Social inequalities, residential greenness and common mental disorders in women: evidence from the Born in Bradford family cohort study

Background: Green space may promote mental health in vulnerable groups but evidence is mixed. We explored prevalence of Common Mental Disorders (CMD) and associations with green space in a deprived urban multiethnic population. Methods: We included 4737 women from the Born in Bradford cohort (64% South Asian origin, 49% most deprived population decile). Green space was measured using the normalised difference vegetation index (NDVI) around home addresses and availabiltiy of major green spaces within 300 m. CMD were identified from health records (diagnosis and prescriptions) and self-reported anxiety and depression symptoms. Area deprivation, ethnicity, education, physical activity, use, and satisfaction with green spaces were collected. Linear and logistic regression models explored the distribution of CMD and residential greenness for different socio-economic groups and associations between greenness metrics and CMD. Mediators (physical activity) and moderators (green space use and satisfaction) were explored. Findings: Thirty percent of participants showed at least one CMD indicator. White British and the least and most educated groups had higher CMD rates. South Asian and Black ethnic groups had less surrounding greenness and greater availability of major green spaces; however used them less frequently. No relationships between green space and CMD were apparent. For those unsatisfied with their local park, living within 300 m of a major green space increased risk of anxiety symptoms, but not other CMD indicators. Interpretation: Availability of quality green spaces alone may not be enough to confer health benefits for populations experiencing high rates of CMD and multiple environmental and social stressors.