This study investigated place-based differences in the association between greenspace and suicide-related outcomes (SROs) among young people, guided by the following two objectives: (1) Contextualize place-based differences in the association between greenspace and SRO prevalence among young people at the community level in five different urbanities (urban, suburban, micropolitan, small towns, and rural/isolated communities) and (2) identify which greenspace metrics (quantity, quality, or accessibility) are most protective for SROs at the community level. Publicly available greenspace datasets were used to derive greenspace quantity, quality, and accessibility metrics. SRO emergency department visits for young people were identified from 2016–2019 in North Carolina, USA. Generalized linear models investigated the association between greenspace metrics and community-level drivers of SRO prevalence. Shapely additive explanations confirmed the most important greenspace variables in accurately predicting community-level SRO prevalence. The prevalence of SROs was highest in communities with the least amount of public greenspace; this association was most pronounced in suburban communities, with SROs 27% higher in suburban communities with low quantities of greenspace (PRR: 1.11, confidence interval [CI]: 1.08–1.13; PRR: 1.27, CI: 1.10–1.46; PRR: 1.21, CI: 1.05–1.39), and in communities with the worst greenspace accessibility (i.e., furthest distance to nearest greenspace) (PRR: 1.07, CI: 1.04–1.10; PRR: 1.95, CI: 1.54–2.49). Our analysis provides place-based, community-specific findings to guide targeted greenspace interventions aimed at addressing the rising prevalence of SROs among young people. Our findings suggest that greenspace quantity interventions may be most effective in urban, suburban, and small-town communities, and greenspace accessibility interventions may be most useful in urban and rural/isolated communities.

中文翻译：

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年轻人中绿地与自杀相关结果之间的关联存在地域差异


本研究调查了年轻人中绿地与自杀相关结果 (SRO) 之间的关联的地点差异，以以下两个目标为指导：(1) 将年轻人中绿地与自杀相关结果 (SRO) 流行率之间的关联的地点差异具体化在五个不同城市（城市、郊区、小城市、小城镇和农村/偏远社区）的社区层面进行评估，(2) 确定哪些绿地指标（数量、质量或可达性）对社区层面的 SRO 最具保护性。使用公开的绿地数据集来得出绿地数量、质量和可达性指标。 2016 年至 2019 年，美国北卡罗来纳州 SRO 为年轻人进行了急诊科就诊。广义线性模型研究了绿地指标与 SRO 流行的社区层面驱动因素之间的关联。形状相加的解释证实了在准确预测社区级 SRO 流行率方面最重要的绿地变量。在公共绿地最少的社区中，SRO 的流行率最高；这种关联在郊区社区最为明显，绿地数量较少的郊区社区的 SRO 高出 27%（PRR：1.11，置信区间 [CI]：1.08–1.13；PRR：1.27，CI：1.10–1.46；PRR：1.21 ，CI：1.05–1.39），以及绿地可达性最差（即到最近绿地的距离最远）的社区（PRR：1.07，CI：1.04–1.10；PRR：1.95，CI：1.54–2.49）。我们的分析提供了基于地点、针对特定社区的调查结果，以指导有针对性的绿地干预措施，旨在解决年轻人中 SRO 日益流行的问题。 我们的研究结果表明，绿地数量干预措施可能在城市、郊区和小镇社区最有效，而绿地可达性干预措施可能在城市和农村/偏远社区最有用。