Health Disparities in the Relationship of Neighborhood Greenness to Mental Health Outcomes in 249,405 U.S. Medicare Beneficiaries

Scott C. Brown, Tatiana Perrino, Joanna Lombard, Kefeng Wang, Matthew Toro, Tatjana Rundek, Carolina Marinovic Gutierrez, Chuanhui Dong, Elizabeth Plater-Zyberk, Maria I. Nardi, Jack Kardys and José Szapocznik
Additional contact information
Scott C. Brown: Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA
Tatiana Perrino: Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA
Joanna Lombard: Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA
Kefeng Wang: Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA
Matthew Toro: ASU Library, Map and Geospatial Hub, Arizona State University, Tempe, AZ 85281, USA
Tatjana Rundek: Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA
Carolina Marinovic Gutierrez: Department of Neurology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1348, Miami, FL 33136, USA
Chuanhui Dong: Department of Neurology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1348, Miami, FL 33136, USA
Elizabeth Plater-Zyberk: University of Miami School of Architecture, 1223 Dickinson Drive, Building 48 Room 320G, Coral Gables, FL 33146, USA
Maria I. Nardi: Miami-Dade County Parks, Recreation and Open Spaces Department (MDPROS), 275 NW 2nd Street, Hickman Building, 3rd floor, Miami, FL 33128, USA
Jack Kardys: Miami-Dade County Parks, Recreation and Open Spaces Department (MDPROS), 275 NW 2nd Street, Hickman Building, 3rd floor, Miami, FL 33128, USA
José Szapocznik: Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1065, Miami, FL 33136, USA

IJERPH, 2018, vol. 15, issue 3, 1-11

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: neighborhood greenness; health disparities; neighborhood income; mental health; Alzheimer’s disease; depression; U.S. Medicare beneficiaries; older adults (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (15)

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