Association of physical activity, green spaces, and psychological distress in the Chilean population: analysis of the 2023 Social Well-Being Survey

Abstract

Objective: To analyze the relationship between physical activity, frequency of visits to green spaces, and psychological distress among Chilean adults during the post-pandemic period. Methods: Cross-sectional study based on a secondary analysis of the 2023 Social Wellbeing Survey (n = 10,848). Psychological distress was assessed using the Patient Health Questionnaire-4 (PHQ-4), with distress defined as a score ≥6. Adjusted binary logistic regression models including behavioral, health-related, and sociodemographic variables were fitted. Results are presented as odds ratios (OR) with 95% confidence intervals (95% CI). Results: Overall, 53.1% of participants presented symptoms of psychological distress. Sufficient physical activity (OR = 0.680) and frequent visits to green spaces (OR = 0.616) were associated with lower odds of distress. Positive self-rated health was the strongest protective factor (OR = 0.171), followed by adequate sleep and high social support. Female sex, urban residence, and higher educational level were associated with increased odds of distress. Conclusions: Physical activity and frequent visits to green spaces were associated with lower odds of psychological distress after adjustment for multiple confounders. Although causality cannot be inferred from the cross-sectional design, these findings support public health strategies promoting active lifestyles and healthy environments.