Effect of changes in green spaces on mental health in older adults: a fixed effects analysis

J Epidemiol Community Health. 2020 Jan;74(1):48-56. doi: 10.1136/jech-2019-212704. Epub 2019 Oct 19.


Background: Urban green spaces have been linked to different health benefits, but longitudinal studies on the effect of green spaces on mental health are sparse and evidence often inconclusive. Our objective was to study the effect of changes in green spaces in the residential environment on changes in mental health using data with 10 years of follow-up (2004-2014).

Methods: Data from 3175 Dutch adults were linked to accessibility and availability measures of green spaces at three time points (2004/2011/2014). Mental health was measured with the Mental Health Inventory-5. Fixed effects analyses were performed to assess the effect of changes in green spaces on mental health.

Results: Cross-sectional analysis of baseline data showed significant associations between Euclidean distances to the nearest green space and mental health, with an increase of 100 m correlating with a lower mental health score of approximately 0.5 (95% CI -0.87 to -0.12) on a 0-100 scale. Fixed effects models showed no evidence for associations between changes in green spaces and changes in mental health both for the entire sample as well as for those that did not relocate during follow-up.

Conclusions: Despite observed cross-sectional correlations between the accessibility of green space in the residential environment and mental health, no evidence was found for an association between changes in green spaces and changes in mental health. If mental health and green spaces are indeed causally linked, then changes in green spaces in the Eindhoven area between 2004 and 2014 are not enough to produce a significant effect.

Keywords: ageing; geographical information systems; mental health; urban development; urban health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Environment
  • Female
  • Humans
  • Male
  • Mental Health / statistics & numerical data*
  • Middle Aged
  • Netherlands
  • Parks, Recreational*
  • Residence Characteristics / statistics & numerical data*
  • Social Environment*