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      Mental health and well-being in times of COVID-19: A mixed-methods study of the role of neighborhood parks, outdoor spaces, and nature among US older adults

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          Abstract

          The role of parks and nature to support well-being during the COVID-19 pandemic is uncertain. To examine this topic, we used mixed-methods data collected in April–May 2020 from US adults aged ≥55 in the COVID-19 Coping Study. We quantitatively evaluated the associations between number of neighborhood parks and depression, anxiety, and loneliness; and conducted qualitative thematic analysis of participants’ outdoor experiences. Among urban residents, depression and anxiety were inversely associated with the number of neighborhood parks. Thematic analysis identified diverse engagement in greenspaces that boosted physical, mental, and social well-being. The therapeutic potential of outdoor and greenspaces should be considered for interventions during future epidemics.

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          Most cited references59

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          Using thematic analysis in psychology

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            A modified poisson regression approach to prospective studies with binary data.

            G Zou (2004)
            Relative risk is usually the parameter of interest in epidemiologic and medical studies. In this paper, the author proposes a modified Poisson regression approach (i.e., Poisson regression with a robust error variance) to estimate this effect measure directly. A simple 2-by-2 table is used to justify the validity of this approach. Results from a limited simulation study indicate that this approach is very reliable even with total sample sizes as small as 100. The method is illustrated with two data sets.
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              Is Open Access

              The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes

              Background The health benefits of greenspaces have demanded the attention of policymakers since the 1800s. Although much evidence suggests greenspace exposure is beneficial for health, there exists no systematic review and meta-analysis to synthesise and quantify the impact of greenspace on a wide range of health outcomes. Objective To quantify evidence of the impact of greenspace on a wide range of health outcomes. Methods We searched five online databases and reference lists up to January 2017. Studies satisfying a priori eligibility criteria were evaluated independently by two authors. Results We included 103 observational and 40 interventional studies investigating ~100 health outcomes. Meta-analysis results showed increased greenspace exposure was associated with decreased salivary cortisol −0.05 (95% CI −0.07, −0.04), heart rate −2.57 (95% CI −4.30, −0.83), diastolic blood pressure −1.97 (95% CI −3.45, −0.19), HDL cholesterol −0.03 (95% CI −0.05, <-0.01), low frequency heart rate variability (HRV) −0.06 (95% CI −0.08, −0.03) and increased high frequency HRV 91.87 (95% CI 50.92, 132.82), as well as decreased risk of preterm birth 0.87 (95% CI 0.80, 0.94), type II diabetes 0.72 (95% CI 0.61, 0.85), all-cause mortality 0.69 (95% CI 0.55, 0.87), small size for gestational age 0.81 (95% CI 0.76, 0.86), cardiovascular mortality 0.84 (95% CI 0.76, 0.93), and an increased incidence of good self-reported health 1.12 (95% CI 1.05, 1.19). Incidence of stroke, hypertension, dyslipidaemia, asthma, and coronary heart disease were reduced. For several non-pooled health outcomes, between 66.7% and 100% of studies showed health-denoting associations with increased greenspace exposure including neurological and cancer-related outcomes, and respiratory mortality. Conclusions Greenspace exposure is associated with numerous health benefits in intervention and observational studies. These results are indicative of a beneficial influence of greenspace on a wide range of health outcomes. However several meta-analyses results are limited by poor study quality and high levels of heterogeneity. Green prescriptions involving greenspace use may have substantial benefits. Our findings should encourage practitioners and policymakers to give due regard to how they can create, maintain, and improve existing accessible greenspaces in deprived areas. Furthermore the development of strategies and interventions for the utilisation of such greenspaces by those who stand to benefit the most.
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                Author and article information

                Journal
                Health Place
                Health Place
                Health & Place
                Elsevier Ltd.
                1353-8292
                1873-2054
                24 May 2022
                July 2022
                24 May 2022
                : 76
                : 102813
                Affiliations
                [a ]Program in Health Disparities Research, University of Minnesota, 717 Delaware St. SE, Suite 156, Minneapolis, MN, 55414, USA
                [b ]School of Public Health, Universidad San Francisco de Quito, Diego de Robles S/n, Quito, 170901, Ecuador
                [c ]Division of Population Health, Royal College of Surgeons in Ireland, Beaux Lane House, Mercer St Lower, Dublin 2, D02DH60, Ireland
                [d ]Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
                [e ]Social Environment and Health Program, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104, USA
                Author notes
                []Corresponding author. Program in Health Disparities Research, University of Minnesota, 717 Delaware St. SE, Suite 156, Minneapolis, MN, 55414, USA.
                [1]

                Authors share first-authorship of this manuscript.

                Article
                S1353-8292(22)00074-0 102813
                10.1016/j.healthplace.2022.102813
                9127349
                35623164
                ce5189dc-b7ab-4794-97ef-7a66be31e91c
                © 2022 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 18 October 2021
                : 4 April 2022
                : 23 April 2022
                Categories
                Article

                Public health
                well-being,physical and mental health,covid-19 pandemic,parks,nature,older adults,urban/rural,therapeutic landscapes,outdoor spaces

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