Do greener childhoods mean fewer eating disorders? Using satellite imagery to uncover insights

Abstract. The benefits of natural environments on mental health have been documented in numerous studies. In spite of this, the underlying mechanisms by which different elements of natural environments affect mental health, and especially eating disorders, are still largely unknown. In this study, we use remote sensing time series from the Landsat missions to associate a degree of exposure to natural vs urban environment of 659 individuals with diagnosed eating disorders (ED), such as anorexia, bulimia, purging, binge (BED), who constitute our cases. We also obtain data from 39 individuals not affected by eating disorders that comprise our control group. We explore associations between growing up surrounded by areas with a higher NDVI to individuals affected by ED. A Cox regression model was used to estimate rates as relative risk ratios and then adjusted for potential confounding from other known risk factors. The results of the Cox regressions show that the relative risk of developing ED is lower for children growing up in environments with a higher NDVI. Rates did not notably change by adjustment for GDP (a proxy for socioeconomic status), elevation, CO₂ and population. In conclusion, we found that growing up surrounded by greener settings may lower the risk of eating disorders by some 33%. According to our findings, ensuring access to natural environments is crucial for improving public health and creating not only more sustainable but also more livable cities.