In short
Mental illnesses are a growing problem in modern societies. In Belgium, the number of people presenting psychological difficulties increased by 6 % between 2008 (26%) and 2013 (32%). Strikingly, these symptoms are more frequent in the Brussels-Capital Region than elsewhere in the country. Several international studies have shown negative impacts of urbanisation on mental health, whereas others highlighted the beneficial impacts of natural areas. Only limited research is available on this topic in Belgium. In the NAMED project we therefore study how the built and non-built environment impact the mental wellbeing of Brussels’ citizens.
Project description
The NAMED project focuses on the Brussels-Capital Region and aims to:
- assess the relationships between the (non-)built environments, air, noise pollution and mental health
- gain knowledge on the underlying mechanisms.
To achieve these goals, we combine 2 complementary approaches:
- on the one hand, we conduct an epidemiological study based on the coupling between data from the national health interview surveys and indicators describing each participant’s place of residence in terms of urban characteristics, air quality and noise. These indicators are developed specifically for the project and rely on geographical information and monitoring systems. This step permits to explore the associations between mental health and living environment. It also allows us to investigate the role of potential intermediary variables, such as the impact of socioeconomic factors, social support, leisure activities, etc.
- in parallel, we interview inhabitants (semi-structured interviews organised in their neighbourhood) about their perceptions and preferences regarding their living environment in relation to mental health. We also consult local stakeholders and experts through focus groups and extended peer evaluation.
These approaches involve experts in medical, epidemiological, geographical and social sciences and enables us to get a comprehensive overview of the topic. Conclusions will permit to inform decision makers and suggest concrete, evidence-based actions significant for public health, urban planning and management of nature.
Results
1. Mental health benefits from a social cohesive environment
The quantitative part showed that social support was an important determinant to mental health. In the qualitative part, participants confirmed the importance of good community ties for mental well-being. Some experienced great mutual support among neighbors which contributed to feeling secure in their neighborhood. Several participants mentioned the importance of having a sense of community with the relating outcomes of feeling part of a bigger community, not being isolated, mutual understanding and support.
2. Mental health benefits from a physically active environment
The quantitative part showed that physical activity was an important determinant to mental health. In the qualitative part, the interviews learned us that several participants needed physical activity to cope with negative feelings, to break their routine, and to feel healthy. Additionally, having the possibility to walk to neighborhood services supported a sense of security and improved neighborhood satisfaction.
3. Citizens are unequally affected by negative and positive environmental factors
The quantitative part showed that following groups are more exposed to air pollution, have less access to green spaces and are more exposed to noise pollution from multiple sources in their residential environment: people with a lower level of education, people with lower income, and people with a non-European country of birth. The qualitative part highlighted that some neighborhoods suffered greatly from neighborhood socio-economic deprivation, referring to the low physical position (vandalism, graffiti, loitering, litter, abandoned buildings) and low social position (substance use, loitering, dealing, crime, harassment, violence) and economical position (income, education level) of a neighborhood. In these neighborhoods, the continued presence of clandestine garbage dumps and vandalism caused negative feelings of frustration and despair. Regarding neighborhood security, participants referred to problems with loitering, vandalism, squatters, drugs dealing, substance use, and burglary. Also annoyance to noise from the traffic and people was mentioned to contribute to mental distress. Finally, participants living in more deprived neighborhoods mentioned to experience a great lack of nearby nature and recreational space.
4. Motorized traffic harms mental health
The data-driven part found a significant association between traffic-related air pollution and depressive disorders. In the qualitative part some participants expressed their concerns about traffic-related air pollution and therefore avoided busy streets. A lack of traffic safety was linked to feeling insecure while cycling or walking, but also to annoyance and confusion by the lack of good infrastructure. Especially, for people with children the lack of traffic safety was a burden to their mental well-being. Traffic noise affected mental well-being as it caused annoyance, impeded people to relax and disturbed bird sounds. The interviews clarified the importance of having a good balance between liveliness and calmness in a neighborhood, and to have nearby opportunities to find peace.
5. Nature strengthens mental health
The quantitative part could not demonstrate a significant positive effect of residential greenness on mental health based on the available data. On one hand, this lack of association may be related to methodological issues. On the other hand, Brussels-Capital Region is a city with very high environmental inequalities: economic status and green space availability are highly correlated. This makes it difficult to disentangle the impact of socio-economic factors and green spaces on mental health. However, the qualitative part strongly underlines the importance of nature to mental health. The most common response of the participants regarding green spaces was the feeling of escaping from the city hustle and to take a break from daily routines. Other responses to mental well-being in relation to green spaces involved: connecting to nature, exploring nature, getting fresh air, relaxing, rebuilding energy. Natural environments were also visited for the self-regulation of negative feelings. Some participants mentioned the importance of green spaces to maintain their physical and social activities, and as such contributing to mental well-being.
6. Urban mental health is complex
The quantitative part showed the importance of both personal determinants, such as socio-economic status and physical activity, social determinants, such as the quality of social support, and physical determinants, such as poor indoor housing quality and air quality to mental health. The qualitative part highlighted the broad range of factors (social, physical, personal, institutional) and interactions among those factors that better explain how Brussels’ inhabitants experience their neighborhood in relation to their mental health. For example, social diversity in the neighborhood contributed positively to mental health as some participants experienced more tolerance and solidarity among neighbors and an ease to connect. Among the physical factors, neighborhood services, such as public transport, commercial, and welfare services were mentioned to contribute positively to mental health as these services met individual needs and offered a certain comfort and sense of security. Several physical neighborhood factors such as parks, local services and citizen-based initiatives were mentioned to support neighbor ties and strengthen a sense of community. Difficult personal life events were shown to enforce restorative needs to cope with negative feelings and sometimes motivated visits to specific places. Regarding the institutional factors, tailoring policies to neighborhood contexts through participatory planning and responsiveness to local demands were mentioned to be important to improve neighborhood satisfaction.
