Exposure to nature and mental health outcomes during COVID-19 lockdown. A comparison between Portugal and Spain

Ana Isabel Ribeiro, Margarita Triguero-Mas, Cláudia Jardim Santos, Alicia Gómez-Nieto, Helen Cole, Isabelle Anguelovski, Filipa Martins Silva, Francesc Baró

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43 Citaten (Scopus)
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To control the spread of the SARS-CoV-2 virus, countries around the world implemented lockdowns with varying intensities. Lockdowns, however, have been associated with a deterioration of mental health, including post-traumatic stress symptoms, anger and anxiety. Exposure to nature might reduce stress and provide relaxation opportunities.

Firstly, we aimed to determine which sociodemographic, housing and lockdown-related characteristics were associated with changes in exposure to nature during the COVID-19 lockdown in Portugal and Spain. Secondly, we sought to estimate the associations of these changes with mental health, and test whether these associations differed according to sociodemographic characteristics and between the two countries, which experienced different restrictions and epidemiological situations.

A cross-sectional study was conducted between March 27 and May 6, 2020, using an online questionnaire to measure changes in exposure to nature (including private green space and other greenery, views of nature from home and public natural spaces); sociodemographic, housing and lockdown-related characteristics; stress levels (visual stress scale); psychological distress (General Health Questionnaire − 12 items) and somatization (somatization scale). Adjusted regression models were fitted to estimate associations.

This study included 3157 participants (1638 from Portugal, 1519 from Spain). In Portugal, maintaining/increasing the use of public natural spaces during the lockdown was associated with lower levels of stress (adjusted beta −0.29; 95%CI −0.49, −0.08) and maintaining/increasing the frequency of viewing nature from home was associated with reduced psychological distress (0.27; −0.51, −0.03), somatization (−0.79; −1.39, −0.20), and stress levels (−0.48; −0.74, −0.23). In Spain, maintaining/increasing contact with private green space and greenery was associated with lower stress levels: for contact with indoor plants (−0.52; −0.96, −0.07) and for use of private community green spaces (−0.82; −1.61, −0.03).

Exposure to nature was associated with better mental health outcomes during lockdowns, but the natural features associated with improved mental health differed between the two countries. Nature should be incorporated into urban planning interventions and housing design and exposure to nature should be promoted during lockdowns.
Originele taal-2English
Aantal pagina's12
TijdschriftEnvironment International
StatusPublished - 28 mei 2021

Bibliografische nota

Funding Information:
This study was supported by FEDER through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology – FCT (Portuguese Ministry of Science, Technology and Higher Education) under the Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; Ref. UID/DTP/04750/2019). This study was also funded by the European Regional Development Fund (FEDER), through the Competitiveness and Internationalization Operational Programme, by national funding from the Foundation for Science and Technology (FCT) under the scope of the project PTDC/GES-AMB/30193/2017 (POCI-01-0145-FEDER-030193, 02/SAICT/2017 - 30193), the European Research Council (project GREENLULUs; grant agreement ID: 678034); and the EU’s Horizon 2020 framework program for research and innovation (project NATURVATION, grant agreement ID: 730243). MTM and HC are funded by Juan de la Cierva fellowships [FJCI-2017-33842, IJC2018-035322-I] awarded by the Spanish Ministry of Economy and Competitiveness. Ana Isabel Ribeiro was supported by National Funds through FCT, under the programme of ‘Stimulus of Scientific Employment – Individual Support’ within the contract CEECIND/02386/2018. The authors would also like to acknowledge all the institutions, media and individuals that shared the questionnaire in their social and personal networks.

Publisher Copyright:
© 2021 The Authors

Copyright 2021 Elsevier B.V., All rights reserved.


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