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Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland Lynette Robertson, Catharine Ward Thompson, Jenny Roe, Peter Aspinall, Rich Mitchell, David Miller

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Presentation on the main findings of the GreenHealth (Green Health) Household Survey study, presented at the Environmental Design Research Association 'Healthy and Healing Places' conference (EDRA 44, Providence, Rhode Island, USA), May 2013.

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Page 1: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Relationships between green space quantity and perceived stress and mental wellbeing in deprived 

urban communities in Scotland

Lynette Robertson, Catharine Ward Thompson, Jenny Roe, Peter Aspinall, Rich Mitchell, David Miller  

Page 2: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Outline • Introduction

– Background– The GreenHealth Project– Research Questions

• Methodology– Study Design 

– Data Analysis

• Results– Green Space Quantity – View to Green Space  from Home

• Summary• Conclusions

Page 3: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Background 

Page 4: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Urban Green Space and Health

Higher levels of residential green space have been associated with lower mortality rates, lower blood pressure and obesity levels, 

and better self‐perceived health (e.g. Maas et al, 2006). 

Page 5: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Urban Green Space and Health

Urban green space is more closely associated with health for those living in poverty/deprivation (e.g. Mitchell & Popham, 2008)

Page 6: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Deprivation and Health in Scotland

Deprivation/inequality is a significant problem in Scotland, 

and is not improving

Page 7: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Deprivation and Health in Scotland

Deprivation/inequality is a significant problem in Scotland, 

and is not improving

UK Poverty and Social Exclusion (PSE) study: Poverty in Scotland at worst levels in 30 years ‐ 1/3 of population living in ‘multiple deprivation’ (PSE UK, 2013)

Page 8: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Deprivation and Health in Scotland

Deprivation/inequality is a significant problem in Scotland, 

and is not improving

UK Poverty and Social Exclusion (PSE) study: Poverty in Scotland at worst levels in 30 years ‐ 1/3 of population living in ‘multiple deprivation’ (PSE UK, 2013)

Still the ‘Sick man of Europe’ (Glasgow Centre for Population 

Health, 2012) 

Page 9: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Deprivation and Health in Scotland

Image: Greenspace Scotland

Page 10: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Image: Greenspace Scotland

Page 11: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

GreenHealth

• ‘The contribution of green and open space in public health and well‐being’

• Funded by the Scottish Government

• April 2008 – March 2012 (2013)

• Led by The James Hutton Institute 

www.hutton.ac.uk/projects/green‐healthwww.greenspacescotland.org.uk/greenhealth‐conference

Page 12: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Green Health: OPENspace & Heriot Watt 

• Examined the relationship between quantity, quality and accessibility of green space and health and wellbeing in deprived urban communities

Page 13: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Green Health: OPENspace & Heriot Watt 

• Examined the relationship between quantity, quality and accessibility of green space and health and wellbeing in deprived urban communities

• Two main studies1. Cortisol  and green space quantity 

(Ward Thompson et al; Roe et al)

Page 14: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Green Health: OPENspace & Heriot Watt 

• Examined the relationship between quantity, quality and accessibility of green space and health and wellbeing in deprived urban communities

• Two main studies1. Cortisol  and green space quantity 

(Ward Thompson et al; Roe et al)2. Household Survey 

o Perceived health and wellbeing and green space quantity and quality

o Green space accessibility and use (including Conjoint analysis)

o Perceptions of green space

Page 15: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Household Survey Study: Research Questions

1. Is there a relationship between the amount of green space in the residential environment and perceived stress and mental wellbeing? 

Page 16: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Household Survey Study: Research Questions

1. Is there a relationship between the amount of green space in the residential environment and perceived stress and mental wellbeing?

2. Is there a link between visual access to green space and perceived health and wellbeing?

Page 17: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Methodology

Page 18: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Study Design

• Cross‐sectional CAPI‐administered household questionnaire, June 2010

• Four deprived urban neighbourhoods, selected using CarstairsDeprivation Index and amount of green space coverage (low and high)– Edinburgh: Pilton & Craigmillar– Dundee: Stobswell & Fintry

• All residents > 16 years (Included people in work, cortisol study = unemployed only)

• Approximately 100 participants from each site (n = 406)

Page 19: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Study Design

• Cross‐sectional CAPI‐administered household questionnaire, June 2010

• Four deprived urban neighbourhoods, selected using CarstairsDeprivation Index and amount of green space coverage (low and high)– Edinburgh: Pilton & Craigmillar– Dundee: Stobswell & Fintry

• All residents > 16 years (Included people in work, cortisol study = unemployed only)

• Approximately 100 participants from each site (n = 406)

Page 20: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Study Design

• Cross‐sectional CAPI‐administered household questionnaire, June 2010

• Four deprived urban neighbourhoods, selected using CarstairsDeprivation Index and amount of green space coverage (low and high)– Edinburgh: Pilton & Craigmillar– Dundee: Stobswell & Fintry

• All residents > 16 years (Included people in work, cortisol study = unemployed only)

• Approximately 100 participants from each site (n = 406)

Page 21: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Study Design

• Cross‐sectional CAPI‐administered household questionnaire, June 2010

• Four deprived urban neighbourhoods, selected using CarstairsDeprivation Index and amount of green space coverage (low and high)– Edinburgh: Pilton & Craigmillar– Dundee: Stobswell & Fintry

• All residents > 16 years (Included people in work, cortisol study = unemployed only)

• Approximately 100 participants from each site (n = 406)

Page 22: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Questionnaire Data 

• Health and wellbeing measures – Perceived Stress Scale, PSS (Cohen & Williamson, 1988)) – Mental Wellbeing, SWEMWBS  ‐ Short Warwick‐Edinburgh Mental 

Wellbeing Scale(Steward‐Brown et al., 2009)– Physical Activity  – General Health– Life Satisfaction

• Green space use (frequency, purpose…)

• Green space accessibility (distance, views)

• Green space perceptions (amount, quality, safety…)

• Other e.g. Life Event, Life Conditions

• Demographics (age, work status etc.)

Page 23: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Questionnaire Data 

• Health and wellbeing measures – Perceived Stress Scale, PSS (Cohen & Williamson, 1988)) – Mental Wellbeing, SWEMWBS  ‐ Short Warwick‐Edinburgh Mental 

Wellbeing Scale(Steward‐Brown et al., 2009)– Physical Activity  – General Health– Life Satisfaction

• Green space use (frequency, purpose…)

• Green space accessibility (distance, views)

• Green space perceptions (amount, quality, safety…)

• Other e.g. Life Event, Life Conditions

• Demographics (age, work status etc.)

Page 24: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Green Space Quantity Data (GIS)

GS Quantity (% unit area)

WardHutton Land Use ClassZone

Page 25: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Green Space Quantity: (1) Ward

• UK CAS (Electoral District) Unit

• Parks, woodlands, scrub + other natural environments; NOprivate gardens

• Area– Min = 57 ha– Max = 689 ha– Median = 126 ha (IQR = 

316)

Page 26: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Green Space Quantity: (2) Zone

• Scottish ‘Data Zone’ Unit

• GS = as Ward (Parks, woodlands, scrub + other natural environments)i. No private gardensii. With gardens

• Area– Min = 5 ha– Max = 445 ha– Median = 13 ha (IQR = 

220)

• Also 300m radius buffer = 28 ha

Page 27: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Green Space Quantity: (3) Hutton Land Use Class (HLUC)

• Scotland Green Space Map Typologies (‘PAN65’) 

• Public open space, gardens, roadside trees and grassi. With woodlandsii. No woodlands

• Areal units– Zone– 300m radius buffer

Page 28: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

View to Green space from the home

• Three point ordinal scale:– No view– Partial view– Full view

• Recorded for each floor/level of the home

Page 29: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Data Analysis• Correlation and Multiple Linear Regression (Heirarchical, 

blocked)– Each green space measure 

Page 30: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Data Analysis• Correlation and Multiple Linear Regression (Heirarchical, 

blocked)– Each green space measure – Controlling for: 

• Income (‘Income Coping’ – 4 point scale)• Deprivation (Carstairs Index)• Physical Activity ‐ with and without 

Page 31: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Data Analysis• Correlation and Multiple Linear Regression (Heirarchical, 

blocked)– Each green space measure – Controlling for: 

• Income (‘Income Coping’ – 4 point scale)• Deprivation (Carstairs Index)• Physical Activity ‐ with and without 

• Sub‐groups:– Gender

Page 32: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Data Analysis• Correlation and Multiple Linear Regression (Heirarchical, 

blocked)– Each green space measure – Controlling for: 

• Income (‘Income Coping’ – 4 point scale)• Deprivation (Carstairs Index)• Physical Activity ‐ with and without 

• Sub‐groups:– Gender– ‘At home more’, identified according to Work Status:

i. Looking after the home/familyii. Retirediii. Long term sick or disabled

Page 33: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Results

Page 34: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Perceived stress (PSS) at each site

Page 35: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Mental wellbeing (SWEMBS) at each site 

Page 36: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Sample Characteristics 

• n = 305 (Pilton, Stobswell & Fintry; Craigmillar removed)

• Ageo 16 – 87 yearso Mean = 43.7 years (SD = 17.1)

• Gender: 136 male (44.6%), 169 female (55.4%)

• Ethnicity: White ‐ 96.1% Scottish, 1.6% other UK, 2.3% non‐UK

• Income Copingo Very difficult = 6.6%o Difficult = 27.5%o Coping = 48.9%o Comfortable = 13.8%

Page 37: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Green Space Quantity

Page 38: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Research Question 1

Is there a relationship between the amount of green space in the residential environment and perceived stress and mental wellbeing? 

Page 39: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Perceived Stress (PSS): was green space quantity a significant predictor?(i) Analysis by Gender 

Page 40: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Perceived Stress (PSS): was green space quantity a significant predictor? (ii) At Home More Sub‐group, by Gender

Page 41: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Perceived Stress and Green Space Quantity: At Home More sub‐group

Men: n = 22 (Δr2 = 0.567, p < 0.01)

Page 42: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Partial Regression Plots

Residuals of Y on the remaining explanatory variables vs residuals of the target explanatory variable on the remaining explanatory variables 

Page 43: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Partial Regression Plots

Residuals of Y on the remaining explanatory variables vs residuals of the target explanatory variable on the remaining explanatory variables 

Moya‐Laraño & Corcobado (2008) ‘Plotting partial correlation and regression in ecological studies’ [Web Ecology 8: 35–46]

o A more appropriate method  for visualizing the true scatter of points around the partial regression line than plotting the dependent variable against the raw values of the independent variable

Page 44: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Partial Regression Plots

Residuals of Y on the remaining explanatory variables vs residuals of the target explanatory variable on the remaining explanatory variables 

Moya‐Laraño & Corcobado (2008) ‘Plotting partial correlation and regression in ecological studies’ [Web Ecology 8: 35–46]

o A more appropriate method  for visualizing the true scatter of points around the partial regression line than plotting the dependent variable against the raw values of the independent variable

o “Partial regression plots should be the ones displayed in publications because they accurately reflect the scatter of partial correlations” 

Page 45: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Perceived Stress and Green Space Quantity: ‘At Home More’ sub‐group

Men: n = 22 (Δr2 = 0.567, p < 0.01)

Green space coverage:  26‐69 %Perceived stress: 2 – 18Work status: ‐ Retired 77%‐ Disabled or long‐term sick 23%

Page 46: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Perceived Stress and Green Space Quantity: ‘At Home More’ sub‐group

Men: n = 22 (Δr2 = 0.567, p < 0.01)          Women: n = 43 (GS = n.s.)

Green space coverage:  26‐69 %Perceived stress: 2 – 18Work status: ‐ Retired 77%‐ Disabled or long‐term sick 23%

Green space coverage:  24 ‐ 68 %Perceived stress: 0 – 27Work status: ‐ Looking after home/family 41%‐ Retired 50%‐ Disabled or long‐term sick 9%

Page 47: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Perceived Stress and Green Space Quantity: Women At Home More

Women: n = 43 (GS = n.s.)Differences between groupso Escape stress (p=0.000)o Life conditions (p=0.005)o Life event (p=0.016, 

could be a positive or negative event, but more events for the high stress‐high GS group)

o Affect of life event (p=0.062)

o GS Freq Summer (p=0.032)

o Years in neighbourhood (p=0.039)   

Page 48: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Mental Wellbeing (SWEMWBS): was green space quantity a significant predictor? (i) Analysis by Gender

Page 49: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Mental Wellbeing (SWEMWBS): was green space quantity a significant predictor? (ii) At Home More Sub‐group, by Gender

Page 50: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Mental Wellbeing (SWEMWBS) and Green Space Quantity: At Home More sub‐group

Men: n = 22 (Δr2 = 0.08, p < 0.01)          Women: n = 43 (GS = n.s.)

Green space coverage:  22 ‐ 69 %Mental Wellbeing: 19 ‐35Work status: ‐ Retired 77%‐ Disabled or long‐term sick 23%

Green space coverage:  22 ‐ 69 %Mental Wellbeing: 17 – 35Work status: ‐ Looking after home/family 41%‐ Retired 50%‐ Disabled or long‐term sick 9%

Page 51: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Research Question 2

Is there a link between visual access to green space from home and perceived health and wellbeing?

Page 52: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

View to green space from the home

• Perceived stress – No significant association 

(for any group)

Page 53: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

View to green space from the home

• Perceived stress – No significant association 

(for any group)

• Mental wellbeing– Significant inverse

association for women (r = ‐.114 , p < 0.05), but not for men

– Not a significant predictor

Page 54: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

View to green space from the home

• Perceived stress – No significant association 

(for any group)

• Mental wellbeing– Significant inverse

association for women (r = ‐.114 , p < 0.05), but not for men

– Not a significant predictor

• BUT, most participants had no view from their home…

Page 55: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

View to green space 

• Physical Activity– Significant positive 

association for women at home more group (r = .263 , p < 0.05)

Page 56: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

View to green space

• Physical Activity– Significant positive 

association for women at home more group (r = .263, p < 0.05, n = 43)

– Women who had a partial or full view from their home were on average 10 times more active than those women with no view from their home

– Men: no difference, but n is small in comparison (n=22)

Page 57: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Summary• Green space quantity in the residential environment was linked 

with perceived stress, and to a lesser extent mental wellbeing.

• The strength and direction of relationships varied by gender and likely amount of time spent at home– Men: lower perceived stress was associated with increasing 

amounts of green space, particularly those likely to spend more time at home

– Women: the relationship between GS quantity and stress was more complicated for women than for men, with only some women showing the same patterns as men

• Having a view from the home was not associated with better perceived stress or mental wellbeing; however, most participants had no view.

Page 58: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Summary• Green space quantity in the residential environment was linked 

with perceived stress, and to a lesser extent mental wellbeing.

• The strength and direction of relationships varied by gender and likely amount of time spent at home– Men: lower perceived stress was associated with increasing 

amounts of green space, particularly those likely to spend more time at home

– Women: the relationship between GS quantity and stress was more complicated for women than for men, with only some women showing the same patterns as men

• Having a view from the home was not associated with better perceived stress or mental wellbeing; however, most participants had no view.

Page 59: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Summary• Green space quantity in the residential environment was linked 

with perceived stress, and to a lesser extent mental wellbeing.

• The strength and direction of relationships varied by gender and likely amount of time spent at home– Men: lower perceived stress was associated with increasing 

amounts of green space, particularly those likely to spend more time at home

– Women: the relationship between GS quantity and stress was more complicated for women than for men, with only some women showing the same patterns as men

• Having a view from the home was not associated with better perceived stress or mental wellbeing; however, most participants had no view.

Page 60: Relationships between green space quantity and perceived stress and mental wellbeing in deprived urban communities in Scotland - Robertson et al (2013)

Summary• Green space quantity in the residential environment was linked 

with perceived stress, and to a lesser extent mental wellbeing.

• The strength and direction of relationships varied by gender and likely amount of time spent at home– Men: lower perceived stress was associated with increasing 

amounts of green space, particularly those likely to spend more time at home

– Women: the relationship between GS quantity and perceived stress was more complicated for women than for men, with only some women showing the same patterns as men

• Having a view from the home was not associated with better perceived stress or mental wellbeing; however, most participants had no view.

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Summary• Green space quantity in the residential environment was linked 

with perceived stress, and to a lesser extent mental wellbeing.

• The strength and direction of relationships varied by gender and likely amount of time spent at home– Men: lower perceived stress was associated with increasing 

amounts of green space, particularly those likely to spend more time at home

– Women: the relationship between GS quantity and perceived stress was more complicated for women than for men, with only some women showing the same patterns as men

• Having a view from the home was not associated with better perceived stress or mental wellbeing, but was associated with higher levels of physical activity.

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ConclusionsGreen space in the residential environment is a factor contributing to the health and wellbeing of residents of deprived urban communities in Scotland, particularly those who are likely to spend more time in and around their neighbourhood.

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ConclusionsIncreasing green space coverage in areas where there is little could reduce stress levels and increase wellbeing for some; but, other aspects of green space which impact on perceptions and use, such as quality and safety, must also be considered.

Image: Greenspace Scotland