Urban public parks and mental health in adult women: Mediating and moderating factors

BACKGROUND:: The association of green spaces such as urban public parks and mental health might vary according to personal characteristics and characteristics of the park and be mediated by the use of the park. AIMS:: We investigate the association between urban public park coverage and mental health in adult women, the moderation of this association by personal and park-related characteristics, and the mediation of the association by use of public space. METHODS:: Combining data from a cross-sectional survey of the adult female population of Tijuana (Mexico) in 2014, and a study of public spaces in 2013, we analyzed the association between park coverage in buffers of 400 and 800 m from participants' homes and score in the Center for Epidemiologic Studies-Depression scale (CES-D). We tested for mediation by use of park and interaction of urban park coverage with personal and park characteristics. RESULTS:: Urban public park coverage in the 400-m buffer had an inverse association with CES-D score that was moderated by age (significant only for younger participants), with no evidence of mediation. Park coverage in the 800-m buffer also had an inverse association with CES-D score, moderated by age and occupation (significant for younger participants and homemakers), and a mediated association was also observed. There was no interaction between park coverage and park characteristics in their association with CES-D score. CONCLUSION:: Our results confirm the potential of public parks to improve mental health and suggest that this effect could be more important at some stages in the life course for women. The upper-middle-income, Latin American country setting adds to the current knowledge that is mostly based on high-income countries.