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Nature and Mental Health in Urban Texas: A NatureScore-Based Study

Author

Listed:
  • Omar M. Makram

    (Center for Health & Nature, Houston Methodist Research Institute, Houston, TX 77030, USA)

  • Alan Pan

    (Center for Health Data Science and Analytics, Houston Methodist Research Institute, Houston, TX 77030, USA)

  • Jay E. Maddock

    (Center for Health & Nature, Houston Methodist Research Institute, Houston, TX 77030, USA
    Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, 1266 TAMU, College Station, TX 77843, USA)

  • Bita A. Kash

    (Center for Health & Nature, Houston Methodist Research Institute, Houston, TX 77030, USA)

Abstract

In this cross-sectional study, we examined the impact of access to nature on mental health utilization in urban neighborhoods using Texas outpatient encounters data merged with NatureScore TM (0–100; low to high nature levels) and US census data (household income, education, employment, poverty, and insurance coverage) at the zipcode level. Our sample size included 61 million outpatient encounters across 1169 zipcodes, with 63% women and 30% elderly. A total of 369,344 mental health encounters were identified, with anxiety/stress and depression encounters representing 68.3% and 23.6%, respectively. We found that neighborhoods with a NatureScore of 60+ had lower overall mental health utilization than those below 40 (RR 0.51, 95%CI 0.38–0.69). This relationship persisted for depression, bipolar disorder, and anxiety/stress and in neighborhoods with a NatureScore above 80 ( p < 0.001). Compared to neighborhoods with a NatureScore below 40, those above 80 had significantly lower depression (aRR 0.68, 95%CI 0.49–0.95) and bipolar (aRR 0.59, 95%CI 0.36–0.99) health encounters after adjusting for demographic and socioeconomic factors. This novel approach, utilizing NatureScore as a proxy for urban greenness, demonstrates the correlation between a higher NatureScore and reduced mental health utilization. Our findings highlight the importance of integrating nature into our healthcare strategies to promote well-being and mental health.

Suggested Citation

  • Omar M. Makram & Alan Pan & Jay E. Maddock & Bita A. Kash, 2024. "Nature and Mental Health in Urban Texas: A NatureScore-Based Study," IJERPH, MDPI, vol. 21(2), pages 1-12, February.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:2:p:168-:d:1331047
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    Cited by:

    1. Hisham Abusaada & Abeer Elshater, 2024. "Revisiting Urban Street Planning and Design Factors to Promote Walking as a Physical Activity for Middle-Class Individuals with Metabolic Syndrome in Cairo, Egypt," IJERPH, MDPI, vol. 21(4), pages 1-30, March.

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