Table 2.
Main characteristics and results of the studies on access to green spaces and mental health.
| Author (Year, Country) | Study Design | Age of the Study Population (Stratifications/Interactions) | N | Tools to Measure Mental Health | Mental Health Item | Access to GS Indicator a | Risk of Mental Health Problems |
|---|---|---|---|---|---|---|---|
| Exclusively children | |||||||
| Amoly et al. 2014, Spain [30] | Cross-sectional | 7–10 y | 2111 | SDQ ADHD/DSM-IV | Emotional & behavioural problems b | Presence of a GS ≥0.05 km2 in a 300 m buffer | - |
| Balseviciene et al. 2014, Lithuania [28] | Cross-sectional | 4–6 y (maternal education) | 1468 | SDQ | Emotional & behavioural problems b | Distance to the nearest park of >1 ha and 65% of the land tree covered | Lower maternal education group: increasing distance ↑ behavioral problems, but not emotional problems |
| Markevych et al. 2014, Germany [29] | Cross-sectional | 10 y (gender, urbanity degree) | 1932 | SDQ | Emotional & behavioural problems b | Distance to the nearest GS | Increasing distance ↑ risk hyperactivity/inattention & peer relationship problems (after stratification only in males) |
| Adults (or population irrespective of age) | |||||||
| Duncan et al. 2013, The USA [26] | Cross-sectional | ~16 y (gender, ethnicity) | 1170 | MDS | Depression symptoms | Recreational open space & parks (400 m & 800 m buffers) | Increasing access to recreational open space in a 400 m buffer: ↓ risk in Asian Increasing access to parks in a 800 m buffer: ↑ risk in Black |
| Fan et al. 2011, The USA [27] | Cross-sectional | Adults 18–75 y | 1544 | PSS | Stress | Distance to the nearest park | - |
| Nutsford et al. 2013, New Zealand [23] | Ecological | >15 y | 319521 | Health ministry database | Anxiety/mood disorder treatment counts | Distance to total and useable GS | Increasing distance to usable GS ↑ risk of treatment |
| Adults (or population irrespective of age) | |||||||
| Reklaitiene et al. 2014, Lithuania [41] | Cross-sectional | 45–72 y (age, gender, park use) | 7161 | CES-D10 | Depressive symptoms | Distance to the nearest park (of >1 ha and 65% of the land covered with green space; | Park users (≥4 h/week): increasing distance ↑ risk of depressive symptoms (after stratification only in females) |
| Sturm et al. 2014, The USA [42] | Cross-sectional | Adults | 1070 | MHI-5 | Mental health | Distance to the studied parks (1.6 km) | Increasing distance ↓ mental health (no association beyond 1.6km) |
| Triguero-Mas et al. 2015, Spain [14] | Cross-sectional | 34–64 y (physical activity, gender, degree of urbanization, socioeconomic status and social support) | 8793 | GHQ-12 SF-36 | Perceived mental health | Presence of a GS within 100 m, 300 m, 500 m and 1 km buffers | - |
ADHD/DMS-IV: ADHD symptom Criteria of Diagnostic and Statistical Manual of Mental Disorder, 4th Edition; CES-D10: Centre for Epidemiologic Studies-Depression Scale (10 items); GS: green space; K6: Kessler Psychological Distress Scale (6 items); MDS: Modified Depression Scale; MHI-5: Mental Health Inventory (5 items); SDQ: Strengths and Difficulties Questionnaire; a All used land-cover map to calculate access to GS except Sturm et al. 2014, who used an audit tool; b SDQ measures hyperactivity, emotional symptoms, conduct problems, peer problems, prosocial behaviour and ADHD/DMS-IV measures inattention and hyperactivity-impulsivity symptoms.