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Health Disparities in the Relationship of Neighborhood Greenness to Mental Health Outcomes in 249,405 U.S. Medicare Beneficiaries

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  • Scott C. Brown

    (Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA
    University of Miami School of Architecture, 1223 Dickinson Drive, Building 48 Room 320G, Coral Gables, FL 33146, USA)

  • Tatiana Perrino

    (Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA)

  • Joanna Lombard

    (Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA
    University of Miami School of Architecture, 1223 Dickinson Drive, Building 48 Room 320G, Coral Gables, FL 33146, USA)

  • Kefeng Wang

    (Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA
    Department of Neurology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1348, Miami, FL 33136, USA)

  • Matthew Toro

    (ASU Library, Map and Geospatial Hub, Arizona State University, Tempe, AZ 85281, USA)

  • Tatjana Rundek

    (Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA
    Department of Neurology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1348, Miami, FL 33136, USA)

  • Carolina Marinovic Gutierrez

    (Department of Neurology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1348, Miami, FL 33136, USA)

  • Chuanhui Dong

    (Department of Neurology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1348, Miami, FL 33136, USA)

  • Elizabeth Plater-Zyberk

    (University of Miami School of Architecture, 1223 Dickinson Drive, Building 48 Room 320G, Coral Gables, FL 33146, USA)

  • Maria I. Nardi

    (Miami-Dade County Parks, Recreation and Open Spaces Department (MDPROS), 275 NW 2nd Street, Hickman Building, 3rd floor, Miami, FL 33128, USA)

  • Jack Kardys

    (Miami-Dade County Parks, Recreation and Open Spaces Department (MDPROS), 275 NW 2nd Street, Hickman Building, 3rd floor, Miami, FL 33128, USA)

  • José Szapocznik

    (Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA
    University of Miami School of Architecture, 1223 Dickinson Drive, Building 48 Room 320G, Coral Gables, FL 33146, USA)

Abstract

Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence) and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer’s disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer’s disease (by 18%) and depression (by 28%) for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37% lower odds of depression in low-income neighborhoods, compared to 27% and 21% lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation.

Suggested Citation

  • Scott C. Brown & Tatiana Perrino & Joanna Lombard & Kefeng Wang & Matthew Toro & Tatjana Rundek & Carolina Marinovic Gutierrez & Chuanhui Dong & Elizabeth Plater-Zyberk & Maria I. Nardi & Jack Kardys , 2018. "Health Disparities in the Relationship of Neighborhood Greenness to Mental Health Outcomes in 249,405 U.S. Medicare Beneficiaries," IJERPH, MDPI, vol. 15(3), pages 1-11, March.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:3:p:430-:d:134194
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    References listed on IDEAS

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    Cited by:

    1. Aaron M Eisen & Gregory N Bratman & Hector A Olvera-Alvarez, 2024. "Susceptibility to stress and nature exposure: Unveiling differential susceptibility to physical environments; a randomized controlled trial," PLOS ONE, Public Library of Science, vol. 19(4), pages 1-26, April.
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    3. David B. Olawade & Melissa McLaughlin & Yinka Julianah Adeniji & Gabriel Osasumwen Egbon & Arghavan Rahimi & Stergios Boussios, 2025. "Urban Microclimates and Their Relationship with Social Isolation: A Review," IJERPH, MDPI, vol. 22(6), pages 1-32, June.
    4. Finlay, Jessica & Esposito, Michael & Langa, Kenneth M. & Judd, Suzanne & Clarke, Philippa, 2022. "Cognability: An Ecological Theory of neighborhoods and cognitive aging," Social Science & Medicine, Elsevier, vol. 309(C).
    5. Jake M. Robinson & Paul Brindley & Ross Cameron & Danielle MacCarthy & Anna Jorgensen, 2021. "Nature’s Role in Supporting Health during the COVID-19 Pandemic: A Geospatial and Socioecological Study," IJERPH, MDPI, vol. 18(5), pages 1-21, February.
    6. Anna Domaradzka & Mikołaj Biesaga & Ewa Domaradzka & Magdalena Kołodziejczyk, 2022. "The Civil City Framework for the Implementation of Nature-Based Smart Innovations: Right to a Healthy City Perspective," Sustainability, MDPI, vol. 14(16), pages 1-20, August.
    7. Kirsti S. Anthun & Ruca Elisa Katrin Maass & Siren Hope & Geir Arild Espnes & Ruth Bell & Matluba Khan & Monica Lillefjell, 2019. "Addressing Inequity: Evaluation of an Intervention to Improve Accessibility and Quality of a Green Space," IJERPH, MDPI, vol. 16(24), pages 1-16, December.
    8. Shan Lu & Wonseok Oh & Ryozo Ooka & Lijun Wang, 2022. "Effects of Environmental Features in Small Public Urban Green Spaces on Older Adults’ Mental Restoration: Evidence from Tokyo," IJERPH, MDPI, vol. 19(9), pages 1-22, April.
    9. Lilah M. Besser & Willa D. Brenowitz & Oanh L. Meyer & Serena Hoermann & John Renne, 2021. "Methods to Address Self-Selection and Reverse Causation in Studies of Neighborhood Environments and Brain Health," IJERPH, MDPI, vol. 18(12), pages 1-19, June.
    10. Changcheng Kan & Qiwei Ma & Anqi Liu & Zhaoyu Yuan, 2023. "Associations between Land-Use Patterns and Cardiovascular Disease Mortality in the Beijing—Tianjin–Hebei Megacity Region," Land, MDPI, vol. 12(12), pages 1-17, December.
    11. Xiangrong Jiang & Linda Larsen & William Sullivan, 2020. "Connections Between Daily Greenness Exposure and Health Outcomes," IJERPH, MDPI, vol. 17(11), pages 1-20, June.
    12. Manshu Huang & Yinying Tao & Shunian Qiu & Yiming Chang, 2023. "Healthy Community Assessment Model Based on the German DGNB System," Sustainability, MDPI, vol. 15(4), pages 1-19, February.
    13. Hao-Ting Chang & Chih-Da Wu & Wen-Chi Pan & Shih-Chun Candice Lung & Huey-Jen Su, 2019. "Association Between Surrounding Greenness and Schizophrenia: A Taiwanese Cohort Study," IJERPH, MDPI, vol. 16(8), pages 1-16, April.
    14. Celina Koh & Michelle C. Kondo & Heather Rollins & Usama Bilal, 2022. "Socioeconomic Disparities in Hypertension by Levels of Green Space Availability: A Cross-Sectional Study in Philadelphia, PA," IJERPH, MDPI, vol. 19(4), pages 1-13, February.
    15. Lilah M. Besser & Marcia Pescador Jimenez & Cameron J. Reimer & Oanh L. Meyer & Diana Mitsova & Kristen M. George & Paris B. Adkins-Jackson & James E. Galvin, 2023. "Diversity of Studies on Neighborhood Greenspace and Brain Health by Racialized/Ethnic Group and Geographic Region: A Rapid Review," IJERPH, MDPI, vol. 20(9), pages 1-22, April.
    16. Benjamin D. S. Cartwright & Mathew P. White & Theodore J. Clitherow, 2018. "Nearby Nature ‘Buffers’ the Effect of Low Social Connectedness on Adult Subjective Wellbeing over the Last 7 Days," IJERPH, MDPI, vol. 15(6), pages 1-20, June.
    17. Miho Nishigaki & Masamichi Hanazato & Chie Koga & Katsunori Kondo, 2020. "What Types of Greenspaces Are Associated with Depression in Urban and Rural Older Adults? A Multilevel Cross-Sectional Study from JAGES," IJERPH, MDPI, vol. 17(24), pages 1-16, December.

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