The quality of the outdoor environment influences childrens health -- a cross-sectional study of preschools

Aim: To test how the quality of the outdoor environment of child day care centres (DCCs) influences children's health.

Methods: The environment was assessed using the Outdoor Play Environmental Categories (OPEC) tool, time spent outdoors and physical activity as measured by pedometer. 172/253 (68%) of children aged 3.0-5.9 from nine DCCs participated in Southern Sweden. Health data collected were body mass index, waist circumference, saliva cortisol, length of night sleep during study, and symptoms and well-being which were scored (1-week diary - 121 parent responders). Also, parent-rated well-being and health of their child were scored (questionnaire, 132 parent responders). MANOVA, ANOVA and principal component analyses were performed to identify impacts of the outdoor environment on health.

Results: High-quality outdoor environment at DCCs is associated with several health aspects in children such as leaner body, longer night sleep, better well-being and higher mid-morning saliva cortisol levels.

Conclusion: The quality of the outdoor environment at DCCs influenced the health and well-being of preschool children and should be given more attention among health care professionals and community planners.