Green, brown, and gray: Associations between different measurements of land patterns and depression among nursing students in El Paso, Texas

Background: While greenness has been associated with lower depression, the generalizability of this association in arid landscapes remains undetermined. We assessed the association between depression and residential greenness, but also brownness and grayness among nursing students living in El Paso, Texas (the Chihuahuan desert). Methods: Depression was measured with the Patient Health Questionnaire-9 scale and greenness with the normalized difference vegetation index across three buffer sizes (i.e., 250, 500, and 1000 m). Using data from the National Land Cover Database, two additional measures of land patterns were analyzed: grayness and brownness. Structural equation models were used to assess the relationships of these land patterns to depression and quantify the indirect effects of peer alienation. Results: After adjusting for individual characteristics, at buffers 250 m, greenness was not associated with a decrease in the Incidence Rate Ratios (IRR) of depression (IRR, 0.51; 95% CI, 0.12–2.10); however, grayness and brownness were respectively associated with increases by 64% (IRR, 1.64; 95% CI, 1.07–2.52) and decreases by 35% (IRR, 0.65; 95% CI, 0.42–0.99). At buffer 250 m, peer alienation explained 17.43% (95% CI, −1.79–36.66) of the association between depression and brownness, suggesting a pathway to depression. Conclusions: We did not observe an association between depression and residential greenness in El Paso, Texas. However, we did observe a protective association between brownness and depression and an adverse association with grayness. These results have theoretical implications as they were based on commonly used frameworks in this literature, and adverse association of brownness (and the lack of greenness) and depression was expected.