Green and blue spaces, COVID-19 lockdowns, and mental health: An Australian population-based longitudinal analysis

Ang Li; Adelle Mansour; Rebecca Bentley

doi:10.1016/j.healthplace.2023.103103

Green and blue spaces, COVID-19 lockdowns, and mental health: An Australian population-based longitudinal analysis

Health Place. 2023 Sep:83:103103. doi: 10.1016/j.healthplace.2023.103103. Epub 2023 Aug 22.

Authors

Ang Li¹, Adelle Mansour², Rebecca Bentley²

Affiliations

¹ NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia. Electronic address: ang.li5@unimelb.edu.au.
² NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia.

PMID: 37611381
DOI: 10.1016/j.healthplace.2023.103103

Abstract

Australia experienced some of the world's longest and most stringent lockdowns during the COVID-19 pandemic. While lockdown measures had consequences for mental health, investigation is lacking on the potential for green and blue space coverage within people's local environments to ameliorate the impact of lockdowns with varied lengths using longitudinal cohorts. This study examined the impact of lockdown durations on population mental health and tests the effect modification of neighbourhood green and inland and coastal blue space coverage in metropolitan areas. We merged population-based longitudinal data on more than 11,000 individuals collected over a ten-year period from 2012 to 2021 with national land use data describing green and blue space coverage. We used fixed effect models to estimate the relationship between lockdowns (with different durations and staggered introduction) and mental health, controlling for sociodemographic, health, and geographical confounders, and tested the significance of effect modification of green and blue space. Results show that extended lockdowns led to considerably larger decreases in mental health (COVID-y1: -2.66, 95%CI: -3.43, -1.89; COVID-y2: -2.65, 95%CI: -3.33, -1.97) relative to short lockdowns. The mental health effect of lockdowns was smaller where green spaces and inland and coastal blue spaces were available. Effect modification was statistically significant for green space, with smaller negative mental health effects observed where there was sizeable green space coverage, particularly during long lockdowns (COVID-y1: -2.69, 95%CI: -3.63, -1.76 for coverage <5%; -3.27, 95%CI: -4.70, -1.84 for coverage 5%-10%; -0.60, 95%CI: -2.03, 0.83 for coverage ≥30%; COVID-y2: -2.74, 95%CI: -3.62, -1.87 for coverage <5%, -2.95, 95%CI: -3.98, -1.92 for coverage 5%-10%; -2.08, 95%CI: -3.28, -0.88 for coverage ≥30%). Findings support the consideration of nature exposure to improve people's mental wellbeing and resilience when designing lockdown measures in response to future public health emergencies.

Keywords: Blue space; COVID-19; Green space; Lockdowns; Mental health; Neighbourhood.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia / epidemiology
COVID-19* / epidemiology
Communicable Disease Control
Humans
Mental Health*
Pandemics