Access to urban green spaces and behavioural problems in children: Results from the GINIplus and LISAplus studies

Aim: We investigated whether objectively measured access to urban green spaces is associated with behavioural problems in 10-year old children living in Munich and its surrounding areas. Methods: Behavioural problems were assessed in the GINIplus and LISAplus 10-year follow-up between 2006 and 2009 using the Strengths and Difficulties Questionnaire. Access to green spaces was defined using the distance from a child's residence to the nearest urban green space. Associations between access to urban green spaces and behavioural problems were assessed using proportional odds and logistic regression models in 1932 children with complete exposure, outcome and covariate data. Results: The distance between a child's residence and the nearest urban green space was positively associated with the odds of hyperactivity/inattention, especially among children with abnormal values compared to children with borderline or normal values (odds ratio (OR) = 1.20 (95% confidence interval (CI) = 1.01–1.42) per 500 m increase in distance). When stratified by sex, this association was only statistically significant among males. Children living further than 500 m away from urban green spaces had more overall behavioural problems than those living within 500 m of urban green spaces (proportional OR = 1.41 (95% CI = 1.06–1.87)). Behavioural problems were not associated with the distance to forests or with residential surrounding greenness. Conclusion: Poor access to urban green spaces was associated with behavioural problems in 10-year old children. Results were most consistent with hyperactivity/inattention problems