Is it important to visit greenspace to keep your mental health good during a pandemic? - a cross-sectional online survey

Abstract

BACKGROUND AND AIM: Along with multiple stressors of COVID-19, access to greenspace may be altered and it would adversely affect health. We suggested mechanisms how a pandemic affects associations between greenspace and mental health and assessed the associations between decreased visits to greenspace and prevalence of depression and anxiety during the pandemic. METHODS: We conducted an online survey recruiting Korean adult participants from social media during September – December 2020 and collected data on basic information, patterns of using greenspace, and mental health symptoms during the past 2 weeks from the time of survey. The Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 2-item (GAD-2) were applied to identify probable cases of depression and anxiety. Multivariable logistic regression models assessed the impact of a categorical variable of decreased visits to greenspace after the outbreak compared to 2019 on depression and anxiety. RESULTS:Among the total 322 survey participants, prevalence of probable cases was 19.3% for depression and 14.9% for anxiety. A higher rate of depression (23.3%) and anxiety (19.4%) was found among persons currently having job-related and financial issues. Of the total participants, 64.9% reported decreased visits to greenspace after the COVID-19 outbreak and low-income persons reported significantly higher reduction in visits to greenspace (p-value=0.046). The major reasons for decreased visits to greenspace were fear and worry regarding Coronavirus and the government’s stay-at-home orders. In multivariable models, decreased visits to greenspace after the outbreak compared to 2019 was significantly associated with increased risk of depression at the time of the survey (OR=2.06, 95% CI: 0.91, 4.67). CONCLUSIONS:Not using greenspace may deprive people of mental health benefits and affect mental illnesses during the pandemic; alternatively, those experiencing mental illnesses may be less likely to visit greenspaces during pandemic. Interventions need to adequately guide greenspace uses under an outbreak combined with mitigation measures. KEYWORDS: Built environment, Mental health outcomes, Green space