Urban green space visitation and mental health wellbeing during COVID-19 in Bangkok, Thailand

Nature contact and health risk Behaviours: Results from an 18 country study

Emerging evidence suggests that residential greenspace is associated with a lower prevalence of health risk behaviours, but it remains unclear whether these effects are generalizable across countries or different types of nature contact. Using representative cross-sectional samples from 18 countries/regions, we examined the associations between two types of nature contact (greenspace, nature visits), current smoking and everyday drinking. After controlling for a range of covariates, greenspace was inversely associated with current smoking and everyday drinking. Visiting natural spaces at least once a week was linked to a lower prevalence of current smoking, but unrelated to everyday drinking. Increasing residential greenspace could be a promising strategy for reducing multiple health risk behaviours, whilst visit-based interventions may be a more appropriate target for smoking cessation.

One-year post lockdown trajectories of mental health and impact of COVID-19 lockdown-related factors

Introduction

Concerns about the impact of restrictive measures on people's wellbeing, especially mental health, were raised by the COVID-19 pandemic and related lockdown measures.

Methods

In this study, we examined longitudinal trajectories of mental health during the initial French lockdown period and up to one-year post-lockdown, among a representative sample of French adults aged over 50. We also assessed the impact of COVID-19 lockdown-related factors on mental health. A cohort of 534 individuals was enrolled during the first French lockdown in March 2020, and four telephone interviews were conducted during the lockdown, and at 1-, 6- and 12-months post-lockdown. Mental health was assessed using validated scores of anxiety and depression (GAD-7 and PHQ-9, respectively). Participants undergoing treatment for anxiety or depression at inclusion were excluded.

Results

Our analysis revealed a significant decrease in the proportion of individuals experiencing poor mental health (elevated GAD-7 or PHQ-9 > 4) from lockdown period to 1 month and 6 months post-lockdown. However, this improvement stopped at 12 months post-lockdown, likely reflecting the reinstatement of strict measures in 2021. We used logistic regression to identify factors independently associated with early and long-lasting deterioration in mental health (elevated GAD-7 or PHQ-9 > 4 at first or second interview that persisted over at least two interviews). History of anxiety, poor perceived global health, female gender, working during lockdown, not being in a relationship, and having a relative suspected of being COVID-positive were significantly associated with deterioration in mental health.

Discussion

Our study highlights factors associated with a mental health impact during and following a lockdown in a representative sample of people, aged over 50 years old, thus at increased risk of severe COVID-19 and more likely to be subject to lockdown measures. These factors could be targeted in public health actions in future pandemics.

Nature exposure and mental health during the COVID-19 pandemic: A Navigation Guide systematic review with meta-analysis

Prior reviews have highlighted that nature exposure was a valuable coping strategy enhancing mental health during the COVID-19 pandemic. However, no existing reviews have determined the quality of evidence and risk of bias of the empirical studies supporting this claim. To address this gap, we employed a Navigation Guide systematic review and meta-analysis approach to investigate associations between nature exposure and mental health during the pandemic. Searches in PubMed, Web of Science, Scopus, CINAHL, and PsycInfo retrieved relevant articles published between January 1, 2020, and March 4, 2024. We used the Navigation Guide methodology to assess the risk of bias and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessments to evaluate the overall quality of evidence. Our search retrieved 113 studies that met the inclusion criteria and reported diverse types of exposure, including nature availability, nature visit frequency, green space accessibility, and green space type, alongside associations with 12 mental health outcomes. Meta-analyses found access to gardens was associated with lower odds of depression [(Pooled odds ratio [OR] = 0.71, 95%CI = 0.61, 0.82), I2 = 0%, n = 3] and anxiety [(Pooled OR = 0.73, 95%CI = 0.63, 0.84), I2 = 0%, n = 3]. Increased time in green spaces was associated with lower level of stress [(Pooled Corr = -0.11, 95%CI = -0.17, -0.05), I2 = 0%, n = 2]. Higher frequency of visits to nature was associated with improved mental well-being [(Pooled standardized beta = 0.10, 95%CI = 0.07, 0.14), I2 = 0%, n = 2] and general mental health [(Pooled standardized beta = 0.11, 95%CI = 0.03-0.38), I2 = 82%, n = 2]. However, the number of pooled studies was small and the overall quality of evidence was "very low" for all outcomes, and high levels of bias were observed (26% of studies had high, 71% probably high). Nonetheless, given the trends in the results, nature-based solutions emphasizing exposure to gardens and green spaces near the home may have promoted psychological resilience during this public health crisis.

Neighbourhood Walkability and Physical Activity during the COVID-19 Pandemic

This study investigated whether living in a walkable neighbourhood could mitigate the adverse effects of the lockdown and closure of public open spaces during the COVID-19 pandemic on physical activity among adults in Bangkok, Thailand. We conducted a telephone survey with 579 respondents and collected information on their physical activity, access to green open spaces, neighbourhood walkability, and socioeconomic characteristics during the pandemic. Our study indicates that living in a walkable neighbourhood is associated with a higher likelihood of engaging in sufficient physical activity during the pandemic. Furthermore, we confirm the influence of socioeconomic factors and health behaviours on physical activity levels, aligning with previous research. Notably, our study highlights the significant association between access to green open spaces during lockdown and increased physical activity. These results underscore the importance of promoting walkable neighbourhoods and ensuring accessible green spaces to enhance physical activity and improve health outcomes during and beyond the pandemic.