Availability, use of, and satisfaction with green space, and children’s mental wellbeing at age 4 years in a multicultural, deprived, urban area: Results from the Born in Bradford cohort study

McEachan, R. R. C., Yang, T. C., Roberts, H., Pickett, K. E., Arseneau-Powell, D., Gidlow, C. J., … Nieuwenhuijsen, M. (2018). Availability, use of, and satisfaction with green space, and children’s mental wellbeing at age 4 years in a multicultural, deprived, urban area: Results from the Born in Bradford cohort study. Lancet Planet Health, 2, 11. http://dx.doi.org/10.1016/S2542-5196(18)30119-0

Positive effects of green space on wellbeing differ by ethnicityMultiple studies show a positive connection between green space and children’s well-being. Only a limited number of these studies investigated possible differences by ethnicity. This study did so. Two aims framed the study: (1) to explore the associations between availability of, satisfaction with, and use of urban green space and mental wellbeing among four-year-old children living in a deprived multi-ethnic urban area and (2) to explore whether or not ethnicity or socioeconomic status moderated any effects of green space.

The study used information collected from 2594 mothers of four-year-old children in the UK. Fifty-eight percent of the mothers were south Asian, 29% white British, and 13% of another ethnicity. All of the mothers completed the Strengths and Difficulties Questionnaire (SDQ), a standardized assessment of children’s mental wellbeing. The SDQ assesses both externalizing (conduct problems and hyperactivity) and internalizing (emotional problems and peer problems) behaviors of concerns. The SDQ also assesses one area of strength: prosocial behavior. The study used a standardized remote sensing tool (Normalized Difference Vegetation Index) to measure residential green space buffers within 100, 300, and 500 meters around participants’ home addresses. A subsample of respondents (N=832) completed an additional questionnaire on green space use and how satisfied they were with the quality of their local green space.

Results of the total sample showed that distance from a major green space did not differ significantly between ethnic groups but that residential spaces were greener for white British mothers than for south Asian mothers. Mothers of the south Asian children were less satisfied with the quality of their green spaces than were the mothers of the white British children. The south Asian children also spent less time playing outside in green spaces than the white British children. Results also showed a significant association between availability of green space and behavioral difficulties among the south Asian children but not among the white British children.  For the south Asian children, more green space was associated with fewer internalizing behaviors and overall behavioral difficulties. However, these relationships were diminished when satisfaction with and use of green space was controlled for. For the south Asian children, mothers' satisfaction with green space predicted fewer internalizing behaviors and greater prosocial behaviors. Overall, the analysis of the data indicated that the quality of local green spaces was a greater predictor of the mental wellbeing of south Asian children than either quantity or use of green space. Unlike some previous studies, there was no evidence of socioeconomic indicators influencing the results.

This study indicates that the positive effects of green space on wellbeing differ by ethnicity and highlights the importance of identifying subgroups for whom interventions to promote green space availability and use might be most effective. While it’s understood that increasing access to nature might function as a tool to reduce health inequalities, it's also important to consider that provision of green space alone is unlikely to produce desired health benefits for certain ethnic groups. Quality of the green space must also be considered.

The Bottom Line

Positive effects of green space on wellbeing differ by ethnicity