Associations between greenspace and mental health prescription rates in urban areas

Abstract

Urban greenspace is often associated with improved mental health, particularly in urban areas, with studies typically carried out at town or city scales. Population level models enable us to extend the understanding of the relationship between mental health and urban greenspace to the national level, with relevance to national level policy and funding decision making. We used linear mixed effects models to investigate the relationship between urban greenspace availability measured at two scales (immediate neighbourhood and within 30 min walk) and prescription rates to treat mental health disorders across all Scottish settlements with over 10,000 residents. We incorporated socio-demographic and area-level covariates shown to be related to mental health and/or greenspace use and corrected for spatial autocorrelation and potential impacts of health boards. Within the immediate neighbourhood we estimated a significant relationship between mental health and urban greenspace in areas with high proportions of individuals identifying as part of a Black and Minority Ethnic group and/or a high proportion of households deprived in more than two dimensions. In these areas higher greenspace was associated with lower prescription rates. When considering greenspace within 30 min walk, no significant relationship was estimated between greenspace and mental health disorders. Our results highlight that the relationship between greenspace and mental health relies not only on the presence of greenspace itself, but also on the characteristics of the population using the greenspace. Although aggregated secondary data does not allow us to make inferences around an individual’s relationship to greenspace, population level models as presented here provide valuable information to urban and land use planning, where decisions are taken at the population level.