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Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Mood Disorders | Research

Proximity to public green spaces and depressive symptoms among South African residents: a population-based study

Authors: Busisiwe Shezi, Hilbert Mendoza, Darshini Govindasamy, Lidia Casas, Yusentha Balakrishna, Jason Bantjes, Renée Street

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

Exposure to green spaces has been suggested to improve mental health and may reduce the risk of depression. However, there is generally limited evidence on the association between green spaces and depression originating from low-and middle-income countries and Africa in particular. Here, we investigate the association between proximity to public green spaces and depressive symptoms among residents of Gauteng Province, South Africa.

Methods

We used data from the 2017/2018 Gauteng quality of life survey. We included all individuals aged 18 years or older residing in the nine municipalities of Gauteng Province that completed the survey (n = 24,341). Depressive symptoms were assessed using the Patient Health Questionnaire-2. Proximity to public green spaces was defined as self-reported walking time (either less or greater than 15 min) from individuals’ homes to the nearest public green space. To assess the association between access to public green spaces and depressive symptoms, we used mixed-effects models, adjusted for age, sex, population group (African, Indian/Asian, Coloured (mixed race), and White), educational attainment, and municipality. We additionally performed stratified analyses by age, sex, educational attainment, and population group to evaluate whether associations differed within subgroups. Associations are expressed as prevalence ratios (PR) and their 95% confidence intervals (95% CI).

Results

We observed a 6% (PR = 0.94, 95%CI = 0.92–0.96) prevalence reduction in depressive symptoms for individuals who reported that the nearest public green space was less than 15 min from their homes as compared to those who reported > 15 min. After stratification, this inverse association was stronger among females, individuals aged 35–59 years,those with higher levels of educational attainment, and Coloured individuals as compared to their counterparts.

Conclusion

Our findings suggest that public green spaces close to residential homes may be associated with a reduction in the occurrence of depressive symptoms among urban populations in resource-constrained settings like South Africa.
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Literature
1.
go back to reference WHO. World mental health report: transforming mental health for all. World Health Organization: Geneva; 2022. WHO. World mental health report: transforming mental health for all. World Health Organization: Geneva; 2022.
2.
go back to reference Craig A et al. The prevalence of probable depression and probable anxiety, and associations with adverse childhood experiences and socio-demographics: a national survey in South Africa. Front Public Health, 2022. 10. Craig A et al. The prevalence of probable depression and probable anxiety, and associations with adverse childhood experiences and socio-demographics: a national survey in South Africa. Front Public Health, 2022. 10.
3.
go back to reference Cassano P, Fava M. Depression and public health: an overview. J Psychosom Res. 2002;53(4):849–57.CrossRefPubMed Cassano P, Fava M. Depression and public health: an overview. J Psychosom Res. 2002;53(4):849–57.CrossRefPubMed
4.
go back to reference Köhler CA, et al. Mapping risk factors for depression across the lifespan: an umbrella review of evidence from meta-analyses and mendelian randomization studies. J Psychiatr Res. 2018;103:189–207.CrossRefPubMed Köhler CA, et al. Mapping risk factors for depression across the lifespan: an umbrella review of evidence from meta-analyses and mendelian randomization studies. J Psychiatr Res. 2018;103:189–207.CrossRefPubMed
6.
go back to reference Yang H et al. Association between Natural/Built Campus Environment and Depression among Chinese undergraduates: Multiscale evidence for the moderating role of socioeconomic factors after Controlling for Residential Self-Selection. Front Public Health, 2022. 10. Yang H et al. Association between Natural/Built Campus Environment and Depression among Chinese undergraduates: Multiscale evidence for the moderating role of socioeconomic factors after Controlling for Residential Self-Selection. Front Public Health, 2022. 10.
7.
go back to reference Sui Y, Ettema D, Helbich M. Longitudinal associations between the neighborhood social, natural, and built environment and mental health: a systematic review with meta-analyses. Health Place. 2022;77:102893.CrossRefPubMed Sui Y, Ettema D, Helbich M. Longitudinal associations between the neighborhood social, natural, and built environment and mental health: a systematic review with meta-analyses. Health Place. 2022;77:102893.CrossRefPubMed
8.
go back to reference Geneshka M, et al. Relationship between Green and Blue Spaces with Mental and Physical Health: a systematic review of Longitudinal Observational studies. Int J Environ Res Public Health. 2021;18(17):9010.CrossRefPubMedPubMedCentral Geneshka M, et al. Relationship between Green and Blue Spaces with Mental and Physical Health: a systematic review of Longitudinal Observational studies. Int J Environ Res Public Health. 2021;18(17):9010.CrossRefPubMedPubMedCentral
9.
go back to reference Jennings V, Bamkole O. The relationship between Social Cohesion and Urban Green Space: An Avenue for Health Promotion. Int J Environ Res Public Health. 2019;16(3):452.CrossRefPubMedPubMedCentral Jennings V, Bamkole O. The relationship between Social Cohesion and Urban Green Space: An Avenue for Health Promotion. Int J Environ Res Public Health. 2019;16(3):452.CrossRefPubMedPubMedCentral
10.
go back to reference Knobel P, et al. Quality of urban green spaces influences residents’ use of these spaces, physical activity, and overweight/obesity. Environ Pollut. 2021;271:116393.CrossRefPubMed Knobel P, et al. Quality of urban green spaces influences residents’ use of these spaces, physical activity, and overweight/obesity. Environ Pollut. 2021;271:116393.CrossRefPubMed
11.
go back to reference Shen J, et al. Green Space and Physical Activity in China: a systematic review. Sustainability. 2021;13(23):13368.CrossRef Shen J, et al. Green Space and Physical Activity in China: a systematic review. Sustainability. 2021;13(23):13368.CrossRef
12.
go back to reference Liu L, et al. Restorative benefits of urban green space: physiological, psychological restoration and eye movement analysis. J Environ Manage. 2022;301:113930.CrossRefPubMed Liu L, et al. Restorative benefits of urban green space: physiological, psychological restoration and eye movement analysis. J Environ Manage. 2022;301:113930.CrossRefPubMed
13.
go back to reference Høj SB, et al. Relative ‘greenness’ and not availability of public open space buffers stressful life events and longitudinal trajectories of psychological distress. Health Place. 2021;68:102501.CrossRefPubMed Høj SB, et al. Relative ‘greenness’ and not availability of public open space buffers stressful life events and longitudinal trajectories of psychological distress. Health Place. 2021;68:102501.CrossRefPubMed
14.
go back to reference Diener A, Mudu P. How can vegetation protect us from air pollution? A critical review on green spaces’ mitigation abilities for air-borne particles from a public health perspective - with implications for urban planning. Sci Total Environ. 2021;796:148605.CrossRefPubMed Diener A, Mudu P. How can vegetation protect us from air pollution? A critical review on green spaces’ mitigation abilities for air-borne particles from a public health perspective - with implications for urban planning. Sci Total Environ. 2021;796:148605.CrossRefPubMed
15.
go back to reference Junior DPM, Bueno C, Silva CMda. The Effect of Urban Green spaces on reduction of Particulate Matter Concentration. Bull Environ Contam Toxicol. 2022;108(6):1104–10.CrossRefPubMedPubMedCentral Junior DPM, Bueno C, Silva CMda. The Effect of Urban Green spaces on reduction of Particulate Matter Concentration. Bull Environ Contam Toxicol. 2022;108(6):1104–10.CrossRefPubMedPubMedCentral
16.
go back to reference Dzhambov A, Dimitrova D. Urban green spaces’ effectiveness as a psychological buffer for the negative health impact of noise pollution: a systematic review. Noise Health. 2014;16(70):157–65.CrossRefPubMed Dzhambov A, Dimitrova D. Urban green spaces’ effectiveness as a psychological buffer for the negative health impact of noise pollution: a systematic review. Noise Health. 2014;16(70):157–65.CrossRefPubMed
17.
go back to reference Schäffer B, et al. Residential green is associated with reduced annoyance to road traffic and railway noise but increased annoyance to aircraft noise exposure. Environ Int. 2020;143:105885.CrossRefPubMed Schäffer B, et al. Residential green is associated with reduced annoyance to road traffic and railway noise but increased annoyance to aircraft noise exposure. Environ Int. 2020;143:105885.CrossRefPubMed
18.
go back to reference Borroni E, et al. Air pollution exposure and depression: a comprehensive updated systematic review and meta-analysis. Environ Pollut. 2022;292(Pt A):118245.CrossRefPubMed Borroni E, et al. Air pollution exposure and depression: a comprehensive updated systematic review and meta-analysis. Environ Pollut. 2022;292(Pt A):118245.CrossRefPubMed
19.
go back to reference Hegewald J et al. Traffic noise and Mental Health: a systematic review and Meta-analysis. Int J Environ Res Public Health, 2020. 17(17). Hegewald J et al. Traffic noise and Mental Health: a systematic review and Meta-analysis. Int J Environ Res Public Health, 2020. 17(17).
20.
go back to reference Roberts H, et al. The effect of short-term exposure to the natural environment on depressive mood: a systematic review and meta-analysis. Environ Res. 2019;177:108606.CrossRefPubMed Roberts H, et al. The effect of short-term exposure to the natural environment on depressive mood: a systematic review and meta-analysis. Environ Res. 2019;177:108606.CrossRefPubMed
21.
go back to reference Markevych I, et al. Exploring pathways linking greenspace to health: theoretical and methodological guidance. Environ Res. 2017;158:301–17.CrossRefPubMed Markevych I, et al. Exploring pathways linking greenspace to health: theoretical and methodological guidance. Environ Res. 2017;158:301–17.CrossRefPubMed
22.
go back to reference Tomita A, et al. Green environment and incident depression in South Africa: a geospatial analysis and mental health implications in a resource-limited setting. Lancet Planet Health. 2017;1(4):e152–62.CrossRefPubMedPubMedCentral Tomita A, et al. Green environment and incident depression in South Africa: a geospatial analysis and mental health implications in a resource-limited setting. Lancet Planet Health. 2017;1(4):e152–62.CrossRefPubMedPubMedCentral
23.
go back to reference Zewdie HY, et al. The association between urban greenspace and psychological health among young adults in Addis Ababa, Ethiopia. Environ Res. 2022;215:114258.CrossRefPubMedPubMedCentral Zewdie HY, et al. The association between urban greenspace and psychological health among young adults in Addis Ababa, Ethiopia. Environ Res. 2022;215:114258.CrossRefPubMedPubMedCentral
24.
go back to reference WHO. Green and blue spaces and mental health: new evidence and perspectives for action. WHO Regional Office for Europe: Copenhagen; 2021. WHO. Green and blue spaces and mental health: new evidence and perspectives for action. WHO Regional Office for Europe: Copenhagen; 2021.
25.
go back to reference Zhang W, et al. Factors affecting the use of urban green spaces for physical activities: views of young urban residents in Beijing. Volume 14. Urban Forestry & Urban Greening; 2015. pp. 851–7. 4. Zhang W, et al. Factors affecting the use of urban green spaces for physical activities: views of young urban residents in Beijing. Volume 14. Urban Forestry & Urban Greening; 2015. pp. 851–7. 4.
28.
go back to reference Girma Y et al. Urban green spaces supply in rapidly urbanizing countries: The case of Sebeta Town, Ethiopia Remote Sensing Applications: Society and Environment, 2019. 13: p. 138–149. Girma Y et al. Urban green spaces supply in rapidly urbanizing countries: The case of Sebeta Town, Ethiopia Remote Sensing Applications: Society and Environment, 2019. 13: p. 138–149.
31.
go back to reference De Kadt J, et al. Quality of Life survey 6 (2020/21): overview report. Johannesburg, South Africa: Gauteng City Regional Observatory; 2021.CrossRef De Kadt J, et al. Quality of Life survey 6 (2020/21): overview report. Johannesburg, South Africa: Gauteng City Regional Observatory; 2021.CrossRef
32.
go back to reference GCRO. QoL V (2017/18) survey: preliminary results results launch. Gauteng City-Region Observatory; 2019. GCRO. QoL V (2017/18) survey: preliminary results results launch. Gauteng City-Region Observatory; 2019.
33.
go back to reference Levis B, et al. Accuracy of the PHQ-2 alone and in combination with the PHQ-9 for screening to detect major depression: systematic review and meta-analysis. JAMA. 2020;323(22):2290–300.CrossRefPubMedPubMedCentral Levis B, et al. Accuracy of the PHQ-2 alone and in combination with the PHQ-9 for screening to detect major depression: systematic review and meta-analysis. JAMA. 2020;323(22):2290–300.CrossRefPubMedPubMedCentral
34.
go back to reference Gascon M, et al. Mental health benefits of long-term exposure to residential green and blue spaces: a systematic review. Int J Environ Res Public Health. 2015;12(4):4354–79.CrossRefPubMedPubMedCentral Gascon M, et al. Mental health benefits of long-term exposure to residential green and blue spaces: a systematic review. Int J Environ Res Public Health. 2015;12(4):4354–79.CrossRefPubMedPubMedCentral
37.
go back to reference Bank W. Republic of South Africa Systematic Country Diagnostic: An Incomplete Transition Overcoming the Legacy of Exclusion in South Africa. 2018. Bank W. Republic of South Africa Systematic Country Diagnostic: An Incomplete Transition Overcoming the Legacy of Exclusion in South Africa. 2018.
38.
go back to reference Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284–92.CrossRefPubMed Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284–92.CrossRefPubMed
39.
go back to reference Pouso S, et al. Contact with blue-green spaces during the COVID-19 pandemic lockdown beneficial for mental health. Sci Total Environ. 2021;756:143984.CrossRefPubMed Pouso S, et al. Contact with blue-green spaces during the COVID-19 pandemic lockdown beneficial for mental health. Sci Total Environ. 2021;756:143984.CrossRefPubMed
40.
go back to reference Sarkar C, et al. Characteristics of the residential environment and their Association with Depression in Hong Kong. JAMA Netw Open. 2021;4(10):e2130777–2130777.CrossRefPubMedPubMedCentral Sarkar C, et al. Characteristics of the residential environment and their Association with Depression in Hong Kong. JAMA Netw Open. 2021;4(10):e2130777–2130777.CrossRefPubMedPubMedCentral
41.
go back to reference Reklaitiene R, et al. The relationship of green space, depressive symptoms and perceived general health in urban population. Scand J Public Health. 2014;42(7):669–76.CrossRefPubMed Reklaitiene R, et al. The relationship of green space, depressive symptoms and perceived general health in urban population. Scand J Public Health. 2014;42(7):669–76.CrossRefPubMed
43.
go back to reference van der Gaag N et al. State of the World’s Fathers: Centering care in a world in crisis, D. Washington, Editor. 2023, Equimundo. van der Gaag N et al. State of the World’s Fathers: Centering care in a world in crisis, D. Washington, Editor. 2023, Equimundo.
44.
go back to reference Richardson EA, Mitchell R. Gender differences in relationships between urban green space and health in the United Kingdom. Soc Sci Med. 2010;71(3):568–75.CrossRefPubMed Richardson EA, Mitchell R. Gender differences in relationships between urban green space and health in the United Kingdom. Soc Sci Med. 2010;71(3):568–75.CrossRefPubMed
45.
go back to reference Astell-Burt T, Feng X, Kolt GS. 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. 2013;57(5):601–6.CrossRefPubMed Astell-Burt T, Feng X, Kolt GS. 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. 2013;57(5):601–6.CrossRefPubMed
46.
go back to reference Venter ZS, et al. Green apartheid: urban green infrastructure remains unequally distributed across income and race geographies in South Africa. Volume 203. Landscape and Urban Planning; 2020. p. 103889. Venter ZS, et al. Green apartheid: urban green infrastructure remains unequally distributed across income and race geographies in South Africa. Volume 203. Landscape and Urban Planning; 2020. p. 103889.
47.
go back to reference Sabirah A et al. Considering the natural environment in the creation of child-friendly cities: implications for children’s Subjective Well-Being. Child Indic Res, 2019. 12(2). Sabirah A et al. Considering the natural environment in the creation of child-friendly cities: implications for children’s Subjective Well-Being. Child Indic Res, 2019. 12(2).
49.
go back to reference Rigolon A, et al. Green Space and Health Equity: a systematic review on the potential of Green Space to Reduce Health disparities. Int J Environ Res Public Health. 2021;18(5):2563.CrossRefPubMedPubMedCentral Rigolon A, et al. Green Space and Health Equity: a systematic review on the potential of Green Space to Reduce Health disparities. Int J Environ Res Public Health. 2021;18(5):2563.CrossRefPubMedPubMedCentral
50.
go back to reference Nguyen PY et al. Green Space Quality and Health: a systematic review. Int J Environ Res Public Health, 2021. 18(21). Nguyen PY et al. Green Space Quality and Health: a systematic review. Int J Environ Res Public Health, 2021. 18(21).
51.
go back to reference Zhang L, et al. Assessing individual environmental exposure derived from the spatiotemporal behavior context and its impacts on mental health. Health Place. 2021;71:102655.CrossRefPubMed Zhang L, et al. Assessing individual environmental exposure derived from the spatiotemporal behavior context and its impacts on mental health. Health Place. 2021;71:102655.CrossRefPubMed
52.
go back to reference Helbich M, et al. Using deep learning to examine street view green and blue spaces and their associations with geriatric depression in Beijing, China. Environ Int. 2019;126:107–17.CrossRefPubMedPubMedCentral Helbich M, et al. Using deep learning to examine street view green and blue spaces and their associations with geriatric depression in Beijing, China. Environ Int. 2019;126:107–17.CrossRefPubMedPubMedCentral
53.
go back to reference Wang R, et al. Urban greenery and mental wellbeing in adults: cross-sectional mediation analyses on multiple pathways across different greenery measures. Environ Res. 2019;176:108535.CrossRefPubMed Wang R, et al. Urban greenery and mental wellbeing in adults: cross-sectional mediation analyses on multiple pathways across different greenery measures. Environ Res. 2019;176:108535.CrossRefPubMed
54.
go back to reference Klompmaker JO, et al. Associations of combined exposures to surrounding green, air pollution and traffic noise on mental health. Environ Int. 2019;129:525–37.CrossRefPubMed Klompmaker JO, et al. Associations of combined exposures to surrounding green, air pollution and traffic noise on mental health. Environ Int. 2019;129:525–37.CrossRefPubMed
55.
go back to reference Abraham Cottagiri S, et al. Increased urban greenness associated with improved mental health among middle-aged and older adults of the Canadian longitudinal study on aging (CLSA). Environ Res. 2022;206:112587.CrossRefPubMed Abraham Cottagiri S, et al. Increased urban greenness associated with improved mental health among middle-aged and older adults of the Canadian longitudinal study on aging (CLSA). Environ Res. 2022;206:112587.CrossRefPubMed
56.
go back to reference Kabisch N. The Influence of Socio-economic and Socio-demographic Factors in the Association Between Urban Green Space and Health, in Biodiversity and Health in the Face of Climate Change, M.R. Marselle, Editors. 2019, Springer International Publishing: Cham. p. 91–119. Kabisch N. The Influence of Socio-economic and Socio-demographic Factors in the Association Between Urban Green Space and Health, in Biodiversity and Health in the Face of Climate Change, M.R. Marselle, Editors. 2019, Springer International Publishing: Cham. p. 91–119.
Metadata
Title
Proximity to public green spaces and depressive symptoms among South African residents: a population-based study
Authors
Busisiwe Shezi
Hilbert Mendoza
Darshini Govindasamy
Lidia Casas
Yusentha Balakrishna
Jason Bantjes
Renée Street
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18385-1

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