Urban green, blue spaces and their joint effect are associated with lower risk of emotional and behavior problem in children and adolescents, a large population-based study in Guangzhou, China

Jing-Hong Liang; Ru-Yu Yang; Mei-Ling Liu; Ying-Qi Pu; Wen-Wen Bao; Yu Zhao; Li-Xin Hu; Yu-Shan Zhang; Shan Huang; Nan Jiang; Xue-Ya Pu; Shao-Yi Huang; Guang-Hui Dong; Ya-Jun Chen

doi:10.1016/j.envres.2023.117475

Urban green, blue spaces and their joint effect are associated with lower risk of emotional and behavior problem in children and adolescents, a large population-based study in Guangzhou, China

Environ Res. 2024 Jan 1;240(Pt 2):117475. doi: 10.1016/j.envres.2023.117475. Epub 2023 Oct 31.

Authors

Affiliations

¹ Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China.
² Northwest Land and Resource Research Center, Shaanxi Normal University, Xi'an, PR China.
³ Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China.
⁴ Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China. Electronic address: chenyj68@mail.sysu.edu.cn.

PMID: 37914012
DOI: 10.1016/j.envres.2023.117475

Abstract

Extensive research has been conducted on the impact of urban Green and blue spaces (GBS) on mental health. However, there is a dearth of studies examining the potential influence of GBS on Emotion and behavior problems (EBP) in youth populations. This study seeks to address this research gap by examining the association between GBS exposure and EBP in youths, utilizing a large population-based survey. Exposure indicators were derived for each participant, taking into account the 1-m resolution land coverage percentage measurements at their residential and school locations, with buffer sizes of 500m and 800m. The study employed the parent-reported Strengths and Difficulties Questionnaire (SDQ) as a measurement to EBP. To investigate this relationship, a Poisson linear mixed-effects model with comprehensive adjustment was utilized. Stratified analyses were conducted, taking into account demographic variables, while sensitivity analyses were performed to evaluate the reliability of the findings. The primary analysis encompassed a sample of 172,490 individuals, with an average age of 10.2 (standard deviation = 2.99), of whom 55.8% were male. Among young individuals residing within a 500-m radius of residential green spaces (GS), those in the second and third tertiles experienced a 5.0% and 7.6% decrease in the risk of developing total difficulties respectively, compared to those in the first tertile. Exposure to blue spaces (BS) around the residence yielded comparable results, with an AOR of 0.896 (95% CI: 0.866, 0.928) for the second tertile and an AOR of 0.991 (95% CI: 0.879, 0.943) for the third tertile, compared to the first tertile. The decrease in EBPs may also be linked to the joint effect of GS and BS. Young individuals were exposed to GS or BS, as well as the higher level of GS in conjunction with comparable BS, exhibited an inverse correlation with self-reported EBPs.

Keywords: Children and adolescents; Emotion and behavior problems; Green and blue spaces; Joint effect; Population-based study.

MeSH terms

Adolescent
Child
China / epidemiology
Emotions*
Female
Humans
Male
Mental Health*
Reproducibility of Results
Surveys and Questionnaires