Abstract
BACKGROUND: Access to green space is considered beneficial to mental and physical health, though the causal pathways are not completely clear. Accordingly, the objective of this study was to examine how access to green space was associated with low mental distress and general health among older adults. METHODS: The data in our study stems from a survey from three Norwegian counties in 2015-16, n = 2937. The main exposure variable was self-reported access to green space, and the outcome variables were self-reported mental distress and general health. Logistic regression adjusted for sex, age, education, physical activity, functional disability, access to cultural/sports facilities and economic security was performed to assess the association between the exposure variable and the outcome variables. RESULTS: Access to green space was associated with both higher odds of low mental distress (Odds Ratio = 3.85**, 95% CI 2.04-6.02) and good general health (OR = 8.20**, 95%CI 5.88-11.49) compared to no access. In models adjusted for sex, age, and education, the ORs were only slightly changed (OR = 4.03**, 95%CI 2.52-6.45) and (OR = 7.91**, 95%CI 5.63-11.13). However, adjusting for general health with low mental distress as outcome, the association was no longer statistically significant; (OR = 1.28 95%CI 0.74-2.21). Adjusting for low mental distress with general health as outcome, the association remained statistically significant; (OR = 3.43** 95%CI 2.34-5.03). CONCLUSIONS: Our findings suggest that the association between access to green space and mental health may be mediated by general health. This implies that studies of associations between access to green space and mental health must take general health into consideration.