Environmental green cover and mental wellbeing in Malta

Abstract

This study investigates the relationship between environmental green cover and mental wellbeing among adults living in Malta, offering one of the first national assessments that integrates geospatial greenery measures with validated psychological wellbeing tools. Green spaces are internationally recognised for their capacity to reduce stress, enhance mood, strengthen social ties, and promote physical activity. Yet, in small island states such as Malta— where land is limited, urban density is high, and green infrastructure is unevenly distributed— the extent to which environmental greenery contributes to mental wellbeing has remained unclear. This study addresses this gap by exploring whether objective measures of greenery surrounding participants’ homes and workplaces are associated with mental wellbeing, while considering key behavioural, environmental, and socio-demographic influences. A cross-sectional sample of 691 adults was recruited across educational institutions, workplaces, and primary care settings. Mental wellbeing was measured using the WHO-5 index, while environmental green cover (grassland, tree canopy, cropland, and total greenery) was quantified within 300 m and 900 m buffers using high-resolution land-cover datasets. After geocoding residential and workplace street names, a comprehensive analysis was undertaken, including descriptive statistics, correlation testing, and multivariable regressions adjusting for demographics, physical activity, chronic disease, social cohesion, sedentary behaviour, and residential conditions. Findings showed considerable variability in both mental wellbeing scores and environmental greenery across Malta and Gozo. Bivariate correlations between greenery and mental wellbeing were weak and non-significant at both buffer distances, and regression models confirmed that environmental greenery did not independently predict mental wellbeing once confounders were included. Instead, stronger predictors emerged, particularly social cohesion, physical activity, housing quality, sedentary behaviour, and chronic illness. These results align with international literature suggesting that the benefits of greenery are mediated through behavioural and social pathways, and that simple measures of quantity may overlook the importance of quality, safety, accessibility, and actual use. The study carries several implications for public health and urban planning in Malta. First, increasing the amount of greenery alone is unlikely to yield significant improvements in population mental wellbeing. Instead, efforts should prioritise enhancing the quality, usability, and accessibility of green spaces, ensuring they are well-maintained, safe, shaded, and equipped with facilities that encourage both social interaction and physical activity. Second, interventions should address inequities in access to high-quality green environments, as disadvantaged communities often face greater environmental burdens and may benefit most from targeted greening initiatives. Third, integrating health considerations into environmental and urban development policies can support more holistic approaches to wellbeing, especially by linking green infrastructure planning with strategies for heat mitigation, active travel, and chronic disease prevention. Recommendations for future research include adopting longitudinal designs to better establish causality; incorporating subjective assessments of perceived greenery, quality, and safety; evaluating patterns of actual use of green spaces; and examining the influence of micro-scale greenery such as street trees and pocket parks. Expanding research to include cultural and behavioural factors specific to small island states would further strengthen policy relevance. Overall, this study contributes foundational evidence on environmental greenery and mental wellbeing in Malta. While objective greenery alone does not independently predict wellbeing, the findings highlight the importance of social, behavioural, and environmental conditions that shape how residents interact with and benefit from nearby green spaces. These insights underscore the value of context-sensitive, equity-driven, and health-informed urban greening strategies for supporting population mental wellbeing.