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Abstract

Background In several countries public health efforts 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 effects of the restrictions imposed during the COVID-19 pandemic. Funding Health Research Board (HRB), grant no. SPHeRE-2019-1.
Abstracts
20
www.thelancet.com/lancetgh
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
Abstract
Background In several countries public health eorts 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 eects 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.
Published Online
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
Geographic
Analysis, Seville, Spain
(M Garrido-Cumbrera PhD,
O Braçe PhD); University of
Winchester, Faculty of
Business, Law and Digital
Technologies, Winchester,
UK(D Hewlett PhD); Maynooth
University, Department of
Geography, Maynooth, Ireland
(R Foley PhD)
Correspondence to:
Dr Viveka Guzman, Division of
Population Health, Royal College
of Surgeons in Ireland, Beaux
Lane House, Mercer Street Lower,
D02DH60, Dublin, Ireland
vivekaguzman@rcsi.ie
... PHE associates oceans, coastlines, rivers, lakes, canals, and waterfalls into blue space. You do not need to be physically within blue space to benefit from it (Guzman et al., 2021), simply having a view of blue spaces can improve people's mental health. ...
... As well as the slew of physical benefits of going to green and blue spaces also shown in literature. One study which examined the role of green and blue spaces within the era of COVID-19 was the GreenCOVID survey (Guzman et al., 2020 ;Guzman et al., 2021). ...
Thesis
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The usage of therapeutic landscapes as devices of healing has long been researched within the sphere of health and medical geography. The aim of this thesis is to identify the usage and accessibility of green and blue spaces from a student cohort study, and partial re-analysis of an already published study. The thesis explores the literature surrounding green and blue spaces and their implications during the COVID-19 pandemic. Using both quantitative statistics and qualitative methods, this thesis examines the role green and blue spaces have played during COVID-19 and relates it to wider literature and other comparable studies. It was found that vast majority of respondents live within two kilometres of green space, while the vast majority do not live within two kilometres of blue space. It was also found that during COVID-19 and the ensuing lockdowns and restrictions, there was a substantial increase of visits to green and blue spaces. A strong correlation between mental health and increased usage of green and blue spaces was also identified. The people who benefited the most from green and blue spaces were people whose mental health had remained the same or slightly declined as a result of COVID-19. Young people and student’s perception of green and blue spaces as devices of healing has shifted between the survey conducted in April of this year and the GreenCOVID survey which took place summer of 2020. This would point towards evidence that green and blue spaces are being used mental health aids and as therapeutic devices as a result of COVID-19.
... Although much research has reported associations between built-environment quality and people's mental health [29,65,66], this study found the association was somewhat weak. One possible reason is that the variations in built-environment features in these two communities (especially in SSP) were not large enough for revealing their effects on reported mental health. ...
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... More and more studies are emerging which illustrate the ways in which urban nature mitigated the negative impacts of COVID-19 and its associated containment measures. Moreover, urban dwellers themselves indicate that the outdoors helped them cope with COVID-19 restrictions (Guzman et al., 2021) and that they found green spaces to be very important for mental health benefits (Berdejo-Espinola et al., 2021;Grima et al., 2020). By cutting access to outdoor spaces, citizens seem to have realised how important that access was for their lives and individual well-being. ...
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Purpose The purpose of the article is to present some preliminary findings and discussions points from a symposium on Public Outdoor Spaces and COVID-19 organised in Wageningen, The Netherlands, in June 2021. Design/methodology/approach The article argues for a salutogenic perspective on infrastructure planning and design, dealing with the interplay between the ideas and practices of infrastructure planning and design and the outcomes of those ideas and practices for health. Findings Within that perspective, the coronavirus (COVID-19) crisis is seen as an opportunity to revive the importance of infrastructure in promoting health and well-being. Originality/value The salutogenic approach adds a much-needed new perspective on infrastructure planning and design, and also involves challenges both in research and practice, for the application of holistic principles to the design of new environments.
... the pandemic (Berdejo-Espinola et al., 2021;Grima et al., 2020;Guzman et al., 2021;Pouso et al., 2021;Tomasso et al., 2021;Ugolini et al., 2021), and may be particularly important for college students seeking to maintain social connections and active lifestyles. Our regression model examining predictors of college students' emotional distress levels confirmed a strong positive relationship between reduced park use and distress during the pandemic (Fig. 1). ...
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