Universität zu Köln

Helbich, Marco, Klein, Nadja ORCID: 0000-0002-5072-5347, Roberts, Hannah ORCID: 0000-0001-6978-4737, Hagedoorn, Paulien and Groenewegen, Peter P. (2018). More green space is related to less antidepressant prescription rates in the Netherlands: A Bayesian geoadditive quantile regression approach. Environ. Res., 166. S. 290 - 298. SAN DIEGO: ACADEMIC PRESS INC ELSEVIER SCIENCE. ISSN 1096-0953

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Abstract

Background: Exposure to green space seems to be beneficial for self-reported mental health. In this study we used an objective health indicator, namely antidepressant prescription rates. Current studies rely exclusively upon mean regression models assuming linear associations. It is, however, plausible that the presence of green space is non-linearly related with different quantiles of the outcome antidepressant prescription rates. These restrictions may contribute to inconsistent findings. Objective: Our aim was: a) to assess antidepressant prescription rates in relation to green space, and b) to analyze how the relationship varies non-linearly across different quantiles of antidepressant prescription rates. Methods: We used cross-sectional data for the year 2014 at a municipality level in the Netherlands. Ecological Bayesian geoadditive quantile regressions were fitted for the 15%, 50%, and 85% quantiles to estimate green space-prescription rate correlations, controlling for physical activity levels, socio-demographics, urbanicity, etc. Results: The results suggested that green space was overall inversely and non-linearly associated with antidepressant prescription rates. More important, the associations differed across the quantiles, although the variation was modest. Significant non-linearities were apparent: The associations were slightly positive in the lower quantile and strongly negative in the upper one. Conclusion: Our findings imply that an increased availability of green space within a municipality may contribute to a reduction in the number of antidepressant prescriptions dispensed. Green space is thus a central health and community asset, whilst a minimum level of 28% needs to be established for health gains. The highest effectiveness occurred at a municipality surface percentage higher than 79%. This inverse dose-dependent relation has important implications for setting future community-level health and planning policies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Helbich, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Klein, Nadja UNSPECIFIED orcid.org/0000-0002-5072-5347 UNSPECIFIED Roberts, Hannah UNSPECIFIED orcid.org/0000-0001-6978-4737 UNSPECIFIED Hagedoorn, Paulien UNSPECIFIED UNSPECIFIED UNSPECIFIED Groenewegen, Peter P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-170221
DOI:	10.1016/j.envres.2018.06.010
Journal or Publication Title:	Environ. Res.
Volume:	166
Page Range:	S. 290 - 298
Date:	2018
Publisher:	ACADEMIC PRESS INC ELSEVIER SCIENCE
Place of Publication:	SAN DIEGO
ISSN:	1096-0953
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NATURAL OUTDOOR ENVIRONMENTS; COMMON MENTAL-DISORDERS; HEALTH-BENEFITS; LIVING ENVIRONMENT; RESIDENTIAL GREEN; PHYSICAL-ACTIVITY; DEPRESSION; ASSOCIATION; MORTALITY; EXPOSURE Multiple languages Environmental Sciences; Public, Environmental & Occupational Health Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17022