Social inequalities, green and blue spaces and mental health in 6-12 years old children participating in the INMA cohort

Mikel Subiza-Pérez; Gonzalo García-Baquero; Ana Fernández-Somoano; Isolina Riaño; Llucia González; Juana Maria Delgado-Saborit; Mónica Guxens; Serena Fossati; Martine Vrijheid; Amanda Fernandes; Jesús Ibarluzea; Nerea Lertxundi

doi:10.1016/j.healthplace.2023.103104

Social inequalities, green and blue spaces and mental health in 6-12 years old children participating in the INMA cohort

Health Place. 2023 Sep:83:103104. doi: 10.1016/j.healthplace.2023.103104. Epub 2023 Aug 21.

Affiliations

¹ Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, Avenida Tolosa 70, 20018, Donostia-San Sebastián, Spain; Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, BD9 6RJ, Bradford, UK; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014, Donostia- San Sebastián, Spain. Electronic address: mikel.subiza@ehu.eus.
² Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014, Donostia- San Sebastián, Spain; Faculty of Pharmacy, University of Salamanca, Avda Licenciado Méndez Nieto s/n, 37007, Salamanca, Spain. Electronic address: ggbmoneo@usal.es.
³ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julian Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33001, Oviedo, Spain. Electronic address: fernandezsana@uniovi.es.
⁴ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julian Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33001, Oviedo, Spain; Servicio de Pediatría, Endocrinología pediátrica, HUCA, Roma Avenue s/n. 33001, Oviedo, Asturias, Spain. Electronic address: isolinariano@gmail.com.
⁵ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Faculty of Nursing and Chiropody, University of Valencia, Avda Menéndez Pelayo, 19, 46010, Valencia, Spain; Joint Research Unit in Epidemiology, Environment and Health, FISABIO-University of Valencia-Universitat Jaume I, Valencia, Spain. Electronic address: gonzalez_llu@gva.es.
⁶ Joint Research Unit in Epidemiology, Environment and Health, FISABIO-University of Valencia-Universitat Jaume I, Valencia, Spain; Department of Medicine, School of Health Sciences, Universitat Jaume I, Av. Vicent Sos Baynat, s/n, 12071, Castelló de la Plana, Spain. Electronic address: delgado@uji.es.
⁷ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. Electronic address: monica.guxens@isglobal.org.
⁸ ISGlobal, Barcelona, Spain. Electronic address: serena.fossati@isglobal.org.
⁹ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain. Electronic address: martine.vrijheid@isglobal.org.
¹⁰ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain. Electronic address: amanda.fernandes@isglobal.org.
¹¹ Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014, Donostia- San Sebastián, Spain; Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, 20013, Donostia-San Sebastián, Spain; Faculty of Psychology, University of the Basque Country UPV/EHU, Avenida Tolosa 70, 20018, Donostia-San Sebastián, Spain. Electronic address: mambien3-san@euskadi.eus.
¹² Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, Avenida Tolosa 70, 20018, Donostia-San Sebastián, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, c/ Monforte de Lemos 3-5, Madrid, 280, Spain; Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014, Donostia- San Sebastián, Spain. Electronic address: Nerea.lertxundi@ehu.eus.

PMID: 37611380
DOI: 10.1016/j.healthplace.2023.103104

Abstract

Availability of green and blue spaces in the area of residence has been related to various health outcomes during childhood, including mental health. These environmental exposures are not evenly distributed among socioeconomic groups, which may increase social inequalities in mental health. The mechanisms through which natural environments may promote mental health are numerous and diverse. This study aimed to explore 1) the potential associations of socioeconomic variables (SES and maternal education attainment) with mental health scores and residential greenness, blueness and NO₂ metrics, and, 2) the association between greenness and blueness metrics and mental health scores of children in the Spanish INfancia y Medio Ambiente (INMA) birth cohort at two different time points. The study samples were composed of 1738 six-to eight-year-olds (49% female) and 1449 ten-to twelve-year-olds (living in Asturias, Gipuzkoa, Sabadell and Valencia, Spain. Individual Normalized Difference Vegetation Index (NDVI) values in 100-, 300- and 500-m buffers and availability of green and blue spaces >5000 m² in 300-m buffers were calculated using Geographic Information Systems software. Residential NO₂ values were estimated using land use regression models. Internalizing, externalizing and total problems scores were obtained with the Strengths and Difficulties Questionnaire (SDQ). Linear and logistic mixed-effects models revealed unequal distribution of environmental exposures by SES and maternal education but did not show statistically significant associations between greenness and blueness metrics and mental health indicators. The protective effect of green and blue spaces on children's mental health could not be confirmed in this study and therefore further research is required.

Keywords: Dagitty; Geographic information systems; Greenness; Neighbourhood attributes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Environment
Female
Humans
Logistic Models
Male
Mental Health*
Nitrogen Dioxide*
Socioeconomic Factors

Substances

Nitrogen Dioxide