Visiting green space is associated with mental health and vitality: A cross-sectional study in four european cities.

Many epidemiological studies have found that people living in environments with more green space report better physical and mental health than those with less green space. However, the association between visits to green space and mental health has seldom been studied. The current study explored the associations between time spent in green spaces by purposeful visits and perceived mental health and vitality in four different European cities, and to what extent gender, age, level of education, attitude towards nature and childhood nature experience moderate these associations. Data was gathered using a questionnaire administered in four European cities (total n=3748). Multilevel analyses showed significant positive associations between time spent visiting green spaces and mental health and vitality in the pooled data, as well as across the four cities. Significant effect modification was found for level of education and childhood nature experience. The findings confirm the hypothesis that more time spent in green space is associated with higher scores on mental health and vitality scales, independent of cultural and climatic contexts.

Surrounding greenness, proximity to city parks and pregnancy outcomes in Kaunas cohort study.

There is increasing evidence that green space can improve the health and well-being of urban residents. However, there has been no consistent evidence of the effect of city parks on reproductive health. We investigated whether surrounding greenness levels and/or distance to city parks affect birth outcomes. This study was based on 3292 singleton live-births from the Kaunas birth cohort, Lithuania (2007-2009), who were enrolled in the FP7 PHENOTYPE project study. Residential surrounding greenness level was ascertained as average of satellite-based normalized difference vegetation index (NDVI) within buffers of 100 m, 300 m, and 500 m of each maternal home and distance to a city park was defined as distance to boundaries of the nearest city park. For each indicator of green space exposure, linear or logistic regression models were constructed to estimate change in birth outcomes adjusted for relevant covariates. An increase in distance to a city parks was associated with an increase in risk of preterm birth and decrease of gestational age. We found a statistically significant association between low surrounding greenness and term low birth weight. After assessing effect modification based on the low surrounding greenness (NDVI-5001000 m), we found increased risks for low birth weight (OR 2.23, 1.20-4.15), term low birth weight (OR 2.97, 1.04-8.45) and preterm birth (OR 1.77, 1.10-2.81) for subjects with low surrounding greenness and farther distance from a park. Both higher surrounding greenness level and proximity to park have beneficial effects on pregnancy outcomes. A beneficial park effect on foetal growth is most apparent in the environment with low surrounding greenness level. Further investigation is needed to confirm this association.

The impact of tobacco smoke exposure on wheezing and overweight in 4-6-year-old children.

AIM: To investigate the association between maternal smoking during pregnancy, second-hand tobacco smoke (STS) exposure, education level, and preschool children's wheezing and overweight. METHODS: This cohort study used data of the KANC cohort--1,489 4-6-year-old children from Kaunas city, Lithuania. Multivariate logistic regression was employed to study the influence of prenatal and postnatal STS exposure on the prevalence of wheezing and overweight, controlling for potential confounders. RESULTS: Children exposed to maternal smoking during pregnancy had a slightly increased prevalence of wheezing and overweight. Postnatal exposure to STS was associated with a statistically significantly increased risk of wheezing and overweight in children born to mothers with lower education levels (OR 2.12; 95% CI 1.04-4.35 and 3.57; 95% CI 1.76-7.21, accordingly). CONCLUSIONS: The present study findings suggest that both maternal smoking during pregnancy and STS increase the risk of childhood wheezing and overweight, whereas lower maternal education might have a synergetic effect. Targeted interventions must to take this into account and address household smoking.

Impact of residential greenness on preschool children's emotional and behavioral problems.

This study investigated the effects of the proximity to city parks and the influence of residential greenness on children's emotional and behavioral problems. This cross-sectional study included 1,468 mothers of children (ages 4 to 6) who were residents of the city of Kaunas, Lithuania. The mothers and their children were enrolled in the FP7 PHENOTYPE project study. The mothers reported on their parenting stress and their children's mental health. Residential greenness was characterized as an average of the satellite-derived normalized difference vegetation index (NDVI) in a 300 m buffer around each home address, and the proximity to city parks was defined as the distance from the subject's residence to the nearest park. Linear regression models were used to investigate the association among the residence distances from city parks, greenness and children's mental health problems. Farther residential distance from city parks was associated with worse mental health (except for the emotional problems subscale) in children whose mothers had a lower education level. More residential greenness was associated with worse mental health (more conditional problems and less prosocial behavior) in children whose mothers had a higher education level. These relationships have important implications for the prevention of emotional and behavioral problems in children.

The influence of proximity to city parks on blood pressure in early pregnancy.

This study investigated the effect of proximity to city parks on blood pressure categories during the first trimester of pregnancy. This cross-sectional study included 3,416 female residents of the city of Kaunas, Lithuania, who were enrolled in the FP7 PHENOTYPE project study. The women were classified into four blood pressure categories: optimal, normal, high-normal blood pressure, and hypertension. Multinomial regression models were used to investigate the association between three women's groups with respect to the residence distances from city parks (300, >300-1,000, and >1,000 m) and four blood pressure categories. When using the optimal blood pressure as the reference group, the crude and adjusted odds ratios (OR) for normal blood pressure and for high-normal blood pressure proved to be statistically significantly higher after the inclusion of the selected covariates into the regression analysis. The probability of normal blood pressure increased by 9%, and that of high-normal blood pressure-by 14% for every 300 m increase in the distance to green spaces. The findings of this study suggest a beneficial impact of nearby city parks on blood pressure amongst 20- to 45-year-old women. This relationship has important implications for the prevention of hypertension and the reduction of hypertension-related morbidity.