Association between greenness at workplaces and outpatient visits and health expenditures for mental disorders

Background

While the mental health benefits of residential green space are well-documented, evidence on workplace green space remains limited.

Methods

This study assessed the association between workplace green space and both outpatient visits and health expenditures related to mental disorders. We collected 127,535 daily outpatient visits and health expenditures records for mental disorders from 2012 to 2014, covering 9,489 workplaces in Guangzhou, China. Greenness at workplaces was measured using the Normalized Difference Vegetation Index (NDVI) from three buffers (500 m, 1000 m, and 1500 m) around each patient's workplace. Daily outpatient visits and health expenditures records were aggregated at monthly and quarterly scales, along with contemporaneous mean NDVI values, and a two-stage time-series approach using generalized linear models (GLMs) was employed, and relative risks (RRs) were calculated to estimate associations.

Results

Workplace green space was associated with a lower risk of total outpatient visits and reduced health expenditures for mental disorders at both monthly and quarterly scales. Significant associations were observed between greenness and reduced quarterly outpatient visits and both monthly and quarterly health expenditures for schizophrenia. Greenness was also associated with lower risks of monthly outpatient visits for mood disorders.

Conclusions

Workplace greenness is associated with reduced outpatient visits and lower healthcare expenditures for mental disorders. Further research is warranted to incorporate multi-dimensional green space metrics, as well as individual-level demographic and work-related stress factors, to validate these findings.