Health disparities in the relationship of neighborhood greenness to mental health outcomes in 249,405 U.S. medicare beneficiaries

Scott Brown, Tatiana Perrino, Joanna Lombard, Kefeng Wang, Matthew Toro, Tatjana Rundek, Carolina Marinovic Gutierrez, Chuanhui Dong, Elizabeth Plater-Zyberk, Maria I. Nardi, Jack Kardys, Jose Szapocznik

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Abstract

Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence) and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer’s disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer’s disease (by 18%) and depression (by 28%) for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37% lower odds of depression in low-income neighborhoods, compared to 27% and 21% lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation.

Original languageEnglish (US)
Article number430
JournalInternational Journal of Environmental Research and Public Health
Volume15
Issue number3
DOIs
StatePublished - Mar 1 2018

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Medicare
Mental Health
Health
Depression
Alzheimer Disease
Satellite Imagery
Multilevel Analysis
Insurance Benefits
Censuses
Interpersonal Relations
Exercise
Population

Keywords

  • Alzheimer’s disease
  • Depression
  • Health disparities
  • Mental health
  • Neighborhood greenness
  • Neighborhood income
  • Older adults
  • U.S. medicare beneficiaries

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

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title = "Health disparities in the relationship of neighborhood greenness to mental health outcomes in 249,405 U.S. medicare beneficiaries",
abstract = "Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence) and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer’s disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer’s disease (by 18{\%}) and depression (by 28{\%}) for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37{\%} lower odds of depression in low-income neighborhoods, compared to 27{\%} and 21{\%} lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation.",
keywords = "Alzheimer’s disease, Depression, Health disparities, Mental health, Neighborhood greenness, Neighborhood income, Older adults, U.S. medicare beneficiaries",
author = "Scott Brown and Tatiana Perrino and Joanna Lombard and Kefeng Wang and Matthew Toro and Tatjana Rundek and Gutierrez, {Carolina Marinovic} and Chuanhui Dong and Elizabeth Plater-Zyberk and Nardi, {Maria I.} and Jack Kardys and Jose Szapocznik",
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T1 - Health disparities in the relationship of neighborhood greenness to mental health outcomes in 249,405 U.S. medicare beneficiaries

AU - Brown, Scott

AU - Perrino, Tatiana

AU - Lombard, Joanna

AU - Wang, Kefeng

AU - Toro, Matthew

AU - Rundek, Tatjana

AU - Gutierrez, Carolina Marinovic

AU - Dong, Chuanhui

AU - Plater-Zyberk, Elizabeth

AU - Nardi, Maria I.

AU - Kardys, Jack

AU - Szapocznik, Jose

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence) and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer’s disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer’s disease (by 18%) and depression (by 28%) for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37% lower odds of depression in low-income neighborhoods, compared to 27% and 21% lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation.

AB - Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence) and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer’s disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer’s disease (by 18%) and depression (by 28%) for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37% lower odds of depression in low-income neighborhoods, compared to 27% and 21% lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation.

KW - Alzheimer’s disease

KW - Depression

KW - Health disparities

KW - Mental health

KW - Neighborhood greenness

KW - Neighborhood income

KW - Older adults

KW - U.S. medicare beneficiaries

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U2 - 10.3390/ijerph15030430

DO - 10.3390/ijerph15030430

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