Associations of the natural and built environment with
mental health and wellbeing during COVID-19:
Irish perspectives from the GreenCOVID study
Viveka Guzman, Marco Garrido-Cumbrera, Olta Braçe, Denise Hewlett, Ronan Foley
Background In several countries public health eorts to contain the COVID-19 pandemic have included movement
restrictions that conﬁne residents to their home or to reduced catchment areas. Household characteristics and assets
of nearby spaces may be particularly relevant to support wellbeing and mental health in this context. The aim of this
study was to explore wellbeing and mental health associations with factors of the immediate natural and built
environment among adults in Ireland during the ﬁrst wave of the COVID-19 pandemic.
Methods We did cross-sectional analyses using Irish data from the GreenCOVID study. Participants were recruited
online between June and July, 2020, with a convenience sampling approach. All respondents who provided informed
consent and data on variables of interest were included in analysis. Wellbeing was assessed with the WHO-5 Wellbeing
Index, and mental health with the Kessler Psychological Distress Scale. Means and SD were used to describe the
perceived importance of views to green and blue spaces and physical access to outdoor spaces (range 0–10). We used
χ2 tests and multiple linear regression models to explore associations of wellbeing and mental health with household
type, household problems, number of bedrooms, number of co-habitants, spaces enabling physical access to the
outdoors, quality of views and views to green spaces from home. Regression models were controlled by age, gender,
city versus non-city household location, marital status, and self-perceived health.
Findings We included data from 243 participants; mean age was 43 years (SD 16) and most participants were women
(n=174 [72%]). Participants perceived that the outdoors helped them cope with restriction measures to a high extent
(mean score 8·54 [SD 1·79]; 43% of respondents reported the maximum score), and highly valued views to blue (7·82
[2·45]) and green spaces (8·84 [1·76]). Household problems were signiﬁcantly associated with lower wellbeing scores
(beta=–9·78 [95% CI –15·675 to –3·885]) and increased likelihood of mental disorders (0·583 [0·284 to 0·889]).
Interpretation Our ﬁndings show high perceived beneﬁts of views to green and blue spaces and access to the outdoors
from home during the ﬁrst wave of COVID-19. Moreover, those living in a household with problems had higher
likelihood of poor mental health outcomes. This study highlights the importance of natural and built environment in
helping people cope with the negative eects of the restrictions imposed during the COVID-19 pandemic.
Funding Health Research Board (HRB), grant no. SPHeRE-2019-1.
Copyright © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Declaration of interests
We declare no competing interests.
March 11, 2021
Royal College of Surgeons in
Ireland, Division of Population
Health, Dublin, Ireland
(V Guzman MD); Health and
Territory Research (HTR),
University of Seville,
Department of Physical
Geography and Regional
Analysis, Seville, Spain
(M Garrido-Cumbrera PhD,
O Braçe PhD); University of
Winchester, Faculty of
Business, Law and Digital
UK(D Hewlett PhD); Maynooth
University, Department of
Geography, Maynooth, Ireland
(R Foley PhD)
Dr Viveka Guzman, Division of
Population Health, Royal College
of Surgeons in Ireland, Beaux
Lane House, Mercer Street Lower,
D02DH60, Dublin, Ireland