Effect of Residential Greenness and Nearby Parks on Respiratory and Allergic Diseases among Middle School Adolescents in a Chinese City

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Abstract

Research on the health impacts of green environments has mainly been conducted in developed countries. Differences in the urban forms between China and Western countries make it essential to understand the role of greenspace in Chinese settings. From 2014 to 2015, middle school students ( n = 5643) in Suzhou, China were enrolled in a study on the health effect of residential greenness. The normalized difference vegetation index (NDVI) and distance to the nearest park were calculated for each home address. Logistic regression was performed to test associations between exposure and self-reported doctor diagnoses of asthma, pneumonia, rhinitis, and eczema, adjusting for important confounders. No statistically significant associations were observed for any seasonal NDVI-based measures. However, the proximity of the participants’ residences to the closest park showed an inverse relationship to reported symptoms. The odds ratios for the furthest quartile compared to the closest quartile based on the distance to the nearest park were 0.58 (95% CI: 0.35, 0.99), 0.70 (95% CI: 0.50, 0.96), 0.92 (95% CI: 0.74, 1.15), 0.97 (95% CI: 0.76, 1.24), 0.86 (95% CI: 0.68, 1.10) for current asthma, ever asthma, ever pneumonia, ever rhinitis, and ever eczema, respectively. These findings focused on a single Chinese city and suggest that exposure to natural vegetation in urban areas may affect health through various pathways.

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Most cited references 28

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A Review of the Health Benefits of Greenness.

Peter James, Rachel Banay, Jaime Hart … (2015)

Researchers are increasingly exploring how neighborhood greenness, or vegetation, may affect health behaviors and outcomes. Greenness may influence health by promoting physical activity and social contact; decreasing stress; and mitigating air pollution, noise, and heat exposure. Greenness is generally measured using satellite-based vegetation indices or land-use databases linked to participants' addresses. In this review, we found fairly strong evidence for a positive association between greenness and physical activity, and a less consistent negative association between greenness and body weight. Research suggests greenness is protective against adverse mental health outcomes, cardiovascular disease, and mortality, though most studies were limited by cross-sectional or ecological design. There is consistent evidence that greenness exposure during pregnancy is positively associated with birth weight, though findings for other birth outcomes are less conclusive. Future research should follow subjects prospectively, differentiate between greenness quantity and quality, and identify mediators and effect modifiers of greenness-health associations.

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Epidemiology and etiology of childhood pneumonia.

Igor Rudan, Cynthia Boschi-Pinto, Zrinka Biloglav … (2008)

Childhood pneumonia is the leading single cause of mortality in children aged less than 5 years. The incidence in this age group is estimated to be 0.29 episodes per child-year in developing and 0.05 episodes per child-year in developed countries. This translates into about 156 million new episodes each year worldwide, of which 151 million episodes are in the developing world. Most cases occur in India (43 million), China (21 million) and Pakistan (10 million), with additional high numbers in Bangladesh, Indonesia and Nigeria (6 million each). Of all community cases, 7-13% are severe enough to be life-threatening and require hospitalization. Substantial evidence revealed that the leading risk factors contributing to pneumonia incidence are lack of exclusive breastfeeding, undernutrition, indoor air pollution, low birth weight, crowding and lack of measles immunization. Pneumonia is responsible for about 19% of all deaths in children aged less than 5 years, of which more than 70% take place in sub-Saharan Africa and south-east Asia. Although based on limited available evidence, recent studies have identified Streptococcus pneumoniae, Haemophilus influenzae and respiratory syncytial virus as the main pathogens associated with childhood pneumonia.

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Neighborhood greenness and 2-year changes in body mass index of children and youth.

Janice Bell, Jeffrey Wilson, Gilbert Liu (2008)

Available studies of the built environment and the BMI of children and youth suggest a contemporaneous association with neighborhood greenness in neighborhoods with high population density. The current study tests whether greenness and residential density are independently associated with 2-year changes in the BMI of children and youth. The sample included children and youth aged 3-16 years who lived at the same address for 24 consecutive months and received well-child care from a Marion County IN clinic network within the years 1996-2002 (n=3831). Multiple linear regression was used to examine associations among age- and gender-specific BMI z-scores in Year 2, residential density, and a satellite-derived measure of greenness, controlling for baseline BMI z-scores and other covariates. Logistic regression was used to model associations between an indicator of BMI z-score increase from baseline to Time 2 and the above-mentioned predictors. Higher greenness was significantly associated with lower BMI z-scores at Time 2 regardless of residential density characteristics. Higher residential density was not associated with Time 2 BMI z-scores in models regardless of greenness. Higher greenness was also associated with lower odds of children's and youth's increasing their BMI z-scores over 2 years (OR=0.87; 95% CI=0.79, 0.97). Greenness may present a target for environmental approaches to preventing child obesity. Children and youth living in greener neighborhoods had lower BMI z-scores at Time 2, presumably due to increased physical activity or time spent outdoors. Conceptualizations of walkability from adult studies, based solely on residential density, may not be relevant to children and youth in urban environments.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Environ Res Public Health

Journal ID (iso-abbrev): Int J Environ Res Public Health

Journal ID (publisher-id): ijerph

Title: International Journal of Environmental Research and Public Health

Publisher: MDPI

ISSN (Print): 1661-7827

ISSN (Electronic): 1660-4601

Publication date (Electronic): 19 March 2019

Publication date (Print): March 2019

Volume: 16

Issue: 6

Electronic Location Identifier: 991

Affiliations

[1 ]Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; jaime.hart@ 123456channing.harvard.edu (J.E.H.); spengler@ 123456hsph.harvard.edu (J.D.S.); gadamkie@ 123456hsph.harvard.edu (G.A.)

[2 ]Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA

[3 ]Department of Biostatistics, Harvard School T.H. Chan School of Public Health, Boston, MA 02115, USA; bacoull@ 123456gmail.com

[4 ]Academy of Building Energy Efficiency, School of Civil Engineering, Guangzhou University, Guangzhou 510006, China; shijie.cao@ 123456gzhu.edu.cn

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[* ]Correspondence: linyan.li@ 123456mail.harvard.edu

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Linyan Li https://orcid.org/0000-0001-5736-2115

Shi-jie Cao https://orcid.org/0000-0001-9136-0949

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Publisher ID: ijerph-16-00991

DOI: 10.3390/ijerph16060991

PMC ID: 6466062

PubMed ID: 30893887

SO-VID: db338d95-756e-46b8-bcc2-76bbb073b1d2

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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

Effect of Residential Greenness and Nearby Parks on Respiratory and Allergic Diseases among Middle School Adolescents in a Chinese City

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European Respiratory Society: COVID-19

Most cited references 28

A Review of the Health Benefits of Greenness.

Epidemiology and etiology of childhood pneumonia.

Neighborhood greenness and 2-year changes in body mass index of children and youth.

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