Assessing the Impact of School-Based Greenness on Mental Health Among Adolescent Students in Ontario, Canada
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources
2.2. Measures of Mental Health (Outcome)
2.2.1. Psychological Distress
2.2.2. Self-Rated Mental Health
2.2.3. Suicide Ideation or Attempt
2.3. School-Based Greenness (Exposure)
2.4. Covariates
2.4.1. Socio-Economic Status
2.4.2. Walkability
2.4.3. Demographics and Other Covariates
2.5. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Mean NDVI (500 m) | ||||
---|---|---|---|---|
N (%) | 25th Percentile | Median | 75th Percentile | |
Age (years) | ||||
11–12 | 804 (12.7) | 0.38 | 0.43 | 0.48 |
13–14 | 2235 (35.4) | 0.37 | 0.42 | 0.49 |
15–16 | 2100 (33.3) | 0.35 | 0.41 | 0.49 |
≥17 | 1173 (18.6) | 0.35 | 0.41 | 0.47 |
Sex | ||||
Male | 2730 (43.2) | 0.36 | 0.42 | 0.48 |
Female | 3583 (56.8) | 0.36 | 0.41 | 0.48 |
Ethno-racial background | ||||
White | 3624 (59.7) | 0.38 | 0.43 | 0.50 |
Asian | 1134 (18.7) | 0.34 | 0.39 | 0.44 |
Black | 459 (7.6) | 0.35 | 0.39 | 0.43 |
Indigenous a | 257 (4.2) | 0.37 | 0.43 | 0.49 |
Latin American | 114 (1.9) | 0.35 | 0.41 | 0.43 |
Multiple b | 482 (7.9) | 0.37 | 0.41 | 0.46 |
Physical activity c | ||||
Meeting guidelines | 671 (10.7) | 0.36 | 0.42 | 0.48 |
Not meeting guidelines | 5575 (89.3) | 0.36 | 0.41 | 0.48 |
Outdoor play d | ||||
At least once last school week | 4700 (75.0) | 0.36 | 0.42 | 0.49 |
None | 1571 (25.1) | 0.36 | 0.41 | 0.48 |
Home language | ||||
English and/or French only | 4732 (75.2) | 0.37 | 0.42 | 0.50 |
Other | 1561 (24.8) | 0.35 | 0.40 | 0.45 |
Years since immigration to Canada | ||||
Canadian-born | 5227 (82.9) | 0.37 | 0.42 | 0.49 |
≤2 | 148 (2.4) | 0.36 | 0.39 | 0.43 |
3–5 | 197 (3.1) | 0.35 | 0.41 | 0.47 |
6–10 | 367 (5.8) | 0.35 | 0.41 | 0.46 |
≥11 | 368 (5.8) | 0.35 | 0.41 | 0.46 |
Self-reported SES e | ||||
Lowest | 40 (0.7) | 0.35 | 0.41 | 0.47 |
Low | 374 (6.1) | 0.37 | 0.42 | 0.49 |
Middle | 1587 (25.7) | 0.36 | 0.41 | 0.49 |
High | 3131 (50.8) | 0.36 | 0.42 | 0.48 |
Highest | 1034 (16.8) | 0.36 | 0.41 | 0.48 |
Material and Social Deprivation Index f | ||||
Low deprivation | 2047 (32.4) | 0.38 | 0.44 | 0.50 |
Medium deprivation | 2229 (35.3) | 0.36 | 0.41 | 0.50 |
High deprivation | 2037 (32.3) | 0.34 | 0.40 | 0.44 |
Region g | ||||
Greater Toronto Area | 2636 (41.8) | 0.33 | 0.38 | 0.46 |
Northern Ontario | 904 (14.3) | 0.30 | 0.36 | 0.43 |
Western Ontario | 1006 (15.9) | 0.41 | 0.45 | 0.52 |
Eastern Ontario | 1767 (28.0) | 0.41 | 0.45 | 0.51 |
Season of participation | ||||
Fall/winter (Nov–Feb) | 3259 (51.6) | 0.38 | 0.43 | 0.50 |
Spring/summer (Mar–Jun) | 3054 (48.4) | 0.33 | 0.39 | 0.46 |
Mental health measures | ||||
Serious psychological distress h | 1018 (16.7) | 0.36 | 0.41 | 0.48 |
Low self-rated mental health i | 1268 (20.3) | 0.36 | 0.41 | 0.49 |
Suicide ideation | 790 (13.5) | 0.36 | 0.41 | 0.48 |
Suicide attempt | 219 (3.7) | 0.36 | 0.41 | 0.48 |
Serious Psychological Distress | Low Self-Rated Mental Health | Suicide Ideation | Suicide Attempt | ||||||
---|---|---|---|---|---|---|---|---|---|
Greenness Measures | Quartile Range | Cases (N = 5732) | aOR (95% CI) | Cases (N = 5881) | aOR (95% CI) | Cases (N = 5521) | aOR (95% CI) | Cases (N = 5535) | aOR (95% CI) |
Max NDVI (1000 m) | 0.74–0.79 | 245 | Ref. | 288 | Ref. | 191 | Ref. | 58 | Ref. |
0.79–0.81 | 258 | 1.04 (0.85, 1.28) | 314 | 1.09 (0.85, 1.41) | 211 | 1.17 (0.92, 1.48) | 56 | 1.04 (0.70, 1.55) | |
0.81–0.83 | 229 | 0.93 (0.78, 1.10) | 295 | 0.99 (0.78, 1.27) | 189 | 1.04 (0.85, 1.28) | 54 | 0.98 (0.68, 1.41) | |
0.83–0.87 | 286 | 1.05 (0.87, 1.27) | 371 | 1.11 (0.89, 1.39) | 199 | 1.01 (0.81, 1.25) | 51 | 0.88 (0.61, 1.26) | |
Max NDVI (500 m) | 0.66–0.76 | 262 | Ref. | 307 | Ref. | 216 | Ref. | 69 | Ref. |
0.76–0.78 | 230 | 0.96 (0.77, 1.19) | 300 | 1.06 (0.82, 1.36) | 174 | 0.83 (0.64, 1.07) | 45 | 0.76 (0.51, 1.12) | |
0.78–0.81 | 248 | 0.99 (0.82, 1.20) | 314 | 1.08 (0.87, 1.34) | 181 | 0.88 (0.72, 1.09) | 46 | 0.73 (0.48, 1.10) | |
0.81–0.86 | 278 | 1.04 (0.86, 1.27) | 347 | 1.09 (0.84, 1.42) | 219 | 0.94 (0.77, 1.16) | 59 | 0.85 (0.61, 1.19) | |
Mean NDVI (1000 m) | 0.25–0.37 | 262 | Ref. | 342 | Ref. | 208 | Ref. | 57 | Ref. |
0.38–0.44 | 248 | 1.00 (0.81, 1.24) | 286 | 0.86 (0.67, 1.10) | 189 | 0.98 (0.78, 1.24) | 48 | 0.99 (0.67, 1.45) | |
0.44–0.50 | 263 | 1.06 (0.87, 1.30) | 316 | 0.96 (0.75, 1.23) | 215 | 1.05 (0.84, 1.32) | 63 | 1.14 (0.78, 1.66) | |
0.50–0.67 | 245 | 0.97 (0.81, 1.18) | 324 | 0.92 (0.72, 1.18) | 178 | 0.93 (0.72, 1.19) | 51 | 1.02 (0.69, 1.51) | |
Mean NDVI (500 m) | 0.23–0.36 | 249 | Ref. | 320 | Ref. | 198 | Ref. | 59 | Ref. |
0.36–0.41 | 275 | 1.05 (0.85, 1.28) | 312 | 0.91 (0.71, 1.18) | 222 | 1.06 (0.84, 1.33) | 53 | 0.81 (0.56, 1.18) | |
0.41–0.48 | 241 | 1.02 (0.84, 1.26) | 300 | 0.99 (0.80, 1.22) | 181 | 0.97 (0.79, 1.18) | 55 | 1.05 (0.72, 1.51) | |
0.48–0.68 | 253 | 1.02 (0.85, 1.22) | 336 | 1.01 (0.80, 1.26) | 189 | 1.02 (0.81, 1.30) | 52 | 0.94 (0.64, 1.39) |
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Srugo, S.A.; de Groh, M.; Jiang, Y.; Morrison, H.I.; Hamilton, H.A.; Villeneuve, P.J. Assessing the Impact of School-Based Greenness on Mental Health Among Adolescent Students in Ontario, Canada. Int. J. Environ. Res. Public Health 2019, 16, 4364. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16224364
Srugo SA, de Groh M, Jiang Y, Morrison HI, Hamilton HA, Villeneuve PJ. Assessing the Impact of School-Based Greenness on Mental Health Among Adolescent Students in Ontario, Canada. International Journal of Environmental Research and Public Health. 2019; 16(22):4364. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16224364
Chicago/Turabian StyleSrugo, Sebastian A., Margaret de Groh, Ying Jiang, Howard I. Morrison, Hayley A. Hamilton, and Paul J. Villeneuve. 2019. "Assessing the Impact of School-Based Greenness on Mental Health Among Adolescent Students in Ontario, Canada" International Journal of Environmental Research and Public Health 16, no. 22: 4364. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16224364