Publication Details

Category Text Publication
Reference Category Journals
DOI 10.3390/ijerph20075241
Licence creative commons licence
Title (Primary) Do multiple sex/gender dimensions play a role in the association of green space and self-rated health? Model-based pecursive rartitioning Results from the KORA INGER study
Author Dandolo, L.; Telkmann, K.; Hartig, C.; Horstmann, S.; Pedron, S.; Schwettmann, L.; Selsam, P.; Schneider, A.; Bolte, G.
Journal International Journal of Environmental Research and Public Health
Year 2023
Department MET
Volume 20
Issue 7
Page From art. 5241
Language englisch
Topic T5 Future Landscapes
Supplements https://www.mdpi.com/article/10.3390/ijerph20075241/s1
Keywords sex; gender; intersectionality; model-based recursive partitioning; decision trees; green spaces
Abstract Exposure to green space has a positive impact on health. Whether sex/gender modifies the green space–health association has so far only been studied through the use of a binary sex/gender category; however, sex/gender should be considered more comprehensively as a multidimensional concept based on theoretical approaches. We therefore explored whether sex/gender, operationalized through multiple sex/gender- and intersectionality-related covariates, modifies the green space–self-rated health association. We collected data from participants involved in the German KORA study (Cooperative Health Research in the Region of Augsburg) in 2019. Self-rated health was assessed as a one-question item. The availability of green spaces was measured subjectively as well as objectively. The multiple sex/gender- and intersectionality-related covariates were measured via self-assessment. To analyze the data, we used model-based recursive partitioning, a decision tree method that can handle complex data, considering both multiple covariates and their possible interactions. We showed that none of the covariates operationalizing an individual sex/gender self-concept led to subgroups with heterogeneous effects in the model-based tree analyses; however, we found effect heterogeneity based on covariates representing structural aspects from an intersectionality perspective, although they did not show the intersectional structuring of sex/gender dimensions. In one identified subgroup, those with a lower education level or a feeling of discrimination based on social position showed a positive green space–self-rated health association, while participants with a higher education level or no feeling of discrimination based on social position had a high level of self-rated health regardless of the availability of green spaces. Model-based recursive partitioning has the potential to detect subgroups exhibiting different exposure–outcome associations, with the possibility of integrating multiple sex/gender- and intersectionality-related covariates as potential effect modifiers. A comprehensive assessment of the relevance of sex/gender showed effect heterogeneity based on covariates representing structural aspects from an intersectionality perspective.
Persistent UFZ Identifier https://www.ufz.de/index.php?en=20939&ufzPublicationIdentifier=23034
Dandolo, L., Telkmann, K., Hartig, C., Horstmann, S., Pedron, S., Schwettmann, L., Selsam, P., Schneider, A., Bolte, G. (2023):
Do multiple sex/gender dimensions play a role in the association of green space and self-rated health? Model-based pecursive rartitioning Results from the KORA INGER study
Int. J. Environ. Res. Public Health 20 (7), art. 5241