Exploring the links between mental health, social health, and physical environment: A prospective network analysis in a nationally representative sample

The rise in mental health issues, urbanization, and loneliness presents significant societal challenges. It is imperative to comprehend the complex relationships among the various factors influencing mental health. This prospective study examines the relationships between mental, physical, and social health, as well as the physical environment, considering individual sociodemographic characteristics and objective macro-factors related to the Sustainable Development Goals, using a network approach. Moreover, the Multidimensional Mental Health Model was validated using a nationally representative sample of 1610 participants (49% women) over a three-month period. The used measurements were: Patient Health Questionnaire-9(PHQ-9), the Generalized Anxiety Disorder-7 scale(GAD-7), the Perceived Stress Scale-10(PSS-10), the Satisfaction With Life Scale(SWLS), the Neighborhood Cohesion Scale, and the Revised UCLA Loneliness Scale(R-UCLA). Physical health was assessed using the Self-Rated Health measure(SRH). The network analysis revealed that the model demonstrated robustness and stability over time. Social health (loneliness and neighborhood cohesion) served as an indirect mechanism linking mental health to the physical environment. Moreover, urbanicity was positively associated with neighborhood belonging but negatively with social cohesion. Additionally, depression symptoms and CO2 emissions emerged as key risk factors, while forest areas and urbanicity served as influential protective factors. The centrality of neighborhood cohesion and green areas increased over time, highlighting their importance. The findings underscore the significance of a multifaceted approach to mental health that considers the interplay among social, environmental, individual, and objective macro-factors. This understanding can help develop more effective mental health prevention programs and provide valuable insights for policymakers and urban planners in creating supportive environments.