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Effect of changes in green spaces on mental health in older adults: a fixed effects analysis
  1. J Mark Noordzij,
  2. Marielle A Beenackers,
  3. Joost Oude Groeniger,
  4. Frank J Van Lenthe
  1. Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
  1. Correspondence to J Mark Noordzij, Public Health, Erasmus Medical Center, Rotterdam 3015 GD, The Netherlands; j.m.noordzij{at}


Background Urban green spaces have been linked to different health benefits, but longitudinal studies on the effect of green spaces on mental health are sparse and evidence often inconclusive. Our objective was to study the effect of changes in green spaces in the residential environment on changes in mental health using data with 10 years of follow-up (2004–2014).

Methods Data from 3175 Dutch adults were linked to accessibility and availability measures of green spaces at three time points (2004/2011/2014). Mental health was measured with the Mental Health Inventory-5. Fixed effects analyses were performed to assess the effect of changes in green spaces on mental health.

Results Cross-sectional analysis of baseline data showed significant associations between Euclidean distances to the nearest green space and mental health, with an increase of 100 m correlating with a lower mental health score of approximately 0.5 (95% CI −0.87 to −0.12) on a 0–100 scale. Fixed effects models showed no evidence for associations between changes in green spaces and changes in mental health both for the entire sample as well as for those that did not relocate during follow-up.

Conclusions Despite observed cross-sectional correlations between the accessibility of green space in the residential environment and mental health, no evidence was found for an association between changes in green spaces and changes in mental health. If mental health and green spaces are indeed causally linked, then changes in green spaces in the Eindhoven area between 2004 and 2014 are not enough to produce a significant effect.

  • mental health
  • urban health
  • geographical information systems
  • urban development
  • ageing

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  • Contributors JMN was responsible for conceptualising the study, conducting the analyses and writing the manuscript. MAB and JOG contributed substantially to the analyses and provided valuable input on the drafts and the final manuscript. FJVL helped with the conceptualisation of the study and provided valuable input on the drafts and the final manuscript. All authors approve the content of the final manuscript.

  • Funding The authors are supported by a grant from the European Union Horizon 2020 Programme (grant agreement n667661 - MINDMAP).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The use of personal data in the GLOBE study follows the Dutch Personal Data Protection Act and the Municipal Database Act and has been registered with the Dutch Data Protection Authority (number 1248943).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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