Prevention & lipidsCohort study
Interplay between mental health, greenness, and environmental factors in cardiovascular mortality: insights from AIR-MIND
- Nationwide registry-based cohort study
- negative binomial regression
- interaction terms and stratified analyses
Authors' conclusion
The findings indicate multidimensional interactions between AP exposure, mental health, and SES conditions in shaping mortality risk. Greater access to mental health services modified the effects of environmental exposures, attenuating the associated risk. Socioeconomic status and greenness exposure might be associated with heterogeneous modifying effects, but seem predominantly to reduce risk.
Study context
- Population
- Nationwide population, individual health data, 2011–2020400 million person-years
- Exposure
- Long-term exposure to air pollution, greenness and mental health service use vs lower exposure
- Outcome
- CVD mortality associated with long-term air pollution exposure (RR per 10 µg/m³ annual increase in PM₂.₅, NO₂, CO; per 1 µg/m³ SO₂)
Main finding
As reported in the abstract
Each row per its own increment, as printed
Observational data: associations, not effects.
Further findings
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| CVD mortality per 5% increase in greenness — Forestation index | 0.967 (0.955–0.979) | P < 0.001 | |
| CVD mortality per 5% increase in greenness — Recreational green spaces | 0.967 (0.952–0.982) | P < 0.001 | |
| 0.512Relative risk (log scale) |
Mental services use with ambient pollutant exposure
- Higher rates of mental services (RR range)
- 1.003-1.053; all P < 0.05
Effect modification of air pollution (AP)–mortality association
- Weaker AP–mortality association with increasing psychiatric hospitalizations and depression-related services
- Greenness and socioeconomic status (SES): mixed modifying effect by pollutant, generally risk reduction
Original publication
Summarised from the published abstract; every number is checked against it