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Objective: To assess the relationship between greenspace exposure and childhood internalizing and externalizing behaviors.Study Design: We analyzed data from the Cincinnati Childhood Allergy and Air Pollution Study, an ongoing prospective birth cohort. Greenspace exposure was estimated based on children's addresses using normalized difference vegetation index (NDVI) images. Neurobehavioral outcomes were assessed using the Behavioral Assessment System for Children, Second Edition. Regression models adjusted for neighborhood deprivation, maternal education, race, and sex assessed the risk for problematic internalizing and externalizing behaviors at residential greenspace buffers of 200, 400, and 800 m.Results: There were 562 and 313 children in our age 7- and 12-year analyses, respectively. At age 7 years, a 0.1-unit increase in NDVI was associated with decreased conduct scores (β = -1.10, 95% CI [-2.14, -0.06], 200 m). At age 12 years, a 0.1-unit increase in NDVI was associated with a decrease in anxiety scores (β = -1.83, 95% CI [-3.44, -0.22], 800 m), decreased depression scores (β = -1.36, 95% CI [-2.61, -0.12], 200 m), and decreased somatization scores (β = -1.83, 95% CI [-3.22, -0.44], 200 m).Conclusions: This study provides evidence that increased exposure to residential greenspace is associated with reduced youth's problematic internal and external behaviors, measured by Behavioral Assessment System for Children, Second Edition, at ages 7 and 12 years. Improved understanding of this mechanism could allow for implementation of neighborhood-level approaches for reducing the risk for childhood behavioral problems. [ABSTRACT FROM AUTHOR]

Objectives: To categorize newborn infants in Hamilton County, Ohio by late pregnancy fetal opioid exposure status and to assess their first-year healthcare utilization.Study Design: We used a population-based cohort of 41 136 live births from 2014-2017 and analyzed healthcare encounters in the first year of life from electronic health records. We prospectively assessed for the presence of opioids in maternal urine collected at delivery and for a diagnosis of newborn neonatal abstinence syndrome (NAS). At birth, infants were classified as unexposed to opioids, exposed to opioids and diagnosed with NAS, or subclinically exposed to opioids (exposure that did not result in NAS).Results: The prevalence of newborn opioid exposure was 37 per 1000 births. The duration of the hospital birth encounter was significantly longer for infants with subclinical exposure compared with unexposed infants (10% increase; 95% CI, 7%-13%). However, duration for infants with subclinical exposure was shorter compared to those with NAS. Neither subclinical exposure nor NAS was associated with total emergency department visits. Subclinical exposure was associated with increased odds of having at least 1 hospitalization in the first year. However, the total length of stay for hospitalizations was 82% that of the unexposed group (95% CI, 75%-89%). Infants with NAS had a 213% longer total length of stay compared with the unexposed group (95% CI, 191%-237%).Conclusions: Subclinical and overt opioid exposure among newborn infants was associated with increased first-year healthcare utilization. From 2014 to 2017, this cost the Hamilton County healthcare system an estimated $1 109 452 for longer birth encounters alone. [ABSTRACT FROM AUTHOR]