| Literature DB >> 34774510 |
Lincoln R Larson1, Lauren E Mullenbach2, Matthew H E M Browning3, Alessandro Rigolon4, Jennifer Thomsen5, Elizabeth Covelli Metcalf6, Nathan P Reigner7, Iryna Sharaievska8, Olivia McAnirlin9, Ashley D'Antonio10, Scott Cloutier11, Marco Helbich12, S M Labib13.
Abstract
The COVID-19 pandemic has negatively affected many people's psychological health. Impacts may be particularly severe among socially vulnerable populations such as college students, a group predisposed to mental health problems. Outdoor recreation and visits to greenspaces such as parks offer promising pathways for addressing the mental health challenges associated with COVID-19. During the early stages of the pandemic (March-May 2020), we surveyed 1280 college students at four large public universities across the United States (U.S.) to assess how, and why, outdoor recreation and park use changed since the emergence of COVID-19. We also measured students' self-reported levels of emotional distress (a proxy for psychological health) and assessed potential demographic and contextual correlates of distress, including county-level per capita park area and greenness, using generalized linear models. We found that 67% of students reported limiting outdoor activities and 54% reported reducing park use during the pandemic. Students who reduced their use of outdoor spaces cited structural reasons (e.g., lockdowns), concerns about viral transmission, and negative emotions that obstructed active lifestyles. Students who maintained pre-pandemic park use levels expressed a desire to be outdoors in nature, often with the explicit goal of improving mental and physical health. Emotional distress among students was widespread. Models showed higher levels of emotional distress were associated with reducing park use during the pandemic and residing in counties with a smaller area of parks per capita. This study of U.S. college students supports the value of park-based recreation as a health promotion strategy for diverse populations of young adults during a time of crisis.Entities:
Keywords: Coronavirus; Emotional distress; Equity; Greenspace; Higher education; Mental health; Outdoor recreation; University students
Mesh:
Year: 2021 PMID: 34774510 PMCID: PMC8648327 DOI: 10.1016/j.envres.2021.112367
Source DB: PubMed Journal: Environ Res ISSN: 0013-9351 Impact factor: 6.498
Characteristics of college students across the United States who completed the study questionnaire between March–May 2020 (N = 1280).
| Characteristic | Mean ( | |
|---|---|---|
| School | ||
| NC State University | 958 [74.60%] | |
| Oregon State University | 126 [10.44%] | |
| University of Montana | 119 [9.12%] | |
| Penn State University | 77 [5.85%] | |
| Relative income | 3.25 (1.10) | |
| Race/ethnicity | ||
| White | 1036 [80.94%] | |
| Asian | 141 [11.02%] | |
| Hispanic/Latinx | 52 [4.06%] | |
| Black | 51 [3.98%] | |
| Sex (female) | 775 [60.55%] | |
| Age (<25 years) | 1018 [79.53%] | |
| General health | 3.27 (1.02) | |
| BMI | 24.10 (4.61) | |
| Knowing someone infected with COVID-19 (yes) | 332 [25.94%] | |
| Worrying about COVID-19 | 3.99 (1.67) | |
| Urban county | 897 [70.08%] | |
| COVID-19 death rate per 1000 country residents | 1.62 (4.11) | |
| Lockdown level index | 7.94 (0.45) | |
| Area (km2) of local parks per 10,000 residents in county | 0.05 (0.08) | |
| Area (km2) of national/state parks per 10,000 residents in county | 8.69 (35.87) | |
| NDVI | 0.69 (0.12) | |
| Limiting outdoor recreation (yes) | 856 [66.88%] | |
| Reducing park use (yes) | 695 [54.30%] | |
| Emotional distress | 57.37 (21.02) | |
Proportion calculated by dividing the number of respondents in each category by the total sample (1,280).
Relative personal income rated on a scale from 1 = well below average to 5 = well above average.
General health was rated on a scale from 1 = poor to 5 = excellent.
BMI was calculated based on self-reported height and weight.
Respondents indicated if they personally knew someone who had been infected by COVID-19.
Worry about coronavirus is measured with the item, “I worry about the coronavirus all of the time,” on a 1 = strongly disagree to 7 = strongly agree response scale.
Urban vs. non-urban status of student's county of residence at the time of the survey calculated based on population densities provided by U.S. Census Bureau.
COVID-19 death rate estimates the cumulative number of COVID-19 deaths in each U.S. county reported through April 30, 2020 (see Table S1 for more details).
Lockdown level index reflects the aggregation of eight different intervention types (e.g., stay-at-home orders, restrictions on large gatherings) employed within different U.S. counties during the early stages of the pandemic (see Table S2 for more details).
Local, state, and national park area (km2) per 10,000 residents calculated based on park statistics (from Esri, 2021) divided by population estimates.
NDVI = Normalized difference vegetation index for the county in which a student resided when completing the survey; NDVI values range from −1 (water cover, no vegetation) to 0 (rock or impervious surfaces, no biomass) to +1 (dense green cover).
Limiting outdoor recreation reported as binary variable where sometimes, most of the time, or always = “yes” and never or rarely = “no”.
Reducing park use reported as binary variable where visiting parks less = “yes” and visiting parks more or not changing visitation = “no”.
Emotional distress is measured as an aggregate scale of 5 items (afraid, irritable, sad, preoccupied, and stressed) ranging from 0 (none) to 100 (most extreme level of emotional distress).
Results of logistic regression model showing correlates of limiting outdoor recreation activities during the early stages of the COVID-19 pandemic (March–May 2020) among undergraduate students across the United States (N = 1280).
| Variables | OR | 95% CI | |
|---|---|---|---|
| University (ref = NC State University) | |||
| Oregon State University | 0.76 | (0.43, 1.35) | .34 |
| | |||
| Penn State University | 0.69 | (0.39, 1.24) | .21 |
| Relative income | 0.89 | (0.79, 1.01) | .065 |
| Race/ethnicity (ref = White) | |||
| Hispanic/Latinx | 1.01 | (0.55, 1.96) | .97 |
| | |||
| | |||
| Sex (female) | 0.78 | (0.60, 1.01) | .065 |
| Age (<25 years) | 1.22 | (0.88, 1.70) | .23 |
| BMI | 0.99 | 0.96, 1.02) | .53 |
| Knowing someone infected with COVID-19 (yes) | 1.22 | (0.92, 1.64) | .17 |
| COVID-19 death rate per 1000 residents | 1.09 | (0.97, 1.09) | .45 |
| Lockdown level index | 1.14 | (0.87, 1.55) | .37 |
| Urban county (yes) | 1.13 | (0.85, 1.49) | .39 |
| Area (km2) of local parks per 10,000 residents in county | 1.05 | (0.91, 1.22) | .50 |
| Area (km2) of national/state parks per 10,000 residents in county | 1.01 | (0.86, 1.19) | .89 |
| NDVI in ZIP code | 0.54 | (0.14, 2.00) | .36 |
Notes: OR = odds ratios; McFadden's pseudo R2 = 0.077; see Table 1 footnotes for description of variable response scales and measurements; variables significantly associated with emotional distress at p < .05 shown in bold font.
Results shown with ordered quantil normalizing transformation applied (Peterson and Cavanaugh, 2020).
Results of logistic regression model showing correlates of reducing park use during the early stages of the COVID-19 pandemic (March–May 2020) among undergraduate students across the United States (N = 1280).
| Variables | OR | 95% CI | |
|---|---|---|---|
| University (ref = NC State University) | |||
| | |||
| University of Montana | 0.83 | (0.46, 1.48) | .52 |
| Penn State University | 0.88 | (0.50, 1.54) | .65 |
| Relative income | 1.06 | (0.95, 1.19) | .28 |
| Race/ethnicity (ref = White) | |||
| Hispanic/Latinx | 1.38 | (0.77, 2.54) | .29 |
| | |||
| | |||
| Sex (female) | 0.90 | (0.71, 1.15) | .40 |
| Age (<25 years) | 0.82 | (0.60, 1.12) | .21 |
| General health | 0.97 | (0.86, 1.08) | .56 |
| BMI | 1.01 | (0.99, 1.04) | .39 |
| Knowing someone infected with COVID-19 (yes) | 1.13 | (0.87, 1.49) | .36 |
| Lockdown level index | 0.92 | (0.70, 1.19) | .53 |
| Urban county (yes) | 0.79 | (0.60, 1.03) | .086 |
| Area (km2) of local parks per 10,000 residents in county | 1.01 | (0.87, 1.16) | .94 |
| Area (km2) of national/state parks per 10,000 residents in county | 1.09 | (0.93, 1.28) | .27 |
| NDVI in ZIP code | 0.65 | (0.18, 2.34) | .51 |
Notes: OR = odds ratios; McFadden's pseudo R2 = 0.048; see Table 1 footnotes for description of variable response scales and measurements; variables significantly associated with emotional distress at p < .05 shown in bold font.
Results shown with ordered quantil normalizing transformation applied (Peterson and Cavanaugh, 2020).
Results of linear regression model examining correlates of emotional distress for undergraduate students (N = 1280) across the United States during the early stages of the COVID-19 pandemic (March–May 2020).
| Variables | 95% CI | ||
|---|---|---|---|
| University (ref = NC State University) | |||
| Oregon State University | 1.30 | (-2.8, 5.4) | .54 |
| University of Montana | 1.60 | (-2.7, 6.0) | .46 |
| | |||
| Race/ethnicity (ref = White) | |||
| Hispanic/Latinx | −1.10 | (-5.5, 3.4) | .64 |
| Asian | 0.64 | (-2.3, 3.6) | .67 |
| Black | −2.50 | (-6.9, 2.0) | .28 |
| Age (<25 years) | 1.70 | (-0.6, 4.0) | .15 |
| BMI | −0.10 | (-0.3, 0.1) | 0.31 |
| COVID-19 death rate per 1000 residents | −0.15 | (-0.6, 0.3) | .46 |
| Lockdown level index | 0.94 | (-1.0, 2.8) | .33 |
| Urban county (yes) | 0.39 | (-1.6, 2.4) | .70 |
| Area (km2) of local parks per 10,000 residents in county | −0.58 | (-1.6, 0.5) | .27 |
| NDVI in ZIP code | 0.02 | (-9.2, 9.3) | .99 |
| Limiting outdoor recreation (yes) | −1.80 | (-3.7, 0.2) | .077 |
Notes: Adjusted R2 = 0.462; see Table 1 for description of variable response scales and measurements; variables significantly associated with emotional distress at p < .05 are shown in bold font.
Results shown with ordered quantil normalizing transformation applied (Peterson and Cavanaugh, 2020).
Fig. 1Summary of key findings showing changes in college students' park use, reasons for shifting park use, and significant correlates of emotional distress during the early stages of the COVID-19 pandemic in the United States. Larger areas of national and state parks per capita, general self-reported health, and relative income were associated with lower levels of emotional distress. Lower park usage, knowing someone with COVID-19, being female, and worrying about COVID-19 were associated with higher levels of emotional distress.