Exposure to nature and mental health outcomes during COVID-19 lockdown. A comparison between Portugal and Spain

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• dc.contributor.author Ribeiro, Ana Isabel
• dc.contributor.author Triguero Mas, Margarita, 1985-
• dc.contributor.author Jardim Santos, Cláudia
• dc.contributor.author Gómez-Nieto, Alicia
• dc.contributor.author Cole, Helen
• dc.contributor.author Anguelovski, Isabelle
• dc.contributor.author Silva, Filipa Martins
• dc.contributor.author Baró Porras, Francesc
• dc.date.accessioned 2022-01-13T06:44:27Z
• dc.date.available 2022-01-13T06:44:27Z
• dc.date.issued 2021
• dc.description.abstract Background: To control the spread of the SARS-CoV-2 virus, countries around the world implemented lockdowns with varying intensities. Lockdowns, however, have been associated with a deterioration of mental health, including post-traumatic stress symptoms, anger and anxiety. Exposure to nature might reduce stress and provide relaxation opportunities. Objective: Firstly, we aimed to determine which sociodemographic, housing and lockdown-related characteristics were associated with changes in exposure to nature during the COVID-19 lockdown in Portugal and Spain. Secondly, we sought to estimate the associations of these changes with mental health, and test whether these associations differed according to sociodemographic characteristics and between the two countries, which experienced different restrictions and epidemiological situations. Methods: A cross-sectional study was conducted between March 27 and May 6, 2020, using an online questionnaire to measure changes in exposure to nature (including private green space and other greenery, views of nature from home and public natural spaces); sociodemographic, housing and lockdown-related characteristics; stress levels (visual stress scale); psychological distress (General Health Questionnaire - 12 items) and somatization (somatization scale). Adjusted regression models were fitted to estimate associations. Results: This study included 3157 participants (1638 from Portugal, 1519 from Spain). In Portugal, maintaining/increasing the use of public natural spaces during the lockdown was associated with lower levels of stress (adjusted beta -0.29; 95%CI -0.49, -0.08) and maintaining/increasing the frequency of viewing nature from home was associated with reduced psychological distress (0.27; -0.51, -0.03), somatization (-0.79; -1.39, -0.20), and stress levels (-0.48; -0.74, -0.23). In Spain, maintaining/increasing contact with private green space and greenery was associated with lower stress levels: for contact with indoor plants (-0.52; -0.96, -0.07) and for use of private community green spaces (-0.82; -1.61, -0.03). Conclusion: Exposure to nature was associated with better mental health outcomes during lockdowns, but the natural features associated with improved mental health differed between the two countries. Nature should be incorporated into urban planning interventions and housing design and exposure to nature should be promoted during lockdowns.
• dc.description.sponsorship This study was supported by FEDER through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology – FCT (Portuguese Ministry of Science, Technology and Higher Education) under the Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; Ref. UID/DTP/04750/2019). This study was also funded by the European Regional Development Fund (FEDER), through the Competitiveness and Internationalization Operational Programme, by national funding from the Foundation for Science and Technology (FCT) under the scope of the project PTDC/GES-AMB/30193/2017 (POCI-01-0145-FEDER-030193, 02/SAICT/2017 - 30193), the European Research Council (project GREENLULUs; grant agreement ID: 678034); and the EU’s Horizon 2020 framework program for research and innovation (project NATURVATION, grant agreement ID: 730243). MTM and HC are funded by Juan de la Cierva fellowships [FJCI-2017-33842, IJC2018-035322-I] awarded by the Spanish Ministry of Economy and Competitiveness.
• dc.format.mimetype application/pdf
• dc.identifier.citation Ribeiro AI, Triguero-Mas M, Jardim Santos C, Gómez-Nieto A, Cole H, Anguelovski I, Silva FM, Baró F. Exposure to nature and mental health outcomes during COVID-19 lockdown. A comparison between Portugal and Spain. Environ Int. 2021;154:106664. DOI: 10.1016/j.envint.2021.106664
• dc.identifier.doi http://dx.doi.org/10.1016/j.envint.2021.106664
• dc.identifier.issn 0160-4120
• dc.identifier.uri http://hdl.handle.net/10230/52204
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Environ Int. 2021;154:106664
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/678034
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/730243
• dc.rights © 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Confinement
• dc.subject.keyword Green space
• dc.subject.keyword Mental health
• dc.subject.keyword Nature
• dc.subject.keyword Pandemic
• dc.subject.keyword SARS-CoV-2
• dc.title Exposure to nature and mental health outcomes during COVID-19 lockdown. A comparison between Portugal and Spain
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion