Impact of green space exposure on children's and adolescents' mental health: A systematic review
Associations between green space exposure and the mental health of children and adolescents warrant the attention of policy makers, urban planners and mental health professionals
Recent reviews of the literature report evidence of possible links between green space and mental health. Only one of these reviews addressed mental health outcomes for children. That review, published in 2015, found the evidence for an association between green space exposure and mental health in children inadequate. This current review provides an update of the literature on the association between green space exposure and mental health outcomes in children and adolescents.
Of the 21 studies included in this review, only 5 were published before 2015. The other 16 were published between 2015 and 2018. The sample size of the population studied (children and adolescents between the ages of 3 and 25) ranged between 72 and 3,000,000. The majority of the studies used at least one objective measure of exposure to green space. Three parameters of mental health were used in evaluating the evidence: (1) emotional and behavioral difﬁculties; (2) mental well-being; and (3) neurocognitive development.
Nine of the 21 studies used the Strengths and Difﬁculties Questionnaire (SDQ) as a measure of emotional and behavioral development. The SDQ is an internationally validated scale consisting of ﬁve domains: emotional symptoms, peer problems, hyperactivity and inattention symptoms, conduct problems, and prosocial behavior. Of these domains, the strongest association between green space exposure and mental health outcomes was in the hyperactivity and inattention domain. Results indicated that as green space exposure increased, symptoms of hyperactivity and inattention decreased. Evidence supporting these results was strong in five out of the six studies investigating this link. Findings relating to an association between green space exposure and mental well-being and neurocognitive development were limited. Some evidence, however, did support a positive association between green space exposure and mental well-being in children.
Studies included in this review suggest that such factors as air pollution, physical activity and social interaction may play a role in how green space exposure impacts children and youth. Findings also indicate that green space exposure seems to be associated with children’s and adolescents’ mental health in different ways depending on their developmental level. For younger children, the availability of a private garden and a shorter distance from their residence to a green space seems to be beneﬁcial. For older children and adolescents, greenness in the surrounding neighborhood and the quality of green spaces seems to be of greater importance.
While more research is needed to more clearly understand associations between green space exposure and mental health outcomes for children and adolescents, enough is known to demand the attention of policy makers and mental healthcare workers, especially in urban environments where access to green space tends to be limited.
Vanaken, G-J., Danckaerts, M., (2018). Impact of green space exposure on children's and adolescents' mental health: A systematic review. International Journal of Environmental Research and Public Health, 15(12)