Quality or quantity? Exploring the relationship between Public Open Space attributes and mental health in Perth, Western Australia
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)
- et al.
From social integration to health: Durkheim in the new millennium
Social Science & Medicine
(2000) - et al.
Mingling, observing, and lingering: everyday public spaces and their implications for well-being and social relations
Health & Place
(2008) - et al.
Parks and physical activity: why are some parks used more than others?
Preventive Medicine
(2010) - et al.
Do features of public open spaces vary according to neighbourhood socio-economic status?
Health & Place
(2008) - et al.
Nowhere to play? The relationship between the location of outdoor play areas and deprivation in Glasgow
Health & Place
(2007) - et al.
Associations between health and different types of environmental incivility: a Scotland-wide study
Public Health
(2009) - et al.
Increasing walking: how important is distance to, attractiveness and size of public open space?
American Journal of Preventive Medicine
(2005) - et al.
Evaluation of the implementation of a state government community design policy aimed at increasing local walking: design issues and baseline results from RESIDE, Perth Western Australia
Preventive Medicine
(2008) - et al.
Landscape planning and stress
Urban Forestry & Urban Greening
(2003) Changing relationships in public open space and private open space in suburbs in south-western Australia
Landscape and Urban Planning
(2009)
The impact of the physical and urban environment on mental well-being
Public Health
Reflection and attentional recovery as distinctive benefits of restorative environments
Journal of Environmental Psychology
Sense of place as an attitude: lakeshore owners attitudes toward their properties
Journal of Environmental Psychology
The role of nature in the context of the workplace
Landscape and Urban Planning
The restorative benefits of nature: toward an integrative framework
Journal of Environmental Psychology
Perceived health is associated with visiting natural favourite places in the vicinity
Health & Place
Urban-related identity: theory, measurement and empirical findings
Journal of Environmental Psychology
Social contacts as a possible mechanism behind the relation between green space and health
Health & Place
Restorative places or scary spaces? The impact of woodland on the mental well-being of young adults
Health & Place
Do green areas affect health? Results from a Danish survey on the use of green areas and health indicators
Health & Place
Components of small urban parks that predict the possibility for restoration
Urban Forestry & Urban Greening
Neighbourhoods and mental well-being: what are the pathways?
Health & Place
Gender differences in relationships between urban green space and health in the United Kingdom
Social Science & Medicine
A quantitative examination of park characteristics related to park use and physical activity among urban youth
Journal of Adolescent Health
Choosing restorative environments across the lifespan: a matter of place experience
Journal of Environmental Psychology
The MOS social support survey
Social Science & Medicine
Stress recovery during exposure to natural and urban environments
Journal of Environmental Psychology
The anatomy of the safe and social suburb: an exploratory study of the built environment, social capital and residents' percpetions of safety
Health & Place
Census of population and housing: Socio-economic indexes for areas (SEIFA), Australia – Data only, 2006
Socio-economic indexes for areas (SEIFA) – A technical paper 2006 (2033.0.55.001)
In-home intervention for depressive symptoms with low-income mothers of infants and toddlers in the United States
Health Care for Women International
Study of the availability and environmental quality of urban open space used for physical activity
The list of threatening experiences: the reliability and validity of a brief life events questionnaire
Acta Psychiatrica Scandinavica
Sense of community through Brunswik lens: a first look
Journal of Community Psychology
A systematic review of the evidence on the effect of the built and physical environment on mental health
Journal of Public Mental Health
Promotion, prevention and early detection for mental health – A monograph
Neighborhood characteristics and depression: an examination of stress processes
Current Directions in Psychological Science
Urban environment and mental health
British Journal of Psychiatry
Liveable neighbourhoods: A Western Australian government sustainable cities initiative. Draft operational policy
Community types and mental health: a multilevel study of local environmental stress and coping
American Journal of Community Psychology
Social ties and health
American Journal of Health
The built environment and mental health
Journal of Urban Health
Associations between public space and mental health in New residential developments
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
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