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Running head: Relationship Between Natural Environment and Depression for Adults

The Association Between Accessibility to a Natural Environment and Depression for Adults.

Andre J. Resto

University of North Florida

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Relationship Between Natural Environment and Depression for Adults

Introduction:
Major depressive disorder is more prevalent in women and it can develop at any age.

According to the Department of Health (2009) 16% of the worldwide population is affected by

poor mental health at any given time. Furthermore, the World Health Organization (2013)

estimates that 300 million people suffer from depression worldwide. The severity of depression

can vary from mild to severe. Severe cases of depression leave the subject immobilized and

unmotivated to socialize, work, or go to classes. Persistent episodes of severe depression can

even cause an individual to commit suicide.

The severity and prevalence of depression among adults has led many researchers to

explore many factors including the impact of the environment on those that are suffering. More

specifically, if living in urban environments leads a decrease in mental health and increase in risk

of developing MDD (Mukherjee et al., 2017). The World Health Organization (2014) states that

50% of the world’s population lives in urban areas. Also studies have found that urban

environments are associated with depression (Weich et al., 2002; Galeaa et al. 2005). Most of the

studies that look for an association between access to a natural environment and depression have

focused on specific regions with populations of varying age, gender, and socioeconomic status

(Triguero-Mas et al. 2015; Mukherjee et al., 2017; McKenzie et al., 2013; Nichani et al., 2017).

The results of studies that pertain to particular regions is that they can be collected so that

their findings can be generalized and offer external validity to larger populations. The aim of this

review is to determine whether there is an association between the accessibility to nature and

depression for adults. If adults have access to parks and green space, then they are expected to

have better mental health and lower depression than if they do not have access to parks and a

green space.
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Relationship Between Natural Environment and Depression for Adults

Body:
I synthesized five articles relating to green space, urbanization, mental health, and

depression. The first article is a cross-sectional study collected data of 8793 adults form the

Catalonia Health Survey to determine if there was an association between natural outdoor

environments and mental health. Triguero-Mas, et al. (2015) hypothesized that natural outdoor

environments have a significantly positive association with better self-perceived mental and

general health. The study used self-perceived general health, perceived risk of poor mental

health, perceived depression and/or anxiety, visits to mental health specialists, and intake of

medication as health indicators. They discovered that living close to green spaces and higher

surrounding greenness was associated with better mental health.

Van der Berg, et al. (2016) discovered a similar conclusion in a study that looked for an

association between visiting green space and mental health and vitality. Using data from the

research project Positive Health of the Natural Outdoor Environment in Typical Populations in

Different Regions in Europe (PHENOTYPE), they were able to create a cross-sectional study to

evaluate if longer visits to green spaces correlate to better mental health. A significant positive

association between visits to green space and mental health and vitality was found. More

specifically, women with less nature childhood experience were most positively affected by

purposeful visits to green spaces. The more frequent they visited green space the lower perceived

level of stress and odds of depressive symptoms decreased. Those with lower level of education

were also affected by visits to green space more than those with medium or higher levels of

education (van der Berg, et al., 2016).

Another aspect of MDD is the detrimental effects of living in urban environments.

McKenzie, Murray, and Booth (2013) conducted analyzed data from the Scottish Neighborhood
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Relationship Between Natural Environment and Depression for Adults

Statistical database using linear multiple regression. The study measured depression and mental

health by acquiring the data for prescribed drugs for anxiety, depression, or psychosis.

Neighborhoods that are more rural had statistically fewer prescription drugs for anxiety,

depression, or psychosis (McKenzie, Murray, and Booth, 2013). The same was true after

socioeconomic status covariates were included.

Mukherjee, et al. (2017) used an alternative form to evaluate green space and park

availability in their study to determine if there is an association between park availability and

major depression in individuals with chronic conditions. ArcGIS is a geographic information

system that that allowed them to measure the distance from the subject’s residence to the nearest

park and total area of all of the local parks. Along with the use of ArcGIS, the cross-sectional

survey Centre for Cardio-Metabolic Risk Reduction in South Asia (CARRS) was also utilized to

collect data on cardio-metabolic disorders like central obesity, insulin resilience, glucose

intolerance, and dyslipidemia). Mukherjee, et al. (2017) also found that individuals living in far

proximity to parks were most likely to have self-reported major depressive disorder. There was

also a statistically significant positive linear trend between small area of the nearest park and

major depressive disorder (Mukherjee, et al., 2017).

Contrary to the previous studies, Nichani, et al. (2017) concluded that there was no

association between access to green space and antenatal depression. The study followed 6822

mothers living in New Zealand during their pregnancy. 15% of these mothers experienced

depression during the antenatal period and throughout all exposure groups (medium, high, and

very high levels), it was concluded that availability of green space was not associated with

antenatal depression.
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Relationship Between Natural Environment and Depression for Adults

Conclusion:

The aim of this review is to determine whether there is an association between the

accessibility to nature and depression for adults. Based on the literature reviewed, the articles

confirmed my hypothesis that there is a positive association between increased access to parks

and natural environments and a decrease in major depressive disorder. Four of the five studies

synthesized concluded that increased use of natural environments improve perceived mental

health and thus decrease depression in adults. The reason parks are beneficial to mental health is

unknown but assumptions can be made. Park aid an increase in physical activity and facilitate

socialization, which is known to decrease depression.

Because each study approach has its limitations, more research is needed. Studies that

used cross-sectional design are flawed due to the lack of causality, Other factors that impede the

reliability of these studies include self-selection bias, quality of the natural environment studied,

and socioeconomic status. Those variables might have played a role in exaggerating or

minimizing the results.

Public health practitioners can use the results of my study by promoting the mental health

benefits of visiting parks and natural environments in general. Those with chronic diseases or

have high risk of developing a chronic condition can decrease their chance of major depressive

disorder by having purposeful visits to parks. Even increasing park visits by one hour a day for a

month is associated with an increase in mental health (van der Berg, et al., 2016). Practitioners

can also implement interventions at parks to encourage community exercise. Public health

professionals can also use the results of my study to devise their own primary study that

pinpoints the beneficial aspects of parks and green spaces.

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Relationship Between Natural Environment and Depression for Adults

Reference List:
Vikram Nichani, Kim Dirks, Bruce Burns, Amy Bird, & Cameron Grant. (2017). Green space and
depression during pregnancy: Results from the growing up in New Zealand study. International
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van den Berg, M., van Poppel, M., van Kamp, I., Andrusaityte, S., Balseviciene, B., Cirach, M., . . .
Maas, J. (2016). Visiting green space is associated with mental health and vitality: A cross-
sectional study in four European cities. Health & Place, 38, 8.
Triguero-Mas, M., Dadvand, P., Cirach, M., Martínez, D., Medina, A., Mompart, A., . . .
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McKenzie, K., Murray, A., & Booth, T. (2013). Do urban environments increase the risk of anxiety,
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