Associations of Residential Green Space with Internalizing and Externalizing Behavior in Early Childhood
Citation
Hazlehurst, M. F., Hajat, A., Tandon, P. S., Szpiro, A. A., Kaufman, J. D., Tylavsky, F. A., … & Karr, C. J. (2024). Associations of residential green space with internalizing and externalizing behavior in early childhood. Environmental Health, 23(1), 1-12. doi.org/10.1186/s12940-024-01051-9
This study looked at whether having more greenery around a child’s home is linked to better child mental and behavioral health health at age 4–6 years. Researchers examined children who were part of the Conditions Affecting Neurocognitive Development and Learning in Early childhood (CANDLE) study in Shelby County, Tennessee. Their behavior was evaluated through parent reporting on the Child Behavior Checklist.
Researchers focused on three types of green space near their homes: overall vegetation, tree cover, and how close they lived to a park. They averaged these measures over the year before each child’s assessment and accounted for many factors that could influence behavior, such as family, household, and neighborhood characteristics.
Researchers found that children who lived in greener areas — measured by overall vegetation — had fewer signs of internalizing problems (e.g., depression, anxiety, and social withdrawal). Tree cover showed a similar trend, but the results were less certain. Living closer to parks did not appear to affect these behaviors. Researchers did not see links between green space and externalizing behaviors (e.g., attention problems, rule-breaking, and aggressive behavior). The associations tended to be stronger for children living in neighborhoods with fewer economic resources, although these differences were not statistically significant.
Overall, the results support growing evidence that greener residential environments may help protect young children from developing internalizing mental health problems. Investing in urban green spaces may be an important way to support children’s well-being.
Abstract
Background
Green space exposures may promote child mental health and well-being across multiple domains and stages of development. The aim of this study was to investigate associations between residential green space exposures and child mental and behavioral health at age 4–6 years.
Methods
Children’s internalizing and externalizing behaviors in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort in Shelby County, Tennessee, were parent-reported on the Child Behavior Checklist (CBCL). We examined three exposures—residential surrounding greenness calculated as the Normalized Difference Vegetation Index (NDVI), tree cover, and park proximity—averaged across the residential history for the year prior to outcome assessment. Linear regression models were adjusted for individual, household, and neighborhood-level confounders across multiple domains. Effect modification by neighborhood socioeconomic conditions was explored using multiplicative interaction terms.
Results
Children were on average 4.2 years (range 3.8-6.0) at outcome assessment. Among CANDLE mothers, 65% self-identified as Black, 29% as White, and 6% as another or multiple races; 41% had at least a college degree. Higher residential surrounding greenness was associated with lower internalizing behavior scores (-0.66 per 0.1 unit higher NDVI; 95% CI: -1.26, -0.07) in fully-adjusted models. The association between tree cover and internalizing behavior was in the hypothesized direction but confidence intervals included the null (-0.29 per 10% higher tree cover; 95% CI: -0.62, 0.04). No associations were observed between park proximity and internalizing behavior. We did not find any associations with externalizing behaviors or the attention problems subscale. Estimates were larger in neighborhoods with lower socioeconomic opportunity, but interaction terms were not statistically significant.
Conclusions
Our findings add to the accumulating evidence of the importance of residential green space for the prevention of internalizing problems among young children. This research suggests the prioritization of urban green spaces as a resource for child mental health.