Association between perceived environmental problems and risk of poor mental health: a population-based study in a Mediterranean region of Spain

Perceived environmental problems may influence population mental health independently of objective exposures, yet few studies have examined this relationship in Mediterranean settings. This study assessed the association between perceived environmental problems and the risk of poor mental health in adult population. We used cross-sectional data from 5,244 individuals who participated in the 2016 Health Survey of the Valencian Community (Spain). Ten perceived environmental problems were analysed and grouped into two latent dimensions - pollution-related and residential environment - using exploratory factor analysis. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12), with a cut-off score of ≥ 3 to identify individuals at risk of poor mental health. Sex-stratified logistic regression models estimated crude and adjusted odds ratios. High perception of pollution-related problems was significantly associated with risk of poor mental health in men (adjusted OR = 1.82, 95% CI: 1.37-2.42), but not in women. Residential environment problems showed an opposite pattern: they were associated with higher odds in women (OR = 1.33, 95% CI: 1.05-1.69) and with lower odds in men (OR = 0.54, 95% CI: 0.38-0.77). The highest odds were observed when both types of environmental problems were reported simultaneously. These findings highlight the relevance of subjective environmental conditions as independent correlates of population mental health.