Exploring uncharted territory: Do urban greenspaces support mental health in low- and middle-income countries?
Exploring uncharted territory: Do urban greenspaces support mental health in low- and middle-income countries?
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DOI：
10.1016/j.envres.2020.110625
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发表时间：
2021-03-01
影响因子：
8.3
通讯作者：
Dallimer, Martin
中科院分区：
文献类型：
--
作者：
Nawrath, Maximilian;Guenat, Solene;Dallimer, Martin
接触城市绿色空间可以促进一系列心理健康益处。了解这些好处至关重要，特别是在低收入和中等收入国家 (LMIC)，这些国家的城市正在以前所未有的速度扩张。然而，现有的关于绿色空间对健康有益的证据基础严重偏向于高收入国家。在这里，我们系统地评估了有关中低收入国家城市绿地对心理健康益处的新证据。我们进行了范围界定审查，以评估调查中低收入国家绿地与心理健康之间关系的证据的范围、类型和质量。我们使用与中低收入国家绿色空间和心理健康相关的关键术语系统地检索了文献数据库 Web of Science、Medline、Embase 和 CAB Abstracts。我们使用叙述综合方法分析了所得研究，同时考虑到研究质量，以评估对心理健康的总体影响。 36 项研究符合纳入标准并被纳入叙述综合中。研究在设计、研究人群、绿地和心理健康评估方面存在差异。虽然超过 90% 的中低收入国家尚未得到研究，但我们发现，十分之八的研究使用经过验证的心理健康筛查工具检测到绿地与一种或多种心理健康结果之间存在正相关。这些研究大多发生在中高收入国家。然而，仍然缺乏来自城市化水平最高地区的证据，只有四项研究评估了中低收入和低收入国家。此外，对中介和调节因素的分析表明，中低收入国家绿色空间与心理健康之间的关系依赖于背景，需要结合当地相关的环境和文化背景进行评估。根据此处审查的证据，接触城市绿地可以支持中高收入国家的多种心理健康结果。然而，我们对较贫穷、快速城市化的国家仍然知之甚少。我们的研究结果强调需要在城市化水平最高的城市地区进行高质量、针对具体情况的研究，以及解决有关中介和调节因素的具体挑战的需要。未来的研究应该将对绿地的稳健生态评估与经过验证的心理健康筛查工具结合起来。
Exposure to urban greenspaces promotes an array of mental health benefits. Understanding these benefits is of paramount importance, particularly in low-and middle-income countries (LMICs), where cities are expanding at an unprecedented rate. However, the existing evidence-base for the health benefits of greenspaces has a strong bias towards high-income countries. Here we systematically assess the emerging evidence regarding the mental health benefits provided by urban greenspaces in LMICs. We carried out a scoping review to assess the extent, type and quality of evidence investigating the relationship between greenspaces and mental health in LMICs. We systematically searched the literature databases Web of Science, Medline, Embase and CAB Abstracts using key terms related to greenspaces and mental health in LMICs. We analysed the resulting studies using a narrative synthesis approach, taking into account study quality, to assess the overall effects on mental health. 36 studies met the inclusion criteria and were included in the narrative synthesis. Studies were heterogeneous in design, study population, greenspace and mental health assessment. While more than 90% of LMICs remain unstudied, we found that eight out of ten studies using validated mental health screening tools detected positive associations between greenspaces and one or more mental health outcomes. These studies mostly took place in upper-middle-income countries. However, there still is a lack of evidence from regions with the highest levels of urbanisation, and only four studies assessed lower-middle and low-income countries. Furthermore, the analysis of mediating and moderating factors indicates that the relationship between greenspaces and mental health in LMICs is context dependent and needs to be assessed in relation to locally relevant environmental and cultural settings. Based on the evidence reviewed here, exposure to urban greenspaces can support multiple mental health out-comes in upper-middle-income countries. However, we still know little about poorer, rapidly urbanising coun-tries. Our findings highlight the need for high-quality, context specific research in those urban areas with the highest levels of urbanisation, and the need to address specific challenges regarding mediating and moderating factors. Future studies should combine robust ecological assessments of greenspaces with validated mental health screening tools.