Neighbourhood green space and mental health: the moderating role of socio-economic status

Abstract Background Persons living in an area with more green experience a better mental health. Unequal distribution of green space across socio-economic groups might limit health benefits for disadvantaged neighbourhoods. We investigated whether neighbourhood socio-economic status (SES) can modify the association between green space and health. Methods The study population is based on the respondents of the 2022 edition of a 4-yearly national Dutch health survey including information on 364,557 individuals (Public Health Monitor Adults and Elderly of the Community Health Services, 2022). Mental health was measured by the Mental Health Inventory-5 score. The socioeconomic status of neighbourhoods was indicated by the SES-WOA score, a numerical indicator of based on wealth, education level, and recent employment history of households. The percentage of green space surface was calculated for all neighbourhoods in the Netherlands. Results Our results show an association between neighbourhood socio-economic status and the percentage of green space. Neighbourhoods with a low socio-economic status are less green. In addition, we found that the association between green space and health is modified by socio-economic status (<0.01). Among neighbourhoods with a high socio-economic status, more green is associated with fewer reported mental health issues (r = -0.49) and a better perceived health (r = 0.20). Among neighbourhoods with a low socio-economic status, the association between green space and mental health issues (r = -0.22) and perceived health (r = 0.08) is less pronounced. Conclusions Our results indicate that neighbourhood socio-economic status modifies the association between green space and health. The low amount of green space within neighbourhoods with a low socio-economic status may partly explain the weaker association between green space and health. Reducing disparities in green space distribution across neighbourhoods could contribute to narrowing health disparities. Key messages • Our study shows that the socio-economic status of Dutch neighbourhoods modifies the association between green space and mental health, with more green linked to better health in high SES areas. • Unequal amount of green space may limit mental health benefits for residents in low socio-economic status neighbourhoods.