Medical Study Finds 41.5%-68.7% Decrease in Depression Following Lot Greening
Participants in a study of proactive “greening interventions” reported feeling less depressed (−41.5%) and worthless (−50.9%); with even greater effects in impoverished neighborhoods.
An important new study on the link between physical spaces and mental health published in the Journal of the American Medical Association (JAMA) started by asking a simple question: does the greening of vacant urban land reduce self-reported poor mental health in community-dwelling adults?
The exhaustive multi-year effort to discover the answer used the city of Philadelphia as a subject. Effect of Greening Vacant Land on Mental Health of Community-Dwelling Adults: A Cluster Randomized Trial sheds objective, data-supported light on the long-suspected link between a neighborhood’s physical condition and mental illness.
The study finds that a community’s quality of place makes a big difference to individual mental health. And, inversely, the lack of quality of place may partially explain persistent socioeconomic disparities, such as the prevalence of poor mental health found in downtrodden areas.
The study’s authors used a city-wide group of 442 randomized community-dwelling adults living in Philadelphia, Pennsylvania, within 110 vacant lot clusters randomly assigned to 3 study groups of varying level of greening effort: (1) sites selected for a robust greening intervention (37 clusters) at a cost of between $1,000 to $3,000 per lot, (2) sites selected for a limited trash cleanup intervention (36 clusters), or (3) sites left alone (37 clusters) as a control group where no intervention occurred.
The full greening interventions involved garbage removal, limited land grading, grass seeding and some tree plantings. Low wooden perimeter fences were also installed and monthly site monitoring and maintenance performed.
The study tracked participants for 18 months of pre-intervention and post-intervention. Intention-to-treat analysis of the greening intervention compared with no intervention demonstrated a significant decrease in participants who were feeling depressed (−41.5%) and worthless (−50.9%). For participants living in neighborhoods below the poverty line, the greening intervention also demonstrated a significant decrease in reported feelings of depression (−68.7%).
Interestingly, mere site cleanup was much less effective. Using the same intention-to-treat analysis, researchers found that those living near the sites undergoing only trash cleanup (group #2 above) showed no significant changes in self-reported poor mental health compared to those with no intervention.
These are stark findings that strongly suggest that a little greening goes a very long way. Given the relatively low cost and wide applicability of similar greening interventions to the abundance of vacant sites across the country, particularly in distressed communities, there seems to be a large opportunity to improve the nation’s mental health from the ground up.
These findings are also very welcome at a time when policymakers and professionals are searching for more cost-effective solutions to America’s mental health crisis. The report’s researchers highlight that “almost 1 in 5 U.S. adults report some form of mental illness” nowadays. 16 million adults experience an episode of depression annually, the report notes, the second largest contributor to disability in the U.S. Unfortunately, notwithstanding the enormous impacts of this disability on U.S. workers, mental health services fall far short of modern needs and only make up ~5% of total medical care spending in the United States. The often-cited reason is because the cost of comprehensive mental healthcare is so high--at least with respect to traditional medical treatment options.
These new, natural methods are not just extremely effective. They are much more affordable, with the added benefits of being able to involve community volunteers, local businesses and other stakeholders in aspects of a greening effort. They produce valuable ecosystem services and can be implemented at a small scale to alleviate big problems, such as in this green infrastructure redevelopment at Chicago public schools.
Vacant properties and dilapidated buildings become unavoidable negative stimuli in the neighborhoods residents in low-resourced, under-infrastructured communities encounter every day. The ever-presence of these poor conditions provide a constant source of stress and potential mental illness. Researchers have found that a neighborhood’s physical conditions, including vacant or dilapidated spaces, trash, and lack of quality infrastructure such as sidewalks and parks, are associated with depression. These environmental factors, they argue, may help explain the persistent prevalence of mental illness in resource-limited communities.
The researchers recommend that a broadening of treatment options to improve mental health is necessary, including physical interventions in the built-environment that fundamentally remove harmful environmental surroundings and replace them with positive ones.
It turns out that eliminating the negative and accentuating the positive is not a mere platitude, but a cost-effective means to turn the tables in the pitched battle against mental illness.
“Spending time and living near green spaces have been associated with various improved mental health outcomes, including less depression, anxiety, and stress,” the researchers note. They build on several previous studies demonstrating a “dose-response relationship between more time spent in green spaces and lower depression rates.” A number of observational studies have demonstrated the positive effect of vacant land greening interventions on urban health, crime, and stress. As such, they hypothesize that “green space may be a potential buffer between inequitable neighborhood conditions and poor mental health outcomes.”
Indeed, such “healthfield” strategies are becoming more frequently relied upon to quickly and flexibly improve the amenity and quality of place of all types of space, vacant and otherwise. These healthfield redevelopments use available land to encourage specific types of development targeted towards specific community health challenges or to improve the general physical and/or psychological health of the community.
The authors of Effect of Greening Vacant Land on Mental Health of Community-Dwelling Adults: A Cluster Randomized Trial note that patient-level therapies for mental illness will always be a vital aspect of treatment. Given the scope and shape of the current mental health crisis of chronic under-resourcing, however, upgrading the places where people live, work, and play may offer an alternative route to broad-based improvements in mental health outcomes.
And in relatively short order. As inexpensive, reproducible vacant land remediation interventions—basically simply greening and trash cleanup—these abandoned property improvements should be easily scalable to communities across the country to immediately begin to make improvements in health and safety. Indeed, most every community is cleaning up rubbish by all manner of public, private and volunteer means each day. And there are also large numbers of talented homegrown lawn care experts managing their own beautiful green spaces on lawns and community plots in every community.
It’s is a solution within reach if motivated by the requisite green focus. The promise of these highly accessible techniques is profound. Greening the country’s otherwise underutilized land with a healthfield purpose could cut depression roughly in half.
Special thanks to BL sponsor
A Healthfield is a site that can be used to improve access to healthcare or to improve the physical and/or psychological health of the community. In real estate redevelopment and economic development, a “Healthfield Strategy” uses available land to encourage specific types of development targeted towards various community health challenges, such as: inadequate access to health care in medically underserved areas, the presence of high food insecurity and/or food deserts, lack of parks, greenspace and pedestrian amenity/infrastructure (including low handicap accessibility and/or unsafe built-environments for children, seniors or other sensitive receptors). In addition to using Healthfields to fill missing sources of health in the community, Healthfield strategies can also target specific health disparities. Use the Healthfield tag as one of the many options in the BrownfieldListings.com Taxonomy to post an available property, project, RFP or planning effort where Healthfield concerns are relevant or Healthfield strategies may play a role.