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. 2020 Nov 2;1(3):100054.
doi: 10.1016/j.xinn.2020.100054. eCollection 2020 Nov 25.

Associations of Residential Greenness with Depression and Anxiety in Rural Chinese Adults

Niu Di  1 , Shanshan Li  2 , Hao Xiang  1 , Yinyu Xie  1 , Zhenxing Mao  3 , Jian Hou  3 , Xiaotian Liu  3 , Wenqian Huo  3 , Boyi Yang  4 , Guanghui Dong  4 , Chongjian Wang  3 , Gongbo Chen  4 , Yuming Guo  2
Affiliations

Associations of Residential Greenness with Depression and Anxiety in Rural Chinese Adults

Niu Di et al. Innovation (Camb). .

Abstract

Background: Depression and anxiety are top contributors to non-fatal health loss globally. Several studies have indicated the association between residential greenness and mental health.

Method: The participants (n = 27,366) were recruited from four counties in Henan Province, China during 2015-2017. Symptoms of depression and anxiety were evaluated using the Patient Health Questionnaire-2 (PHQ-2) and the Generalized Anxiety Disorder-2 (GAD-2) in the baseline survey. The level of residential greenness during the 3-year period before the baseline survey was assessed using the Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI). The mixed-effect linear regression model was applied to examine the associations of residential greenness with depression and anxiety.

Results: The results of adjusted models showed that the score of PHQ-2 (Δscore and 95% confidence interval [CI]) decreased by -0.024 (-0.041, -0.006) and -0.022 (-0.038, -0.004) with an interquartile range (IQR) increase in NDVI and EVI within a 1,000-m buffer radius, respectively. The score of GAD-2 (Δscore and 95% CI) decreased by -0.024 (-0.040, -0.006) and -0.028 (-0.044, -0.011), in relation to an IQR increase in NDVI and EVI within a 1,000-m buffer radius, respectively.

Conclusions: A higher level of residential greenness was significantly associated with lower risk of depression and anxiety in rural areas of Henan Province. Improving residential greenness accessibility may help to promote the mental health of rural populations.

Keywords: anxiety; depression; epidemiology; residential greenness; rural residents.

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Conflict of interest statement

All authors declare no competing interests.

Figures

None
Graphical abstract
Figure 1
Figure 1
Decreased PHQ-2/GAD-2 Score (and 95% CI) Associated with Each IQR Increase in NDVI1000 m/EVI1000 m during the 3-Year Period Prior to the Survey IQR = 0.064 for NDVI1000 m; IQR = 0.058 for EVI1000 m. Model 2 was adjusted for age, gender, and body mass index; Model 3 was further adjusted for smoking status, drinking status, physical activity, marital status, education level, income, and PM2.5 based on Model 2. PHQ-2, Patient Health Questionnaire-2; GAD-2, Generalized Anxiety Disorder-2; NDVI, Normalized Difference Vegetation Index; EVI, Enhanced Vegetation Index.
Figure 2
Figure 2
Changes in the Score of PHQ-2/GAD-2 Associated with NDVI1000 m/EVI1000 m during the 3-Year Period Prior to the Survey Modified by Age, Gender, BMI, Education Level, and Income Low, primary school or illiteracy; Moderate, junior high school; High, high school or above. PHQ-2, Patient Health Questionnaire-2; GAD-2, Generalized Anxiety Disorder-2; NDVI, Normalized Difference Vegetation Index; BMI, body mass index; EVI, Enhanced Vegetation Index.
Figure 3
Figure 3
The Study Region (A) Location of Henan Province, China. (B) Location of the five counties studied in Henan.
See this image and copyright information in PMC

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