Two- and three-dimensional indicators of green and grey space exposure and psychiatric conditions and medicine use: A longitudinal study in a large population-based Italian cohort
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- dc.contributor.author Spano, Giuseppina
- dc.contributor.author Nobile, Federica
- dc.contributor.author Giannico, Vincenzo
- dc.contributor.author Elia, Mario
- dc.contributor.author Michelozzi, Paola
- dc.contributor.author Bosco, Andrea
- dc.contributor.author Dadvand, Payam
- dc.contributor.author Sanesi, Giovanni
- dc.contributor.author Stafoggia, Massimo
- dc.date.accessioned 2024-06-17T06:33:38Z
- dc.date.available 2024-06-17T06:33:38Z
- dc.date.issued 2023
- dc.description.abstract Background: Evidence available on the associations between urban greenness and mental health is mainly based on cross-sectional studies and has relied on 2D indicators of greenness. This longitudinal study aimed at investigating the association between 2D and 3D indicators of green and grey spaces and incident mental health-related outcomes in a large population-based cohort. Methods: Our study used data from 593,894 Italian adults (≥30 years) from the Rome Longitudinal Study. Mental health outcomes were defined using either drug prescriptions (antidepressants, antipsychotics, lithium and other mood stabilisers, and anxiolytics, hypnotics and sedatives), or hospitalisation records (for schizophrenia spectrum disorder, depression, anxiety, stress-related and somatoform, or substance use disorders). We obtained 2D and 3D indicators of green and grey exposures including Normalized Difference Vegetation Index (NDVI), green volume, grey volume, number of trees, and Normalized Difference Green-Grey Volume Index around participants' homes. Cox proportional hazards regression models were developed to estimate the association of green and grey space exposure and psychiatric conditions and medicine use, adjusted for relevant covariates. Results: We found beneficial associations of NDVI and the number of trees with antipsychotic and lithium and other mood stabiliser drugs. We also observed detrimental associations between grey volume and lithium and other mood stabilisers and anxiolytic, hypnotic and sedative drugs. Finally, we found a protective association of the NDGG with lithium and other mood stabilisers (HR: 0.977; 95% CI: 0.965-0.990) and anxiolytic, hypnotic and sedative drugs (HR: 0.851; 95% CI: 0.762-0.950). The associations for hospitalisation for psychiatric conditions were less consistent and generally not statistically significant. Conclusions: Findings suggested that higher greenness areas around residential addresses are associated with reduced use of drugs for psychiatric conditions, while the opposite is true for higher grey space exposure. The study highlights the importance of accurately characterising green and grey spaces, using novel exposure indicators.
- dc.format.mimetype application/pdf
- dc.identifier.citation Spano G, Nobile F, Giannico V, Elia M, Michelozzi P, Bosco A, et al. Two- and three-dimensional indicators of green and grey space exposure and psychiatric conditions and medicine use: A longitudinal study in a large population-based Italian cohort. Environ Int. 2023 Dec;182:108320. DOI: 10.1016/j.envint.2023.108320
- dc.identifier.doi http://dx.doi.org/10.1016/j.envint.2023.108320
- dc.identifier.issn 0160-4120
- dc.identifier.uri http://hdl.handle.net/10230/60485
- dc.language.iso eng
- dc.publisher Elsevier
- dc.relation.ispartof Environ Int. 2023 Dec;182:108320
- dc.rights © 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword 3D indicator
- dc.subject.keyword Cohort study
- dc.subject.keyword Green and grey exposure
- dc.subject.keyword Medicine prescription
- dc.subject.keyword Mental health
- dc.subject.keyword Urban forest
- dc.title Two- and three-dimensional indicators of green and grey space exposure and psychiatric conditions and medicine use: A longitudinal study in a large population-based Italian cohort
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion