Mental health and where you live : exploring relationships between walkability, green space, depression and anxiety

Background: Mental health disorders, specifically depression and anxiety, significantly contribute to the global disease burden. Built and natural environment factors are increasingly recognized as important determinants. Neighbourhood walkability (built environment) and green space (natural environment) are hypothesized to affect mental health, though evidence remains inconclusive and context-dependent. Evidence is more robust for natural environment. Objectives: This study examines associations between neighbourhood walkability and green space with depression and anxiety among adults aged 35+ in Greater Vancouver area. It also investigates moderating effects of age, sex, and income. Methods: Health outcome data from the BC Generations Project, greenspace data from the Canadian Urban Environmental Health Research Consortium, and walkability data from Phase II of the Where Matters study were linked. Multivariable logistic and linear regression models adjusted for demographic, socioeconomic, and health-related covariates were used. Stratified analyses assessed moderating effects. Results: Walkability was not consistently associated with depression. However, in low-income groups, higher walkability (Q4) correlated with higher depression scores. No significant association was observed between walkability and anxiety overall. Among middle-income groups, anxiety scores was higher in more walkable areas (Q4). This may reflect different stress tolerance for urban stressors and lifestyle expectations. Green space showed no significant association with depression in the total sample after adjustments. However, adults aged 35–65, middle-income individuals living in high green space areas (Q4) reported higher depression scores, suggesting demographic variability in green space benefits. For anxiety, green space was associated with lower scores only among adults aged 66+, though this lost significance after adjustments for area-level deprivation. Conclusions: This study reveals nuanced relationships between walkability, green space and mental health, shaped by demographic and environmental factors. Walkable neighbourhoods show mixed associations, particularly in low-income areas. Higher walkability for lower-income residents may indicate densification, air pollution, noise, injury risk, and limited green space—issues less prevalent in affluent neighbourhoods. Conversely, green space shows potential mental health benefits for anxiety among older adults, though associations with depression vary across demographic groups. These findings highlight the complexity of the associations between environment and mental health. Further research is needed to clarify these context-dependent relationships.