The Association of Active Living Environments and Mental Health: A Canadian Epidemiological Analysis.

Aysha Lukmanji,Jeanne V.A Williams,Scott B Patten,Andrew G.M Bulloch,Ashley K Dores

doi:10.3390/ijerph17061910

Aysha Lukmanji, Jeanne V.A Williams + Show 3 more

Open Access

https://doi.org/10.3390/ijerph17061910

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Abstract

Environments that promote use of active transport (walking, biking, and public transport use) are known as “active living environments” (ALE). Using a Canadian national sample, our aim was to determine if ALEs were associated with mental health outcomes, including depressive symptoms, and mood and anxiety disorders. Data from the Canadian Community Health Survey from 2015–2016 was used for demographic characteristics and mental health outcomes (n ≈ 110,000). This data was linked to datasets from the Canadian Urban Environmental Health Research Consortium, reporting ALE and social and material deprivation. Depressive symptoms were evaluated using standard dichotomized scores of 5+ (mild) and 10+ (moderate/severe) from the Patient Health Questionnaire-9. Self-reported diagnosed mood and anxiety disorders were also included. Logistic regression was used to determine the association of mental health outcomes with four classes of ALE. The analysis included adjustments for social and material deprivation, age, sex, chronic conditions, marital status, education, employment, income, BMI, and immigrant status. No association between any mental health outcome and ALE were observed. While the benefits of ALE to physical health are known, these results do not support the hypothesis that more favorable ALE and increased use of active transport is associated with better mental health outcomes.

Highlights

Elements of the built environment which promote physical activity are believed to be associated with positive physical health outcomes
Using a Canadian epidemiological sample, our objective is to determine whether active living environments and the use of active transportation are associated with more positive indicators of mental health
The relationship between social deprivation and a set of well-known determinants of mental health demonstrated the expected effects in the models. These results suggest that the relationship between the built environment and mental health differs from that of physical health

Summary

Introduction

Elements of the built environment which promote physical activity are believed to be associated with positive physical health outcomes. Research has established that features of the built environment, including intersections, points of interest, dwelling density, and transit availability are linked to an increased type of activity classified as “active transportation” [1]. “Active living environments” are regions which promote the use of active transport due to features of the built environment. Increased physical activity from living in an environment conducive to being active has been associated with a lower risk of obesity among other chronic conditions, such as diabetes and cardiovascular disease [2,3,4,5]. Despite the increasing number of studies demonstrating the association between physical health and active transportation, interest towards the impact of these active environments on mental health outcomes is increasing

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