Association between green spaces and behavioral problems of children and adolescents: the moderating effects of PM2.5

Abstract

Purpose Recent studies suggest green spaces benefit mental health, yet the interaction between environmental factors and behavioral outcomes remains underexplored. This study examines the association between green space exposure and behavioral problems in children and adolescents, considering the potential moderating effects of fine particulate matter (PM_2.5). Methods We used the Strengths and Difficulties Questionnaire (SDQ) to assess behavioral problems in children and adolescents. Green space exposure was measured by the Normalized Difference Vegetation Index (NDVI) within a 1500-meter radius of participants' residences. Daily PM_2.5 concentrations were estimated from the Tracking Air Pollution in China website. A generalized linear model (GLM) with a quasi-Poisson link function estimated the association between green spaces and behavioral problems, considering the moderating effects of PM_2.5. Results The analysis included 4,782 children and adolescents, averaging 12.29 years. A 0.1 increase in NDVI was linked to a 1.19% (95% CI: -2.08 to -0.30%) reduction in total difficulties score and a 1.19% (95% CI: -2.18 to -0.20%) reduction in peer relationship problems. In high PM_2.5 areas, a 0.1 NDVI increase was associated with a 1.78% (95% CI: -3.05 to -0.60%) reduction in total difficulties and a 3.34% (95% CI: -5.92 to -0.60%) reduction in emotional problems. Stronger associations were observed in younger children (< 12 years), girls, and those from non-left-behind or lower-income families. Conclusion Exposure to residential surrounding green space might contributes to the reduction of behavioral problems among children and adolescents, suggesting a protective effect, particularly for those exposed to high levels of PM_2.5.