Access to urban green spaces and behavioural problems in children: Results from the GINIplus and LISAplus studies

doi:10.1016/j.envint.2014.06.002

Environment International

Volume 71, October 2014, Pages 29-35

https://doi.org/10.1016/j.envint.2014.06.002 Get rights and content

Highlights

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Larger distance to urban green spaces was associated with more hyperactivity problems.
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This association was only significant in males.
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A neighbourhood with no urban green spaces was associated with poorer mental health.
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Access to forests and surrounding greenness was unrelated to children's mental health.

Abstract

Aim

We investigated whether objectively measured access to urban green spaces is associated with behavioural problems in 10-year old children living in Munich and its surrounding areas.

Methods

Behavioural problems were assessed in the GINIplus and LISAplus 10-year follow-up between 2006 and 2009 using the Strengths and Difficulties Questionnaire. Access to green spaces was defined using the distance from a child's residence to the nearest urban green space. Associations between access to urban green spaces and behavioural problems were assessed using proportional odds and logistic regression models in 1932 children with complete exposure, outcome and covariate data.

Results

The distance between a child's residence and the nearest urban green space was positively associated with the odds of hyperactivity/inattention, especially among children with abnormal values compared to children with borderline or normal values (odds ratio (OR) = 1.20 (95% confidence interval (CI) = 1.01–1.42) per 500 m increase in distance). When stratified by sex, this association was only statistically significant among males. Children living further than 500 m away from urban green spaces had more overall behavioural problems than those living within 500 m of urban green spaces (proportional OR = 1.41 (95% CI = 1.06–1.87)). Behavioural problems were not associated with the distance to forests or with residential surrounding greenness.

Conclusion

Poor access to urban green spaces was associated with behavioural problems in 10-year old children. Results were most consistent with hyperactivity/inattention problems.

Introduction

Currently, more than half of the world's population lives in urban settings (United Nations, 2011). An increasing number of children grow up in cities and often have limited access to green spaces. The effects of urbanisation on the well-being of children have not been adequately investigated. Further insight into the effects of urban green space access on children's health is needed to inform efficient city planning and the development of effective health policies (Kyttä et al., 2012, Lee and Maheswaran, 2010).

Green spaces appear to have positive effects on human psychological health (Bowler et al., 2010, Lee and Maheswaran, 2010). However, with only a few exceptions, most studies examining associations between green spaces and mental health have been conducted among adults (Bowler et al., 2010, Lee and Maheswaran, 2010). Moreover, objective measurements of green space access have rarely been used in these studies (Annerstedt et al., 2012, Kyttä et al., 2012, Lee and Maheswaran, 2010, Stigsdotter et al., 2010).

Several hypotheses have been proposed to explain how green spaces may have a beneficial effect on mental health and well-being. There is mounting evidence supporting the restorative and stress reductive effects of green spaces (Fan et al., 2011). Better access to green spaces is also hypothesised to promote physical activity, which could ultimately lead to improved mental functioning (Fan et al., 2011, Lee and Maheswaran, 2010). Finally, green spaces might also improve psychological health by encouraging the development of social contacts (Maas et al., 2009).

We investigated whether objectively measured access to urban green spaces was associated with behavioural problems in 10-year old children living in Munich and its surrounding areas.

Section snippets

Study population

The “German Infant Study on the Influence of Nutrition Intervention plus Environmental and Genetic Influences on Allergy Development” (GINIplus) study and the “Influence of Life-Style Factors on the Development of the Immune System and Allergies in East and West Germany plus the Influence of Traffic Emissions and Genetics” study (LISAplus) are ongoing population-based birth cohorts. Both cohorts have a similar study design and recruited healthy full-term neonates with a normal birth weight.

Results

The socio-demographic characteristics and exposure levels of study participants are presented in Table 1. The age of children ranged from 9.4 to 11.7 years and 51.4% of them were male. The median distance to the nearest urban green space was 289.1 m and the interquartile range was 368.1 m. The prevalence of behavioural problems among the study participants, as measured by the SDQ subscales, and the total difficulties scores are presented in Table 2. The internal consistency of the SDQ subscales

Key findings

Hyperactivity/inattention and peer relationship problems in 10-year old children were positively associated with increasing distances to urban green spaces. The effects were slightly stronger for children residing in the inner city of Munich. When stratified by sex, the observed association with hyperactivity/inattention was only statistically significant among males. Children living further than 500 m away from any urban green space had more overall behavioural problems than those living within

Conclusions

Our findings suggest that children with poorer access to urban green spaces are more likely to have hyperactivity/inattention problems at 10 years of age. This association was only significant in males. Moreover, the absence of urban green spaces in a child's neighbourhood was associated with poorer overall mental health. Behavioural problems were not associated with the distance to a forest or with residential surrounding greenness. Given the general lack of studies on the influence of green

Funding

GINIplus study was mainly supported for the first three years of the Federal Ministry for Education, Science, Research and Technology (interventional arm, no. 01 EE 9401-4) and Helmholtz Zentrum Munich (former GSF) (observational arm). The four year, six year, and ten year follow-up examinations of the GINIplus study were covered from the respective budgets of the 5 study centres (Helmholtz Zentrum Munich (former GSF), Research Institute at Marien-Hospital Wesel, LMU Munich, TU Munich and from

Acknowledgements

GINIplus study group. Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, GINI/LISA South (Heinrich J, Wichmann HE, Sausenthaler S, Zutavern A, Chen CM, Schnappinger M, Rzehak P); Department of Pediatrics, Marien-Hospital, GINI/LISA North (Berdel D, von Berg A, Beckmann C, Groß I); Department of Pediatrics, Ludwig-Maximilians-University, GINI/LISA South (Koletzko S, Reinhardt D, Krauss-Etschmann S); Department of Pediatrics, Technical

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Access to urban green spaces and behavioural problems in children: Results from the GINIplus and LISAplus studies

Highlights

Abstract

Aim

Methods

Results

Conclusion

Introduction

Section snippets

Study population

Results

Key findings

Conclusions

Funding

Acknowledgements

J Clin Epidemiol

Am J Prev Med

Health Place

J Environ Psychol

Health Place

Health Place

J Clin Epidemiol

Environ Res

J Environ Psychol

Environ Res

J Allergy Clin Immunol

Green qualities in the neighbourhood and mental health — results from a longitudional cohort study in Southern Sweden

BMC Public Health

Validation of the parent and teacher SDQ in a clinical sample

Eur Child Adolesc Psychiatry

A systematic review of evidence for the added benefits to health of exposure to natural environments

BMC Public Health

Coefficient alpha and the internal structure of tests

Psychometrika

Surrounding greenness and pregnancy outcomes in four Spanish birth cohorts

Environ Health Perspect

Validation of Walk Score for estimating neighborhood walkability: an analysis of four US metropolitan areas

Int J Environ Res Public Health

The great outdoors: how a green exercise environment can benefit all

Extrem Physiol Med

The Strengths and Difficulties Questionnaire: a research note

J Child Psychol Psychiatry

Allergens and endotoxin on mothers' mattresses and total immunoglobulin E in cord blood of neonates

Eur Respir J