Abstract
Objectives
There is increasing evidence that parks and green areas have beneficial effects on mental health; however, most studies have been limited to a certain or small geographic area. This study investigated whether parks and green areas were associated with the risk for depression or suicidal indicators among adults.
Methods
We used the 2009 Korean Community Health Survey data (n = 169,029). Residential geographical codes were used to determine the amount of parks and green areas in each administrative district.
Results
The median amount of parks and green areas was 19.73 m2 per capita. Compared with adults living the highest amount of parks and green areas (1st quartile), those living in regions with the lowest amount of parks and green areas (4th quartile) had 16–27% greater odds for depression and suicidal indicators, after adjusting for all potential variables. People without moderate physical activity had higher odds for self-reported depression and suicidal ideation than those with moderate physical activity.
Conclusions
We observed protective associations between parks and green areas and depression and suicidal indicators. In addition, moderate physical activity may help to lower the risk for depression and suicidal indicators.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alcock I, White MP, Wheeler BW, Fleming LE, Depledge MH (2014) Longitudinal effects on mental health of moving to greener and less green urban areas. Environ Sci Technol 48(2):1247–1255. doi:10.1021/es403688w
Anderson P, Jane-Llopis E (2011) Mental health and global well-being. Health Promot Int 26(Suppl 1):i147–i155. doi:10.1093/heapro/dar060
Astell-Burt T, Feng X, Kolt GS (2013) Mental health benefits of neighbourhood green space are stronger among physically active adults in middle-to-older age: evidence from 260,061 Australians. Prev Med 57(5):601–606. doi:10.1016/j.ypmed.2013.08.017
Astell-Burt T, Mitchell R, Hartig T (2014) The association between green space and mental health varies across the lifecourse. A longitudinal study. J Epidemiol Commun. Health (London) 68(6):578–583. doi:10.1136/jech-2013-203767
Barton J, Pretty J (2010) What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environ Sci Technol 44(10):3947–3955. doi:10.1021/es903183r
Beyer KM, Kaltenbach A, Szabo A, Bogar S, Nieto FJ, Malecki KM (2014) Exposure to neighborhood green space and mental health: evidence from the survey of the health of Wisconsin. Int J Environ Res Public Health 11(3):3453–3472. doi:10.3390/ijerph110303453
Bowler DE, Buyung-Ali LM, Knight TM, Pullin AS (2010) A systematic review of evidence for the added benefits to health of exposure to natural environments. BMC Public Health 10:456. doi:10.1186/1471-2458-10-456
Brownson RC, Baker EA, Housemann RA, Brennan LK, Bacak SJ (2001) Environmental and policy determinants of physical activity in the United States. Am J Public Health 91(12):1995–2003
Cho MJ, Kim KH (1993) Diagnostic validity of the CES-D (Korean version) in the assessment of DSM-III-R major depression. J Korean Neuropsychiatr Assoc 32:381–399
Chou KL, Liang K, Sareen J (2011) The association between social isolation and DSM-IV mood, anxiety, and substance use disorders: wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 72(11):1468–1476. doi:10.4088/JCP.10m06019gry
Cohen-Cline H, Turkheimer E, Duncan GE (2015) Access to green space, physical activity and mental health: a twin study. J Epidemiol Community Health 69(6):523–529. doi:10.1136/jech-2014-204667
de Vries S, van Dillen SM, Groenewegen PP, Spreeuwenberg P (2013) Streetscape greenery and health: stress, social cohesion and physical activity as mediators. Soc Sci Med 94(1):26–33. doi:10.1016/j.socscimed.2013.06.030
Diez Roux AV, Evenson KR, McGinn AP et al (2007) Availability of recreational resources and physical activity in adults. Am J Public Health 97(3):493–499. doi:10.2105/ajph.2006.087734
Gascon M, Triguero-Mas M, Martinez D et al (2015) Mental health benefits of long-term exposure to residential green and blue spaces: a systematic review. Int J Environ Res Public Health 12(4):4354–4379. doi:10.3390/ijerph120404354
Kim HJ, Min JY, Kim HJ, Min KB (2016) Parks and Green Areas Are Associated with Decreased Risk for Hyperlipidemia. Int J Environ Res Public Health. 13(12):E1205
Korea Centers for Disease Control and Prevention (2015) Korea Community Health Survey. https://chs.cdc.go.kr/chs/index.do. Accessed 31 March 2016
Korean Statistical Information Service (2009) http://kosis.kr/eng/. Accessed 31 March 2016
Maas J, Verheij RA, de Vries S, Spreeuwenberg P, Schellevis FG, Groenewegen PP (2009) Morbidity is related to a green living environment. J Epidemiol Commun. Health (London) 63(12):967–973. doi:10.1136/jech.2008.079038
McCormack GR, Rock M, Toohey AM, Hignell D (2010) Characteristics of urban parks associated with park use and physical activity: a review of qualitative research. Health Place 16(4):712–726. doi:10.1016/j.healthplace.2010.03.003
McDaid D, Park AL (2011) Investing in mental health and well-being: findings from the DataPrev project. Health Promot Int 26(Suppl 1):i108–i139. doi:10.1093/heapro/dar059
McEachan RR, Prady SL, Smith G et al (2016) The association between green space and depressive symptoms in pregnant women: moderating roles of socioeconomic status and physical activity. J Epidemiol Community Health 70(3):253–259. doi:10.1136/jech-2015-205954
Mitchell R, Popham F (2008) Effect of exposure to natural environment on health inequalities: an observational population study. Lancet (London, England) 372(9650):1655–1660. doi:10.1016/s0140-6736(08)61689-x
Nepon J, Belik SL, Bolton J, Sareen J (2010) The relationship between anxiety disorders and suicide attempts: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Depress Anxiety 27(9):791–798. doi:10.1002/da.20674
Otsuka K, Nakamura H, Kudo K et al (2015) The characteristics of the suicide attempter according to the onset time of the suicidal ideation. Ann Gen Psychiatry 14:48. doi:10.1186/s12991-015-0087-6
Park JH, Kim KW (2011) A review of the epidemiology of depression in Korea. J Korean Med Assoc 54(4):362–369. doi:10.5124/jkma.2011.54.4.362
Radloff LS (1977) The CES-D scale: a self report depression scale for research in the general population. Appl Psych Meas 1:385–401
Reklaitiene R, Grazuleviciene R, Dedele A et al (2014) The relationship of green space, depressive symptoms and perceived general health in urban population. Scand J Public Health 42(7):669–676. doi:10.1177/1403494814544494
Roe J, Aspinall P (2011) The restorative benefits of walking in urban and rural settings in adults with good and poor mental health. Health Place 17(1):103–113. doi:10.1016/j.healthplace.2010.09.003
Richardson EA, Pearce J, Mitchell R, Kingham S (2013) Role of physical activity in the relationship between urban green space and health. Public Health 127(4):318–324. doi:10.1016/j.puhe.2013.01.004
Rihmer Z (2007) Suicide risk in mood disorders. Curr Opin Psychiatry 20(1):17–22. doi:10.1097/YCO.0b013e3280106868
Ro J, Park J, Lee J, Jung H (2015) Factors that affect suicidal attempt risk among korean elderly adults: a path analysis. J Prev Med. Public Health 48(1):28–37. doi:10.3961/jpmph.14.030
Roe JJ, Thompson CW, Aspinall PA et al (2013) Green space and stress: evidence from cortisol measures in deprived urban communities. Int J Environ Res Public Health 10(9):4086–4103. doi:10.3390/ijerph10094086
Simon TR, Powell KE, Swann AC (2004) Involvement in physical activity and risk for nearly lethal suicide attempts. Am J Prev Med 27(4):310–315. doi:10.1016/j.amepre.2004.07.003
Strohle A (2009) Physical activity, exercise, depression and anxiety disorders. J Neural Transm (Vienna) 116(6):777–784. doi:10.1007/s00702-008-0092-x
Sugiyama T, Leslie E, Giles-Corti B, Owen N (2008) Associations of neighbourhood greenness with physical and mental health: do walking, social coherence and local social interaction explain the relationships? J Epidemiol Commun. Health (London) 62(5):e9
Tamosiunas A, Grazuleviciene R, Luksiene D et al (2014) Accessibility and use of urban green spaces, and cardiovascular health: findings from a Kaunas cohort study. Environ Health 13(1):20. doi:10.1186/1476-069x-13-20
Teo AR, Choi H, Valenstein M (2013) Social relationships and depression: ten-year follow-up from a nationally representative study. PLoS ONE 8(4):e62396. doi:10.1371/journal.pone.0062396
Teychenne M, Ball K, Salmon J (2008) Physical activity and likelihood of depression in adults: a review. Prev Med 46(5):397–411. doi:10.1016/j.ypmed.2008.01.009
Thompson Coon J, Boddy K, Stein K, Whear R, Barton J, Depledge MH (2011) Does participating in physical activity in outdoor natural environments have a greater effect on physical and mental wellbeing than physical activity indoors? A systematic review. Environ Sci Technol 45(5):1761–1772. doi:10.1021/es102947t
Triguero-Mas M, Dadvand P, Cirach M et al (2015) Natural outdoor environments and mental and physical health: relationships and mechanisms. Environ Int 77:35–41. doi:10.1016/j.envint.2015.01.012
Tsai AC, Lucas M, Sania A, Kim D, Kawachi I (2014) Social integration and suicide mortality among men: 24-year cohort study of U.S. health professionals. Ann Intern Med 161(2):85–95. doi:10.7326/m13-1291
Tsai AC, Lucas M, Kawachi I (2015) Association between social integration and suicide among women in the United States. JAMA. Psychiatry 72(10):987–993. doi:10.1001/jamapsychiatry.2015.1002
World Health Organization (2009) Mental health, resilience and inequalities. http://www.euro.who.int/__data/assets/pdf_file/0012/100821/E92227.pdf. Accessed 31 July 2016
World Health Organization (2013) Investing in mental health: evidence for action. http://apps.who.int/iris/bitstream/10665/87232/1/9789241564618_eng.pdf. Accessed 31 March 2016
Acknowledgements
Funding
This study was funded by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (Grant Numbers 2015R1A1A3A04000923, 2015R1D1A1A01057619, 2015R1D1A1A01059048).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
KB Min has received research grants from by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology. KB Min declares that he has no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
This study used the public anonymous data and was exempted from obtaining informed consent from ethics review.
Rights and permissions
About this article
Cite this article
Min, Kb., Kim, HJ., Kim, HJ. et al. Parks and green areas and the risk for depression and suicidal indicators. Int J Public Health 62, 647–656 (2017). https://doi.org/10.1007/s00038-017-0958-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-017-0958-5