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Int. J. Environ. Res. Public Health 2018, 15(3), 430; https://doi.org/10.3390/ijerph15030430

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

1
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
2
University of Miami School of Architecture, 1223 Dickinson Drive, Building 48 Room 320G, Coral Gables, FL 33146, USA
3
Department of Neurology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Soffer Clinical Research Center Room 1348, Miami, FL 33136, USA
4
ASU Library, Map and Geospatial Hub, Arizona State University, Tempe, AZ 85281, USA
5
Miami-Dade County Parks, Recreation and Open Spaces Department (MDPROS), 275 NW 2nd Street, Hickman Building, 3rd floor, Miami, FL 33128, USA
*
Author to whom correspondence should be addressed.
Received: 4 January 2018 / Revised: 12 February 2018 / Accepted: 27 February 2018 / Published: 1 March 2018
(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)
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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. View Full-Text
Keywords: neighborhood greenness; health disparities; neighborhood income; mental health; Alzheimer’s disease; depression; U.S. Medicare beneficiaries; older adults neighborhood greenness; health disparities; neighborhood income; mental health; Alzheimer’s disease; depression; U.S. Medicare beneficiaries; older adults
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Brown, S.C.; Perrino, T.; Lombard, J.; Wang, K.; Toro, M.; Rundek, T.; Gutierrez, C.M.; Dong, C.; Plater-Zyberk, E.; Nardi, M.I.; Kardys, J.; Szapocznik, J. Health Disparities in the Relationship of Neighborhood Greenness to Mental Health Outcomes in 249,405 U.S. Medicare Beneficiaries. Int. J. Environ. Res. Public Health 2018, 15, 430.

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