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Cities 109 (2021) 103039

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Cities
journal homepage: www.elsevier.com/locate/cities

Understanding the relationship between neighbourhood green space and


mental wellbeing: A case study of Beijing, China
Bo Qin a, Wei Zhu b, *, Jiejing Wang a, Yanyan Peng a
a
Department of Urban Planning and Management, School of Public Administration and Policy, Renmin University of China, Beijing, China
b
Urban Construction School, Beijing City University, Beijing, China

A R T I C L E I N F O A B S T R A C T

Keywords: The past few decades have seen increasing academic interest in the association between green space and mental
Green space health. However, the existing studies have largely been undertaken in developed countries, while less attention
Mental health has been paid to rapidly urbanizing countries. Based on a 2015 survey of 701 residents in 16 typical neigh­
Social cohesion
bourhoods of Beijing, this study aims to partially fill this gap by investigating the complex relationship between
Physical activity
Mediation analysis
neighbourhood green space and residents’ mental health in urban China. We developed multilevel regression
Beijing models to test the associations among green space, social cohesion, physical activity, and mental health. The
findings reveal the positive association between green space and mental health in a high-density and compact
urban environment and suggest that physical activity and social cohesion might play a mediating role in the
association. The study provides an empirical evidence for the potential benefit of green space on mental health
from an Asian perspective and sheds light on the ways to promote public mental health through effective urban
planning and design.

1. Introduction community from reaching conclusive agreement regarding green


space’s cause-effect relationship to mental health. This study, based on a
In recent years, planning for health has been an increasingly survey in Beijing, aims to partially fill the gap by providing empirical
important subject in urban studies and the planning profession (Boarnet, evidence on the association between neighbourhood green space and
2006; Corburn, 2009; Handy, Boarnet, Ewing, & Killingsworth, 2002; residents’ mental health in urban China.
Sarkar, Webster, & Gallacher, 2016). Green space has been suggested as Conceptually, urban green spaces are associated with mental health
a key feature of the urban built environment that relates to positive by their direct and indirect influences. Research has demonstrated that
mental health (Kardan et al., 2015; Pfeiffer & Cloutier, 2016; White, exposure to green space has a variety of direct benefits, such as a
Alcock, Wheeler, & Depledge, 2013). However it has been difficult to reduction of negative emotions, attention span, restorative experience,
identify the relationship between green space and mental health as and speeding-up of the recovery from stress and attention fatigue
causality, because the underlying mechanisms have neither been fully (Bowler, Buyung-Ali, Knight, & Pullin, 2010; Hartig, Evans, Jamner,
established yet nor rigorously examined and supported by consistent Davis, & Gärling, 2003; Kaplan, 1995; Ulrich, 1984). Green space could
evidence and longitudinal studies (Astell-Burt, Mitchell, & Hartig, 2014; facilitate physical activities, including walking, running, cycling, and
De Vries, Van Dillen, Groenewegen, & Spreeuwenberg, 2013; Gubbels, other sports, which have psychological benefits (De Vries et al., 2013;
Kremers, & Droomers, 2016). It is of note that the inconsistencies of Koohsari et al., 2015). Subsequently, encouraging physical activities is
empirical evidence could be attributed to the differences in research considered a mediating role in the association between green space and
methodology and spatial context of the study areas (Lachowycz & Jones, mental health (Richardson, Pearce, Mitchell, & Kingham, 2013;
2013; Lee & Maheswaran, 2011; Noordzij, Beenackers, Oude Groeniger, Sugiyama, Leslie, Giles-Corti, & Owen, 2008). Green space could also
& Van Lenthe, 2019). Most of the existing studies, nevertheless, were promote social interactions by providing meeting places for group-based
conducted in developed countries, and less scholarly attention has been activities, such as conversations, group exercise, picnics, et al. (Maas,
paid to rapidly urbanizing countries, which impedes the academic Van Dillen, Verheij, & Groenewegen, 2009). Better social relationships

* Corresponding author.
E-mail addresses: qinbo@ruc.edu.cn (B. Qin), zhuwei2016@ruc.edu.cn (W. Zhu), wangjiejing@ruc.edu.cn (J. Wang), pengyanyan2011@ruc.edu.cn (Y. Peng).

https://doi.org/10.1016/j.cities.2020.103039
Received 17 March 2019; Received in revised form 5 November 2020; Accepted 15 November 2020
Available online 2 December 2020
0264-2751/© 2020 Elsevier Ltd. All rights reserved.
B. Qin et al. Cities 109 (2021) 103039

and affiliations are associated with a variety of positive health outcomes systematic review of 50 empirical studies across different spatial con­
(Berkman, Glass, Brissette, & Seeman, 2000; Hawe & Shiell, 2000), and texts illustrated that only 40% found significant relationships between
social cohesion seems to mediate between neighbourhood green space physical activity levels and green spaces (Lachowycz & Jones, 2011). A
and residents’ mental health (Brown, Perkins, & Brown, 2003; Dong & recent study confirmed that associations between green space and better
Qin, 2017; Ruijsbroek et al., 2017). general and mental health but found no association between green space
However, the existing empirical evidence on the mediating role of and physical activity and social contacts (Triguero-Mas et al., 2015).
physical activity and social cohesion in the association between green While an empirical study from the Netherlands provided strong evi­
space and mental health are far from conclusive. For example, a dence to support the mediating role of social cohesion between green

Fig. 1. Distribution and size of the 16 typical neighbourhoods in Beijing, China.

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B. Qin et al. Cities 109 (2021) 103039

space and mental health (Maas et al., 2009), a study from Australia neighbourhood. For each cluster, we selected individuals by adopting
demonstrated that only closer interactions, rather than simple social convenience and quota sampling. The respondents were invited to
contacts, are meaningful and impactful (Sugiyama et al., 2008). participate in a person-to-person survey at their home or any convenient
In summary, there seems to be an increasing scholarly interest in the place within the neighbourhoods. The surveys in all the neighbourhoods
potential benefit of green space on mental health, but empirical studies were collected both on working days and at the weekend from 12 noon
have yielded inconsistent and mixed results. This is probably because to 8 pm. A gift of roughly USD 15 was given to respondents who
the association between green space and mental health is complicated completed the questionnaires, and we received 701 valid observations
and is affected by a variety of context-specific factors. Evidence from from 801 surveys. The questions in our survey included basic de­
developed countries may not be applicable to other countries, and mographic and socioeconomic information of the respondents and their
empirical studies conducted in developing counties, where urban built households. The respondents were asked to answer a set of standardized
environments are different from those in developed counties, are thus scales regarding their mental health, interpersonal relationships with
necessary to help reach a consensus on the association between green other residents within their neighbourhoods, and their physical exercise
space and mental health. Cities in China, for instance, often have higher activities during the past week. We compared the demographic char­
populations and building densities and more compact urban form than acteristics of our survey sample with the Beijing 1% population sample
their counterparts in U.S. and European countries (Chen, Jia, & Lau, survey conducted in 2015 by the Beijing Statistical Bureau. Table 1 il­
2008; Liu et al., 2019), which offer a unique Asian perspective to verify lustrates that the demographic structure of our sample is generally
the association and to investigate the mediating role of physical activity consistent with the 1% population sample in Beijing. The share of re­
and social cohesion. spondents aged 60–74 was about 10 percentage points higher than the
By analysing a survey of 701 residents in 16 neighbourhoods of 1% population sample, and the levels of educational attainment in our
Beijing, China, this paper provides a solid evidence to understand the sample were higher as well. This is most likely because our selected
association between green space and mental health. We hypothesized neighbourhoods are in the central city, where the average age and
that neighbourhood green space has a positive association with resi­ educational attainment are higher than those for Beijing as a whole.
dents’ mental health, and the underlying mechanisms can be concep­
tualized as both direct and indirect. Indirect association between green 2.2. Variables
space and mental health occur in two main ways: first, green space helps
build better social cohesion that are also positively associated with 2.2.1. Measuring mental health
mental health; and second, green space promotes physical activity, There is a range of ways to define and measure mental health. In this
which in turn is positively associated with improved mental health. To study, following Easterlin (2003) and Pfeiffer and Cloutier (2016), we
test our hypotheses, we developed multilevel regression models to adopted a broad definition of mental health, namely, a state of subjec­
examine whether the association between neighbourhood green space tive wellbeing that includes happiness and life satisfaction. Mental
and residents’ mental health is statistically significant and whether the health, so defined, is not simply a state without mental illness. According
association is mediated by social cohesion and physical activity, after to Bond et al. (2012), positive mental health denotes a state of happiness
controlling the factors at both neighbourhood level, e.g. housing prices, and satisfaction with life, consisting of two dimensions: how we feel
floor area ratio, and individual level such as age, gender, education (hedonic wellbeing) and how we function (eudaimonic wellbeing).
attainment, income, etc. In the survey questionnaire, we provided six statements adopted
from the widely used short 7-item version of the Warwick-Edinburgh
2. Data and methodology Mental Wellbeing Scale (SWEMWBS) to measure residents’ subjective
mental health. SWEMWBS is more responsive to the multidimensional
2.1. Data collection and subjective nature of mental wellbeing than other mental wellbeing
assessment scales, such as the Kessler Psychological Distress Scale, the
Our primary data were derived from a survey conducted in 2015 in Brief Psychiatric Rating Scale, and the Cornell Medical Index (Tennant
the central city of Beijing. By consulting senior urban planners of the
Beijing Municipal Institute of City Planning and Design, we identified 16 Table 1
typical neighbourhoods according to their size, population, land use Comparison of study sample demographic structure and the Beijing 1% Popu­
density, housing pattern, and distance from public transit and the city lation Sample Survey.
centre (Fig. 1). The 16 neighbourhoods can be categorised according to The study sample Beijing 1% population sample
their diverse housing types, including traditional neighbourhoods (%) survey (2015)a (%)
(hutong), commercial apartment neighbourhoods, public housing Total Urban
neighbourhoods, and work unit (danwei) neighbourhoods. In general population population
traditional neighbourhoods contain one-story buildings developed
Gender
before 1949; work unit neighbourhoods consist of buildings of up to six Male 53 51 51
stories developed from the 1950s to the mid-1990s; commercial apart­ Female 47 49 49
ment neighbourhoods have been developed since the housing reform in Age
China, from the mid-1990s onwards; and public housing neighbour­ <30 13 20 20
hoods are made of high rise buildings for low/middle-income families 30–44 34 31 32
(Qin & Tian, 2014). Two of the sixteen neighbourhoods are traditional 45–59 18 27 26
60–74 28 16 16
neighbourhoods within the second Ring road, eleven are located be­
>75 7 6 6
tween the second and fifth Ring roads, and three are in the suburban
region (outside the fifth Ring road). Educational attainment
Junior high school and
We invited adult residents (≥18 years old) in the neighbourhoods to below
11 35 28
complete our questionnaires, but random sampling was not feasible Senior high school 23 20 20
because we did not have a full list of home addresses in Beijing to College 55 37 43
construct a perfect sampling frame. To ensure as much representative­ Graduate and above 11 7 9
ness as possible, we adopted a combination of cluster random sampling, Notes:
convenience sampling, and quota sampling. The population was first a
The Beijing 1% Population Sample Survey is conducted by the Beijing Sta­
subdivided into several clusters based on the buildings in the tistical Bureau every ten years.

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B. Qin et al. Cities 109 (2021) 103039

et al., 2007). In the pilot survey, we found that not all the statements in 2015. High spatial resolution helps distinguish neighbourhood green
the SWEMWBS could be easily understood after being translated into space from other land cover (Wang, Wang, & Wu, 2016).
Chinese. Most of the respondents responded that they were confused by We measured the NDVI for each neighbourhood with a 1.5 km
the fourth item in the SWEMWBS, ‘I have been dealing with problems Euclidean buffer (Table 5). In western cities, 1.0 km is a commonly re­
well’. Therefore, we selected six statements that were appropriate and ported distance that people are willing to walk to access various re­
easy to understand and cover both hedonic and eudaimonic aspects of sources (Lee & Moudon, 2006; Paquet et al., 2013), but this willing
mental health (Table 2). We formed a five-point Likert scale for each walking distance may be longer for residents living in Chinese cities that
statement: none of the time, rarely, some of the time, often, and all the usually have large-scale street blocks known as the work-unit (Danwei)
time, which scored from 1 to 5, respectively. The respondents were (Chai, 2014). We chose 1.5 km because it is equivalent to an estimated
asked to choose one that best describes their psychological feelings in walking time of 15 min at an average speed of 5–6 km/h. To provide
the past two weeks. accessible public services and facilities, such as parks, hospitals, stores,
We extracted the latent factor of mental health based on the six for urban residents. Chinese cities are also introducing the idea of a
statements through a factor analysis (FA), and the principal component ‘community living circle’ into their plans by placing facilities within 15-
method was used to estimate the FA parameters (Table 2); and a higher minute walking time around residential neighbourhoods (Xi, Wu,
score of the latent factor reflects better mental health. The Cronbach’s α Zhang, & Zheng, 2017).
test, with a result of 0.806 implies a high internal consistency among the
six statements, and the extracted factor explains 51.1% of the total 2.2.3. Social cohesion
variance. The overall KMO test result of 0.787 indicates that the six Following Maas et al. (2009), we construct the variable for social
questions are uni-dimensional, and the variable of mental health is cohesion at the individual level. Three aspects of neighbourhood social
defined as the standardized score of the extracted latent factor. cohesion: acquaintanceship, getting along with each other, and will­
ingness to help (Sampson & Graif, 2009). Subsequently, three questions
2.2.2. Neighbourhood green space were asked in the survey: 1) I know most of my neighbours; 2) Residents get
There are two commonly used methods to define green space along in my neighbourhood; and 3) Residents in my neighbourhood are
(Nieuwenhuijsen, Khreis, Triguero-Mas, Gascon, & Dadvand, 2017; willing to help their neighbours. The answers were ‘strongly disagree’,
Taylor & Hochuli, 2017). The first uses green space to refer to an ‘somewhat disagree’, ‘somewhat agree’, and ‘strongly agree’, which
overarching concept of nature, which could be an antonym of urbani­ scored − 1, 0, 1, and 2, respectively. We constructed a latent factor that
zation. The second relates green space to vegetated open space, referring indicates a respondent’s subjective evaluation of the social cohesion of
to the area covered by vegetation in the city. In this study, following their neighbourhood through FA. A higher score of the latent factor
relevant studies (Leung et al., 2019; Lo & Jim, 2012), we defined green indicates better social environments, and it can explain 74.7% of the
space as urban land that is partly or completely covered with grass, total variance of the three statements. The Cronbach’s α (0.829) and
trees, shrubs, or other vegetation, including parks, yards, sparsely- KMO (0.676) tests indicated that the three scale items have high internal
landscaped streets, and gardens. consistencies and are uni-dimensional (Table 3).
Following McEachan et al. (2018) and Markevych et al. (2014), we
used an integrated and effective indicator, namely, the Normalized 2.2.4. Physical activity
Difference Vegetation Index (NDVI), to measure the green spaces both in We measured the respondents’ participation in physical activity in
these neighbourhoods and nearby. The NDVI is a commonly used indi­ the past week by using the Chinese version of the International Physical
cator that reflects not only the fractional vegetation cover, but the plant Activity Questionnaire short form (IPAQ-C). This scale has been
productivity, growth vigour, and biomass of vegetation within a range of demonstrated to be valid and reliable in assessing physical activity
neighbourhoods (Markevych et al., 2014). The NDVI is derived from the participation among Chinese people (Deng et al., 2008). In our survey,
differential surface reflectance in the red (R), and infrared (IR) bands we asked the respondents to provide detailed information about the
from a multispectral raster dataset (Weier & Herring, 2000), and the frequency and duration of five outdoor physical activities lasting at least
differential is measured using the following formula: 10 min in the last week: walking, jogging, ball games, cycling, and
dance. The IPAQ-C data were classified and converted to metabolic
NDVI = (IR − R)/(IR + R)
equivalent scores (MET⋅min⋅wk.− 1) for each type of physical activity.
The values of the NDVI are between − 1 and 1, with negative values According to the procedures recommended by the International
representing clouds, water, and snow, and values near zero mainly Consensus Group for the Development of the IPAQ, the MET scores for
indicating rock and bare soil. Positive values indicate green vegetation, low-intensity activities (walking), moderate-intensity activities
and higher values indicate higher densities of green vegetation, (jogging, cycling, dance), and vigorous activities (ball games) were 3.3,
implying that residents may have higher possibilities of exposure to
green space. In our study, the NDVI was derived from GF-2 satellite
images at a 0.8 m spatial resolution that were taken during October Table 3
Extracting social cohesion variable through FA.
Extracting the latent factor of social cohesion
Table 2
Statements Loading
Extracting the latent factor of mental health through FA.
1. I know most of my neighbours 0.806
Extracting the latent factor of mental health
2. Residents get along in my neighbourhood 0.912
Statements Loading 3. Residents in my neighbourhood are willing to help their neighbours 0.871
Eigenvalue of the principal component 2.241
1. I have been feeling optimistic about the future 0.693
Explained variance 0.747
2. I have been feeling useful 0.797
Cronbach’s α 0.829
3. I have been feeling relaxed 0.671
Overall KMO 0.676
4. I’ve been thinking clearly 0.619
Number of observations 701
5. I’ve been feeling close to other people 0.706
6. I’ve been able to make up my own mind about things 0.784
Eigenvalue of the principal component 3.063
Explained variance 0.511 4.0 and 8.0, respectively. The value for the level of each physical activity
Cronbach’s α 0.806 is the product of the MET score and the duration (min) of the activity and
Overall KMO 0.787 its frequency within the past week, which was expressed as: MET score

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× minutes of activity × events per week.1 dents’ mental health. Two indicators, namely Floor Area Ratio (FAR)
and mixed land use, were included to capture the observed physical
2.2.5. Demographic and socioeconomic characteristics of the respondents form of these neighbourhoods. FAR is the ratio of the floor space on all
Empirical studies have demonstrated that demographic and socio­ floors to the building lot and is a standard measure of density. The FAR
economic characteristics are important in determining people’s mental values for the 16 neighbourhoods range from 0.66 to 3.06, suggesting a
health. Gender, age, educational attainment, health status, family type, great variation of building density among the studied neighbourhoods.
income, and housing conditions are all important (Dolan, Peasgood, & Mixed land use is another indicator of the neighbourhood environment.
White, 2008; Easterlin, 2003). In this study, we controlled for individual We measured mixed land use with the Simpson index, calculated by
and family factors suggested by the existing literature, and the using the proportion of floor areas of commercial, residential, and office
descriptive statistics of these variables are illustrated in Tables 1 and 4. buildings within the boundary of the neighbourhood. The Simpson
Approximately 53.1% of the respondents were male, and the average index values range between 0 and 1, and a higher value implies a higher
age of the respondents was 48. They generally had a high level of degree of mixed land use in the neighbourhood. We also included the
educational attainment, and nearly 66% held at least a college degree. average house prices of the 16 neighbourhoods in 2015 as a proxy for
In terms of the self-reported health status, about 38% of the re­ multiple factors related to the house price, such as distance to the city
spondents reported their health status as good; 31% as very good; and centre, quality of buildings, and public services. Finally, a dummy var­
31% as very poor, poor, or fair. Based on the respondents’ marital status iable was included to control for the influences of the neighbourhood’s
and household arrangement, we defined four family types: single, physical environment deterioration and this value equalled 1 if the
couple, parent(s) with child(ren), and grandparent householder. neighbourhood was built after the year 2000. We choose 2000, not only
Approximately 11% of the respondents were single. Couple respondents, because eight neighbourhoods (50%) in our sample were built in/after
childless couples not living together with their parents or grandparents, 2000, but also because this year was a turning point in the housing
accounted for around 30% of the sample. One-third of the respondents market, and when Beijing property prices began to skyrocket (Chen,
lived in families of parent(s) with child (ren), as they had at least one Guo, & &Wu, Y., 2011). Table 5 reports these built environment vari­
child and were not living with their parents. Grandparent(s) house­ ables for the 16 neighbourhoods in the study.
holder respondents were families headed by grandparents, including
three-generation families (grandparents plus parents with child[ren]) 2.3. Model and hypotheses
and a very few two-generation families (grandparents plus grandchild
[ren]). All the respondents were classified into five income groups. As the 701 observations were clustered in 16 neighbourhoods, we
Approximately 40% of the respondents have incomes between RMB used multilevel regression models to explore the association between
3000 yuan and 6000 yuan (roughly USD 436 to 872) per month, and 7% neighbourhood green space and residents’ mental health. Multilevel
of the respondents were in the upper-income group (over RMB 20000 regression models can account for the shared variance in clustered
yuan, USD 2906, per month). datasets (Snijders & Bosker, 1999), and the models were specifically
designed to address the potential clustering and non-independence be­
2.2.6. Neighbourhood building environment tween neighbours in the same neighbourhoods because they allow us to
In addition to the NDVI, we introduced several neighbourhood-level test the contextual effects of neighbourhood-level factors as well as
variables to control for the influences of neighbourhood on the resi­ individual-level characteristics on mental health. The two-level regres­
sion with random coefficients is specified as follows.
The level-1 model at the individual level is:
Table 4
Descriptive variables at the individual level.
Table 5
Frequency Percent (%) The built environment variables for the 16 neighbourhoods.
General health status
D Built- Housing FAR Land use Average NDVI
Very good 217 31.0 up type mix house price within
Good 266 37.9 year (Simpson (1000 USD/ 1.5 km
Fair, poor or very poor 218 31.1 index) per sq.m.) buffer
Family type 01 1950s Traditional 1.23 0.32 9.08 0.19
Single 76 10.8 02 2000s Public 1.95 0.18 9.45 0.24
Couple 208 29.7 03 2000s Commodity 3.06 0.23 9.38 0.28
Parent(s) with child(ren) 231 33.3 04 2000s Work unit 2.65 0.00 12.52 0.25
Grandparent(s) householder 186 26.5 05 2000s Commodity 2.16 0.38 10.25 0.24
Income (per month, RMB yuan) 06 1990s Work unit 2.12 0.68 11.04 0.25
Less than 3000 (USD 436) 144 20.5 07 1990s Work unit 1.87 0.26 10.78 0.28
3000–6000 (USD 872) 280 39.9 08 1980s Work unit 1.04 0.10 10.87 0.27
6000–10,000 (USD 1453) 135 19.3 09 1970s Commodity 2.1 0.30 5.88 0.31
10,000–20,000 (USD 2906) 93 13.3 10 1980s Work unit 1.71 0.32 6.96 0.25
20,000 and over 49 7.0 11 2000s Commodity 3.04 0.08 10.37 0.28
12 1990s Commodity 2.65 0.34 5.62 0.26
13 2000s Commodity 2.40 0.11 6.30 0.26
Min Max Mean Std. dev. 14 2000s Public 1.6 0.17 3.38 0.24
15 2010s Commodity 1.93 0.26 2.82 0.33
Mental health − 3.6 1.7 0 1
16 1990s Traditional 0.66 0.00 2.21 0.29
Social cohesion − 3.4 1.4 0 1
Physical activity 0 5544 884.4 675.8
Age 18 89 48.4 17.2 Descriptive statistics of the built environment variables
Home size (m2 per person) 6.7 72 31.4 17.4
Observation Min Max Mean Std. dev.

NDVI 16 0.19 0.33 0.27 0.03


Floor area ratio 16 0.66 3.06 1.96 0.67
Mixed land use 16 0 0.38 0.23 0.12
Average house price 16 2.21 12.52 7.64 3.03
1 After 2000 16 0 1 0.5 0.5
For details of the calculation, please see www.ipaq.ki.se.

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Yij = β0j + β1j X1ij + β2j X2ij + … + βPj XPij (1) models.

where, Yij is the mental health of respondent i in neighbourhood j, and 3. Results


β0j is the intercept. X1ij, X2ij, …XPij denote individual-level characteristics
for respondent i in neighbourhood j, and β1j, β2j…βPj represent the cor­ We first constructed a null model without including any independent
responding coefficients. At level-2, a set of neighbourhood-level vari­ variables. This model decomposes the total variance of the dependent
ables, W1j, W2j, …, WQj, were included to examine the contextual effects variable (mental health) into individual and neighbourhood levels. The
of the neighbourhood’s characteristics on residential mental health. As results demonstrated that the individual level variance is 0.868 and the
we are mainly interested in the association between neighbourhood neighbourhood level variance is 0.142. The intra-neighbourhood cor­
characteristics and residential mental health, only the level-1 intercept relation coefficient is 0.141, indicating that 14.1% of the variance in
(β0j) was allowed to vary across neighbourhoods, which is known as the residents’ mental health can be explained by the difference at the
random-intercept model. Thus, the level-2 models were written in the neighbourhood level. The presence of a cluster effect further legitimizes
following format: the use of the multilevel regression modelling approach in this study
(Table 6).
β0j = γ00 + γ 01 W1j + γ02 W2j + … + γ0Q WQj + u0j (2)
In the second model, we added all the individual-level variables to
model 1. The results suggested that women and older people are asso­
where, γ 00 is the average intercept representing the overall mean of the
ciated with better mental health, and a higher level of education has a
dependent variable Yij. The coefficients, γ01, γ02, …, γ0Q, denote the main
positive association with mental health, but the association was statis­
effects of neighbourhood-level variables and W1j, W2j, …, WQj, denote
tically significant only for those who hold postgraduate degrees. A
the mental health of residents. For the random effects, u0j captures the
person’s mental health is positively related to their self-perceived gen­
between-neighbourhood variability in the average intercept and as­
eral health status. Those who reported good or very good health status
sumes that u0j follows normal distributions.
have better mental health than those who reported fair or poor health
We applied the multilevel mediational modelling technique pro­
status. In terms of family type, the results suggest that the respondents
posed by Krull and MacKinnon (2001) for the mediation analysis. To
living in families with grandparents tend to have better mental health.
determine the extent to which neighbourhood social environment and
There was no evidence that housing conditions (home size per person)
physical activity mediate the cross-level effects of neighbourhood green
are associated with mental health. The results also indicated that income
space on residents’ mental health, we constructed a 2-1-1 cross-level
is positively associated with mental health, and those whose monthly
mediation test, where the explanatory variable (the NDVI) at the
income is higher than RMB 20000 yuan (USD 2906) have significantly
neighbourhood level and the mediators (social environment and phys­
better mental health. Our results of the relationships between mental
ical activity) and dependent variable (mental health) at the individual
health and individual characteristics are generally consistent with the
level were included. Fig. 2 presents our analytical framework and hy­
findings of prior studies, suggesting that the relationships are robust and
potheses. First, we expected neighbourhood green space to have a pos­
independent of neighbourhood physical environment and social context
itive association with the mental health of residents (Path A). Second,
(Coldwell & Evans, 2018).
neighbourhood green space may be associated with mental health by
In model 3, we added the neighbourhood-level variables: FAR,
improving the residents’ social cohesion (path B and C), and/or by
average housing price, mixed land use, a dummy of construction year,
encouraging the residents’ physical activity (path D and E). As such,
and the NDVI. The five variables explain about one-third of the variance
social cohesion and physical activity were proposed as two mediators
at the neighbourhood level. The results demonstrated that among the
between green space and mental health. Several variables measuring
five neighbourhood-level variables, only the NDVI demonstrates a sig­
individual and family characteristics and neighbourhood building en­
nificant (at the 10% level) association with residents’ mental health. The
vironments were included to control for their influences on mental
coefficient of the NDVI was 4.725, which suggests that a major change in
health. Control variables at both the individual-level and
the NDVI of the 1.5 km buffer of a neighbourhood could be associated
neighbourhood-level were also included in our multilevel regression
with its residents’ mental health substantially. For example, compared

Fig. 2. Analytical framework and hypotheses of this study.

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B. Qin et al. Cities 109 (2021) 103039

Table 6 activity in the association between green space and mental health in
Modelling the associations between individual and neighbourhood variables and models 4–7 (Table 7). We examined the paths B and C in Fig. 2 firstly.
mental health. Social cohesion was used as the dependent variable in model 4 and
Variables Model 1 Model 2 Model 3 included as a predictor of mental health in model 5. All the other vari­
Mental Mental health Mental health
ables are the same as model 3. The variable of NDVI (3.023) was sta­
health tistically significant (at 10% level) in model 4, which suggests a positive
association between green space and social cohesion (path B). In model
Constant − 0.0445 − 1.319*** − 2.562***
(0.105) (0.325) (0.911) 5 the variable of social cohesion was still positive and significant (at 10%
level), but NDVI became insignificant (path C). The findings lend sup­
Individual-level variables
Gender (male = 1) − 0.157* − 0.147*
port to the hypotheses that social cohesion may mediate the association
(0.085) (0.0841) between green space and mental health.
Age 0.009*** 0.0091*** We then examined the paths D and E in Fig. 2, i.e. whether physical
(0.002) (0.0024) activity plays a mediating role. Physical activity was employed as the
Educational attainment
dependent variable in model 6 and independent variable in model 7. We
Junior high school and below (ref.)
Senior high school 0.124 (0.122) 0.122 (0.122) found a significant and positive association between NDVI and physical
College 0.067 (0.103) 0.0513 (0.105) activity in model 6 (path D). In model 7 the variable of physical activity
Graduate and above 0.302** (0.151) 0.288* (0.155) was still statistically significant (at 10% level), but NDVI became
General health status insignificant (path E). The findings also suggest that physical activity
Fair, poor, or very poor (ref.)
could mediate the association between green space and mental health.
Good 0.378*** 0.383***
(0.104) (0.103) In this study, neighbourhood green space may be associated with mental
Very good 0.650*** 0.658*** health in part by improving the residents’ social cohesion, and in part,
(0.134) (0.135) by encouraging residents’ physical activity.
Family type
Single
Couple 0.156 (0.195) 0.144 (0.198) 4. Discussion
Parent(s) with child 0.192 (0.188) 0.177 (0.192)
(ren) We developed multilevel regression models to analyse mental health
Grandparent(s) 0.459** (0.190) 0.430** (0.192) of 701 residents in 16 typical neighbourhoods in Beijing, China. Our
householder
Home size (m2 per 0.00314 0.00204
modelling analyses show that the residents’ mental health is associated
person) (0.00326) (0.00356) with their self-reported health status and demographic and socioeco­
Monthly Income (RMB yuan) nomic characteristics, including gender, age, educational attainment,
Less than 3000 (ref.) income, and family type. These associations among the individual
3001–6000 0.119 (0.119) 0.115 (0.119)
characteristics and mental health are consistent with most findings of
6001–10,000 0.205 (0.133) 0.201 (0.137)
10,001–20,000 0.196 (0.140) 0.185 (0.141) prior studies (Dolan et al., 2008; Dong & Qin, 2017). Additionally, our
20,001 and over 0.398** (0.154) 0.390** (0.155) modelling results demonstrate the substantial variation in mental health
Neighbourhood-level variables
between neighbourhoods. Fourteen percent of the variance in residents’
Floor area ratio 0.141 (0.178) mental health can be attributed to neighbourhood-level factors,
Average house price − 0.0190 including floor area ratio, average housing price, mixed land use, the
(0.0329) construction year, and NDVI.
Mixed land use − 0.0845 (0.767)
It is of note that among the five neighbourhood-level factors, our
After 2000 (yes = 1) − 0.127 (0.165)
NDVI 4.725* (2.773) modelling results indicate that only the NDVI, which measures green
spaces in and surrounding these neighbourhoods, demonstrates a sig­
nificant association with mental health. This suggests that the residents
Random effects Variance S. D. Variance S. D. Variance S. D.
of neighbourhoods with more green space may have better mental
Intercept 0.142 0.037 0.140 0.039 0.098 0.036 health. The finding is consistent with most previous studies (Maas et al.,
residual 0.868 0.084 0.761 0.073 0.761 0.073
Level-1 R2 0.123 0.123
2009; White et al., 2013), and this suggests that research from other
Level-2 R2 0.310 parts of the world is relevant to urban China. Neighbourhood green
Log likelihood − 961.5 − 916.2 − 914.0 spaces would also have a positive association with residents’ mental
Observations 701 701 701 health in a rapidly urbanizing country with compact and high-density
Number of 16 16 16
urban environment.
groups
Our analyses also suggest that the positive association between
Note: *** significant at 1% level; ** significant at 5% level; * significant at 10% neighbourhood green space and mental health could be mediated by
level. Standard errors are reported in parentheses. both neighbourhood social environment and physical activity. The
modelling results indicate that the neighbourhoods’ NDVI is positively
with living in a neighbourhood with an NDVI one standard deviation associated with the residents’ participation in physical activity and
below the mean (an NDVI of 0.24, roughly equal to that of neighbour­ subjective evaluation of neighbourhood social cohesion, which are
hood 02), living in a neighbourhood with the NDVI one standard devi­ further associated with their mental health. The associations are also
ation above the mean (an NDVI of 0.31, roughly equal to that of identified and documented in the studies of North American, European,
neighbourhood 09) would have a 0.33 standard deviation increase in and Australian cities (for instance, see De Vries et al., 2013; Ruijsbroek
mental health. In our sample, a resident with the mean value for mental et al., 2017; Sugiyama et al., 2008). This suggests that simply looking at
health would rank 336th in the 701 interviewees. With an increase of green space may contribute directly to mental health (Path A in Fig. 2),
0.33 standard deviation in the mean value for mental health, a resident but green space could also indirectly contribute to mental health by
would score 455th, which represents an increase from the 48th to the encouraging physical exercise (Path D & E) or/and enhancing neigh­
65th percentile. It suggests that, controlling for other factors, neigh­ bourhood social cohesion (Path B & C). A case in point is the emerging
bourhood green space may have direct association with mental health, phenomenon of “square dance” in urban China, that older people who
as indicated in the stress and restorative theories (Kaplan, 1995). dance in urban parks and therefore have more physical exercises and
We run the mediation analysis for social cohesion and physical social interactions, tend to enjoy better mental health (Tan et al., 2018).

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B. Qin et al. Cities 109 (2021) 103039

Table 7
The mediation analysis of social cohesion and physical activity.
Variables Model 4 Model 5 Model 6 Model 7

Social cohesion Mental health Physical activity Mental health

Constant − 1.136*(0.659) − 2.434***(0.938) 383.3(398.0) − 2.610***(0.932)

Individual-level variables
Gender (male = 1) − 0.00285(0.0469) − 0.147*(0.0845) 111.3*(60.32) − 0.158*(0.0831)
Age 0.0144***(0.0023) 0.0075***(0.0028) 4.318(2.773) 0.0087***(0.0025)
Educational attainment
Junior high school and below (ref.)
Senior high school 0.0642(0.152) 0.113(0.131) − 90.13(83.74) 0.132(0.123)
College − 0.133(0.0903) 0.0657(0.101) − 65.43(67.03) 0.0586(0.107)
Graduate and above − 0.273(0.171) 0.318**(0.144) − 81.45(108.0) 0.296*(0.159)
General health status
Fair, poor, or very poor (ref.)
Good 0.185**(0.0771) 0.362***(0.107) 61.21(55.78) 0.379***(0.100)
Very good 0.108(0.0714) 0.645***(0.140) 58.32(48.56) 0.652***(0.133)
Family type
Single
Couple 0.0805(0.194) 0.136(0.179) 72.16(91.89) 0.140(0.192)
Parent(s) with child(ren) 0.203(0.234) 0.154(0.177) − 18.56(83.48) 0.181(0.187)
Grandparent(s) householder 0.142(0.227) 0.414**(0.180) 57.86(120.7) 0.427**(0.185)
Home size (m2 per person) 0.000945(0.00343) 0.00189(0.00356) − 0.352(2.678) 0.00210(0.00348)
Monthly income (RMB yuan)
Less than 3000(ref.)
3001–6000 − 0.171*(0.101) 0.135(0.119) − 205.8**(102.8) 0.134(0.114)
6001–10,000 − 0.0883(0.122) 0.211(0.141) − 178.2*(106.4) 0.216(0.132)
10,001 –20,000 0.0287(0.0912) 0.181(0.141) − 303.0**(140.5) 0.213(0.133)
20,001 and over − 0.276(0.195) 0.422***(0.157) − 408.3**(165.4) 0.429***(0.148)
Social cohesion 0.115*(0.0695)
Physical activity 9.98e-05*(5.39e-05)

Neighbourhood-level variables
Floor area ratio − 0.404***(0.0876) 0.188(0.173) − 82.55(56.32) 0.149(0.175)
Average house price 0.0521**(0.0204) − 0.0251(0.0327) 6.363(10.266) − 0.0198 (0.0326)
Mixed land use − 0.234(0.347) − 0.0586(0.782) 154.9(213.3) − 0.0946(0.772)
After 2000 (yes = 1) − 0.00741(0.138) − 0.127(0.153) − 25.11(71.47) − 0.126(0.161)
NDVI 3.023*(1.782) 4.383(2.732) 1926.2**(957.8) 4.552(2.799)

Random effects Variance S. D. Variance S. D. Variance S. D. Variance S. D.

Intercept 0.041 0.021 0.096 0.038 0.0139 1.67 0.099 0.0362


residual 0.762 0.084 0.752 0.069 422,587.5 45,976.7 0.757 0.071
Level-1 R squared 0.134 0.128
Level-2 R squared 0.324 0.303
Log likelihood − 909.1 − 909.3 − 5535.1 − 912.1
Observations 701 701 701 701
Number of groups 16 16 16 16

Note: *** significant at 1% level; ** significant at 5% level; * significant at 10% level. Standard errors are reported in parentheses.

There are limitations to the study. First, we could not use a random space (walkable and open green spaces, for example) are more likely to
sampling approach when collecting the data (our survey respondents contribute to improving residents’ mental health (Gaston et al., 2018).
tend to be older and have higher than average levels of education More rigorous research design is also required to avoid the self-selection
attainment), and some questions in the questionnaire were adapted from problem and explore the causality between green space and mental
the international standard version of SWEMWBS, which may prevent a health. Given that the complex relationship between green space and
straightforward generalization of the findings of this study. Second, the mental health may be context-specific, more studies are called for across
modelling results demonstrated that the positive associations between cities that differ in culture, socioeconomic development, and the built
the NDVI and mental health (and social cohesion) were significant at environment.
10% percent. This may suggest that the relationship between green
space and subjective mental health is complicated. Third, conceptually 5. Conclusion
the associations between neighbourhood green spaces and residential
mental health could be attributed to the frequency, duration, and in­ Using the survey data of 701 residents from 16 typical neighbour­
tensity of the ‘dose’ of nature (Shanahan, Fuller, Bush, Lin, & Gaston, hoods in Beijing, China, we investigated the relationship between green
2015), which, unfortunately, were not measured in our cross-sectional space and mental health. Our multilevel models confirmed the positive
survey. These prevent us from claiming a causal relationship between association between green space and mental health and examined the
green space and mental health. mediating role of social cohesion and physical activity. The positive
Despite its limitations, the study provides the first empirical evidence association is likely not only because green spaces are ‘green’ (direct
from a large city in a developing country that suggests the positive as­ effect), but also because they could encourage residents to do more
sociation between green space and mental health. Further research is physical exercise or/and have more meaningful social interactions.
necessary to clarify how the quality of green space (for instance, its Though more cross-city empirical studies are still needed for a conclu­
biodiversity features such as bird song, butterflies, and wetlands that sive understanding of the association (or even causality) between green
could not be measured by using the NDVI) and the accessibility of green space and mental health, the policy implications of this study are valid,

8
B. Qin et al. Cities 109 (2021) 103039

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Liu, Y., Wang, R., Grekousis, G., Liu, Y., Yuan, Y., & Li, Z. (2019). Neighbourhood
This article was supported by the National Natural Science Foun­ greenness and mental wellbeing in Guangzhou, China: What are the pathways?
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