Greenspace positively impacts mental health. Previous research has focused on the greenspace-mental health relationship in urban areas. Yet, little work has looked at rural areas despite rural communities reporting similar rates of poor mental health outcomes and higher rates of suicide mortality compared with urban areas. This ecological research study examined the following research questions: (1) Do public and/or private greenspaces affect the spatial distribution of mental health outcomes in North Carolina? (2) Does this relationship change with rurality? Emergency department data for 6 mental health conditions and suicide mortality data from 2009 to 2018 were included in this analysis. Spatial error and ordinary least squares regressions were used to examine the influence of public and private greenspace quantity on mental health in rural and urban communities. Results suggest greenspace benefits mental health in rural and urban communities. The strength of this relationship varies with urbanity and between public and private greenspaces, suggesting a more complex causal relationship. Given the high case counts and often lower density of mental health care facilities in rural areas, focusing attention on low-cost mental health interventions, such as greenspace, is important when considering rural mental health care.
more »
« less
Advancing Understanding on Greenspace and Mental Health in Young People
Abstract Mental distress among young people has increased in recent years. Research suggests that greenspace may benefit mental health. The objective of this exploratory study is to further understanding of place‐based differences (i.e., urbanity) in the greenspace‐mental health association. We leverage publicly available greenspace data sets to operationalize greenspace quantity, quality, and accessibility metrics at the community‐level. Emergency department visits for young people (ages 24 and under) were coded for: anxiety, depression, mood disorders, mental and behavioral disorders, and substance use disorders. Generalized linear models investigated the association between greenspace metrics and community‐level mental health burden; results are reported as prevalence rate ratios (PRR). Urban and suburban communities with the lowest quantities of greenspace had the highest prevalence of poor mental health outcomes, particularly for mood disorders in urban areas (PRR: 1.19, 95% CI: 1.16–1.21), and substance use disorders in suburban areas (PRR: 1.35, 95% CI: 1.28–1.43). In urban, micropolitan, and rural/isolated areas further distance to greenspace was associated with a higher prevalence of poor mental health outcomes; this association was most pronounced for substance use disorders (PRRUrban: 1.31, 95% CI: 1.29–1.32; PRRMicropolitan: 1.47, 95% CI: 1.43–1.51; PRRRural 2.38: 95% CI: 2.19–2.58). In small towns and rural/isolated communities, poor mental health outcomes were more prevalent in communities with the worst greenspace quality; this association was most pronounced for mental and behavioral disorders in small towns (PRR: 1.29, 95% CI: 1.24–1.35), and for anxiety disorders in rural/isolated communities (PRR: 1.61, 95% CI: 1.43–1.82). The association between greenspace metrics and mental health outcomes among young people is place‐based with variations across the rural‐urban continuum.
more »
« less
- Award ID(s):
- 2044839
- PAR ID:
- 10569016
- Publisher / Repository:
- Wiley
- Date Published:
- Journal Name:
- GeoHealth
- Volume:
- 8
- Issue:
- 3
- ISSN:
- 2471-1403
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
More Like this
-
-
Abstract Increasing evidence suggests that temperatures adversely impact mental and behavioral disorders (MBD). This study explores the effects of temperatures on mental health outcomes using over 5.9 million MBD-related emergency department (ED) visits across three geographical regions of North Carolina (i.e., Mountains, Piedmont, and Coast) from 2016 to 2019. A distributed lag non-linear model (DLNM) with a generalized linear model and quasi-Poisson distribution adjusted for humidity, long-term seasonal time trends, and day of the week examined the acute impact (i.e., 7-day) of temperature on daily MBD-related ED visits at zip code tabulation area (ZCTA) locations. Results were pooled at the region and state levels and reported in reference to the median temperature using a case-time series design for the analysis of small-area data. Stratified analyses were conducted for age, sex, and specific mental-health related ED visits (substance use, mood disorders, anxiety disorders). At the state level, we found significant positive associations between high temperatures (97.5th percentile) and an increase in relative risk (RR) for total MBDs (RR:1.04, 95% CI,1.03–1.05) and psychoactive substance use (RR:1.04, 95% CI, 1.02–1.06). Low air temperatures (2.5th percentile) only increased risk for the elderly (i.e., 65 and older) and predominantly white communities (RR: 1.03, CI: 1.03–1.05). During high temperatures (97.5th percentile), majority-white communities (RR:1.06, CI: 1.01–1.10) and low-income communities had the highest risk for MBDs (RR: 1.05, CI: 1.03–1.07). Our findings suggest there is a positive association between exposure to high temperatures and increased MBD-related ED visits, modified by patient age and place-based sociodemographic (ie., race and income) context.more » « less
-
OBJECTIVES Discrimination has been shown to have profound negative effects on mental and behavioral health and may influence these outcomes early in adulthood. We aimed to examine short-term, long-term, and cumulative associations between different types of interpersonal discrimination (eg, racism, sexism, ageism, and physical appearance discrimination) and mental health, substance use, and well-being for young adults in a longitudinal nationally representative US sample. METHODS We used data from 6 waves of the Transition to Adulthood Supplement (2007–2017, 1834 participants) of the Panel Study of Income Dynamics. Outcome variables included self-reported health, drug use, binge drinking, mental illness diagnosis, Languishing and Flourishing score, and Kessler Psychological Distress Scale score. We used logistic regression with cluster-robust variance estimation to test cross-sectional and longitudinal associations between discrimination frequency (overall, cumulative, and by different reason) and outcomes, controlling for sociodemographics. RESULTS Increased discrimination frequency was associated with higher prevalence of languishing (relative risk [RR] 1.34 [95% CI 1.2–1.4]), psychological distress (RR 2.03 [95% CI 1.7–2.4]), mental illness diagnosis (RR 1.26 [95% CI 1.1–1.4]), drug use (RR 1.24 [95% CI 1.2–1.3]), and poor self-reported health (RR 1.26 [95% CI 1.1–1.4]) in the same wave. Associations persisted 2 to 6 years after exposure to discrimination. Similar associations were found with cumulative high-frequency discrimination and with each discrimination subcategory in cross-sectional and longitudinal analyses. CONCLUSIONS In this nationally representative longitudinal sample, current and past discrimination had pervasive adverse associations with mental health, substance use, and well-being in young adults.more » « less
-
IMPORTANCE Length of custody is a mechanism by which carceral systems can worsen health. However, there are fewer studies examining US immigration detention, in large part because US immigration detention is largely privately operated and opaque by design. OBJECTIVES To examine the association between duration spent in US immigration detention with subsequent health outcomes. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used a referral sample of recently detained immigrants who were released from Immigrations and Customs Enforcement (ICE) under a series of court orders in 2020 and 2021. Data were analyzed from June 2023 to October 2024. EXPOSURE Detention duration less than 6 months vs 6 months or longer. MAIN OUTCOMES AND MEASURES We used multivariable regression analysis to assess the association of detention duration and several variables: (1) self-rated health, (2) mental illness (Kessler 6-item psychological distress scale), and (3) posttraumatic stress disorder (PTSD) (Primary Care-PTSD-5 Screen).We then calculated the likelihood of experiencing each outcome, controlling for covariates. As a robustness check, we conducted sensitivity analyses with detention duration as a continuous measure. RESULTS The study included 200 respondents (mean [SD] age, 40.3 [10.1] years; 175 male [87.5%]; 149 Hispanic or Latino ethnicity [74.5%]). Results revealed a high prevalence of poor self-rated health, mental illness, and PTSD for all respondents, but especially among those who had been detained for 6 months or longer, who had significantly higher likelihood of poor or fair self-rated health (49.1% [95%CI, 40.5%-57.6%] vs 30.4%[95%CI, 21.8%-39.1%]; P < .001), mental illness (37.0%[95%CI, 28.2%-45.8%] vs 20.7%[95%CI, 12.6%-28.7%]; P < .001), and PTSD (59.3%[95% CI, 50.3%-68.3%] vs 34.8%[95%CI, 25.3%-44.3%]; P < .001). Sensitivity analysis confirmed the general robustness of these findings, with longer detention duration significantly associated with mental illness (OR, 1.11 [95%CI, 1.02-1.20]; P = .01) and PTSD (OR, 1.11 [95%CI, 1.03-1.20]; P = .005) in our adjusted models. CONCLUSIONS AND RELEVANCE In this cross-sectional study, detained immigrants experienced a high prevalence of poor health, mental illness, and PTSD, with detention periods of 6 months or more associated with higher rates compared with those detained less than 6 months. Duration of custody is one mechanism by which immigration detention might be a catalyst for worsening health.more » « less
-
Objective: The COVID-19 pandemic has put unprecedented stress on essential workers and their children. Limited cross-sectional research has found increases in mental health conditions from workload, reduced income, and isolation among essential workers. Less research has been conducted on children of essential workers. We examined trends in the crisis response of essential workers and their children from April 2020 through August 2021. Methods: We investigated the impact during 3 periods of the pandemic on workers and their children using anonymized data from the Crisis Text Line on crisis help-seeking texts for thoughts of suicide or active suicidal ideation (desire, intent, capability, time frame), abuse (emotional, physical, sexual, unspecified), anxiety/stress, grief, depression, isolation, bullying, eating or body image, gender/sexual identity, self-harm, and substance use. We used generalized estimating equations to study the longitudinal change in crisis response across the later stages of the pandemic using adjusted odds ratios (aORs) for worker status and crisis outcomes. Results: Results demonstrated higher odds of crisis outcomes for thoughts of suicide (aOR = 1.06; 95% CI, 1.00-1.12) and suicide capability (aOR = 1.14; 95% CI, 1.02-1.27) among essential workers than among nonessential workers. Children of essential workers had higher odds of substance use than children of nonessential workers (aOR = 1.33; 95% CI, 1.08-1.65), particularly for Indigenous American children (aOR = 2.76; 95% CI, 1.35-5.36). Essential workers (aOR = 1.17; 95% CI, 1.07-1.27) and their children (aOR = 1.18; 95% CI, 1.07-1.30) had higher odds of grief than nonessential workers and their children. Conclusion: Essential workers and their children had elevated crisis outcomes. Immediate and low-cost psychologically supportive interventions are needed to mitigate the mental health impacts of the COVID-19 pandemic on these populations.more » « less
An official website of the United States government

