Access to outdoor spaces benefits mental health, wellbeing during COVID-19 lockdown

People in European countries with the strictest COVID-19 lockdown policies were more likely to show symptoms of depression and anxiety, according to an international study investigating the impact of disconnecting from nature.

Led by the Basque technology center AZTI, and involving the University of Exeter, the study built on pre-COVID-19 evidence that access to outdoor spaces benefitted mental health and wellbeing. Researchers sought to answer the question of whether being forced to disconnect from nature affected mental health. The study, published in the journal Science of the Total Environment, was carried out during the first wave of COVID-19 in Europe (March-May 2020).

The team of international researchers from Spain, United Kingdom and Norway invited citizens to voluntarily respond a simple questionnaire to check their behavior and mental health status in the face of severe measures that restricted mobility. In less than 20 days, 6,769 people from 77 different countries answered the survey, although for analysis purposes we focused on 5,218 responses from 9 countries.

The main conclusion is that people who were under the strictest lockdown during the first wave of COVID-19 (those who were only allowed to go out for work or essentials purchases, as was the case of Italy and Spain) were more likely to show symptoms compatible with depression and anxiety, compared to countries with more relaxed lockdowns where people could still visit natural places such as parks."

Dr Sarai Pouso, from AZTI

The researchers analyzed in greater detail the case of Spain, where, due to the epidemiological situation in March, the possibility for practicing outdoor activities, such as walking or playing sports, was totally forbidden. "The results indicate that having access from the home to outdoor spaces (e.g., garden, balcony) and having window views to open spaces or natural element (e.g., coast, park, forest) decreased the probability of showing symptoms of depression. Furthermore, people with access to outdoor spaces and with nature views, managed to maintain a more positive mood during lockdown", adds María C. Uyarra, who together with Dr Ángel Borja and Dr Sarai Pouso, made up the AZTI team involved in the study.

The effects of having access to gardens and views of nature from the home were far less important in countries in where people were allowed, or even encouraged, to visit parks and other natural locations as long as safe social distancing recommendations were adhered to (e.g. Norway, United Kingdom).

Results suggest that, under stressful circumstances such as lockdown, allowing people to spend some time outdoors in nature may help reduce the likelihood of developing symptoms of depression and or anxiety. This may be particularly important for people without gardens or views of nature, who are more likely to have lower incomes and live in more built up urban areas, concluded the research team.

Looking at different population subgroups, women and young people were more likely to experience symptoms of depression and anxiety. However, the researchers remain cautious. "The study was unable to obtain a fully representative sample and did not include data from certain groups that may have been particularly affected by the lockdown situation, such as children or many older adults" says Dr Mat White, from the University of Exeter, United Kingdom.

Results suggest that if governments have to implement new lockdown measures in the near future, they should consider allowing the population to spend some time outdoors. "Spending time outdoors has a protective effect on mental health. Restoring and expanding green and blue spaces in urban areas increases the resilience of cities in the face of pandemics", adds Erik Gómez-Baggethun, Professor at the Norwegian University of Life Sciences.

The study proposes that future urban developments should pay special attention to the inclusion of elements that would enable to contact with nature (e.g., more green areas in public spaces, etc.), as well as special attention to the most vulnerable sectors of the population.

"This research is important for so that future planners take into account that is crucial for people to have equal access to high-quality blue and green environments. We have now contributed to a robust and compelling body of evidence that tells us this access can both prevent and treat mental health issues, especially in urban areas. This is particularly key in the context of a pandemic, but actually it should be a planning priority that could improve our health, regardless of COVID-19" adds Lora E. Fleming, director of the European Centre for Environment and Human Health, from the University of Exeter.

"In summary, this study shows that the strict lockdown isolation to which certain populations (e.g., in Spain) were exposed had a negative effect on their mental health. However, we still do not know if these symptoms have been persistent or if they disappeared once the lockdown measures ended", concludes Dr Pouso.