2026 / Green spaces, Health and well-being, Stress

Early Life Stress Enhances the Association Between Residential Nature Exposure and Fasting Blood Glucose

Citation

Eisen, A. M., Cedeño Laurent, J. G., Spengler, J. D., Slavich, G. M., & Olvera-Alvarez, H. A. (2026). Early life stress enhances the association between residential nature exposure and fasting blood glucose. PLOS One, 21(7), e0352771. doi.org/10.1371/journal.pone.0352771

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A growing body of research suggests that people in lower socioeconomic positions tend to get greater health benefits from exposure to nature than people who are more advantaged. The authors had previously proposed a possible explanation for this pattern. Their framework suggests that groups in lower socioeconomic positions are often exposed to more stress early in life, which can create a lifelong sensitivity to stress through various biological pathways. This heightened sensitivity is typically seen as a greater reaction to negative experiences, but it might also mean a stronger response to protective or health-promoting environments — leading to worse outcomes in harmful settings, but greater benefits in supportive ones.

This study looked at whether early-life stress changes the relationship between how much nature people are exposed to where they live and their fasting glucose levels, a marker of blood sugar regulation. The researchers measured neighborhood greenness using a satellite-based index and assessed early-life stress with a standardized survey. They used baseline data from a group of 340 nursing students.

An initial analysis did not support a simple straight-line relationship. But when the researchers explored the data more closely based on their theory, they found a curved pattern. Participants who had experienced either high levels of early-life stress or very low levels both had lower fasting glucose when they lived in greener neighborhoods. For participants with a moderate amount of early-life stress, however, there was no link between neighborhood greenness and their glucose levels.

These findings add to the evidence that increasing access to nature in disadvantaged neighborhoods could be an effective way to reduce metabolic risks and narrow health gaps among vulnerable groups. As more studies support this framework, it could help guide more targeted public health strategies — ones that take into account individual differences in sensitivity to the environment in order to promote health equity in a more nuanced way.

Abstract

Background

Emerging epidemiological evidence indicates that groups in low socioeconomic positions exhibit more pronounced health benefits from nature exposure compared to more privileged groups. We have previously posited one possible mechanism underlying this phenomenon through our framework: (susceptibility to stress) groups in low socioeconomic positions are often exposed to more early-life stressors, which can induce a lifelong susceptibility to stress through various neurobiological pathways; (environmental sensitivity) susceptibility to stress, traditionally understood as heightened reactivity to stressors, could also encompass enhanced responsivity to health-protective exposures, inducing greater risks in adverse environments, but also greater benefits in protective environments.

Objective

Examine the moderation effect of early life stress on the association between residential nature exposure and fasting glucose.

Methods

We assessed the impact of residential nature exposure (Normalized Difference Vegetation Index) on glucose dysregulation (elevated levels of fasting blood glucose) with a specific focus on the moderation effect of early life stress (Stress and Adversity Inventory for Adults) using baseline data from a cohort of 340 nursing students.

Results

An initial analysis did not support our linear dose-response hypothesis. However, a theory-guided exploration revealed a significant curvilinear trend wherein participants with higher but also lower exposure to early-life stressors both exhibited lower levels of fasting glucose when living in greener neighborhoods. By contrast, for participants with relatively moderate early-life stressor exposure, there was no association between neighborhood greenness and fasting glucose.

Discussion

Our findings contribute to growing evidence and further support the idea that increasing access to nature within disadvantaged neighborhoods could be an effective strategy to mitigate metabolic risks and attenuate health disparities among vulnerable populations. As the evidence for this framework expands, it could inform more targeted interventions that leverage individual differences in environmental sensitivity to promote health equity, ultimately providing more nuanced and socioeconomically attuned approaches to public health.