Green Space and Internalizing or Externalizing Symptoms Among Children.

Autor:	Towe-Goodman N; Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill., McArthur KL; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland., Willoughby M; Education and Workforce Development, RTI International, Research Triangle Park, North Carolina., Swingler MM; Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill., Wychgram C; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland., Just AC; Department of Epidemiology, Institute at Brown for Environment and Society, Brown University, Providence, Rhode Island., Kloog I; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York., Bennett DH; Department of Public Health Sciences, University of California, Davis, Sacramento., Berry D; Institute of Child Development, University of Minnesota, Minneapolis., Hazlehurst MF; Department of Environmental & Occupational Health Sciences, School of Public Health, University of Washington, Seattle., James P; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health, Boston, Massachusetts., Jimenez MP; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts., Lai JS; Department of Medical Social Sciences, Northwestern University, Chicago, Illinois., Leve LD; Prevention Science Institute, University of Oregon, Eugene., Gatzke-Kopp L; Department of Human Development and Family Studies, The Pennsylvania State University, University Park., Schweitzer JB; Department of Public Health Sciences, University of California, Davis, Sacramento., Bekelman TA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora., Calub C; Department of Public Health Sciences, University of California, Davis, Sacramento., Carnell S; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland., Deoni S; Maternal, Newborn, and Child Health Discovery & Tools, Bill & Melinda Gates Foundation, Seattle, Washington., D'Sa V; Department of Pediatrics, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island., Kelly C; Department of Pediatrics, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island., Koinis-Mitchell D; Department of Pediatrics, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island., Petriello M; Institute of Environmental Health Sciences, Department of Pharmacology, Wayne State University, Detroit, Michigan., Thapaliya G; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland., Wright RJ; Department of Epidemiology, Institute at Brown for Environment and Society, Brown University, Providence, Rhode Island.; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York., Zhang X; Education and Workforce Development, RTI International, Research Triangle Park, North Carolina., Kress AM; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2024 Apr 01; Vol. 7 (4), pp. e245742. Date of Electronic Publication: 2024 Apr 01.
DOI:	10.1001/jamanetworkopen.2024.5742
Abstrakt:	Importance: Evidence suggests that living near green space supports mental health, but studies examining the association of green space with early mental health symptoms among children are rare. Objective: To evaluate the association between residential green space and early internalizing (eg, anxiety and depression) and externalizing (eg, aggression and rule-breaking) symptoms. Design, Setting, and Participants: Data for this cohort study were drawn from the Environmental Influences on Child Health Outcomes cohort; analysis was conducted from July to October 2023. Children born between 2007 and 2013 with outcome data in early (aged 2-5 years) and/or middle (aged 6-11 years) childhood who resided in 41 states across the US, drawing from clinic, hospital, and community-based cohorts, were included. Cohort sites were eligible if they recruited general population participants and if at least 30 children had outcome and residential address data to measure green space exposure. Nine cohorts with 13 sites met these criteria. Children diagnosed with autism or developmental delay were excluded, and 1 child per family was included. Exposures: Green space exposure was measured using a biannual (ie, summer and winter) Normalized Difference Vegetation Index, a satellite image-based indicator of vegetation density assigned to monthly residential history from birth to outcome assessment. Main Outcome and Measures: Child internalizing and externalizing symptoms were assessed using the Child Behavior Checklist for Ages 1½ to 5 or 6 to 18. The association between green space and internalizing and externalizing symptoms was modeled with multivariable linear regression using generalized estimating equations, adjusting for birthing parent educational level, age at delivery, child sex, prematurity, and neighborhood socioeconomic vulnerability. Models were estimated separately for early and middle childhood samples. Results: Among 2103 children included, 1061 (50.5%) were male; 606 (29.1%) identified as Black, 1094 (52.5%) as White, 248 (11.9%) as multiple races, and 137 (6.6%) as other races. Outcomes were assessed at mean (SD) ages of 4.2 (0.6) years in 1469 children aged 2 to 5 years and 7.8 (1.6) years in 1173 children aged 6 to 11 years. Greater green space exposure was associated with fewer early childhood internalizing symptoms in fully adjusted models (b = -1.29; 95% CI, -1.62 to -0.97). No associations were observed between residential green space and internalizing or externalizing symptoms in middle childhood. Conclusions and Relevance: In this study of residential green space and children's mental health, the association of green space with fewer internalizing symptoms was observed only in early childhood, suggesting a sensitive period for nature exposure. Policies protecting and promoting access to green space may help alleviate early mental health risk.
Databáze:	MEDLINE
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