The environment an adult resides within is associated with their health behaviours, mental and physical health outcomes: A nationwide geospatial study

Abstract

Background: The determinants of health behaviours and health outcomes are multifaceted and the surrounding environment is increasingly considered as an important influence. This pre-registered study investigated the association between the geospatial environment people live within and their health behaviours as well as mental and physical health outcomes. Method: We used the newly developed Healthy Location Index (HLI) to identify health-promoting and healthconstraining environmental features that people live around. We then used Time 10 (2018) data from the New Zealand Attitudes and Values Survey (NZAVS; N = 47,951), a national probability sample of New Zealand adults, to gauge mental health outcomes including depression, anxiety and psychological distress, physical health outcomes including BMI and type II diabetes, and health behaviours such as tobacco smoking and vaping. Linear and logistic multilevel mixed effect regression models with random intercepts of individuals nested within geographical areas (meshblocks) were employed. Results: The presence of health-constraining environmental features were adversely associated with selfreported mental health outcomes of depression, anxiety, and psychological distress, physical health outcomes of BMI and type II diabetes, and negative health behaviours of tobacco smoking and vaping. By contrast, health-promoting environmental features were uniquely associated with physical health outcomes of BMI and type II diabetes. Conclusion: The current study advances research on environmental determinants of health behaviours by demonstrating that close proximity to health-constraining environmental features is related to a number of self-reported physical and mental health outcomes or behaviours. We provide some evidence to support the notion that preventive population-health interventions should be sought.