Is green space exposure beneficial in a developing country?
Previous studies have confirmed the beneficial effects of green space exposure on depressive disorders, but the majority of them were conducted in developed countries. Given the difference in utilization of green spaces in countries with agriculturally heavy economies such as Indonesia, the effects of green space remain unknown. This study aimed to investigate the association between green space exposure and depressive disorders, focusing on Indonesia. Depressive disorders data provided by the Institute for Health Metrics and Evaluation was used. Exposure to the green space was based on the normalized difference vegetation index (MODIS-NDVI) and green land-cover data provided by the Geospatial Information Agency of Indonesia. A generalized additive mixed model was conducted, followed by a sensitivity test and positive-negative control analysis, to evaluate the association. Stratified analysis was employed to assess the effects of green space on depressive disorders in areas with different levels of urbanization. Exposure to green space significantly reduced the risk of depressive disorders by up to 5% per interquartile unit increment of NDVI. Moreover, there was a 12.4% reduced risk of depressive disorders coinciding with an 8.4% increase in the proportion of forest and total vegetation. In high-urbanization areas, the results of sensitivity analysis illustrated that green spaces reduced the risk of depressive disorders by 10%. Exposure to green spaces was confirmed to be associated with a reduced risk of depressive disorders in Indonesia. Findings of this ecological study could serve as references for urban planning, considering the health benefits of green spaces in developing countries.
Kusumaning Asri, A; Lee, HY; Pan, WC; Tsai, HJ; Chang, HT; Candice Lung, SC; Su, HJ; Yu, CP; Ji, JS; Wu, CD; Spengler, JD
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