Residential greenness and depressive symptoms in the Mexican adult population: A cross-sectional study

Introduction: Evidence from high-income countries suggests that residential greenness may protect against adverse mental health outcomes. However, few studies have explored this association in low- and middle-income countries (LMICs) such as Mexico. Methods: We used nationally representative data from working-age adult participants (aged 20-59 years) in the 2018-19 Mexican National Health and Nutrition Survey to estimate the cross-sectional association of exposure to residential greenness, using the satellite-based Normalized Difference Vegetation Index (NDVI). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale-Short Form (CESD-7; range: 0-21). Linear regression models estimated the association of NDVI with depressive symptoms, adjusting for individual sociodemographic factors. Results: Overall, 16.2% of the analytical sample reported high prevalence of depressive symptoms (CESD-7 ≥ 9 points). In adjusted models, higher greenness was associated with a lower depressive symptom score (b = -0.34; 95% CI: -0.56, -0.13). Results suggested a protective association for women (b = -0.34; 95% CI: -0.61, -0.08), men (b = -0.32; 95% CI: -0.65, -0.01), and residents of urban areas (b = -0.44; 95% CI: -0.70, -0.18), but not for residents of non-urban areas. Conclusion: Our findings suggest that exposure to residential greenness is associated with lower depressive symptoms among Mexican adults.