Urban factors and mental health symptoms in children of the Tokyo Early Adolescence Survey; impact of proximity to railway stations

Abstract

IntroductionThere is an evolving literature on the association of the proximity of place of residence to specific urban features with mental health symptoms or diagnoses, although few studies have examined these associations in children. This study tested the hypothesis that proximity of home to railway stations is a positive predictor of mental health at age 10 years. MethodsWe used data from a large population-based survey conducted in three municipalities in Tokyo, Japan, the Tokyo Early Adolescence Survey. We examined relationships between distance from home to the nearest railway station and Strengths and Difficulties Questionnaire (SDQ) scores for hyperactivity/inattention, prosocial behaviour and emotional symptoms. We undertook unadjusted analyses and then adjusted for urban, child and parental co-variates. Analyses were performed both in the whole sample and after stratification by child gender. Multiple Imputation with Chained Equations was used for missing data analyses. ResultsGreater distance to the nearest railway station was associated with higher SDQ-derived hyperactivity/inattention scores (i.e. more symptoms) in the unadjusted analysis across all 4052 analyzable children (β = 0.144, 95% C.I. 0.013 to 0.276, p = 0.031), and in the fully adjusted analysis in boys (β = 0.186, 95% C.I. 0.001 to 0.372, p = 0.049) but not in girls (β = 0.020, 95% C.I. −0.146 to 0.185, p = 0.817). There were no associations with the other SDQ-based outcomes of prosocial behaviour and emotional symptoms. ConclusionsThese findings suggest that access to high-frequency rail transit may be associated with improved hyperactivity/inattention outcomes in children living in urban environments, raising the possibility that an additional benefit of transit-oriented developments in urban settings may be a positive impact on this important aspect of children's mental health.