Quality or quantity? Exploring the relationship between Public Open Space attributes and mental health in Perth, Western Australia

https://doi.org/10.1016/j.socscimed.2012.01.032Get rights and content

Abstract

Mental health is a public health priority globally. Public Open Space (POS) may enhance mental health by facilitating contact with nature and the development of supportive relationships. Despite growing interest in the influence of the built environment on mental health, associations between POS attributes and mental health remain relatively unexplored. In particular, few studies have examined the relative effects of the quantity and quality of POS within a neighbourhood on mental health. Guided by a social–ecological framework, this study investigated the relationship between POS attributes (i.e., quantity and quality) and better mental health (i.e., low risk of psychological distress) in residents of new housing developments in the Perth metropolitan area, Western Australia. The extent to which relationships between POS attributes and mental health were confounded by psychosocial factors (e.g., social support, sense of community) and frequent use of POS was also explored. Data were obtained from a cross-sectional survey (n = 911), a POS audit, and Geographical Information Systems, and was analysed using logistic regression. Approximately 80% of survey participants were at low risk of psychological distress. Residents of neighbourhoods with high quality POS had higher odds of low psychosocial distress than residents of neighbourhoods with low quality POS. This appeared to be irrespective of whether or not they used POS. However, the quantity of neighbourhood POS was not associated with low psychological distress. From a mental health perspective, POS quality within a neighbourhood appears to be more important than POS quantity. This finding has policy implications and warrants further investigation.

Highlights

► Public Open Space (POS) quality appears significantly and negatively associated with psychological distress. ► Residents near medium or high quality POS have twice the odds of better mental health as those near low quality POS. ► POS quality appears to be more important for mental health than POS quantity. ► Residents may not need to use POS to benefit from it.

Introduction

Recently, there has been a growing awareness of the impact of the physical or ‘built’ environment on health (Jackson, 2003). While most health-related research regarding the built environment has focused on physical health (McLeod, Pryor, & Meade, 2004), there is an emerging body of evidence linking the built environment and mental health (Clark, Myron, Stansfield, & Candy, 2007; Cutrona, Wallace, & Wesner, 2006; Dalgard & Tambs, 1997; Evans, 2003; Galea, Ahern, Rudenstine, Wallace, & Vlahov, 2005; Guite, Clark, & Ackrill, 2006; Milligan & Bingley, 2007). Five of the ten leading causes of world-wide disability and premature death are psychiatric conditions, while depression is predicted to be the second leading cause of global disease burden by 2020 (Murray & Lopez, 1996; WHO, 2004). Furthermore, positive mental health is recognised as a basic human right and a protective factor against both mental and physical illness (Raphael, Schmolke, & Wooding, 2005; WHO, 2004). Settings and interventions with the potential to benefit the mental health of whole populations are therefore required (Maller, Townsend, Pryor, Brown, & St Leger, 2005). Public Open Space (POS) is one such setting. Neighbourhood POS can be highly accessible, often attracting users of different ages, genders and cultural backgrounds. As land that is available to the public, POS can include parks, recreational grounds, sports fields, commons, esplanades and bushland/wilderness.

To date, research regarding POS and health has tended to focus on POS as a setting for physical activity rather than mental health (Cohen et al., 2010; Kaczynski, Potwarka, Smale, & Havitz, 2009; Ries et al., 2009). However, evidence from studies of the broader built environment suggest that settings such as POS may influence mental health both directly and indirectly (Evans, 2003). POS may directly impact mental health via the restorative benefits arising from contact with nature (Herzog, Black, Fountaine, & Knotts, 1997; Kaplan, 1995). Alternatively, POS can indirectly influence mental health by providing places for people to meet and socialize (Semenza, 2003), which can yield social contact known to be protective of mental health (Berkman, Glass, Brissette, & Seeman, 2000; Ellis, 2006; Evans, 2003; Halpern, 1995). People may therefore need to use POS in order to gain benefit. Gehl and Gemzoe (2000) note that POS use is determined by more than its presence, with the quality of the space also influencing the occupation of, and activity within, a given area (Gehl & Gemzoe, 2000). While low quality spaces may engender “necessary” activities (e.g., dog walking), high quality space is said to accommodate a range of optional (e.g., recreational) and social activities “because place and situation now invite people to stop, sit, eat, play, and so on” (Gehl, 2006, p.11). Thus, not only is the quality of POS as important as the amount or “quantity” of POS in a neighbourhood, but potential relationships between POS attributes and mental health may be influenced by the frequency of POS use and social relations.

Although few studies have considered POS attributes in relation to mental health (Cattell, Dines, Gesler, & Curtis, 2008), there is a large body of literature regarding the mental health benefits of nature (Grahn & Stigsdotter, 2003; Korpela, Hartig, Kaiser, & Fuhrer, 2001; Milligan & Bingley, 2007; Nielsen & Hansen, 2007; Scopelliti & Giuliani, 2004; Sugiyama, Leslie, Giles-Corti, & Owen, 2008). Similarly, studies investigating concepts related to POS quality, such as restoration (Nordh, Hartig, Hagerhall, & Fry, 2009) and neighbourhood greenness (Maas, van Dillen, Verheij, & Groenewegen, 2009; Sugiyama et al., 2008), have found positive relationships between these concepts and social interaction and mental health. For the most part however, studies involving POS have focused on ‘macro’ features such as location and proximity (e.g., Grahn and Stigsdotter, 2003; Lund, 2003), rather than ‘micro’ features, such as the qualities of, and amenities within POS, that might encourage POS use, foster social relations and enhance mental health (e.g., Cattell et al, 2008).

While traditional biomedical models of illness have tended to focus on biological causal factors, in recent decades mental health is seen to be influenced by a range of factors that interact in complex ways (Commonwealth Department of Health and Aged Care, 2000). A social–ecological approach recognises the interrelationship between individuals and their social, physical and socio-cultural environments (Stokols, 1996). This study uses a social–ecological framework to: a) investigate associations between POS attributes (i.e., quality and quantity) and mental health (as measured by low psychological distress) independently of other demographic, individual, social, physical environmental and POS ‘use’ correlates; and b) the extent to which the relationship between POS attributes and mental health can be explained by psychosocial factors and the frequency of POS use (Fig. 1).

Section snippets

Study background

This mental health study was a sub-study of the RESIDential Environments (RESIDE) Project. Commencing in 2003, RESIDE is a five year longitudinal study evaluating the impact of a State government sub-division planning design code in Perth, Western Australia (outlined below) (Giles-Corti et al., 2007). Study participants completed a self-administered survey before moving into their new home (n = 1813), then 12 months (n = 1379), and 36 months (n = 1230) later. All Perth residents building homes

Survey and objective measure results

Table 1 presents the characteristics of the study sample. Overall, 80% of study participants had a low risk of psychological distress, 16% had a moderate risk, and 4% a high risk.

Table 2 presents univariate and multivariate analyses examining the association with better mental health (low psychological distress). Of the eight demographic variables examined, univariate analysis revealed that low psychological distress was significantly more likely in males than females (p = 0.020), and

Discussion

This study found that from a mental health perspective, the quality of POS within a neighbourhood appears to be more important than the quantity of POS. Specifically, residents of neighbourhoods with higher quality POS were more likely to have better mental health than residents living in neighbourhoods with lower quality POS. The relationship between POS quality and mental health was not confounded by how frequently participants used POS or the strength of their psychosocial attributes such as

References (88)

  • H.F. Guite et al.

    The impact of the physical and urban environment on mental well-being

    Public Health

    (2006)
  • T.R. Herzog et al.

    Reflection and attentional recovery as distinctive benefits of restorative environments

    Journal of Environmental Psychology

    (1997)
  • B.S. Jorgensen et al.

    Sense of place as an attitude: lakeshore owners attitudes toward their properties

    Journal of Environmental Psychology

    (2001)
  • R. Kaplan

    The role of nature in the context of the workplace

    Landscape and Urban Planning

    (1993)
  • S. Kaplan

    The restorative benefits of nature: toward an integrative framework

    Journal of Environmental Psychology

    (1995)
  • K.M. Korpela et al.

    Perceived health is associated with visiting natural favourite places in the vicinity

    Health & Place

    (2007)
  • M. Lalli

    Urban-related identity: theory, measurement and empirical findings

    Journal of Environmental Psychology

    (1992)
  • J. Maas et al.

    Social contacts as a possible mechanism behind the relation between green space and health

    Health & Place

    (2009)
  • C. Milligan et al.

    Restorative places or scary spaces? The impact of woodland on the mental well-being of young adults

    Health & Place

    (2007)
  • T.S. Nielsen et al.

    Do green areas affect health? Results from a Danish survey on the use of green areas and health indicators

    Health & Place

    (2007)
  • H. Nordh et al.

    Components of small urban parks that predict the possibility for restoration

    Urban Forestry & Urban Greening

    (2009)
  • P. O'Campo et al.

    Neighbourhoods and mental well-being: what are the pathways?

    Health & Place

    (2009)
  • E.A. Richardson et al.

    Gender differences in relationships between urban green space and health in the United Kingdom

    Social Science & Medicine

    (2010)
  • A.V. Ries et al.

    A quantitative examination of park characteristics related to park use and physical activity among urban youth

    Journal of Adolescent Health

    (2009)
  • M. Scopelliti et al.

    Choosing restorative environments across the lifespan: a matter of place experience

    Journal of Environmental Psychology

    (2004)
  • C.D. Sherbourne et al.

    The MOS social support survey

    Social Science & Medicine

    (1991)
  • R.S. Ulrich et al.

    Stress recovery during exposure to natural and urban environments

    Journal of Environmental Psychology

    (1991)
  • L. Wood et al.

    The anatomy of the safe and social suburb: an exploratory study of the built environment, social capital and residents' percpetions of safety

    Health & Place

    (2008)
  • ABS

    Census of population and housing: Socio-economic indexes for areas (SEIFA), Australia – Data only, 2006

    (2008)
  • ABS

    Socio-economic indexes for areas (SEIFA) – A technical paper 2006 (2033.0.55.001)

    (2008)
  • L.S. Beeber et al.

    In-home intervention for depressive symptoms with low-income mothers of infants and toddlers in the United States

    Health Care for Women International

    (2004)
  • M. Broomhall

    Study of the availability and environmental quality of urban open space used for physical activity

    (1996)
  • T.S. Brugha et al.

    The list of threatening experiences: the reliability and validity of a brief life events questionnaire

    Acta Psychiatrica Scandinavica

    (1990)
  • D.M. Chavis et al.

    Sense of community through Brunswik lens: a first look

    Journal of Community Psychology

    (1986)
  • C. Clark et al.

    A systematic review of the evidence on the effect of the built and physical environment on mental health

    Journal of Public Mental Health

    (2007)
  • Commonwealth Department of Health and Aged Care

    Promotion, prevention and early detection for mental health – A monograph

    (2000)
  • C.E. Cutrona et al.

    Neighborhood characteristics and depression: an examination of stress processes

    Current Directions in Psychological Science

    (2006)
  • O.S. Dalgard et al.

    Urban environment and mental health

    British Journal of Psychiatry

    (1997)
  • Department of Planning and Infrastructure and Western Australian Planning Commission

    Liveable neighbourhoods: A Western Australian government sustainable cities initiative. Draft operational policy

    (2004)
  • V. Dupere et al.

    Community types and mental health: a multilevel study of local environmental stress and coping

    American Journal of Community Psychology

    (2007)
  • J.A. Ellis

    Social ties and health

    American Journal of Health

    (2006)
  • G.W. Evans

    The built environment and mental health

    Journal of Urban Health

    (2003)
  • J. Francis

    Associations between public space and mental health in New residential developments

    (2010)
  • T.A. Furukawa et al.

    The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being

    Psychological Medicine

    (2003)
  • Cited by (270)

    View all citing articles on Scopus
    View full text