016, The Journal of nutrition.

[10]  F. Laden,et al.  Exposure to Greenness and Mortality in a Nationwide Prospective Cohort Study of Women , 2016, Environmental health perspectives.

[11]  J. Böhnke.  Explanation in causal inference: Methods for mediation and interaction. , 2016, Quarterly journal of experimental psychology.

[12]  R. McEachan,et al.  The association between green space and depressive symptoms in pregnant women: moderating roles of socioeconomic status and physical activity , 2015, Journal of Epidemiology & Community Health.

[13]  F. Laden,et al.  A Review of the Health Benefits of Greenness , 2015, Current Epidemiology Reports.

[14]  X. Basagaña,et al.  Natural outdoor environments and mental and physical health: relationships and mechanisms. , 2015, Environment international.

[15]  Payam Dadvand,et al.  Mental Health Benefits of Long-Term Exposure to Residential Green and Blue Spaces: A Systematic Review , 2015, International journal of environmental research and public health.

[16]  E. Turkheimer,et al.  Access to green space, physical activity and mental health: a twin study , 2015, Journal of Epidemiology & Community Health.

[17]  R. Kahn,et al.  STRESS EXPOSURE ACROSS THE LIFE SPAN CUMULATIVELY INCREASES DEPRESSION RISK AND IS MODERATED BY NEUROTICISM , 2014, Depression and anxiety.

[18]  R. Gražulevičienė,et al.  The relationship of green space, depressive symptoms and perceived general health in urban population , 2014, Scandinavian journal of public health.

[19]  Duanping Liao,et al.  Spatio-temporal modeling of particulate air pollution in the conterminous United States using geographic and meteorological predictors , 2014, Environmental Health.

[20]  C. Brayne,et al.  The association between community environment and cognitive function: a systematic review , 2014, Social Psychiatry and Psychiatric Epidemiology.

[21]  J. Heinrich,et al.  A cross-sectional analysis of the effects of residential greenness on blood pressure in 10-year old children: results from the GINIplus and LISAplus studies , 2014, BMC Public Health.

[22]  Jacqueline Kerr,et al.  Effects of buffer size and shape on associations between the built environment and energy balance. , 2014, Health & place.

[23]  F. Nieto,et al.  Exposure to Neighborhood Green Space and Mental Health: Evidence from the Survey of the Health of Wisconsin , 2014, International journal of environmental research and public health.

[24]  G. Kolt,et al.  Mental health benefits of neighbourhood green space are stronger among physically active adults in middle-to-older age: evidence from 260,061 Australians. , 2013, Preventive medicine.

[25]  P. Groenewegen,et al.  Streetscape greenery and health: stress, social cohesion and physical activity as mediators. , 2013, Social science & medicine.

[26]  P. Aspinall,et al.  Green Space and Stress: Evidence from Cortisol Measures in Deprived Urban Communities , 2013, International journal of environmental research and public health.

[27]  A. Ananthakrishnan,et al.  Association between depressive symptoms and incidence of Crohn's disease and ulcerative colitis: results from the Nurses' Health Study. , 2013, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[28]  H. Blake.  Physical activity and exercise in the treatment of depression , 2012, Front. Psychiatry.

[29]  Erika Upegui,et al.  Mapping heatwave health risk at the community level for public health action , 2012, International Journal of Health Geographics.

[30]  Erik Skärbäck,et al.  Green qualities in the neighbourhood and mental health – results from a longitudinal cohort study in Southern Sweden , 2012, BMC Public Health.

[31]  R. Kessler.  The costs of depression. , 2012, The Psychiatric clinics of North America.

[32]  G. D. Jenerette,et al.  Ecosystem services and urban heat riskscape moderation: water, green spaces, and social inequality in Phoenix, USA. , 2011, Ecological applications : a publication of the Ecological Society of America.

[33]  W. Willett,et al.  Dietary intake of n-3 and n-6 fatty acids and the risk of clinical depression in women: a 10-y prospective follow-up study. , 2011, The American journal of clinical nutrition.

[34]  R. Maheswaran,et al.  The health benefits of urban green spaces: a review of the evidence. , 2011, Journal of public health.

[35]  B. Hudson.  Federal Constitutions, Global Governance, and the Role of Forests in Regulating Climate Change , 2011 .

[36]  P. Groenewegen,et al.  Morbidity is related to a green living environment , 2009, Journal of Epidemiology & Community Health.

[37]  P. Cuijpers,et al.  Screening for mood and anxiety disorders with the five-item, the three-item, and the two-item Mental Health Inventory , 2009, Psychiatry Research.

[38]  P. Groenewegen,et al.  Social contacts as a possible mechanism behind the relation between green space and health. , 2009, Health & place.

[39]  G. Carrus,et al.  Benefits and well-being perceived by people visiting green spaces in periods of heat stress. , 2009 .

[40]  N. Owen,et al.  Associations of neighbourhood greenness with physical and mental health: do walking, social coherence and local social interaction explain the relationships? , 2008, Journal of Epidemiology & Community Health.

[41]  A. Gidlöf-Gunnarsson,et al.  Noise and well-being in urban residential environments: The potential role of perceived availability to nearby green areas , 2007 .

[42]  R. Araya,et al.  Common mental disorders and the built environment in Santiago, Chile. , 2007, The British journal of psychiatry : the journal of mental science.

[43]  J. C. Stevens,et al.  Air pollution removal by urban trees and shrubs in the United States , 2006 .

[44]  Ariane L. Bedimo-Rung,et al.  The significance of parks to physical activity and public health: a conceptual model. , 2005, American journal of preventive medicine.

[45]  Frank M. Perna,et al.  The Benefits of Exercise for the Clinically Depressed. , 2004, Primary care companion to the Journal of clinical psychiatry.

[46]  G. Keating,et al.  Paroxetine Controlled Release , 2004, CNS drugs.

[47]  J. Manson,et al.  Depressive symptoms and risk of type 2 diabetes in women. , 2004, Diabetes care.

[48]  V. Stearns,et al.  Paroxetine controlled release in the treatment of menopausal hot flashes: a randomized controlled trial. , 2003, JAMA.

[49]  L. Berkman,et al.  From social integration to health: Durkheim in the new millennium. , 2000, Social science & medicine.

[50]  P. Flandre,et al.  Estimating the proportion of treatment effect explained by a surrogate marker by D. Y. Lin, T. R. Fleming and V. De Gruttola, Statistics in Medicine, 16, 1515–1527 (1997) , 1999 .

[51]  J. Youniss,et al.  Social Integration , 1997 .

[52]  J. Manson,et al.  The Nurses' Health Study: 20-year contribution to the understanding of health among women. , 1997, Journal of women's health.

[53]  G A Colditz,et al.  Reproducibility and validity of a self-administered physical activity questionnaire. , 1994, International journal of epidemiology.

[54]  J. Sorensen,et al.  The costs of depression , 1993, International clinical psychopharmacology.

[55]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[56]  K. Mobily.  Using physical activity and recreation to cope with stress and anxiety: a review. , 1982, American corrective therapy journal.

[57]  L. Berkman,et al.  Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. , 1979, American journal of epidemiology.