Brief ReportNeighborhood Environments and Socioeconomic Inequalities in Mental Well-Being
Introduction
Most research on environment and health has focused on the threats to health that some environments make and those threats’ inequitable distribution.1 However, an alternative perspective is emerging, asking whether some environments might protect health and limit socioeconomic health inequalities.2, 3, 4, 5, 6 Access to green space is one factor that has received attention, with studies7, 8, 9, 10, 11, 12, 13, 14 showing benefits to the physiologic and psychological health of individuals and populations. At least three studies15, 16, 17 suggest particular benefit for socioeconomically deprived populations and that green space may therefore narrow health inequalities. However, these did not compare green space with other features of the environment. It is plausible, indeed probable, that neighborhoods with better access to green space also possess other characteristics or services that may promote health. This study is, therefore, the first to ask which neighborhood characteristics or services are associated with narrower socioeconomic health inequalities in a large, international sample of urban residents.
Section snippets
Study Sample
The 2012 European Quality of Life Survey (EQLS) was designed to assess influences on quality of life among those aged ≥18 years in 34 European nations.18 Full sampling and survey details are available elsewhere.19 This analysis, run in 2014, only included respondents living in urban areas (Appendix Table 1).
Measures
Mental well-being was measured using the robust and validated WHO-5,20, 21, 22 assessing respondents’ attitude toward life in the 2 weeks prior to interview (Appendix Table 2). Scores range
Results
Reported access to recreational/green areas was the only neighborhood service to have a significant interaction with financial strain in its relationship with mental well-being. Inequality in mental well-being was narrower among those reporting better access to recreational/green areas (chi-squared=16.08, p=0.041) (Appendix Table 3). Figure 1 illustrates this in two ways. First, it shows that the difference in estimated WHO-5 scores between those under most and least financial strain fell
Discussion
Socioeconomic inequalities in mental well-being were smaller among urban dwellers reporting good access to recreational/green areas, compared with those reporting difficulty with access. There was no such difference for the other tested neighborhood services.
The frequency or type of use of recreational/green areas was not reported. Although it is plausible that those experiencing financial strain who reported easier access use their areas more, or in ways that have greater benefits for
Acknowledgments
We are grateful to Frank Popham for comments on an earlier draft. We are indebted to the Eurofound team for collecting and curating the European Quality of Life survey. This work was supported by the European Research Council (ERC-2010-StG Grant 263501). The funder had no role at all in study design, analysis, interpretation, writing, or the decision to submit.
RM designed the study, carried out the analyses, and wrote the first draft. JP, NS, and ER contributed to the concept and design of the
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