Effects of Home Neighborhood Tree Canopy Coverage on Mental Health Outcomes: A Traumatic Brain Injury Model Systems Investigation.
Shannon B Juengst, Raj G Kumar, Alexandra Holland and 10 others
PMID 39928731WHAT IT FOUND
In adults with traumatic brain injury, more neighborhood tree cover was linked to higher depression and anxiety scores in rural areas.
This association disappeared after adjusting for socioeconomic disadvantage. Neighborhood poverty, not tree cover, appears to drive the mental health differences.
Key findings
01Among participants living in rural neighborhoods, greater tree canopy coverage was associated with increased depressive symptoms before adjusting for socioeconomic disadvantage.
02The association between tree canopy coverage and anxiety symptoms in rural neighborhoods was also positive before adjustment but became non-significant after controlling for socioeconomic disadvantage.
03Living in a disadvantaged neighborhood was associated with worse mental health regardless of the extent of tree canopy coverage.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study is cross-sectional, so it cannot prove that tree cover causes changes in mental health or vice versa. Tree canopy coverage was measured at the census tract level (neighborhood average), which may not reflect what an individual person actually sees or accesses from their home. The analysis did not account for lifetime history of psychiatric issues or substance misuse, which are major drivers of mental health outcomes. The authors note that the 'modifiable areal unit problem' means results can change depending on the geographic scale used (e.g., tract vs. individual property).
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not conclude that trees harm mental health in rural areas. The negative association disappeared when adjusting for socioeconomic disadvantage, suggesting that poverty and lack of resources in rural neighborhoods, rather than the trees themselves, are linked to worse mental health outcomes.