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Schizophr Res. 2018 Sep;199:142-148. doi: 10.1016/j.schres.2018.03.026. Epub 2018 Mar 21.

Childhood exposure to green space - A novel risk-decreasing mechanism for schizophrenia?

Author information

1
Section for Ecoinformatics & Biodiversity, Department of Bioscience, Aarhus University, Aarhus C, Denmark; Centre for Integrated Register-based Research, CIRRAU, Aarhus University, 8210 Aarhus V, Denmark. Electronic address: engemann@bios.au.dk.
2
Centre for Integrated Register-based Research, CIRRAU, Aarhus University, 8210 Aarhus V, Denmark; National Centre for Register-based Research, Aarhus BSS, Department of Economics and Business Economics, Aarhus University, 8210 Aarhus V, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, 8210 Aarhus V, Denmark. Electronic address: cbp@econ.au.dk.
3
Center for Massive Data Algorithmics, MADALGO, Department of Computer Science, Aarhus University, Aarhus N, Denmark. Electronic address: large@cs.au.dk.
4
Center for Massive Data Algorithmics, MADALGO, Department of Computer Science, Aarhus University, Aarhus N, Denmark. Electronic address: constant@madalgo.au.dk.
5
Centre for Integrated Register-based Research, CIRRAU, Aarhus University, 8210 Aarhus V, Denmark; National Centre for Register-based Research, Aarhus BSS, Department of Economics and Business Economics, Aarhus University, 8210 Aarhus V, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, 8210 Aarhus V, Denmark. Electronic address: pbm@econ.au.dk.
6
Section for Ecoinformatics & Biodiversity, Department of Bioscience, Aarhus University, Aarhus C, Denmark. Electronic address: svenning@bios.au.dk.

Abstract

Schizophrenia risk has been linked to urbanization, but the underlying mechanism remains unknown. Green space is hypothesized to positively influence mental health and might mediate risk of schizophrenia by mitigating noise and particle pollution exposure, stress relief, or other unknown mechanisms. The objectives for this study were to determine if green space are associated with schizophrenia risk, and if different measures of green space associate differently with risk. We used satellite data from the Landsat program to quantify green space in a new data set for Denmark at 30×30m resolution for the years 1985-2013. The effect of green space at different ages and within different distances from each person's place of residence on schizophrenia risk was estimated using Cox regression on a very large longitudinal population-based sample of the Danish population (943,027 persons). Living at the lowest amount of green space was associated with a 1.52-fold increased risk of developing schizophrenia compared to persons living at the highest level of green space. This association remained after adjusting for known risk factors for schizophrenia: urbanization, age, sex, and socioeconomic status. The strongest protective association was observed during the earliest childhood years and closest to place of residence. This is the first nationwide population-based study to demonstrate a protective association between green space during childhood and schizophrenia risk; suggesting limited green space as a novel environmental risk factor for schizophrenia. This study supports findings from other studies highlighting positive effects of exposure to natural environments for human health.

KEYWORDS:

Health geography; Incidence rate ratio; Mental health; Normalized difference vegetation index; Prospective study; Survival analyses

PMID:
29573946
DOI:
10.1016/j.schres.2018.03.026
[Indexed for MEDLINE]

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