Mental health benefits of long-term exposure to residential green and blue spaces: a systematic review.

Mireia Gascon,Payam Dadvand,Joan Forns,David Martínez,Margarita Triguero-Mas,Antoni Plasència,Mark Nieuwenhuijsen

doi:10.3390/ijerph120404354

Abstract

Many studies conducted during the last decade suggest the mental health benefits of green and blue spaces. We aimed to systematically review the available literature on the long-term mental health benefits of residential green and blue spaces by including studies that used standardized tools or objective measures of both the exposures and the outcomes of interest. We followed the PRISMA statement guidelines for reporting systematic reviews and meta-analysis. In total 28 studies were included in the systematic review. We found limited evidence for a causal relationship between surrounding greenness and mental health in adults, whereas the evidence was inadequate in children. The evidence was also inadequate for the other exposures evaluated (access to green spaces, quality of green spaces, and blue spaces) in both adults and children. The main limitation was the limited number of studies, together with the heterogeneity regarding exposure assessment. Given the increase in mental health problems and the current rapid urbanization worldwide, results of the present systematic review should be taken into account in future urban planning. However, further research is needed to provide more consistent evidence and more detailed information on the mechanisms and the characteristics of the green and blue spaces that promote better mental health. We provide recommendations for future studies in order to provide consistent and evidence-based recommendations for policy makers.

Highlights

Mental, neurological and substance use disorders account for 13% of the total global burden of disease [1]
After screening the title and the abstracts and checking for duplicates, 65 articles were chosen for full-text evaluation, of which 27 articles were included in the systematic review
We identified two studies assessing the mental health benefits of the quality of green spaces, which was evaluated using different non-validated audit tools based on subjective judgment [17,43]

Summary

Introduction

Neurological and substance use disorders account for 13% of the total global burden of disease [1]. A recent study reported that the global cost of mental health disorders in 2010 was an estimated US$ 2.5 trillion, and that these costs can raise to US$ 6.0 trillion by 2030 [2]. Many factors play a role in the occurrence of mental health disorders, including multiple social, psychological, and biological factors, as well as the environment in where we live, the characteristics of the urban environment [1]. About half of the world population is currently living in cities and it is projected that by 2030 three of every five persons will live in urban areas worldwide [3]. Living in a city can be beneficial for people’s well-being as it facilitates the establishment of social networks and access to several services, including health care services. Some aspects of living in a city can be detrimental for people's health (e.g., air pollution, space restrictions, noise), and these city detrimental aspects may increase in the coming years [4]

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