PMID- 37775008
OWN - NLM
STAT- MEDLINE
DCOM- 20231108
LR  - 20231108
IS  - 1096-0953 (Electronic)
IS  - 0013-9351 (Linking)
VI  - 238
IP  - Pt 2
DP  - 2023 Dec 1
TI  - Association between residential greenspace and mental health among cancer 
      survivors in Shanghai, China.
PG  - 117155
LID - S0013-9351(23)01959-X [pii]
LID - 10.1016/j.envres.2023.117155 [doi]
AB  - BACKGROUND: Living near and enjoying visually green landscapes is associated with 
      better mental health, but evidence focusing on vulnerable populations (such as 
      cancer survivors) is sparse. The purpose of this study was to explore the 
      association between residential greenspace and anxiety and depressive symptoms 
      among cancer survivors in Shanghai, China. METHODS: In total, 4195 cancer 
      survivors participated in this study from the 2022 Shanghai Cancer Patient Needs 
      Survey. The estimation of residential greenspaces was based on Normalized 
      Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI). The 
      presence and severity of depressive and anxiety symptoms were assessed by using 
      the Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 
      (GAD-2). The relation between mental health and green space was assessed using 
      the Generalized Additive Model (GAM) after controlling for relevant individual 
      covariates and contextual characteristics. RESULTS: The prevalence of anxiety and 
      depression in cancer survivors was 36.2% and 28.3% respectively. After 
      multivariate adjustment, each increase in inter-quartile range (IQR) for NDVI in 
      the 250 m buffer (NDVI(-250m)) was associated with a decrease in PHQ-2 score 
      ( big up tri, openscore (95%CI): 0.018 (-0.034, -0.002)) and GAD-2 score ( big up tri, openscore (95%CI): 0.018 
      (-0.034, -0.002)), respectively. We observed that an increase in IQR for 
      NDVI(-250m) was associated with a 3.3% (Odds ratio (OR) (95%CI):0.967 (0.943, 
      0.991)) reduction in anxiety symptoms. More pronounced greenspace-mental health 
      effects were found among young adults (18-65 years) and participants living in 
      suburban areas, compared to young people over 65 and those living in urban areas 
      (P(-interaction) < 0.05). CONCLUSIONS: Higher levels of residential green space 
      are associated with lower risk of depression and anxiety disorders. Our findings 
      will fill the gap in the relationship between green space and mental health among 
      cancer survivors in urban China, and provide new evidence for garden 
      afforestation, community planning and policy-making. To better understand this 
      association, more longitudinal studies are necessary to investigate the 
      mechanisms involved.
CI  - Copyright (c) 2023 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Li, Ruijia
AU  - Li R
AD  - Shanghai Health Development Research Center, Shanghai Medical Information Center, 
      Shanghai, 200031, China.
FAU - Liu, Mengying
AU  - Liu M
AD  - School of Pharmacy, Anhui Xinhua University, Hefei, 230088, China.
FAU - Song, Jie
AU  - Song J
AD  - Shanghai Health Development Research Center, Shanghai Medical Information Center, 
      Shanghai, 200031, China.
FAU - Xu, Yuan
AU  - Xu Y
AD  - Shanghai Health Development Research Center, Shanghai Medical Information Center, 
      Shanghai, 200031, China.
FAU - He, Amei
AU  - He A
AD  - Shanghai Health Development Research Center, Shanghai Medical Information Center, 
      Shanghai, 200031, China.
FAU - Hu, Xiaojing
AU  - Hu X
AD  - Shanghai Health Development Research Center, Shanghai Medical Information Center, 
      Shanghai, 200031, China.
FAU - Yang, Shanshi
AU  - Yang S
AD  - Shanghai Health Development Research Center, Shanghai Medical Information Center, 
      Shanghai, 200031, China.
FAU - Ding, Gang
AU  - Ding G
AD  - Oncology Department, Shanghai International Medical Center, 200120, Shanghai, 
      China.
FAU - Chen, Minxing
AU  - Chen M
AD  - Shanghai Health Development Research Center, Shanghai Medical Information Center, 
      Shanghai, 200031, China. Electronic address: chenminxing@shdrc.org.
FAU - Jin, Chunlin
AU  - Jin C
AD  - Shanghai Health Development Research Center, Shanghai Medical Information Center, 
      Shanghai, 200031, China. Electronic address: jinchunlin@shdrc.org.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230927
PL  - Netherlands
TA  - Environ Res
JT  - Environmental research
JID - 0147621
SB  - IM
MH  - Young Adult
MH  - Humans
MH  - Adolescent
MH  - Mental Health
MH  - Parks, Recreational
MH  - *Cancer Survivors
MH  - China
MH  - Longitudinal Studies
MH  - *Neoplasms
OTO - NOTNLM
OT  - Anxiety
OT  - Cancer survivors
OT  - Depression
OT  - Mental health
OT  - Public health
OT  - Residential greenspace
COIS- Declaration of competing interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/09/30 09:42
MHDA- 2023/11/08 06:42
CRDT- 2023/09/29 19:18
PHST- 2023/03/15 00:00 [received]
PHST- 2023/08/27 00:00 [revised]
PHST- 2023/09/14 00:00 [accepted]
PHST- 2023/11/08 06:42 [medline]
PHST- 2023/09/30 09:42 [pubmed]
PHST- 2023/09/29 19:18 [entrez]
AID - S0013-9351(23)01959-X [pii]
AID - 10.1016/j.envres.2023.117155 [doi]
PST - ppublish
SO  - Environ Res. 2023 Dec 1;238(Pt 2):117155. doi: 10.1016/j.envres.2023.117155. Epub 
      2023 Sep 27.