Reference
Corley J, Okely JA, Taylor AM, et al. Home garden use during COVID-19: Associations with physical and mental wellbeing in older adults. J Environ Psychol. 2021;73:101545.
Study Objective
To determine the physical and mental/emotional health impacts of gardening on elderly adults during the 2020 Covid-19 lockdown
Participants
The study involved 171 elderly participants (all were born in 1936, 53% male) of the ongoing Lothian Birth Cohort 1936 study in Scotland, UK.
Design
Cross-sectional cohort of an ongoing longitudinal study
Intervention
Researchers mailed participants a letter asking them to complete a 145-item, at-home online survey. This survey inquired about their frequency of gardening activity and various health measures both before the onset of the UK Covid-19 lockdown (March 2020) and at the current time 2 months later (May/June 2020).
Researchers conducted all data analyses as ordinary regressions, adjusted for participants’ sex, size of household, education level, occupational social class, symptoms of anxiety and depression, body mass index (BMI), and history of cardiovascular disease and diabetes.
Outcome Measures
The online survey contained demographic and Covid-awareness information, as well as 5-item Likert-type questions regarding pre- and postlockdown gardening activities and frequency, physical health, emotional and mental health, sleep quality, and anxiety about Covid-19. Researchers assessed an additional composite health score as an amalgam of the other health scores.
Key Findings
After the researchers adjusted for all covariates, they found that participants who had higher frequency of garden use in the 2 months following Covid-19 lockdown had significantly associated better health measures than those who did not garden, including:
- Self-rated physical health (0.74, 95% CI 0.23–1.25, P<0.005)
- Emotional and mental health (0.58, 95% CI 0.02–1.13, P=0.04)
- Sleep quality (0.58, 95% CI 0.07–1.09, P=0.03)
- Composite health score (0.79, 95% CI 0.32–1.25, P=0.001)
Researchers found no significant results related to participants’ perceived pre- vs postlockdown change in any of the health measures.
Practice Implications
The global COVID-19 pandemic has caused massive disruptions to public health, including both physical and mental health. In addition to viral infection causing high rates of hospitalization and mortality, societal lockdowns have drastically limited individuals’ and communities’ typical abilities to work, socialize, and participate in many activities. The resultant reductions in health behaviors like physical activity and social interaction are negatively impacting many aspects of physical health as well as mental health, such as depression, anxiety, and insomnia.1–3 This is especially concerning for elderly populations, who simultaneously are at higher risk of sequelae from both Covid-19 infection and multiple physical and mental conditions as a result of limited physical mobility, weaker immune systems, and increased social isolation in non-Covid times.4
The development of urban parks occurred partially in response to pandemics of infectious diseases like cholera and polio that were frequently occurring during the late 19th century.
One way to address these health declines is by spending more time in nature. The numerous health benefits of contact with outdoor green space have been widely reported and are well understood.5 These simple methods are easily available to most people, even when living in urban settings. In fact, the development of urban parks occurred partially in response to pandemics of infectious diseases like cholera and polio that were frequently occurring during the late 19th century.6 Providing areas where people could be physically active and get plenty of fresh air and sunlight, while avoiding the unsanitary conditions of preplumbing city living, was an urban-planning answer to a public health problem.8 Accessing green spaces has been proposed as a way to maintain health during the current pandemic as well. In fact, during the initial stages of the pandemic, there was a global increase in people spending more time outside, in exact opposition to many municipalities’ efforts to limit time in parks and other green spaces.7
There are many ways to access nature. In particular, gardening is a simple and effective way to experience all of nature’s health benefits. Spending time gardening provides people with opportunities to increase physical activity, breathe fresh air, absorb sunlight and increase vitamin D, and have a local source of low-cost, high-quality nutrition. It also lets people relax and reduce stress, calm their mind, distract themselves from other life concerns, and increase their self-esteem and feelings of self-efficacy while also connecting to familial and cultural roots and activities. And digging in the soil brings exposure to many beneficial microbes that modulate healthy function of the digestive, immune, and nervous systems.
Multiple studies have confirmed the wide range of gardening’s benefits, including reductions in blood pressure and salivary cortisol and improvements in depression, anxiety, quality of life, and subjective well-being.9–11 The study reviewed here suggests that these may directly benefit the elderly and other populations negatively affected by the Covid-19 pandemic.
Limitations
As a cross-sectional study, this survey was not able to investigate longitudinal cause-and-effect relationships. It may be that positive findings reflect healthier participants’ interest and/or ability to garden more frequently, not vice versa. Evidence exists suggesting both are accurate, so further investigation is warranted.
As a survey, multiple limitations must be considered. The self-report method of the survey provides only subjective response data, which are inherently prone to bias and recall error. Asking participants to compare their pre-post Covid lockdown health changes is not as valid as analyzing data collected during both the pre- and postlockdown period. Such a longitudinal approach may have provided more compelling data regarding health status changes from the survey.
The format of the survey was also limiting. A 145-item online survey completed by 84-year-old participants is a suboptimal method of data collection. It is likely that technological limitations of accessing the internet and the length of the survey prevented otherwise eligible individuals from participating.
Conclusion
The Covid-19 pandemic has affected physical and mental health globally, especially in vulnerable populations such as the elderly. This is the result of direct effects of the virus as well as systemic effects of societal lockdown, which indirectly limits many of the lifestyle and environmental factors that influence health. Gardening may be a feasible method of overcoming some of these imposed barriers and supporting and restoring the opportunity to increase individuals’ physical and mental health and wellbeing.
