Ecological pressures show uneven links with mental health in 22 EU countries

A panel study of 22 European Union countries found that higher ecological footprints were associated with poorer population-level mental health between 1996 and 2019, but the relationships varied across environmental pressures, mental-health outcomes and the direction of change. The analysis covered the overall ecological footprint and six components: cropland, grazing land, forest footprint, fishing grounds, built-up land and carbon footprint. Each component had a positive, statistically significant association with the Mental Health Index, indicating that greater pressure in each measured area was linked to less favorable mental-health outcomes at the population level.

Researchers used Driscoll–Kraay panel regression to estimate the country-level associations across the 24-year study period. The model was applied to the aggregate ecological footprint and separately to its six components. Although every component showed a significant relationship with the Mental Health Index, the broader analysis indicated that the environmental–mental-health relationship was multidimensional rather than uniform. An aggregate footprint therefore represented a shared pattern, while the component-level models identified differences associated with carbon-related pressure and pressures linked to land, forests and fishing resources. These results concern associations in country-level panel data; they do not establish that any environmental component directly caused a change in mental health.

The researchers complemented the regression with an asymmetric bootstrap panel causality approach. It considered positive and negative shocks in ecological footprint indicators alongside five mental-health outcomes: schizophrenia, anxiety disorders, depressive disorders, bipolar disorder and eating disorders. The estimated relationships differed according to the ecological component, the mental-health indicator, the type of shock and the direction of analysis. Carbon footprint showed particularly widespread relationships under positive environmental shocks, while schizophrenia appeared frequently in reverse-direction models linking mental-health indicators to ecological footprint components. The reported findings therefore support treating positive and negative changes as potentially distinct rather than assuming that increases and decreases in environmental pressure would have equivalent associations.

For schizophrenia, anxiety disorders, depressive disorders, bipolar disorder and eating disorders, the direction and strength of the modeled relationships were not uniform. Some connections were concentrated in the environmental-to-mental-health direction, others appeared in the reverse direction, and the carbon footprint was prominent in many of the positive-shock relationships. The authors’ interpretation is that aggregate environmental indicators or symmetric analytical approaches may miss component-specific patterns. Their results also identify carbon-related pressures as a prominent area for further attention while showing why land and resource indicators remain relevant to environmental and public-health monitoring.

Several limitations define the scope of the findings. The study examined only 22 European Union countries and only the period from 1996 to 2019, so the results cannot automatically be generalized to other regions, periods or smaller geographic scales. The regression estimated associations, while the asymmetric bootstrap causality framework examined potential directional relationships. Neither approach, as reported, demonstrates individual-level mechanisms or proves that changing an ecological indicator would produce a specified improvement in mental health. The evidence instead supports integrated monitoring of specific ecological pressures and mental-health indicators, with attention to the direction of environmental change and the outcome under consideration.

Subject of Research: Associations between ecological footprint components and population-level mental health in 22 European Union countries.

Article Title: Ecological footprint dimensions and mental health: asymmetric evidence across environmental pressures

Article References: Gündüz, M. (2026). Ecological footprint dimensions and mental health: asymmetric evidence across environmental pressures. BMC Public Health. https://doi.org/10.1186/s12889-026-29744-5

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29744-5

Keywords: ecological footprint, mental health, carbon footprint, environmental pressure, public health, European Union, asymmetric relationships, panel regression, environmental degradation, health indicators, Ecological, footprint