Access to Public Spaces and the Mental Health of Adult Women in Tijuana, Mexico

Public spaces (PS) (parks, sports fields, etc.), are elements of the built urban environment related to both physical and mental health. By providing a free-access space where people can engage in physical activity, social interaction, or relax, PS could be especially important for less affluent communities and persons. However, previous studies in Latin American cities have documented that the PS are distributed differentially, benefiting higher-income persons. The inequitable distribution of PS in cities might be a determinant of avoidable differences in health, and the association of PS and health.

We analyse the association of access to PS and mental health in a sample of adult women living in Tijuana, Mexico. We combined data from a representative household survey conducted in 2014 (n=2,345), and from a study that inventoried PS in the city in 2013, to assess: 1) The prevalence of depressive symptoms (DS) as measured by the Centers for Epidemiological Studies – Depression Scale (CES-D); 2) The association of DS with access to PS; and 3) If the strength of the association varied by indicators of social position.

The prevalence of DS was 17.7% (CI95% 15.1, 20.7). Adjusting for individual characteristics, the association between access to PS in a 400m buffer around home and DS was protective and marginally significant (OR 0.75, p=.081). The interaction between access to PS and years of education was also marginally significant (OR 0.95, p=.097), showing that the protective effect of access to PS was stronger for participants with higher levels of education. In the presentation, we explore possible explanations for this unexpected result, including differences in the quality of PS available to participants in different areas, and differences in other elements of the built environment and in social practices related to use of PS.