This study examined the association of sociodemographic and environmental factors with mental health in preschool children. Data was collected from health monitoring surveys administered during school entrance examinations in six regions of Bavaria, Germany involving 6206 preschool children.
Data included (1) sociodemographic characteristics of the family (such as income, employment status, nationality, parental education, and number of siblings), (2) environmental characteristics of the family's home and surrounding area (such as the number of people in the home, traffic around the home, and access to green space), and (3) the mental health status of the child. The parent version of the Strengths and Difficulties Questionnaire (SDQ) was used for the mental health data. The SDQ is a 25-item assessment tool addressing such concerns as emotional symptoms, behavior problems, hyperactivity-inattention, and peer relationship problems.
Mental health problems were found in 11% of the preschool children, with a greater prevalence found in boys than girls. Factors associated with mental health problems included low household income, unemployment, low educational level of parents, crowding in the home, traffic-related conditions near the home, and lack of accessibility to green space (such as public parks) in the family's residential area. While low household income was the strongest sociodemographic indicator of mental health issues, non-accessibility of neighborhood green space was a strong environmental indicator. Children without access to neighborhood green space showed as much as 20% higher prevalence of borderline or abnormal SDQ scores. Statistical analysis indicates that the results of this study are representative of all preschool children in Bavaria.
These findings are consistent with previous research indicating exposure to nature or green space is associated with better mental health of children.
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