Association Between Urban Greenspace and Mental Wellbeing During the COVID-19 Pandemic in a US Cohort

The Coronavirus Disease 2019 (COVID-19) pandemic brought unprecedented socially isolating measures to mitigate the spread of disease, heightening the importance of public outdoor urban greenspace. Here, we investigated the association between tree-rich greenspace and mental health in a large opportunity sample surveyed using a crowdsourcing research website (www.covid19resilience.org) between April 6th and October 12th, 2020 during the pandemic in the United States. Participants living in the U.S. (N = 2,089, 83.1% females, mean age 42 years, age range 18-90 years) were mapped to 1,080 unique ZIP Codes and mean tree canopy density was calculated with a 250m buffer around each ZIP Code grouped by quartile as a proxy for nearby greenspace. Four mental health parameters were assessed: (1) COVID-19-related worries;(2) anxiety symptoms;(3) depression symptoms;and (4) a standardized and weighted composite mental health score of all three parameters. Multivariate regression analyses with multilevel models were used to study the association between nearby greenspace and the four mental health outcomes, controlling for participant demographics and ZIP Code urbanicity. In the entire cohort, increased nearby greenspace showed a significant protective effect for depression (Coef. = -0.27;p = 0.0499), and composite mental health scores (Coef. = -0.19;p = 0.038) when comparing ZIP Codes with the most greenspace to ZIP Codes with the least, with no observed effects on COVID-19 related worries or anxiety individually. Stratifying by age suggested protective trends of greenspace on mental health in older subsets of the population (top age quartile, over 51 years old) experiencing less depression (Coef. = -0.45;p = 0.048) and lower composite mental health scores (Coef. = -0.34;- = 0.032) as a function of nearby greenspace. Additionally, younger subsets of the population (second youngest age quartile, 31-38 years) experienced lower COVID-19 related worries (Coef. = -1.34;p = 0.022) as a function of greenspace. These findings may indicate that tree-rich greenspace plays a protective role on mental health during the COVID-19 pandemic, specifically in certain age groups, supporting the use of greenspace-related strategies to help mitigate mental health burden during this challenging and isolating time.

The COVID-19 pandemic's impact on worry and medical disruptions reported by individuals with chromosome 22q11.2 copy number variants and their caregivers.

BACKGROUND: The world has suffered immeasurably during the COVID-19 pandemic. Increased distress and mental and medical health concerns are collateral consequences to the disease itself. The Genes to Mental Health (G2MH) Network consortium sought to understand how individuals affected by the rare copy number variations of 22q11.2 deletion and duplication syndrome, associated with neurodevelopmental/neuropsychiatric conditions, were coping. The article focuses on worry and disruptions in medical care caused by the pandemic. METHODS: The University of Pennsylvania COVID-19 Stressor List and care disruption questions were circulated by 22 advocacy groups in English and 11 other languages. RESULTS: A total of 512 people from 23 countries completed the survey; most were caregivers of affected individuals. Worry about family members acquiring COVID-19 had the highest average endorsed worry, whilst currently having COVID-19 had the lowest rated worry. Total COVID-19 worries were higher in individuals completing the survey towards the end of the study (later pandemic wave); 36% (n = 186) of the sample reported a significant effect on health due to care interruption during the pandemic; 44% of individuals (n = 111) receiving care for their genetic syndrome in a hospital setting reported delaying appointments due to COVID-19 fears; 12% (n = 59) of the sample reported disruptions to treatments; and of those reporting no current disruptions, 59% (n = 269) worried about future disruptions if the pandemic continued. Higher levels of care disruptions were related to higher COVID-19 worries (Ps < 0.005). Minimal differences by respondent type or copy number variation type emerged. CONCLUSIONS: Widespread medical care disruptions and pandemic-related worries were reported by individuals with 22q11.2 syndrome and their family members. Reported worries were broadly consistent with research results from prior reports in the general population. The long-term effects of COVID-19 worries, interruptions to care and hospital avoidance require further study.

Association among income loss, financial strain and depressive symptoms during COVID-19: evidence from two longitudinal studies.

BACKGROUND: The COVID-19 pandemic has major ramifications for global health and the economy, with growing concerns about economic recession and implications for mental health. Here we investigated the associations between COVID-19 pandemic-related income loss with financial strain and mental health trajectories over a 1-month course. METHODS: Two independent studies were conducted in the U.S and in Israel at the beginning of the outbreak (March-April 2020, T1; N = 4 171) and at a 1-month follow-up (T2; N = 1 559). Mixed-effects models were applied to assess associations among COVID-19-related income loss, financial strain, and pandemic-related worries about health, with anxiety and depression, controlling for multiple covariates including pre-COVID-19 income. FINDINGS: In both studies, income loss and financial strain were associated with greater depressive symptoms at T1, above and beyond T1 anxiety, worries about health, and pre-COVID-19 income. Worsening of income loss was associated with exacerbation of depression at T2 in both studies. Worsening of subjective financial strain was associated with exacerbation of depression at T2 in one study (US). INTERPRETATION: Income loss and financial strain were uniquely associated with depressive symptoms and the exacerbation of symptoms over time, above and beyond pandemic-related anxiety. Considering the painful dilemma of lockdown versus reopening, with the tradeoff between public health and economic wellbeing, our findings provide evidence that the economic impact of COVID-19 has negative implications for mental health. FUNDING: This study was supported by grants from the National Institute of Mental Health, the US-Israel Binational Science Foundation, Foundation Dora and Kirsh Foundation.