Urban green spaces and mental health: Findings from Uganda

Background: Urban green spaces (UGS) may improve mental health in high-income countries. However, evidence from low-income African countries is scarce. Here, we assessed the associations of UGS with depressive and anxiety symptoms among adult residents of Kampala District (Uganda), the potential eff...

Full description

Saved in:
Bibliographic Details
Main Authors: Hilbert Mendoza, Solomon T. Wafula, Katrien De Troeyer, Hayat Bentouhami, Busisiwe Shezi, Grace Biyinzika Lubega, Rawlance Ndejjo, John Bosco Isunju, Richard Mugambe, David Musoke, Lidia Casas
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Hygiene and Environmental Health Advances
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2773049225000091
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849468237327106048
author Hilbert Mendoza
Solomon T. Wafula
Katrien De Troeyer
Hayat Bentouhami
Busisiwe Shezi
Grace Biyinzika Lubega
Rawlance Ndejjo
John Bosco Isunju
Richard Mugambe
David Musoke
Lidia Casas
author_facet Hilbert Mendoza
Solomon T. Wafula
Katrien De Troeyer
Hayat Bentouhami
Busisiwe Shezi
Grace Biyinzika Lubega
Rawlance Ndejjo
John Bosco Isunju
Richard Mugambe
David Musoke
Lidia Casas
author_sort Hilbert Mendoza
collection DOAJ
description Background: Urban green spaces (UGS) may improve mental health in high-income countries. However, evidence from low-income African countries is scarce. Here, we assessed the associations of UGS with depressive and anxiety symptoms among adult residents of Kampala District (Uganda), the potential effect modification by sociodemographic factors, and the mediation roles of social interaction, outdoor physical activity, and residential distance to major roads as a proxy of traffic-related air pollution. Methods: We conducted a cross-sectional survey among 641 adults. We objectively measured UGS using the Normalized Difference Vegetation Index (NDVI) within buffers of 100 m and 1,000 m around the residences. We assessed the utilization of UGS as a self-reported frequency (never, occasionally, and frequently) by which individuals visited UGS in the past 6 months. The Patient Health Questionnaire-9 and the Generalized Anxiety Disorder 7-item scale were used to examine the severity of depressive and anxiety symptoms respectively. We used modified Poisson regression models to obtain prevalence ratios (PR) with their 95 % confidence intervals (CI), stratified our models, and conducted mediation analyses. Results: We observed an inverse association between UGS and both outcomes. For example, an inter-quartile range increase in UGS within a 100 m buffer was associated with a 6 % and 8 % decrease in depressive and anxiety symptoms, respectively (PR=0.94; 95 % CI=0.89–0.99, and PR=0.92; 95 % CI=0.85–0.95, respectively). Consistently, frequent visits to UGS relative to no visits were associated with a 33 % and 35 % lower prevalence of depressive and anxiety symptoms (PR=0.67; 95 %CI=0.53–0.84, and PR=0.65; 95 %CI=0.47–0.91, respectively). Depending on the UGS metric, we observed varying potential effect modification findings by sex, age, and educational level. Finally, residential distance to major roads emerged as a mediator in the association between residential surrounding greenness and depressive symptoms. Conclusion: Our study suggests that UGS may also improve the mental health among residents of rapidly urbanizing African low-income cities.
format Article
id doaj-art-05d3569e54bb438fa19f874b2aef664d
institution Kabale University
issn 2773-0492
language English
publishDate 2025-06-01
publisher Elsevier
record_format Article
series Hygiene and Environmental Health Advances
spelling doaj-art-05d3569e54bb438fa19f874b2aef664d2025-08-20T03:25:54ZengElsevierHygiene and Environmental Health Advances2773-04922025-06-011410012610.1016/j.heha.2025.100126Urban green spaces and mental health: Findings from UgandaHilbert Mendoza0Solomon T. Wafula1Katrien De Troeyer2Hayat Bentouhami3Busisiwe Shezi4Grace Biyinzika Lubega5Rawlance Ndejjo6John Bosco Isunju7Richard Mugambe8David Musoke9Lidia Casas10Social Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Campus Drie Eiken, Doornstraat 331, BE-2610 Wilrijk, Belgium; Corresponding author.Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, UgandaSocial Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Campus Drie Eiken, Doornstraat 331, BE-2610 Wilrijk, BelgiumSocial Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Campus Drie Eiken, Doornstraat 331, BE-2610 Wilrijk, BelgiumEnvironment and Health Research Unit, South African Medical Research Council, Durban, South Africa; Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South AfricaDepartment of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, UgandaDepartment of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, UgandaDepartment of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, UgandaDepartment of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, UgandaDepartment of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, UgandaSocial Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Campus Drie Eiken, Doornstraat 331, BE-2610 Wilrijk, Belgium; Institute for Environment and Sustainable Development (IMDO), University of Antwerp, Antwerp, Belgium; Laboratory of Applied Microbiology and Biotechnology (LAMB), Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171 2020 Antwerp, BelgiumBackground: Urban green spaces (UGS) may improve mental health in high-income countries. However, evidence from low-income African countries is scarce. Here, we assessed the associations of UGS with depressive and anxiety symptoms among adult residents of Kampala District (Uganda), the potential effect modification by sociodemographic factors, and the mediation roles of social interaction, outdoor physical activity, and residential distance to major roads as a proxy of traffic-related air pollution. Methods: We conducted a cross-sectional survey among 641 adults. We objectively measured UGS using the Normalized Difference Vegetation Index (NDVI) within buffers of 100 m and 1,000 m around the residences. We assessed the utilization of UGS as a self-reported frequency (never, occasionally, and frequently) by which individuals visited UGS in the past 6 months. The Patient Health Questionnaire-9 and the Generalized Anxiety Disorder 7-item scale were used to examine the severity of depressive and anxiety symptoms respectively. We used modified Poisson regression models to obtain prevalence ratios (PR) with their 95 % confidence intervals (CI), stratified our models, and conducted mediation analyses. Results: We observed an inverse association between UGS and both outcomes. For example, an inter-quartile range increase in UGS within a 100 m buffer was associated with a 6 % and 8 % decrease in depressive and anxiety symptoms, respectively (PR=0.94; 95 % CI=0.89–0.99, and PR=0.92; 95 % CI=0.85–0.95, respectively). Consistently, frequent visits to UGS relative to no visits were associated with a 33 % and 35 % lower prevalence of depressive and anxiety symptoms (PR=0.67; 95 %CI=0.53–0.84, and PR=0.65; 95 %CI=0.47–0.91, respectively). Depending on the UGS metric, we observed varying potential effect modification findings by sex, age, and educational level. Finally, residential distance to major roads emerged as a mediator in the association between residential surrounding greenness and depressive symptoms. Conclusion: Our study suggests that UGS may also improve the mental health among residents of rapidly urbanizing African low-income cities.http://www.sciencedirect.com/science/article/pii/S2773049225000091Mental healthUrban green spacesLow-income countriesUrban healthSub-Saharan Africa
spellingShingle Hilbert Mendoza
Solomon T. Wafula
Katrien De Troeyer
Hayat Bentouhami
Busisiwe Shezi
Grace Biyinzika Lubega
Rawlance Ndejjo
John Bosco Isunju
Richard Mugambe
David Musoke
Lidia Casas
Urban green spaces and mental health: Findings from Uganda
Hygiene and Environmental Health Advances
Mental health
Urban green spaces
Low-income countries
Urban health
Sub-Saharan Africa
title Urban green spaces and mental health: Findings from Uganda
title_full Urban green spaces and mental health: Findings from Uganda
title_fullStr Urban green spaces and mental health: Findings from Uganda
title_full_unstemmed Urban green spaces and mental health: Findings from Uganda
title_short Urban green spaces and mental health: Findings from Uganda
title_sort urban green spaces and mental health findings from uganda
topic Mental health
Urban green spaces
Low-income countries
Urban health
Sub-Saharan Africa
url http://www.sciencedirect.com/science/article/pii/S2773049225000091
work_keys_str_mv AT hilbertmendoza urbangreenspacesandmentalhealthfindingsfromuganda
AT solomontwafula urbangreenspacesandmentalhealthfindingsfromuganda
AT katriendetroeyer urbangreenspacesandmentalhealthfindingsfromuganda
AT hayatbentouhami urbangreenspacesandmentalhealthfindingsfromuganda
AT busisiweshezi urbangreenspacesandmentalhealthfindingsfromuganda
AT gracebiyinzikalubega urbangreenspacesandmentalhealthfindingsfromuganda
AT rawlancendejjo urbangreenspacesandmentalhealthfindingsfromuganda
AT johnboscoisunju urbangreenspacesandmentalhealthfindingsfromuganda
AT richardmugambe urbangreenspacesandmentalhealthfindingsfromuganda
AT davidmusoke urbangreenspacesandmentalhealthfindingsfromuganda
AT lidiacasas urbangreenspacesandmentalhealthfindingsfromuganda