The role of nature exposure for mental health outcomes : Population-based studies of adults in Sweden, before and during the COVID-19 pandemic
Year: 2024
Type: dissertation
Study design: Observational Study
Abstract: Poor mental health is a major public health concern, globally and in Sweden. It is linked to individual suffering and systematic issues such as long-term sick leave, rehabilitation costs, early work exit, or productivity loss. The COVID-19 pandemic and associated restrictions emerged as a crisis involving challenges to individuals’ private and work situations. With increasing urbanization, the role of natural environments in promoting mental health has gained recognition. Exposure to natural environments has been linked to mental health benefits, also during the COVID-19 pandemic when this may have been an important resilience factor. However, few population-based studies have investigated individual-level residential greenspace (RGS) and mental health-related outcomes (MHO) using high-quality exposure measures. Also, longitudinal studies of nature visits and MHO, and the role of nature visits for loneliness in the working population, over time during COVID-19, are scarce. Thus, the overall aim of this thesis was to fill these gaps by examining the role of various types of nature exposure for MHO across different situations and time frames before and during COVID-19 in three quantitative studies. Study I examined the role of individual RGS on MHO in a population-based sample of adults residing in urban areas in Sweden, using high-resolution geographic land-cover data. Results showed that higher levels of residential green and green-blue space cover were associated with better MHO, specifically lower symptoms of depression and burnout among non-working individuals, and higher life satisfaction in the whole sample, after adjustment for demographic and socioeconomic variables. Consistently, green and green-blue space in the immediate residential surroundings (50 m) showed the most robust associations with MHO. Study II investigated the development of nature-related habits (NRH) from before and during two years of the COVID-19 pandemic (2019–2022), and their relationship with MHO over time, in a population-based sample in Sweden. It was found that most nature visits increased over time (2019–2022), with forest visits also increasing significantly in the short term (2019–2020). Frequent NRH, particularly garden time and forest visits, were related to lower levels of depression, anxiety, loneliness, and sleep problems in early 2021 and 2022. Maintaining and increasing NRH frequency over time was related to better MHO or protected against worse MHO in association with decreasing NRH over time. Study III investigated whether working mainly remotely during COVID-19 was associated with higher levels of loneliness in a population-based sample of working adults in Sweden and whether nature visits buffered against loneliness over time among those working mainly remotely. It was found that loneliness levels during the pandemic were highest and increased the most compared to before among individuals working mainly remotely. Engaging daily in NRH mitigated the detrimental association between remote work and loneliness over time. Overall, the results across the three studies showed that the various types of nature exposure investigated were consistently associated with better MHO across various situations and time frames. This underscores the importance of preserving and developing natural environments in urban areas to promote mental health, in alignment with the UN Sustainable Development Goals.
Author: Klein, Yannick
Language: English
Topic: Urban Green Space and Health
Subfield: Urban Studies
Field: Social Sciences
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7005665066