IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v20y2023i7p5241-d1105364.html
   My bibliography  Save this article

Do Multiple Sex/Gender Dimensions Play a Role in the Association of Green Space and Self-Rated Health? Model-Based Recursive Partitioning Results from the KORA INGER Study

Author

Listed:
  • Lisa Dandolo

    (Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
    Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany)

  • Klaus Telkmann

    (Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
    Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany)

  • Christina Hartig

    (Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
    Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany)

  • Sophie Horstmann

    (Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
    Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany)

  • Sara Pedron

    (Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
    Professorship of Public Health and Prevention, Technical University of Munich, 80992 Munich, Germany)

  • Lars Schwettmann

    (Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
    Division for Health Economics, Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, 26129 Oldenburg, Germany)

  • Peter Selsam

    (Department Monitoring and Exploration Technologies, Helmholtz Centre for Environmental Research—UFZ, 04318 Leipzig, Germany)

  • Alexandra Schneider

    (Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
    These authors contributed equally to this work.)

  • Gabriele Bolte

    (Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
    Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
    These authors contributed equally to this work.)

  • on behalf of the INGER Study Group

    (Members as listed below in the acknowledgments.)

Abstract

Exposure to green space has a positive impact on health. Whether sex/gender modifies the green space–health association has so far only been studied through the use of a binary sex/gender category; however, sex/gender should be considered more comprehensively as a multidimensional concept based on theoretical approaches. We therefore explored whether sex/gender, operationalized through multiple sex/gender- and intersectionality-related covariates, modifies the green space–self-rated health association. We collected data from participants involved in the German KORA study (Cooperative Health Research in the Region of Augsburg) in 2019. Self-rated health was assessed as a one-question item. The availability of green spaces was measured subjectively as well as objectively. The multiple sex/gender- and intersectionality-related covariates were measured via self-assessment. To analyze the data, we used model-based recursive partitioning, a decision tree method that can handle complex data, considering both multiple covariates and their possible interactions. We showed that none of the covariates operationalizing an individual sex/gender self-concept led to subgroups with heterogeneous effects in the model-based tree analyses; however, we found effect heterogeneity based on covariates representing structural aspects from an intersectionality perspective, although they did not show the intersectional structuring of sex/gender dimensions. In one identified subgroup, those with a lower education level or a feeling of discrimination based on social position showed a positive green space–self-rated health association, while participants with a higher education level or no feeling of discrimination based on social position had a high level of self-rated health regardless of the availability of green spaces. Model-based recursive partitioning has the potential to detect subgroups exhibiting different exposure–outcome associations, with the possibility of integrating multiple sex/gender- and intersectionality-related covariates as potential effect modifiers. A comprehensive assessment of the relevance of sex/gender showed effect heterogeneity based on covariates representing structural aspects from an intersectionality perspective.

Suggested Citation

  • Lisa Dandolo & Klaus Telkmann & Christina Hartig & Sophie Horstmann & Sara Pedron & Lars Schwettmann & Peter Selsam & Alexandra Schneider & Gabriele Bolte & on behalf of the INGER Study Group, 2023. "Do Multiple Sex/Gender Dimensions Play a Role in the Association of Green Space and Self-Rated Health? Model-Based Recursive Partitioning Results from the KORA INGER Study," IJERPH, MDPI, vol. 20(7), pages 1-23, March.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:7:p:5241-:d:1105364
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/20/7/5241/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/20/7/5241/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Achim Zeileis & Kurt Hornik, 2007. "Generalized M‐fluctuation tests for parameter instability," Statistica Neerlandica, Netherlands Society for Statistics and Operations Research, vol. 61(4), pages 488-508, November.
    2. Gabriele Bolte & Sarah Nanninga & Lisa Dandolo, 2019. "Sex/Gender Differences in the Association between Residential Green Space and Self-Rated Health—A Sex/Gender-Focused Systematic Review," IJERPH, MDPI, vol. 16(23), pages 1-17, November.
    3. Bauer, Greta R. & Scheim, Ayden I., 2019. "Methods for analytic intercategorical intersectionality in quantitative research: Discrimination as a mediator of health inequalities," Social Science & Medicine, Elsevier, vol. 226(C), pages 236-245.
    4. Mariya Geneshka & Peter Coventry & Joana Cruz & Simon Gilbody, 2021. "Relationship between Green and Blue Spaces with Mental and Physical Health: A Systematic Review of Longitudinal Observational Studies," IJERPH, MDPI, vol. 18(17), pages 1-29, August.
    5. Steffen Andreas Schüle & Lisa Karla Hilz & Stefanie Dreger & Gabriele Bolte, 2019. "Social Inequalities in Environmental Resources of Green and Blue Spaces: A Review of Evidence in the WHO European Region," IJERPH, MDPI, vol. 16(7), pages 1-15, April.
    6. Hanneke Kruize & Nina van der Vliet & Brigit Staatsen & Ruth Bell & Aline Chiabai & Gabriel Muiños & Sahran Higgins & Sonia Quiroga & Pablo Martinez-Juarez & Monica Aberg Yngwe & Fotis Tsichlas & Pani, 2019. "Urban Green Space: Creating a Triple Win for Environmental Sustainability, Health, and Health Equity through Behavior Change," IJERPH, MDPI, vol. 16(22), pages 1-22, November.
    7. Mireia Gascon & Margarita Triguero-Mas & David Martínez & Payam Dadvand & Joan Forns & Antoni Plasència & Mark J. Nieuwenhuijsen, 2015. "Mental Health Benefits of Long-Term Exposure to Residential Green and Blue Spaces: A Systematic Review," IJERPH, MDPI, vol. 12(4), pages 1-26, April.
    8. Phi-Yen Nguyen & Thomas Astell-Burt & Hania Rahimi-Ardabili & Xiaoqi Feng, 2021. "Green Space Quality and Health: A Systematic Review," IJERPH, MDPI, vol. 18(21), pages 1-38, October.
    9. Annemarie Ruijsbroek & Mariël Droomers & Hanneke Kruize & Elise Van Kempen & Christopher J. Gidlow & Gemma Hurst & Sandra Andrusaityte & Mark J. Nieuwenhuijsen & Jolanda Maas & Wim Hardyns & Karien St, 2017. "Does the Health Impact of Exposure to Neighbourhood Green Space Differ between Population Groups? An Explorative Study in Four European Cities," IJERPH, MDPI, vol. 14(6), pages 1-15, June.
    10. Michelle C. Kondo & Jaime M. Fluehr & Thomas McKeon & Charles C. Branas, 2018. "Urban Green Space and Its Impact on Human Health," IJERPH, MDPI, vol. 15(3), pages 1-28, March.
    11. Alessandro Rigolon & Matthew H. E. M. Browning & Olivia McAnirlin & Hyunseo (Violet) Yoon, 2021. "Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities," IJERPH, MDPI, vol. 18(5), pages 1-27, March.
    12. Gabriele Bolte & Katharina Jacke & Katrin Groth & Ute Kraus & Lisa Dandolo & Lotta Fiedel & Malgorzata Debiak & Marike Kolossa-Gehring & Alexandra Schneider & Kerstin Palm, 2021. "Integrating Sex/Gender into Environmental Health Research: Development of a Conceptual Framework," IJERPH, MDPI, vol. 18(22), pages 1-18, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lisa Dandolo & Christina Hartig & Klaus Telkmann & Sophie Horstmann & Lars Schwettmann & Peter Selsam & Alexandra Schneider & Gabriele Bolte & on behalf of the INGER Study Group, 2022. "Decision Tree Analyses to Explore the Relevance of Multiple Sex/Gender Dimensions for the Exposure to Green Spaces: Results from the KORA INGER Study," IJERPH, MDPI, vol. 19(12), pages 1-25, June.
    2. Zheng Xian & Tomoki Nakaya & Kun Liu & Bing Zhao & Junhua Zhang & Jiao Zhang & Yuxuan Lin & Jinguang Zhang, 2024. "The effects of neighbourhood green spaces on mental health of disadvantaged groups: a systematic review," Palgrave Communications, Palgrave Macmillan, vol. 11(1), pages 1-19, December.
    3. Argyro Anna Kanelli & Margarita Kokkinaki & Marios-Dimitrios Sinvare & Chrisovalantis Malesios & Panayiotis G. Dimitrakopoulos & Olga-Ioanna Kalantzi, 2023. "Keep Calm and Go Out: Urban Nature Exposure, Mental Health, and Perceived Value during the COVID-19 Lockdown," Sustainability, MDPI, vol. 15(11), pages 1-20, May.
    4. Matthew H. E. M. Browning & Alessandro Rigolon, 2018. "Do Income, Race and Ethnicity, and Sprawl Influence the Greenspace-Human Health Link in City-Level Analyses? Findings from 496 Cities in the United States," IJERPH, MDPI, vol. 15(7), pages 1-22, July.
    5. Yiyi Chen & Mark Stephens & Colin A. Jones, 2019. "Does Residents’ Satisfaction with the Neighbourhood Environment Relate to Residents’ Self-Rated Health? Evidence from Beijing," IJERPH, MDPI, vol. 16(24), pages 1-15, December.
    6. Kaili Chen & Tianzheng Zhang & Fangyuan Liu & Yingjie Zhang & Yan Song, 2021. "How Does Urban Green Space Impact Residents’ Mental Health: A Literature Review of Mediators," IJERPH, MDPI, vol. 18(22), pages 1-27, November.
    7. Kristoffer Mattisson & Anna Axmon & Gunilla Carlsson & Agneta Malmgren Fänge & Connie Lethin & Emilie Stroh, 2022. "Sociodemographic Variations in the Availability of Urban Green Spaces in an Older Swedish Population," IJERPH, MDPI, vol. 19(19), pages 1-17, October.
    8. Nafsika Afentou & Patrick Moore & Katrina Hull & Jenny Shepherd & Stephanie Elliott & Emma Frew, 2022. "Inland Waterways and Population Health and Wellbeing: A Cross-Sectional Study of Waterway Users in the UK," IJERPH, MDPI, vol. 19(21), pages 1-23, October.
    9. Judith Schröder & Susanne Moebus & Julita Skodra, 2022. "Selected Research Issues of Urban Public Health," IJERPH, MDPI, vol. 19(9), pages 1-28, May.
    10. Na’Taki Osborne Jelks & Viniece Jennings & Alessandro Rigolon, 2021. "Green Gentrification and Health: A Scoping Review," IJERPH, MDPI, vol. 18(3), pages 1-23, January.
    11. Brenda B. Lin & Susan Thompson & Richard Mitchell & Thomas Astell-Burt & Evelyne De Leeuw & Bin Jalaludin & Xiaoqi Feng, 2023. "Policymaker and Practitioner Perceptions of Parks for Health and Wellbeing: Scoping a Holistic Approach," Sustainability, MDPI, vol. 15(6), pages 1-16, March.
    12. Jean C. Bikomeye & Sima Namin & Chima Anyanwu & Caitlin S. Rublee & Jamie Ferschinger & Ken Leinbach & Patricia Lindquist & August Hoppe & Lawrence Hoffman & Justin Hegarty & Dwayne Sperber & Kirsten , 2021. "Resilience and Equity in a Time of Crises: Investing in Public Urban Greenspace Is Now More Essential Than Ever in the US and Beyond," IJERPH, MDPI, vol. 18(16), pages 1-39, August.
    13. Alessandro Rigolon & Matthew H. E. M. Browning & Olivia McAnirlin & Hyunseo (Violet) Yoon, 2021. "Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities," IJERPH, MDPI, vol. 18(5), pages 1-27, March.
    14. Gill Hubbard & Chantal den Daas & Marie Johnston & Peter Murchie & Catharine Ward Thompson & Diane Dixon, 2021. "Are Rurality, Area Deprivation, Access to Outside Space, and Green Space Associated with Mental Health during the COVID-19 Pandemic? A Cross Sectional Study (CHARIS-E)," IJERPH, MDPI, vol. 18(8), pages 1-17, April.
    15. Nicole V. DeVille & Linda Powers Tomasso & Olivia P. Stoddard & Grete E. Wilt & Teresa H. Horton & Kathleen L. Wolf & Eric Brymer & Peter H. Kahn & Peter James, 2021. "Time Spent in Nature Is Associated with Increased Pro-Environmental Attitudes and Behaviors," IJERPH, MDPI, vol. 18(14), pages 1-18, July.
    16. Andreia Teixeira & Ronaldo Gabriel & José Martinho & Irene Oliveira & Mário Santos & Graça Pinto & Helena Moreira, 2023. "Distance to Natural Environments, Physical Activity, Sleep, and Body Composition in Women: An Exploratory Analysis," IJERPH, MDPI, vol. 20(4), pages 1-20, February.
    17. Sophie Ch. Fichter & Katrin Groth & Nina Fiedler & Marike Kolossa-Gehring & Małgorzata Dębiak & on behalf of the INGER Study Group, 2022. "Lysmeral Exposure in Children and Adolescences Participating in the German Environmental Survey (2012–2015): Integrating Sex/Gender into Analysis," IJERPH, MDPI, vol. 19(24), pages 1-16, December.
    18. Xindi Zhang & Yixin Zhang & Jun Zhai & Yongfa Wu & Anyuan Mao, 2021. "Waterscapes for Promoting Mental Health in the General Population," IJERPH, MDPI, vol. 18(22), pages 1-15, November.
    19. David Rojas-Rueda & Elida Vaught & Daniel Buss, 2021. "Why a New Research Agenda on Green Spaces and Health Is Needed in Latin America: Results of a Systematic Review," IJERPH, MDPI, vol. 18(11), pages 1-16, May.
    20. Alistair Woodward & Andrea Hinwood & Daniel Bennett & Brenton Grear & Sotiris Vardoulakis & Neha Lalchandani & Katrina Lyne & Carmel Williams, 2023. "Trees, Climate Change, and Health: An Urban Planning, Greening and Implementation Perspective," IJERPH, MDPI, vol. 20(18), pages 1-7, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:20:y:2023:i:7:p:5241-:d:1105364. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.