Background: Previous studies have found positive associations between urban green space and better physical and mental health. In addition many ecological studies have found that greater residential area green space was associated with lower mortality rates, although some of these studies found no significant associations between green space and mortality. Methods: We obtained data on all suicide deaths in Hong Kong from 2008 through 2014 classified by 5-year age group, gender, and small area of residence. Mean normalized difference vegetation index (NDVI), and indicator of greenery, was estimated for all small areas for the year 2011 from a satellite image. Negative binomial regression with logarithm transformed suicide counts as the outcome and age group, gender, NDVI, and area-level socioeconomic indicators as predictors, with person-years as the offset term. Results: An increase in area level NDVI from the 25th to 75th percentile was non-significantly associated with a relative risk of suicide mortality = 0.91 (95% confidence interval = 0.81, 1.03) after controlling for age, gender, and small area level socioeconomic status variables. Lower area level education levels and higher percentage never married individuals, but not median household income, were significantly associated with higher suicide mortality rates. Conclusions: Higher area level green space may be associated with lower suicide mortality rates but further studies are needed to confirm this association.
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