Green space, health inequality and pregnancy

• Published in: Environment international Vol. 40; pp. 110 - 115
• Main Authors: Dadvand, Payam, de Nazelle, Audrey, Figueras, Francesc, Basagaña, Xavier, Su, Jason, Amoly, Elmira, Jerrett, Michael, Vrijheid, Martine, Sunyer, Jordi, Nieuwenhuijsen, Mark J.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.04.2012; Elsevier
• Subjects: Air Pollutants - analysis; Air Pollution - statistics & numerical data; Biological and medical sciences; Birth Weight; Environment; Environment. Living conditions; Female; Gestational age; Green space; Health; Health Status Disparities; Housing. Living conditions; Humans; Infant, Low Birth Weight; Infant, Newborn; Landsat; Male; Maternal Exposure - statistics & numerical data; Medical sciences; Pregnancy; Pregnancy Complications - epidemiology; Pregnancy Outcome - epidemiology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Socioeconomic Factors; Socioeconomic position; Spain; Urban Health; Europe; Spain; Green space; Pregnancy; Landsat; Birth weight; Socioeconomic position; NDVI; Gestational age; ETM; SEP; Human; Green area; Social Inequality; Poverty; Socioeconomic status; Health and environment; Developmental stage; Woman; Public health
• ISSN: 0160-4120; 1873-6750
• DOI: 10.1016/j.envint.2011.07.004

Green spaces have been suggested to improve physical and mental health and well-being by increasing physical activity, reducing air pollution, noise, and ambient temperature, increasing social contacts and relieving psychophysiological stress. Although these mechanisms also suggest potential beneficial effects of green spaces on pregnancy outcomes, to our knowledge there is no available epidemiological evidence on this impact. We investigated the effects of surrounding greenness and proximity to major green spaces on birth weight and gestational age at delivery and described the effect of socioeconomic position (SEP) on these relationships. This study was based on a cohort of births (N=8246) that occurred in a major university hospital in Barcelona, Spain, during 2001–2005. We determined surrounding greenness from satellite retrievals as the average of Normalized Difference Vegetation Index (NDVI) in a buffer of 100m around each maternal place of residence. To address proximity to major green spaces, a binary variable was used to indicate whether maternal residential address is situated within a buffer of 500m from boundaries of a major green space. For each indicator of green exposure, linear regression models were constructed to estimate change in outcomes adjusted for relevant covariates including individual and area level SEP. None of the indicators of green exposure was associated with birth weight and gestational age. After assessing effect modification based on the level of maternal education, we detected an increase in birth weight (grams) among the lowest education level group (N=164) who had higher surrounding NDVI (Regression coefficient (95% confidence interval (CI) of 436.3 (43.1, 829.5)) or lived close to a major green space (Regression coefficient (95% CI)) of 189.8 (23.9, 355.7)). Our findings suggest a beneficial effect of exposure to green spaces on birth weight only in the lowest SEP group. ► No available evidence on pregnancy-green exposure link. ► Beneficial effect of green exposure on birth weight in lower socioeconomic group. ► No beneficial effect of green exposure on gestational age at delivery. ► Socioeconomic status is an effect modifier for the birth weight-green exposure link.