Residential Greenness Exposure Research Articles

Residential greenness alleviated the adverse associations of long-term exposure to ambient PM1 with cardiac conduction abnormalities in rural adults

Ambient air pollution was linked to elevated risks of adverse cardiovascular events, and alterations in electrophysiological properties of the heart might be potential pathways. However, there is still lacking research exploring the associations between PM1 exposure and cardiac conduction parameters. Additionally, the interactive effects of PM1 and residential greenness on cardiac conduction parameters in resource-limited areas remain unknown. A total of 27483 individuals were enrolled from Henan Rural Cohort study. Cardiac conduction parameters were tested by 12-lead electrocardiograms. Concentrations of PM1 were predicted by satellite-based spatiotemporal models. Levels of residential greenness were assessed using Enhanced Vegetation Index (EVI) and Normalized difference vegetation index (NDVI). Logistic regression models and restricted cubic splines were fitted to explore the associations of PM1 and residential greenness exposure with cardiac conduction abnormalities risk, interaction plot method was performed to visualize their interaction effects. The 3-year median concentration of PM1 was 56.47 (2.55) μg/m3, the adjusted odds rate (ORs) and 95% confidence intervals (CIs) for abnormal HR, PR, QRS, and QTc interval risk in response to 1 μg/m3 increase in PM1 were 1.064 (1.044, 1.085), 1.037 (1.002, 1.074), 1.061 (1.044, 1.077) and 1.046 (1.028, 1.065), respectively. Participants exposure to higher levels of PM1 had increased risks of abnormal HR (OR = 1.221, 95%CI: 1.144, 1.303), PR (OR = 1.061, 95%CI: 0.940, 1.196), QRS (OR = 1.225, 95%CI: 1.161, 1.294) and QTc interval (OR = 1.193, 95%CI: 1.121, 1.271) compared with lower levels of PM1. Negative interactive effects of exposure to PM1 and residential greenness on abnormal HR, QRS, and QTc intervals were observed (Pfor interaction < 0.05). Long-term PM1 exposure was associated with elevated cardiac conduction abnormalities risks, and this adverse association might be mitigated by residential greenness to some extent. These findings emphasize that controlling PM1 pollution and increasing greenness levels might be effective strategies to reduce cardiovascular disease burdens in resource-limited areas.

Association between residential greenness and severe psychological distress and the moderating role of ‘stay-at-home’ status: a population-based cross-sectional study during the COVID-19 pandemic in Japan

ObjectiveThere is a need for public health strategies to address the negative psychological consequences of the COVID-19 pandemic, and the role of residential green exposure has gained prominence, particularly in...

From quantity to quality: Effects of urban greenness on life satisfaction and social inequality

Although a burgeoning literature has focused on greenspace quantity and relevant contribution to life satisfaction, little effort has been devoted to greenspace quality and nuanced differences in shaping the nexus of urban greenness and life satisfaction across social groups. Taking Beijing as an example, this study attempts to (1) explore the effects of both the quantity (availability and accessibility) and the quality (attractiveness and natural aesthetics) of neighborhood greenspaces on residents’ subjective life satisfaction, and (2) examine the heterogeneity in these effects across different social groups defined by household registration and housing status. Combining geo-coded, street-level residential greenness exposure data and city-scale social survey data in a multilevel ordered logit model, the results reveal that greenness quality play more pronounced roles, while both quantity and quality features could contribute positively to life satisfaction. When interacting quantity dimensions with quality ones, evident complementary roles of greenspace quality are detected. The impacts of four greenspace dimensions on life satisfaction are stronger for residents with Beijing hukou than those without. While availability becomes insignificant for residents in private-housing, and natural aesthetics is insignificant for those in social-housing. This study enriches our understanding of the nexus between multi-dimensions of urban greenspaces and life satisfaction, and complements existing research on green inequality to how unequal greenness in terms of quantity and quality affects individuals’ life satisfaction across different social strata. Our findings offer useful insights for fleshing out urban greening as central to crafting livable cities that can improve population life satisfaction and narrow inequalities.

Nine-year exposure to residential greenness and the risk of metabolic syndrome among Luxembourgish adults: A longitudinal analysis of the ORISCAV-Lux cohort study.

Growing evidence shows a beneficial effect of exposure to greenspace on cardiometabolic health, although limited by the cross-sectional design of most studies. This study examined the long-term associations of residential greenness exposure with metabolic syndrome (MetS) and MetS components within the ORISCAV-LUX study (Wave 1: 2007-2009, Wave 2: 2016-2017, n=395 adults). Objective exposure to residential greenness was measured in both waves by the Soil-Adjusted Vegetation Index (SAVI) and by Tree Cover Density (TCD). Linear mixed models were fitted to estimate the effect of baseline levels and change in residential greenness on MetS (continuous score: siMS score) and its components (waist circumference, triglycerides, HDL-cholesterol, fasting plasma glucose and systolic blood pressure), respectively. This study provides evidence that an increase in SAVI, but not TCD, may play a role in preventing MetS, as well as improving HDL-cholesterol and fasting plasma glucose levels. Greater baseline SAVI was also associated with lower fasting plasma glucose levels in women and participants living in municipalities with intermediate housing price, and greater baseline TCD was associated with larger waist circumference. Overall, findings suggest a mixed impact of increased greenness on cardiometabolic outcomes. Further longitudinal research is needed to better understand the potential effects of different types of greenness exposure on cardiometabolic outcomes.

Associations between Residential Greenspace and Fecundability in a North American Preconception Cohort Study.

Residential green space can have positive physiological effects on human health through various mechanisms, including reducing stress and/or depression or facilitating physical activity. Although green space has been consistently associated with improved birth outcomes in several studies, there has been limited study of its effect on other reproductive outcomes, including fertility. We examined associations between residential green space and fecundability, the per-cycle probability of conception. We analyzed data from 8,563 female participants enrolled between 2013 and 2019 in Pregnancy Study Online (PRESTO), a prospective preconception cohort study of North American couples attempting conception. Participants completed a baseline questionnaire on sociodemographic, behavioral, and reproductive factors, and bimonthly follow-up questionnaires for up to 12 months to ascertain pregnancies. Using geocoded addresses, we calculated residential green space exposure using the Normalized Difference Vegetation Index (NDVI) within 50-, 100-, 250-, and buffers across multiple temporal scales: annual maximum, seasonal maximum, and seasonal mean. We used proportional probabilities regression models to estimate fecundability ratios (FRs), adjusting for sociodemographic, behavioral, and neighborhood characteristics. We also evaluated the extent to which associations were mediated by reductions in perceived stress or depressive symptoms and increased physical activity. When comparing the highest () with the lowest () NDVI exposures within , we observed positive associations in the annual maximum NDVI [FR: 1.33; 95% confidence interval (CI): 1.06, 1.67] and seasonal maximum NDVI (FR: 1.19; 95% CI: 1.00, 1.41) models, but little association in the seasonal mean NDVI models (FR: 0.98; 95% CI: 0.73, 1.30). Restricted cubic splines showed evidence of nonlinearity in this association. Results were similar across buffer distances. Perceived stress, depressive symptoms, and physical activity explained of mediation across all NDVI metrics. In this cohort, greater residential green space was associated with a modest increase in fecundability. https://doi.org/10.1289/EHP10648.

Residential green space improves cognitive performances in primary schoolchildren independent of traffic-related air pollution exposure

BackgroundCognitive performances of schoolchildren have been adversely associated with both recent and chronic exposure to ambient air pollution at the residence. In addition, growing evidence indicates that exposure to green space is associated with a wide range of health benefits. Therefore, we aimed to investigate if surrounding green space at the residence improves cognitive performance of primary schoolchildren while taking into account air pollution exposure.MethodsCognitive performance tests were administered repeatedly to a total of 307 primary schoolchildren aged 9-12y, living in Flanders, Belgium (2012–2014). These tests covered three cognitive domains: attention (Stroop and Continuous Performance Tests), short-term memory (Digit Span Forward and Backward Tests), and visual information processing speed (Digit-Symbol and Pattern Comparison Tests). Green space exposure was estimated within several radii around their current residence (50 m to 2000 m), using a aerial photo-derived high-resolution (1 m2) land cover map. Furthermore, air pollution exposure to PM2.5 and NO2 during the year before examination was modelled for the child’s residence using a spatial–temporal interpolation method.ResultsAn improvement of the children’s attention was found with more residential green space exposure independent of traffic-related air pollution. For an interquartile range increment (21%) of green space within 100 m of the residence, a significantly lower mean reaction time was observed independent of NO2 for both the sustained-selective (-9.74 ms, 95% CI: -16.6 to -2.9 ms, p = 0.006) and the selective attention outcomes (-65.90 ms, 95% CI: -117.0 to -14.8 ms, p = 0.01). Moreover, green space exposure within a large radius (2000 m) around the residence was significantly associated with a better performance in short-term memory (Digit-Span Forward Test) and a higher visual information processing speed (Pattern Comparison Test), taking into account traffic-related exposure. However, all associations were attenuated after taking into account long-term residential PM2.5 exposure.ConclusionsOur panel study showed that exposure to residential surrounding green space was associated with better cognitive performances at 9–12 years of age, taking into account traffic-related air pollution exposure. These findings support the necessity to build attractive green spaces in the residential environment to promote healthy cognitive development in children.

Residential greenness exposure and decreased prevalence of diabetic retinopathy: A nationwide analysis in China

ObjectiveDiabetic retinopathy (DR) is a leading cause of vision impairment and blindness among diabetics. We aimed to explore whether long-term exposure to residential greenness was beneficial to DR. Research design and methodsWe used data from a large-scale, cross-sectional screening survey conducted in 129 cities of 27 provincial regions of China from 2018 to 2021 among patients with diabetes. We measured residential greenness exposure as the 3-year average of annual maximum Normalized Difference Vegetation Index (NDVI) at a spatial resolution of 250 m. DR was assessed by ophthalmologists based on fundus photographs. The primary outcome was DR, and secondary outcome included DR severity status (i.e., nonproliferative and proliferative), hallmarks of retinal lesions and macular oedema. ResultsA total of 484,380 adult participants with diabetes were included in the current analysis, and 15.7% of them were diagnosed with DR. NDVI was inversely and linearly associated with DR prevalence, and an increment of 0.1 NDVI was associated with a 10% (9%–10%) decrease in DR prevalence. Significant and inverse associations were further found for nonproliferative and proliferative DR, hallmarks of lesions and macular oedema. The association between greenness and DR was stronger among participants who were older, obese, lived in the south, had longer duration of diabetes or did not take antidiabetic medications. ConclusionsThis large-scale nationwide study provides the first-hand epidemiological evidence on the associations of residential greenness with DR. Our findings highlight the importance of residential greenness in alleviating DR risk especially in an era of aging and urbanization.

Associations and pathways between residential greenness and metabolic syndromes in Fujian Province.

Greenness exposure is beneficial to human health, but its potential mechanisms through which the risk for metabolic syndrome (MetS) could be reduced have been poorly studied. We aimed to estimate the greenness-MetS association in southeast China and investigate the independent and joint mediation effects of physical activity (PA), body mass index (BMI), and air pollutants on the association. A cross-sectional study was conducted among the 38,288 adults based on the Fujian Behavior and Disease Surveillance (FBDS), established in 2018. MetS was defined as the presence of three or more of the five components: abdominal obesity, elevated triglyceride, reduced high-density lipoprotein cholesterol (HDL-C), high blood pressure, and elevated fasting glucose. The residential greenness exposure was measured as the 3-year mean values of the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) within the 250, 500, and 1,000 meters (m) buffer zones around the residential address of each participant. Logistic regression models were used to estimate the greenness-MetS association. The causal mediation analysis was used to estimate the independent and joint mediation effects of PA, BMI, particulate matter with an aerodynamic diameter of 2.5 μm (PM2.5), particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide (NO2), and sulfur dioxide (SO2). Each interquartile range (IQR) increase in greenness was associated with a decrease of 13% (OR = 0.87 [95%CI: 0.83, 0.92] for NDVI500m and OR = 0.87 [95%CI: 0.82, 0.91] for EVI500m) in MetS risk after adjusting for covariates. This association was stronger in those aged < 60 years (e.g., OR = 0.86 [95%CI: 0.81, 0.92] for NDVI500m), males (e.g., OR = 0.73 [95%CI: 0.67, 0.80] for NDVI500m), having an educational level of primary school or above (OR = 0.81 [95%CI: 0.74, 0.89] for NDVI500m), married/cohabitation (OR = 0.86 [95%CI: 0.81, 0.91] for NDVI500m), businessman (OR = 0.82 [95%CI: 0.68, 0.99] for NDVI500m), other laborers (OR = 0.77 [95%CI: 0.68, 0.88] for NDVI500m), and non-smokers (OR = 0.77 [95%CI: 0.70, 0.85] for NDVI500m). The joint effect of all six mediators mediated about 48.1% and 44.6% of the total effect of NDVI500m and EVI500m on the MetS risk, respectively. Among them, BMI showed the strongest independent mediation effect (25.0% for NDVI500m), followed by NO2 and PM10. Exposure to residential greenness was associated with a decreased risk for MetS. PA, BMI, and the four air pollutants jointly interpreted nearly half of the mediation effects on the greenness-MetS association.

The effect modification of extreme temperatures on mental and behavior disorders by environmental factors and individual-level characteristics in Canada

ObjectiveAmbient extreme temperatures have been associated with mental and behavior disorders (MBDs). However, few studies have assesed whether vulnerability factors such as ambient air pollution, pre-existing mental health conditions and residential environmental factors increase susceptibility. This study aims to evaluate the associations between short-term variations in outdoor ambient extreme temperatures and MBD-related emergency department (ED) visits and how these associations are modified by vulnerability factors. MethodsWe conducted a case-crossover study of 9,958,759 MBD ED visits in Alberta and Ontario, Canada made between March 1st, 2004 and December 31st, 2020. Daily average temperature was assigned to individual cases with ED visits for MBD using gridded data at a 1 km × 1 km spatial resolution. Conditional logistic regression was used to estimate associations between extreme temperatures (i.e., risk of ED visit at the 2.5th percentile temperature for cold and 97.5th percentile temperature for heat for each health region compared to the minimal temperature risk) and MBD ED visits. Age, sex, pre-existing mental health conditions, ambient air pollution (i.e. PM2.5, NO2 and O3) and residential environmental factors (neighborhood deprivation, residential green space exposure and urbanization) were evaluated as potential effect modifiers. ResultsCumulative exposure to extreme heat over 0–5 days (odds ratio [OR] = 1.145; 95% CI: 1.121–1.171) was associated with ED visits for any MBD. However, cumulative exposure to extreme cold was associated with lower risk of ED visits for any MBD (OR = 0.981; 95% CI: 0.976–0.987). We also found heat to be associated with ED visits for specific MBDs such as substance use disorders, dementia, neurotic disorders, schizophrenia and personality behavior disorder. Individuals with pre-existing mental health conditions, those exposed to higher daily concentrations of NO2 and O3 and those residing in neighborhoods with greater material and social deprivation were at higher risk of heat-related MBD ED visits. Increasing tree canopy coverage appeared to mitigate risks of the effect of heat on MBD ED visits. ConclusionsFindings provide evidence that the impacts of heat on MBD ED visits may vary across different vulnerability factors.

Rural-urban disparities in the associations of residential greenness with diabetes and prediabetes among adults in southeastern China

AimsGreenness offers health benefits to prevent diabetes in urban areas. However, urban-rural disparities in this association have not been explored, with the underlying pathways understudied as well. We aimed to investigate and compare the associations and potential pathways between residential greenness and the risks for diabetes and prediabetes in urban and rural areas. MethodsDiabetes and prediabetes were diagnosed by fasting blood glucose (FBG). The participants' residential greenness exposure was estimated by the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). The association of residential greenness with the risks for diabetes and prediabetes was estimated by logistic regression and the generalized additive model. The potential mediation effects of air pollution, body mass index (BMI), and physical activity (PA) were examined by causal mediation analysis. ResultsOf the 50,593 included participants, and the prevalence of prediabetes and diabetes were 21.22 % and 5.63 %, respectively. Each 0.1-unit increase in EVI500m and NDVI500m for healthy people reduced the risk for prediabetes by 12 % and 8 %, respectively, and substantially reduced the risk for diabetes by 23 % and 19 %, respectively. For those with prediabetes, each 0.1-unit increase in EVI500m and NDVI500m reduced the diabetes risk by 14 % and 12 %, respectively. Compared to the risks for diabetes at the 25th percentile of EVI500m/NDVI500m, such risks significantly reduced when EVI500m (NDVI500m) increased over 0.43 (0.48) and 0.28 (0.39) in urban and rural areas, respectively. The residential greenness-prediabetes/diabetes associations were mediated by air pollution and PA in urban areas and by air pollution and BMI in rural areas. ConclusionsExposure to residential greenness was associated with a lower risk for prediabetes and diabetes in urban areas and, more strongly, in rural areas, which were partly mediated by air pollution, PA, and BMI.

Adverse associations of long-term exposure to ambient ozone with molecular biomarkers of aging alleviated by residential greenness in rural Chinese adults.

Both ambient ozone exposure and residential greenness are linked to the aging process. However, their interactive effect on molecular biomarkers of aging (telomere length (TL) and mitochondrial DNA copy number (mtDNA-CN)) remains unclear. This study was conducted among 6418 rural Chinese adults. The concentration of ambient ozone was assessed using a random forest model. Residential greenness was represented by the normalized difference vegetation index (NDVI). Molecular biomarkers of aging (relative TL and relative mtDNA-CN) were determined by quantitative real-time polymerase chain reaction. Generalized linear regression models were applied to investigate the independent and combined effects of ambient ozone and residential greenness on relative TL and relative mtDNA-CN. The estimated percent changes and 95% confidence intervals (CIs) of relative TL in response to per-unit increase in ambient ozone were -22.43% (-23.74%, -21.18%), -14.19% (-15.63%, -12.72%) and -4.50% (-6.57%, -2.27%) for participants with low (NDVI≤0.53), moderate (0.54-0.55) and high (≥0.56) residential greenness exposure, respectively, while the corresponding figures of relative mtDNA-CN were -12.63% (-13.84%, -11.31%), -9.52% (-10.60%, -8.33%) and 2.12% (0.20%, 4.19%). Furthermore, negative interactive effects between ambient ozone and residential greenness exposure on molecular biomarkers of aging were observed (Pfor interaction<0.001 for relative TL, and 0.098 for relative mtDNA-CN). Long-term exposure to high concentrations of ambient ozone and low residential greenness was associated with decreased mtDNA-CN and shortened TL. The adverse effect of ambient ozone exposure on molecular biomarkers of aging may be attenuated by increased residential greenness.

Association between residential greenness and all-cause mortality and the joint mediation effect of air pollutants among old people with disability: A prospective cohort study

BackgroundResidential greenness offers health benefits to old people, but evidence of its association with the health of old people with disability is scarce. Moreover, due to the limited mobility of this vulnerable population, air pollutants may play an indispensable mediating role in that association, which however remains understudied. ObjectivesThis study aimed to investigate the association between residential greenness and all-cause mortality risk and the joint mediation effect of air pollutants among old people with disability. MethodsA total of 34,075 old people with disability were included in the Chengdu Long-term Care Insurance cohort. Participants' residential greenness exposure was measured by an enhanced vegetation index within the 500 m buffer zone (EVI500m). Causal mediation analysis was conducted to assess the total effect (TE) of residential greenness and the natural indirect effect (NIE) through PM2.5, CO, NO2, SO2, and O3 on all-cause mortality. ResultsThe TE of EVI500m on the all-cause mortality risk in overall participants showed negative, which, decreased from the 2nd quartile (HR = 0.93, 95 % CI: 0. 91, 0.95) to the 4th quartile (HR = 0.81, 95 % CI: 0.76, 0.85); the NIE through the five air pollutants also decreased from the 2nd quartile (HR = 0.96, 95 % CI: 0.95, 0.98) to the 4th quartile (HR = 0.90, 95 % CI: 0.88, 0.93), with the proportion mediated decreased from 48 % to 44 %. The stronger TE or NIE were observed in participants aged <80 years old, men, with mild-moderate disability, and having outdoor experience every week. ConclusionExposure to residential greenness was associated with a decreased risk of mortality, partially through the pathways of air pollutants, which varied by age, sex, degree of disability, and frequency of weekly outdoors. Our findings would provide evidence to develop aging-friendly cities.

Residential greenness, air pollution, and incident ischemic heart disease: A prospective cohort study in China

Background and aim: Green living environments are associated with beneficial health outcomes, whereas higher air pollution exposure might increase the risk of chronic diseases. Moreover, few studies have explored the interaction between residential greenness and air pollution on the risk of ischemic heart disease (IHD). Therefore we aimed to estimate the associations of residential greenness and air pollution with IHD and their interaction. Methods: We performed a prospective cohort study that included 29,141 adult participants recruited from Yinzhou District, Ningbo, China. Normalized Difference Vegetation Index (NDVI) around each participant’s residence was calculated to measure residential greenness exposure. Land-use regression models were conducted to estimate long-term individual exposure to air pollutants, including nitrogen dioxide (NO2) and particulate matter with aerodynamic diameters &amp;#x2264; 2.5 &amp;#x3bc;m (PM2.5) and &amp;#x2264;10 &amp;#x3bc;m (PM10). Cox proportional hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association of residential greenness and air pollutants with the risk of incident IHD. Results: During 101,172.5 person-years of follow-up, 1,392 incident IHD cases were reported in the study population. Residential greenness, expressed as an interquartile range (IQR) increase in NDVI within 300m, was inversely associated with incident IHD. However, long-term air pollution exposures were associated with higher IHD incidence. Mediation analyses suggested that the beneficial effect of residential greenness on incident IHD could be partly mediated by reducing the exposure to PM2.5. Conclusion: Higher greenness was associated with decreased risk of IHD, while air pollutants were positively associated with incident IHD. Meanwhile, residential greenness may decrease the risk of IHD by reducing PM2.5 exposure. Keywords: Residential greenness; Air pollution; Ischemic heart disease; Cohort study; Effect mediation

External exposome and sleep outcomes in the Nurses’ Health Study

BACKGROUND AND AIM: Multiple environmental exposures, including greenness, light-at-night, and air pollution, have been associated with sleep. However, these associations have not been investigated using large longitudinal cohorts with repeated measures. We examined the association between multiple environmental exposures and sleep duration and quality in the Nurses’ Health Study (NHS). METHODS: Between 2000 and 2014, 81,202 NHS participants self-reported sleep duration on biennial questionnaires, and in 2000, 81,294 NHS participants self-reported sleep quality. We estimated annual average greenness using Landsat Normalized Difference Vegetation Index (NDVI) in 270m buffers, annual average light-at-night (LAN) from the U.S. Defense Meteorological Satellite Program’s Operational Linescan System, and predicted PM2.5 from validated nationwide spatiotemporal models at each residential address. Due to evidence of non-linearity, we modeled exposures in quintiles. Sleep duration was dichotomized (&amp;#x2265;7 hours; &amp;#x3c;7 hours) and modeled with generalized estimating equations. Sleep quality was dichotomized (difficulty sleeping none/a little/some of the time; difficulty sleeping a good bit of/all the time) and modeled using logistic regression. We estimated odds ratios (OR) of adverse sleep outcomes comparing the highest and lowest quintile and 95% confidence intervals (CI) for each exposure. We adjusted for individual-level risk factors and included all exposures simultaneously for mutual adjustment. RESULTS: In mutually-adjusted models, higher annual average residential greenness exposure was associated with suggestive lower odds of short sleep duration (OR: 0.97 95% CI: 0.94, 1.00) with similar associations for poor sleep quality (OR: 0.97; 95% CI: 0.90, 1.00). Higher exposure to LAN was associated higher odds of with short sleep duration (OR: 1.18 95% CI: 1.14, 1.23) and poorer sleep quality (OR: 1.12; 95% CI: 1.03, 1.22). Higher exposure to PM2.5 was not associated with sleep outcomes. CONCLUSION: In the NHS cohort, lower residential greenness and higher LAN exposures were associated with lower self-reported sleep duration and quality.

Residential greenness, air pollution, and incident ischemic heart disease: A prospective cohort study in China.

Greener residential surroundings are associated with beneficial health outcomes, whereas higher air pollution exposure is linked with elevated risks of chronic diseases. To date, limited studies have explored the interaction between residential greenness and air pollution on the risk of ischemic heart disease (IHD). We performed a prospective cohort study that included 29,141 adult participants recruited from Yinzhou District, Ningbo, China. Normalized Difference Vegetation Index (NDVI) around each participant's residence was calculated to measure residential greenness exposure. Land-use regression models were conducted to estimate long-term individual exposure to air pollutants, including nitrogen dioxide (NO2) and particulate matter with aerodynamic diameters ≤ 2.5 μm (PM2.5) and ≤10 μm (PM10). Cox proportional hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the associations of residential greenness and air pollutants with the risk of incident IHD. During 101,172.5 person-years of follow-up, 1392 incident IHD cases were reported in the study population. Residential greenness, expressed as an interquartile range (IQR) increase in NDVI within 250 m, was inversely associated with incident IHD (HR = 0.89, 95%CI: 0.81,0.98). However, long-term exposures to air pollution were associated with higher IHD incidence (HR = 1.21, 95%CI:1.10,1.33 per IQR increase for PM2.5; HR = 1.12, 95%CI:1.03,1.22 per IQR increase for PM10; HR = 1.09, 95%CI:1.02,1.16 per IQR increase for NO2). Mediation analyses suggested that the beneficial effect of residential greenness on incident IHD could be partly mediated by reducing the exposure to PM2.5. These findings suggested that higher greenness was associated with decreased risk of IHD, while air pollutants were positively associated with incident IHD. Meanwhile, residential greenness may decrease the risk of IHD by reducing exposure to PM2.5.

Neighbourhood greenspace quantity, quality and socioeconomic inequalities in mental health

There is tentative evidence suggesting that socioeconomically disadvantaged groups may benefit more from access to neighbourhood greenspace and therefore could be a lever for narrowing socioeconomic inequalities (‘equigenesis’) in mental health, although studies are equivocal. One potential explanation for this inconsistency is differences in study designs, particularly how greenspace is measured. Most previous studies are from high income countries, and there has been no investigations into equigenic environments in China. Using survey data collected from 26 neighbourhoods in Guangzhou, China, this study examines whether local greenspaces may narrow socioeconomic inequalities in health (i.e. equigenesis) in the Chinese context. The study is the first to explore the contribution of greenspace in reducing socioeconomic inequalities in mental health in the Chinese context. It uses Normalized Difference Vegetation Index (NDVI), Street View Greenness (SVG) and self-reported neighbourhood greenness quality as estimates of residential greenness exposure Results show that SVG-quantity, SVG-quality and self-reported greenspace quality narrow the neighbourhood socioeconomic inequalities in mental health. Our findings demonstrate the importance of improving equity in local green infrastructure for promoting health equity through urban planning and design, including improving access to green spaces, and providing more street trees in socioeconomically disadvantaged neighbourhoods.

“Residential greenness and site-specific cancer: A registry based cohort of 144,427 participants with a 21-years of follow-up, Tel-Aviv district, Israel”

BackgroundFew longitudinal studies evaluated the beneficial associations between cumulative residential greenness and site-specific cancer. Our objective was to evaluate the associations between cumulative residential greenness exposure and site-specific cancer incidence (lung, bladder, breast, prostate, and skin cancer) within a registry-based cohort study. MethodsThis study was based on 144,427 participants who lived in the Tel Aviv district during 1995–2015. The residential greenness exposure was estimated for every participant, as the weighted mean residential greenness exposure, based on the mean Normalized Difference Vegetation Index (NDVI) in the residential area and the duration of the residence in this area. Cox regression models were used to evaluate the unadjusted and adjusted associations between exposure to greenness and cancer incidence during 1998–2015 (Hazard Ratios (HRs) and 95% Confidence Intervals (CIs)). Covariates included in adjusted models were selected based on prior knowledge and directed acyclic graphs. We imputed missing data and further sensitivity analyses were conducted. ResultsAfter adjustments, beneficial associations between exposure to greenness and cancer incidence were observed. An interquartile range (IQR) increase in NDVI was associated with a lower HRs for lung cancer (HRadj. = 0.75 95% CI: 0.66–0.85), bladder cancer (HRadj. = 0.71, 95% CI: 0.62–0.82), breast cancer (HRadj. = 0.81, 95% CI: 0.74–0.88), prostate cancer (HRadj. = 0.77, 95% CI: 0.70–0.86) and skin cancer (HRadj. = 0.78, 95% CI: 0.69–0.88). Generally, the patterns of associations were consistent between complete-case models and imputed models, when estimated for participants aged 16 years or 40 years and older at baseline, when stratified by area level socioeconomic status, when evaluated for non-movers participants and after further adjustment to social determinants of health. ConclusionResidential greenness may reduce the risk for lung, bladder, breast, prostate, and skin cancers. If our observations will be replicated, it may present a useful avenue for public-health intervention to reduce cancer burden.

Early life exposure to residential green space impacts cognitive functioning in children aged 4 to 6 years.

During early childhood, neuronal networks are highly susceptible to environmental factors. Previous research suggests that green space exposure is beneficial for cognitive functioning. Here, we investigate the associations between residential green space exposure and behavioral problems and cognitive development in children aged four to six years. We included children participating in the ENVIRONAGE birth cohort. Residential green spaces were calculated based on high-resolution land cover data within several buffers (50-1,000 m) around the residence. The children's behavior was assessed with the Strengths and Difficulties Questionnaire (SDQ) among 411 children. In addition, to evaluate cognitive function, 456 children completed four tasks of the Cambridge Neuropsychological Test Automated Battery (CANTAB). We used multivariate logistic and linear regression models while accounting for potential confounders and covariables. An interquartile (IQR) increase of residential green space within 50 m was associated with a 38% (95% CI: 56;14) lower odds of a child having hyperactivity problems. Additionally, we found a beneficial influence of residential green space in close proximity (50-100 m) on the attention and psychomotor speed, represented by the Motor Screening Task. For example, we found a decrease of 0.45 (95% CI: -0.82;-0.09) pixel units from target center with an IQR increase of residential green space in a 50 m buffer. In addition, we observed an improved visual recognition/working memory, represented by the Delayed Matching to Sample Task within all included buffers (50-1000 m). For example, we observed a decrease of 4.91% (95 %CI: -7.46;-2.36) probability of an error occurring if the previous trial was correct and a 2.02% (95 %CI: 0.08; 3.97) increase of correct trials with an IQR increase of green space within a 100 m buffer. This study provides additional indications for a beneficial influence of green space exposure on the development of behavioral problems and cognitive function as young as four years of age.

Multisite greenness exposure and oxidative stress in children. The potential mediating role of physical activity

Residential greenness exposure has been reported to positively impact health mainly by reducing overweight/obesity risk, improving mental health and physical activity. Less is known on biological pathways involved in these health benefits. We aimed to investigate the association between multisite greenness exposure and oxidative stress in children and explore the potential mediating role of physical activity in this association. This cross-sectional study involved 323 healthy subjects (8–11 y) from five schools in Asti (Italy). Children's parents filled a questionnaire providing the residential address, parental education, and physical activity frequency. Oxidative stress was quantified in spot urine by isoprostane (15-F2t-IsoP) using ELISA technique. Residential and scholastic greenness were defined by the Normalized Difference Vegetation Index (NDVI) in buffers with 100, 250, 300, 500 and 1000 m radii, and vegetated portion was also estimated. Multisite exposures were derived accounting for NDVI around home and school, weighted for time spent in each location. Linear mixed models, age-adjusted, with schools as random intercept, tested the association between 500 m-radius buffer multisite grenness variables and log (15-F2t-IsoP), reporting decreased oxidative stress per interquartile range (IQR) increase in multisite NDVI (β: 012, 95%CI -0.240 to 0.004) and multisite vegetated portion (β: 0.14, 95%CI -0.270 to −0.006). The mediation analysis did not support the hypothesis that physical activity frequency could mediate these associations. Multisite greenness exposure is associated with decreased oxidative stress in children and our data did not support the mediating role of physical activity.

Residential greenness is associated with disease severity among COVID-19 patients aged over 45 years in Wuhan, China

Evidence regarding environmental factors associated with disease severity of COVID-19 remained scarce. This study aimed to investigate the association of residential greenness exposure with COVID-19 severity applying a retrospective cross-sectional study in Wuhan, China. We included 30,253 COVID-19 cases aged over 45 years from January 1 to February 27, 2020. Residential greenness was quantitatively assessed using normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). A multilevel generalized linear model using Poisson regression was implemented to analyze the association between greenness exposure and disease severity of COVID-19, after adjusting for potential covariates. A linear exposure-response relationship was found between greenness and COVID-19 severity. In the adjusted model, one 0.1 unit increase of NDVI and EVI in the 1000-m buffer radius was significantly associated with a 7.6% (95% confidence interval (CI): 4.0%, 11.1%) and 10.0% (95% CI: 5.1%, 14.7%) reduction of the prevalence of COVID-19 severity, respectively. The effect of residential greenness seemed to be more pronounced among participants with lower population density and economic levels. Air pollutants mediated 0.82~12.08% of the greenness and COVID-19 severity association, particularly to nitrogen dioxide. Sensitivity analyses suggested the robustness of the results. Our findings suggested that residential greenness exposure was beneficial to reduce the prevalence of COVID-19 severity.