Evidence map›Paper›PMID 33903601›Full record

ArticleScientific reports2021

Associations between green/blue spaces and mental health across 18 countries.

Mathew P White, Lewis R Elliott, James Grellier, Theo Economou, Simon Bell, Gregory N Bratman, Marta Cirach, Mireia Gascon, Maria L Lima, Mare Lõhmus and 6 more

Abstract read
In one paragraph

Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 115 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
115citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

115 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  12. The Community-Environment-Health Nexus: Connecting Community-Led Climate Action to Health Co-Benefits.International journal of environmental research and public health · 2026
    Article
  13. Community severance and mental health-related hospital visits in New York City.Environmental epidemiology (Philadelphia, Pa.) · 2026
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55 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Mathew P WhiteCognitive Science HUB, University of Vienna, Liebbigasse 5, 1110, Vienna, Austria. mathew.white@univie.ac.at.
Lewis R ElliottEuropean Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK.
James GrellierEuropean Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK.
Theo EconomouCollege of Engineering, Mathematics, and Physical Sciences, University of Exeter, Exeter, UK.
Simon BellEstonian University of Life Sciences, Tartu, Estonia.
Gregory N BratmanSchool of Environmental and Forest Sciences, College of the Environment, University of Washington, Washington, USA.
Marta CirachISGlobal, Barcelona, Spain.
Mireia GasconISGlobal, Barcelona, Spain.
Maria L LimaDepartment of Social and Organizational Psychology, ISCTE - University Institute of Lisbon, Lisbon, Portugal.
Mare LõhmusInstitute of Environmental Medicine, Karolinska Institute, Solna, Sweden.
Mark NieuwenhuijsenISGlobal, Barcelona, Spain.
Ann OjalaNatural Resources Institute Finland (Luke), Helsinki, Finland.
Anne RoikoSchool of Medicine, Griffith University, Brisbane, Australia.
P Wesley SchultzDepartment of Psychology, California State University San Marcos, San Marcos, USA.
Matilda van den BoschISGlobal, Barcelona, Spain.
Lora E FlemingEuropean Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Living near, recreating in, and feeling psychologically connected to, the natural world are all associated with better mental health, but many exposure-related questions remain. Using data from an 18-country survey (n = 16,307) we explored associations between multiple measures of mental health (positive well-being, mental distress, depression/anxiety medication use) and: (a) exposures (residential/recreational visits) to different natural settings (green/inland-blue/coastal-blue spaces); and (b) nature connectedness, across season and country. People who lived in greener/coastal neighbourhoods reported higher positive well-being, but this association largely disappeared when recreational visits were controlled for. Frequency of recreational visits to green, inland-blue, and coastal-blue spaces in the last 4 weeks were all positively associated with positive well-being and negatively associated with mental distress. Associations with green space visits were relatively consistent across seasons and countries but associations with blue space visits showed greater heterogeneity. Nature connectedness was also positively associated with positive well-being and negatively associated with mental distress and was, along with green space visits, associated with a lower likelihood of using medication for depression. By contrast inland-blue space visits were associated with a greater likelihood of using anxiety medication. Results highlight the benefits of multi-exposure, multi-response, multi-country studies in exploring complexity in nature-health associations.

Indexed as

AnxietyDepressionMental HealthParks, RecreationalAdultFemaleHumansMale

Identifiers

PMID33903601
PMCPMC8076244

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.