Urban green, blue spaces and their joint effect are associated with lower risk of emotional and behavior problem in children and adolescents, a large population-based study in Guangzhou, China.

Extensive research has been conducted on the impact of urban Green and blue spaces (GBS) on mental health. However, there is a dearth of studies examining the potential influence of GBS on Emotion and behavior problems (EBP) in youth populations. This study seeks to address this research gap by examining the association between GBS exposure and EBP in youths, utilizing a large population-based survey. Exposure indicators were derived for each participant, taking into account the 1-m resolution land coverage percentage measurements at their residential and school locations, with buffer sizes of 500m and 800m. The study employed the parent-reported Strengths and Difficulties Questionnaire (SDQ) as a measurement to EBP. To investigate this relationship, a Poisson linear mixed-effects model with comprehensive adjustment was utilized. Stratified analyses were conducted, taking into account demographic variables, while sensitivity analyses were performed to evaluate the reliability of the findings. The primary analysis encompassed a sample of 172,490 individuals, with an average age of 10.2 (standard deviation = 2.99), of whom 55.8% were male. Among young individuals residing within a 500-m radius of residential green spaces (GS), those in the second and third tertiles experienced a 5.0% and 7.6% decrease in the risk of developing total difficulties respectively, compared to those in the first tertile. Exposure to blue spaces (BS) around the residence yielded comparable results, with an AOR of 0.896 (95% CI: 0.866, 0.928) for the second tertile and an AOR of 0.991 (95% CI: 0.879, 0.943) for the third tertile, compared to the first tertile. The decrease in EBPs may also be linked to the joint effect of GS and BS. Young individuals were exposed to GS or BS, as well as the higher level of GS in conjunction with comparable BS, exhibited an inverse correlation with self-reported EBPs.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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