Model System:


Reference Type:

Journal article

Accession No.:



Dialogues in Health

Year, Volume, Issue, Page(s):

, 2, 100129,

Publication Website:


Study assessed the feasibility of examining the effects of tree canopy coverage (TCC), an environmental variable, on mental health after traumatic brain injury (TBI). A secondary data analysis was conducted using information from the TBI Model System on mental health after moderate-to-severe TBI. Mental health was measured using the Generalized Anxiety Disorder-7 scale for anxiety and the Patient Health Questionnaire-9 for depression. The data were compared with data on TCC in the state of Texas that was obtained from the Multi-Resolution Land Characteristics Consortium. TCC as an indicator of neighborhood socioeconomic status (SES) was also examined using the Neighborhood SES Index. TCC had weak and non-significant correlations with anxiety and depression scores, as well as neighborhood SES. Data analysis was limited by small sample size. However, there is a higher percentage (18.8 percent) of participants who reported moderate-to-severe depression symptoms in areas with less than 30 percent TCC, compared with 6.6 percent of participants who endorsed moderate-to-severe depression symptoms and live in areas with more than 30 percent TCC; there was no difference in anxiety scores. Results confirm the feasibility of measuring the effects of TCC on mental health after brain injury and warrants further investigation into examining TCC and depression after TBI. Future work will include nationwide analyses to potentially detect significant relationships, as well as examine differences in geographic location.


Holland, Alexandra B.|Cohen, Achituv|Faerman, Afik|Nelson, Trisalyn A.|Wright, Brittany|Kumar, Raj G.|Ngan, Esther|Herrera, Susan|Juengst, Shannon B.|

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