Residential Greenness and Birth Outcomes: Evaluating the Influence of Spatially Correlated Built-Environment Factors

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Abstract

Background: Half the world’s population lives in urban areas. It is therefore important to identify characteristics of the built environment that are beneficial to human health. Urban greenness has been associated with improvements in a diverse range of health conditions, including birth outcomes; however, few studies have attempted to distinguish potential effects of greenness from those of other spatially correlated exposures related to the built environment.

Objectives: We aimed to investigate associations between residential greenness and birth outcomes and evaluate the influence of spatially correlated built environment factors on these associations.

Methods: We examined associations between residential greenness [measured using satellite-derived Normalized Difference Vegetation Index (NDVI) within 100 m of study participants’ homes] and birth outcomes in a cohort of 64,705 singleton births (from 1999–2002) in Vancouver, British Columbia, Canada. We also evaluated associations after adjusting for spatially correlated built environmental factors that may influence birth outcomes, including exposure to air pollution and noise, neighborhood walkability, and distance to the nearest park.

Results: An interquartile increase in greenness (0.1 in residential NDVI) was associated with higher term birth weight (20.6 g; 95% CI: 16.5, 24.7) and decreases in the likelihood of small for gestational age, very preterm (< 30 weeks), and moderately preterm (30–36 weeks) birth. Associations were robust to adjustment for air pollution and noise exposures, neighborhood walkability, and park proximity.

Conclusions: Increased residential greenness was associated with beneficial birth outcomes in this population-based cohort. These associations did not change after adjusting for other spatially correlated built environment factors, suggesting that alternative pathways (e.g., psychosocial and psychological mechanisms) may underlie associations between residential greenness and birth outcomes.

Citation: Hystad P, Davies HW, Frank L, Van Loon J, Gehring U, Tamburic L, Brauer M. 2014. Residential greenness and birth outcomes: evaluating the influence of spatially correlated built-environment factors. Environ Health Perspect 122:1095–1102; http://dx.doi.org/10.1289/ehp.1308049

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Green space, urbanity, and health: how strong is the relation?

Jolanda Maas, Robert A. Verheij, Peter Groenewegen … (2006)

To investigate the strength of the relation between the amount of green space in people's living environment and their perceived general health. This relation is analysed for different age and socioeconomic groups. Furthermore, it is analysed separately for urban and more rural areas, because the strength of the relation was expected to vary with urbanity. The study includes 250 782 people registered with 104 general practices who filled in a self administered form on sociodemographic background and perceived general health. The percentage of green space (urban green space, agricultural space, natural green space) within a one kilometre and three kilometre radius around the postal code coordinates was calculated for each household. Multilevel logistic regression analyses were performed at three levels-that is, individual level, family level, and practice level-controlled for sociodemographic characteristics. The percentage of green space inside a one kilometre and a three kilometre radius had a significant relation to perceived general health. The relation was generally present at all degrees of urbanity. The overall relation is somewhat stronger for lower socioeconomic groups. Elderly, youth, and secondary educated people in large cities seem to benefit more from presence of green areas in their living environment than other groups in large cities. This research shows that the percentage of green space in people's living environment has a positive association with the perceived general health of residents. Green space seems to be more than just a luxury and consequently the development of green space should be allocated a more central position in spatial planning policy.

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Socioeconomic disparities in adverse birth outcomes: a systematic review.

Philip Blumenshine, Susan Egerter, Colleen J Barclay … (2010)

Adverse birth outcomes, such as preterm birth and low birth weight, have serious health consequences across the life course. Socioeconomic disparities in birth outcomes have not been the subject of a recent systematic review. The aim of this study was to systematically review the literature on the association of socioeconomic disadvantage with adverse birth outcomes, with specific attention to the strength and consistency of effects across socioeconomic measures, birth outcomes, and populations. Relevant articles published from 1999 to 2007 were obtained through electronic database searches and manual searches of reference lists. English-language studies from industrialized countries were included if (1) study objectives included examination of a socioeconomic disparity in a birth outcome and (2) results were presented on the association between a socioeconomic predictor and a birth outcome related to birth weight, gestational age, or intrauterine growth. Two reviewers extracted data and independently rated study quality; data were analyzed in 2008-2009. Ninety-three of 106 studies reported a significant association, overall or within a population subgroup, between a socioeconomic measure and a birth outcome. Socioeconomic disadvantage was consistently associated with increased risk across socioeconomic measures, birth outcomes, and countries; many studies observed racial/ethnic differences in the effect of socioeconomic measures. Socioeconomic differences in birth outcomes remain pervasive, with substantial variation by racial or ethnic subgroup, and are associated with disadvantage measured at multiple levels (individual/family, neighborhood) and time points (childhood, adulthood), and with adverse health behaviors that are themselves socially patterned. Future reviews should focus on identifying interventions to successfully reduce socioeconomic disparities in birth outcomes. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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Author and article information

Journal

Journal ID (nlm-ta): Environ Health Perspect

Journal ID (iso-abbrev): Environ. Health Perspect

Journal ID (publisher-id): EHP

Title: Environmental Health Perspectives

Publisher: NLM-Export

ISSN (Print): 0091-6765

ISSN (Electronic): 1552-9924

Publication date (Electronic): 11 July 2014

Publication date (Print): October 2014

Volume: 122

Issue: 10

Pages: 1095-1102

Affiliations

[1 ]College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA

[2 ]School of Population and Public Health, and

[3 ]School of Community and Regional Planning, University of British Columbia, Vancouver, British Columbia, Canada

[4 ]Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands

Author notes

Address correspondence to P. Hystad, College of Public Health and Human Sciences, School of Biological and Population Health Sciences, 20C Milam Hall, Corvallis, OR 97331 USA. Telephone: (541) 737-4829. E-mail: perry.hystad@ 123456oregonstate.edu

Article

Publisher ID: ehp.1308049

DOI: 10.1289/ehp.1308049

PMC ID: 4181932

PubMed ID: 25014041

SO-VID: 55e4a7db-9ade-4763-a87d-c44edb0f8a7b

License:

Publication of EHP lies in the public domain and is therefore without copyright. All text from EHP may be reprinted freely. Use of materials published in EHP should be acknowledged (for example, “Reproduced with permission from Environmental Health Perspectives”); pertinent reference information should be provided for the article from which the material was reproduced. Articles from EHP, especially the News section, may contain photographs or illustrations copyrighted by other commercial organizations or individuals that may not be used without obtaining prior approval from the holder of the copyright.

History

Date received : 20 December 2013

Date accepted : 10 July 2014

Date: 11 July 2014

Date: 01 October 2014

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