Exposure to urban green spaces and mental health during the COVID-19 pandemic: evidence from two low and lower-middle-income countries

Muhammad Mainuddin Patwary; Mondira Bardhan; Hüseyin Ertan İnan; Matthew H E M Browning; Asma Safia Disha; Md Zahidul Haque; Mai Helmy; Sadia Ashraf; Angel M Dzhambov; Faysal Kabir Shuvo; Md Ashraful Alam; Sharif Mutasim Billah; Md Pervez Kabir; Md Riad Hossain; Md Golam Azam; Md Mijanur Rahman; Sarya Swed; Ranjit Sah; Juan J Montenegro-Idrogo; D Katterine Bonilla-Aldana; Alfonso J Rodriguez-Morales

doi:10.3389/fpubh.2024.1334425

Exposure to urban green spaces and mental health during the COVID-19 pandemic: evidence from two low and lower-middle-income countries

Front Public Health. 2024 Mar 1:12:1334425. doi: 10.3389/fpubh.2024.1334425. eCollection 2024.

Authors

Muhammad Mainuddin Patwary^{1

2}, Mondira Bardhan^{1

3}, Hüseyin Ertan İnan^{3

4}, Matthew H E M Browning³, Asma Safia Disha^{1

5}, Md Zahidul Haque^{1

2}, Mai Helmy^{6

7}, Sadia Ashraf², Angel M Dzhambov^{8

9

10

11}, Faysal Kabir Shuvo¹², Md Ashraful Alam¹³, Sharif Mutasim Billah^{1

2}, Md Pervez Kabir^{1

14}, Md Riad Hossain¹⁵, Md Golam Azam¹⁶, Md Mijanur Rahman¹⁷, Sarya Swed¹⁸, Ranjit Sah^{19

20}, Juan J Montenegro-Idrogo^{21

22}, D Katterine Bonilla-Aldana²³, Alfonso J Rodriguez-Morales^{21

24

25}

Affiliations

¹ Environment and Sustainability Research Initiative, Khulna, Bangladesh.
² Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
³ Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC, United States.
⁴ Department of Tourism Management, Faculty of Tourism, Ondokuz Mayıs University, Samsun, Türkiye.
⁵ Department of Environmental Science and Management, North South University, Dhaka, Bangladesh.
⁶ Psychology Department, College of Education, Sultan Qaboos University, Muscat, Oman.
⁷ Psychology Department, Faculty of Arts, Menoufia University, Shibin el Kom, Egypt.
⁸ Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.
⁹ Research Group "Health and Quality of Life in a Green and Sustainable Environment", SRIPD, Medical University of Plovdiv, Plovdiv, Bulgaria.
¹⁰ Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria.
¹¹ Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria.
¹² Swinburne University of Technology, Hawthorn, VIC, Australia.
¹³ Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan.
¹⁴ Department of Civil Engineering, University of Ottawa, Ottawa, ON, Canada.
¹⁵ Institute of Disaster Management, Khulna University Engineering & Technology, Khulna, Bangladesh.
¹⁶ Remote Sensing, Center for Environmental and Geographic Information Services (CEGIS), Dhaka, Bangladesh.
¹⁷ Department of Geography and Environment, Jagannath University, Dhaka, Bangladesh.
¹⁸ Faculty of Medicine, Aleppo University, Aleppo, Syria.
¹⁹ Green City Hospital, Kathmandu, Nepal.
²⁰ Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, India.
²¹ Faculty of Health Sciences, Universidad Cientifica del Sur, Lima, Peru.
²² Infectious and Tropical Diseases Service, Hospital Nacional Dos de Mayo, Lima, Peru.
²³ Research Unit, Universidad Continental, Huancayo, Peru.
²⁴ Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas-Institución Universitaria Visión de las Américas, Pereira, Colombia.
²⁵ Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon.

Abstract

Introduction: The COVID-19 pandemic has had a significant impact on mental health globally, with limited access to mental health care affecting low- and middle-income countries (LMICs) the most. In response, alternative strategies to support mental health have been necessary, with access to green spaces being a potential solution. While studies have highlighted the role of green spaces in promoting mental health during pandemic lockdowns, few studies have focused on the role of green spaces in mental health recovery after lockdowns. This study investigated changes in green space access and associations with mental health recovery in Bangladesh and Egypt across the pandemic.

Methods: An online survey was conducted between January and April 2021 after the first lockdown was lifted in Bangladesh (n = 556) and Egypt (n = 660). We evaluated indoor and outdoor greenery, including the number of household plants, window views, and duration of outdoor visits. The quantity of greenness was estimated using the normalized difference vegetation index (NDVI). This index was estimated using satellite images with a resolution of 10x10m during the survey period (January-April 2021) with Sentinel-2 satellite in the Google Earth Engine platform. We calculated averages within 250m, 300m, 500m and 1000m buffers of the survey check-in locations using ArcGIS 10.3. Multiple linear regression models were used to evaluate relationships between changes in natural exposure and changes in mental health.

Results: The results showed that mental health improved in both countries after the lockdown period. People in both countries increased their time spent outdoors in green spaces after the lockdown period, and these increases in time outdoors were associated with improved mental health. Unexpectedly, changes in the number of indoor plants after the lockdown period were associated with contrasting mental health outcomes; more plants translated to increased anxiety and decreased depression. Refocusing lives after the pandemic on areas other than maintaining indoor plants may assist with worrying and feeling panicked. Still, indoor plants may assist with depressive symptoms for people remaining isolated.

Conclusion: These findings have important implications for policymakers and urban planners in LMICs, highlighting the need to increase access to natural environments in urban areas to improve mental health and well-being in public health emergencies.

Keywords: COVID-19; LMIC; NDVI; green space exposure; mental health.

Copyright © 2024 Patwary, Bardhan, İnan, Browning, Disha, Haque, Helmy, Ashraf, Dzhambov, Shuvo, Alam, Billah, Kabir, Hossain, Azam, Rahman, Swed, Sah, Montenegro-Idrogo, Bonilla-Aldana and Rodriguez-Morales.

MeSH terms

COVID-19* / epidemiology
Communicable Disease Control
Developing Countries
Humans
Mental Health*
Pandemics
Parks, Recreational

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. AMD’s time on this publication is partially supported by the “Strategic Research and Innovation Program for the Development of Medical University – Plovdiv (SRIPD-MUP),” funded by the EU – NextGenerationEU, contract N° BG-RRP-2.004-0007-C01. The funding above source had no involvement in the study’s design, collection, analysis, interpretation of the data, writing of the report, nor in the decision to submit the manuscript for publication. Universidad Continental, Peru, covered the APC of this publication.