Associations Between Exposures to Nature and the Occurrence of Psychosomatic Symptoms Among Canadian Adolescents
Background: Spending time outdoors and connecting with nature are beneficial for the physical and mental health of humans. Nature has been associated with promotion of positive mental health through stress reduction and multiple other pathways. Much of the work on this topic has focused on adult populations. The ways that nature may relate to the mental health of young people represents an important gap in knowledge. Objectives: Using a large, nationally representative sample of Canadian adolescents, the objectives of this thesis were: 1) to examine the association between outdoor play and psychosomatic symptoms; 2) to examine the association between perceived importance of nature connectedness and psychosomatic symptoms; and 3) to determine whether these associations were dependent on sex and/or age. Methods: In an analysis of data collected from young Canadians in 2013/2014, I described the prevalence of outdoor play, perceived importance of nature connectedness, and psychosomatic symptoms. Next, I developed a series of log-binomial regression models to quantify associations between the exposures to nature and the outcome in the form of relative risks and 95% confidence intervals. After accounting for relevant confounders in the models, sex and age were tested as effect modifiers. Results: The association between outdoor play and psychosomatic symptoms was found to be modified by sex but not age group. Among female adolescents, playing outdoors for at least 30 minutes/week was associated with a 24% (95% CI: 5%, 40%) reduction in the prevalence of high psychosomatic symptoms compared to those reporting no weekly outdoor time. Among males, there was no statistically significant relationship between outdoor play and psychosomatic symptoms. The association between perceived importance of nature connectedness and psychosomatic symptoms did not differ according to sex or age. Perception of connection to nature as ‘important’ was associated with a 25% (95% CI: 9%, 38%) reduction in the prevalence of high psychosomatic symptoms compared to those who perceived connection to nature as ‘not important’. Conclusion: This study highlights the importance of adolescent engagement with nature as one strategy to promote their psychological well-being. It also emphasizes the importance of accounting for differences between the sexes when researching, planning, and implementing public mental health initiatives that consider exposure to the outdoors.