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      Residential green space and child intelligence and behavior across urban, suburban, and rural areas in Belgium: A longitudinal birth cohort study of twins

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          Abstract

          Background

          Exposure to green space has beneficial effects on several cognitive and behavioral aspects. However, to our knowledge, no study addressed intelligence as outcome. We investigated whether the level of urbanicity can modify the association of residential green space with intelligence and behavior in children.

          Methods and findings

          This study includes 620 children and is part of the East Flanders Prospective Twin Survey (EFPTS), a registry of multiple births in the province of East Flanders, Belgium. Intelligence was assessed with the Wechsler Intelligence Scale for Children-Revised (WISC-R) in 620 children (310 twin pairs) between 7 and 15 years old. From a subset of 442 children, behavior was determined based on the Achenbach Child Behavior Checklist (CBCL). Prenatal and childhood residential addresses were geocoded and used to assign green space indicators. Mixed modeling was performed to investigate green space in association with intelligence and behavior while adjusting for potential confounding factors including sex, age, parental education, neighborhood household income, year of assessment, and zygosity and chorionicity.

          We found that residential green space in association with both intelligence and behavior in children was modified by the degree of urbanicity ( p < 0.001). In children living in an urban environment, multivariable adjusted mixed modeling analysis revealed that an IQR increment of residential green space (3,000-m radius) was associated with a 2.6 points (95% CI 1.4–3.9; p < 0.001) higher total intelligence quotient (IQ) and 2.0 points (95% CI −3.5 to −0.4; p = 0.017) lower externalizing behavioral score. In children residing in a rural or suburban environment, no association was found. A limitation of this study is that no information was available on school location and the potential for unmeasured confounding (e.g., time spend outdoors).

          Conclusions

          Our results indicate that residential green space may be beneficial for the intellectual and the behavioral development of children living in urban areas. These findings are relevant for policy makers and urban planners to create an optimal environment for children to develop their full potential.

          Abstract

          Esmée M Bijnens and colleagues reveal beneficial effects of a green environment on a child's development and behaviour.

          Author summary

          Why was this study done?
          • This study examines residential surrounding green space in association with intelligence and behavior in a study area that includes a spectrum of urban to rural environments.

          • Previous studies mainly focused on urban areas, whereas only a few studies have explored differences in the effect of green space on cognition in nonurban settings.

          • Understanding the health disparities that exist between urban and rural environments is essential for maintaining and improving human well-being in a rapidly urbanizing world.

          What did the researchers do and find?
          • This longitudinal birth cohort study of twins assessed intelligence in 620 children between 7 and 15 years old.

          • Our results indicate that residential green space is especially beneficial for intellectual and behavioral development of children living in an urban environment.

          What do these findings mean?
          • We show that low residential green space in urban children is associated with a “shift” towards a higher incidence of low IQ demonstrating the public health impact of our findings.

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          Most cited references60

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          What are the Benefits of Interacting with Nature?

          There is mounting empirical evidence that interacting with nature delivers measurable benefits to people. Reviews of this topic have generally focused on a specific type of benefit, been limited to a single discipline, or covered the benefits delivered from a particular type of interaction. Here we construct novel typologies of the settings, interactions and potential benefits of people-nature experiences, and use these to organise an assessment of the benefits of interacting with nature. We discover that evidence for the benefits of interacting with nature is geographically biased towards high latitudes and Western societies, potentially contributing to a focus on certain types of settings and benefits. Social scientists have been the most active researchers in this field. Contributions from ecologists are few in number, perhaps hindering the identification of key ecological features of the natural environment that deliver human benefits. Although many types of benefits have been studied, benefits to physical health, cognitive performance and psychological well-being have received much more attention than the social or spiritual benefits of interacting with nature, despite the potential for important consequences arising from the latter. The evidence for most benefits is correlational, and although there are several experimental studies, little as yet is known about the mechanisms that are important for delivering these benefits. For example, we do not know which characteristics of natural settings (e.g., biodiversity, level of disturbance, proximity, accessibility) are most important for triggering a beneficial interaction, and how these characteristics vary in importance among cultures, geographic regions and socio-economic groups. These are key directions for future research if we are to design landscapes that promote high quality interactions between people and nature in a rapidly urbanising world.
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            More green space is linked to less stress in deprived communities: Evidence from salivary cortisol patterns

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              Green spaces and cognitive development in primary schoolchildren.

              Exposure to green space has been associated with better physical and mental health. Although this exposure could also influence cognitive development in children, available epidemiological evidence on such an impact is scarce. This study aimed to assess the association between exposure to green space and measures of cognitive development in primary schoolchildren. This study was based on 2,593 schoolchildren in the second to fourth grades (7-10 y) of 36 primary schools in Barcelona, Spain (2012-2013). Cognitive development was assessed as 12-mo change in developmental trajectory of working memory, superior working memory, and inattentiveness by using four repeated (every 3 mo) computerized cognitive tests for each outcome. We assessed exposure to green space by characterizing outdoor surrounding greenness at home and school and during commuting by using high-resolution (5 m × 5 m) satellite data on greenness (normalized difference vegetation index). Multilevel modeling was used to estimate the associations between green spaces and cognitive development. We observed an enhanced 12-mo progress in working memory and superior working memory and a greater 12-mo reduction in inattentiveness associated with greenness within and surrounding school boundaries and with total surrounding greenness index (including greenness surrounding home, commuting route, and school). Adding a traffic-related air pollutant (elemental carbon) to models explained 20-65% of our estimated associations between school greenness and 12-mo cognitive development. Our study showed a beneficial association between exposure to green space and cognitive development among schoolchildren that was partly mediated by reduction in exposure to air pollution.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: VisualizationRole: Writing – original draft
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: SupervisionRole: Writing – original draft
                Role: Academic Editor
                Journal
                PLoS Med
                PLoS Med
                plos
                plosmed
                PLoS Medicine
                Public Library of Science (San Francisco, CA USA )
                1549-1277
                1549-1676
                18 August 2020
                August 2020
                : 17
                : 8
                : e1003213
                Affiliations
                [1 ] Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
                [2 ] Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium
                [3 ] Centre of Human Genetics, University Hospitals Leuven, Leuven, Belgium
                [4 ] Department of Neurology, Ghent University Hospital, Ghent, Belgium
                [5 ] Department of Public Health, Leuven University (KU Leuven), Leuven, Belgium
                Helmholtz Zentrum München- German Research Center for Environmental Health, GERMANY
                Author notes

                The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0001-8537-843X
                http://orcid.org/0000-0003-2828-8037
                http://orcid.org/0000-0002-3583-3593
                Article
                PMEDICINE-D-19-03156
                10.1371/journal.pmed.1003213
                7446904
                32810193
                f4f4078b-9487-4dde-a0c1-71f1354baaeb
                © 2020 Bijnens et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 2 September 2019
                : 8 July 2020
                Page count
                Figures: 4, Tables: 2, Pages: 20
                Funding
                Funded by: Delacroix foundation
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100003130, Fonds Wetenschappelijk Onderzoek;
                Funded by: Twins
                Dr. Bijnens holds a fellowship from the Marguerite-Marie Delacroix foundation. Since its start, the East Flanders Prospective Twin Survey has been partly supported by grants from the Fund of Scientific Research Flanders and Twins, a nonprofit Association for Scientific Research in Multiple Births (Belgium). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Intelligence
                Human Intelligence
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Intelligence
                Human Intelligence
                Social Sciences
                Psychology
                Cognitive Psychology
                Intelligence
                Human Intelligence
                People and Places
                Population Groupings
                Age Groups
                Children
                People and Places
                Population Groupings
                Families
                Children
                Biology and Life Sciences
                Developmental Biology
                Twins
                Ecology and Environmental Sciences
                Terrestrial Environments
                Urban Environments
                Earth Sciences
                Geography
                Human Geography
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                Human Geography
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                Earth Sciences
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                Sociology
                Education
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                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Intelligence
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                Psychology
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                Intelligence
                Social Sciences
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                Cognitive Psychology
                Intelligence
                Biology and Life Sciences
                Psychology
                Psychometrics
                Intelligence Tests
                Social Sciences
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                Custom metadata
                Green space data (CORINE land cover) used in this study can be obtained from the European Environment Agency (EEA) ( https://land.copernicus.eu/pan-european/corine-land-cover). Air pollution data used in this study can be obtained from IRCEL ( https://www.irceline.be/en). Access to and use of summarized health data of study participants requires submission of a research proposal to the East Flanders Prospective Twin Survey, Ghent University, contact email, twins@ 123456uzgent.be .

                Medicine
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