|More than one built environment domain (n = 3 studies; N/POS: n = 3, HOUS: n = 3, SERV: n = 1)|
|Baumgardner et al. (2010) ||USA||50,463||Case-control||N/POS-1: Distance from child’s home address to closest park|
N/POS-2: Distance from child’s home to nearest waterway
HOUS: Suburban home address (compared with central-city address)
|MHD: ADHD diagnosis (cases) versus no diagnosis (controls)||5–17 years||Child’s age, child’s sex, child’s race, Eastern Wisconsin vs. Milwaukee County (stratified), population density, median household income (area-level)||N/POS-1|
MHD: In Eastern Wisconsin, larger distance associated with higher odds of ADHD diagnosis (OR: 1.04, 95% CI 1.03–1.04).
MHD: In Eastern Wisconsin, NS. MHD: In Milwaukee County, larger distance to nearest waterway associated with lower odds of ADHD diagnosis (OR: 0.92, 95% CI 0.88–0.97).
MHD: In Milwaukee County, suburban address associated with higher odds of ADHD (OR: 1.40, 95% CI 1.20–1.63).
|Christian et al. (2017) ||Australia||149 NHs (23,395 children)||Partial ecological||N/POS-1: Population-based median distance to nearest park|
N/POS-2: Population-based median distance to nearest attractive park
N/POS-3: Population-based median distance to nearest pocket park
N/POS-4: Population-based median distance to nearest nature/conservation area
SERV-1: Population-based median distance to nearest Kindergarten
SERV-2: Population-based median distance to nearest child-center-based care
SERV-3: Population-based median distance to nearest
family support service
SERV-4: Population-based median distance to nearest
child health clinic
SERV-5: Population-based median distance to nearest
HOUS-1: % residential land not part of building footprint (home yard space in NH)
HOUS-2: Residential density
|MHC: Social competence (TR): Odds of poor social competence.|
MHC: Emotional maturity (TR): Odds of poor emotional maturity.
|5 years||NH SES, % households in NH with 4 year old that were: female, Aboriginal or Torres Strait Islander origin, had one or more siblings, at least one parent > 24 years, single parent families, at least one parent educated beyond secondary school, family income < $3000/fortnight, moved in last 12 months||N/POS-1|
MHC: Larger distance to nearest park associated with better social competence (OR: 0.996, 95% CI 0.993 to 0.999) and better emotional maturity (OR: 0.989, 95% CI 0.977 to 0.998).
MHC: Larger distance to nearest attractive park associated with better social competence (OR: 0.990, 95% CI 0.978 to 0.999). Emotional maturity: NS.
N/POS-3 & N/POS-4
MHC: Larger distance to child-center-based-care associated with better social competence and better emotional maturity.
SERV-1, 3, 4, & 5
MHC: Higher % home yard space in NH associated with better emotional maturity (5th quintile OR: 0.745, 95% CI 0.567 to 0.969).
|Richardson et al. (2017) ||Scotland||2909||Cross-sectional (by age 4 years); |
Prospective cohort (by age 6 years)
|N/POS-1: % land area that is public parks around 500m (Euclidean) of child’s home postcode|
N/POS-2: % land area that is natural space around 500m (Euclidean) of child’s home postcode
HOUS: Access to sole or shared private garden (yes/no) (PR)
|MHD: Total difficulties (PR)|
MHC: Prosocial behavior
Outcome at 6 years: change in MHD or MHC over time.
|Child’s sex, maternal education (stratified)||N/POS-1|
MHD: Overall and in both maternal education groups: NS at 4 years, 6 years. MHC: Overall and in both education groups: NS at 4 years, 6 years.
MHD: Overall NS at 4 years, 6 years. MHD: In lower education group, higher % area natural space associated with fewer peer problems (−0.08 per IQR increase) at 4 years, NS at 6 years. MHC: Higher % natural space associated with more prosocial behavior at 4 years (+0.08 per IQR increase), NS at 6 years. MHC: In higher education group, % area natural space associated with more prosocial behavior (+0.12 per IQR increase).
MHD: Overall no garden access associated with higher: total difficulties (+1.15), peer problems (+0.23), hyperactivity (+0.52), conduct problems (+0.27) at 4 years. MHD: Overall, change in difficulties over time (at 6 years): NS. In high education group, no garden access associated with worsening emotional problems and total difficulties over time (at 6 years), but NS for low education group. MHC: Overall: NS.
|Nature and public open space domain (n = 6)|
|Balseviciene et al. (2014) ||Lithuania||1,468||Cross-sectional||N/POS-1: Distance (straight line) from child’s home address to closest park|
N/POS-2: Residential greenness (average NDVI in 300m buffer around child’s home)
|MHD: Total difficulties (PR)|
MHC: Prosocial behavior (PR)
|4–6 years||Child’s sex,|
child’s age, maternal education (stratified), parenting stress
MHD: In lower education group, larger distance associated with more total difficulties (β: 0.069, p < 0.05) and more peer problems, conditional problems, and hyperactivity. In higher education group, NS except for larger distance nearly associated with fewer emotional problems (β: −0.008, p < 0.1). MHC: In lower education group, larger distance associated with less prosocial behavior (β: −0.029, p < 0.05). Higher education group: NS.
MHD: In higher education group, higher NDVI associated with more total difficulties (β: 2.286, p < 0.1), and more conditional problems and hyperactivity. MHC: NS in low education group. In high education group, higher NDVI associated with less prosocial behavior (β: −1.104, p < 0.05).
|Feng & Astell-Burt (2017) ||Australia||4968||Prospective Cohort||N/POS-1: % land area classified as parkland within child’s area of residence (SA-2).|
N/POS-2: Perception (PR) of good parks, playgrounds, play spaces in neighborhood (low quality vs high quality).
|MHD: total difficulties, internalizing, externalizing (PR)||6–7 years (ages 4–5 years at baseline)||Child’s sex, child’s Indigenous status, child’s age group, NH SES, NH urbanicity||N/POS-1|
MHD: Higher % parkland associated with lower difficulties (21 to 40% bracket: −0.29 (95% CI −0.47 to −0.10), and both lower internalizing and externalizing difficulties.
MHD: Poor quality parks associated with higher difficulties (disagree vs. agree: 0.53, 95% CI 0.34 to 0.72) and both higher internalizing and externalizing difficulties.
|Flouri et al. (2014) ||England||6384||Prospective Cohort||N/POS: % land area that is green space ||MHD:|
Emotional and behavioral problems (PR)
|5 years, |
|Family SES (PR)|
(stratified), NH SES
|MHD: Overall sample: NS. MHD: In low SES group, higher % green space associated with fewer emotional difficulties at 5 years.|
|Scott et al. (2018) ||USA||1551||Prospective Cohort||N/POS-1: % houses within 0.5 miles of public park (public, outdoor recreation area) around child’s home.|
N/POS-2: % impervious surface around child’s home.
N/POS-3: % tree canopy around child’s home.
|MHD: behavioral concerns (TR)|
MHC: Socio-emotional functioning (TR): Initiative, self-regulation, attachment
|4–5 years ||Child’s age, child’s race (Hispanic ethnic status), area-level median income, violent crime rate, population density, multilevel techniques (accounted for nested data).||N/POS-1|
MHD: NS. MHC: NS.
MHD: NS. MHC: NS.
MHD: Higher % tree canopy associated with improved (less) behavior concerns (γ = −0.19, p < 0.01). MHC: Higher % tree canopy associated with improved self-regulation (γ = 0.175, p < 0.01).
|Zach et al. (2016) ||Germany||5117||Cross-sectional||N/POS: Availability (PR) of public parks or green space in neighborhood (yes vs. no). ||MHD: total difficulties and hyperactivity. Binary—classified as ‘normal’ vs. ‘borderline or abnormal.’ (PR)||Preschool, age not specified||Child’s sex, family SES, NH traffic load, crowding||MHD: In sample (unweighted) no access to green space was associated with higher odds of difficulties (OR: 1.92, 95% CI 1.72–2.96) and higher odds of hyperactivity-inattention (OR: 1.53, 95% CI 0.99–2.35). MHD: In weighted data (representative of Bavaria), no access to green space associated with higher odds of difficulties (OR: 3.17, 95% CI 1.76–5.70) and higher odds of hyperactivity-inattention (OR: 3.03, 95% CI 1.64–5.58)|
|Housing domain (n = 6)|
|Casas et al. (2013) ||Spain||381||Prospective cohort||HOUS: Dampness in child’s bedroom, parent’s bedroom, living room, any other room in first 2 years of life (PR). Categorized as ‘never’, ‘ever (<2 years)’, ‘persistent (2 years)’.||MHC: Social competence (TR)||4 years||Child’s age, child’s sex, maternal education, maternal smoking during pregnancy, weeks of breastfeeding, folic acid intake during pregnancy, number of people living in the house, housing location (urban area, housing estate, country house)||MHC: Persistent dampness in child’s room associated with worse social competence scores (compared with non-persistent) (β: −6.54, 95%CI −12.19 to −0.89). MHC: Ever damp in child’s room (compared with never): NS. Dampness at home, in parent’s room, in living room: NS (irrespective of ever/never, persistent/non-persistent). |
|Morales et al. (2009) ||Spain||398||Prospective cohort||HOUS: Number (1 or 2) of household gas appliances (cooking, heating and cooling systems) compared with no gas appliances (HV)||MHD: ADHD (PR and TR).|
MHD: Inattention subset (PR and TR)
MHD: Hyperactivity subset (PR and TR)
|4 years||Child’s sex, maternal SES,|
school trimester at testing, outcome evaluator (neuropsychologist), maternal smoking during pregnancy, number of smokers at home, maternal alcohol consumption during pregnancy, home location.
|MHD: Two gas appliances associated with higher odds of inattention (OR: 3.59, 95% CI 1.14–11.33) and nearly associated with higher odds of ADHD (OR: 2.72, 95% CI 1.01–7.28) compared with no gas appliances. MHD: One gas appliance: NS. |
|Richman (1974) ||England||75||Cross-sectional||HOUS: Living in high-rise flats (higher than four floors), low-rise flats (not higher than four floors), houses (HV). ||MHD: proportion in each group with behavior problems (PR and HV). ||3 years||No statistical adjustments. |
Comparable SES between the three groups.
|MHD: No significant differences between the three groups in proportion of behavior problems (high-rise flats: 16.0%, low-rise flats: 28.0%, houses: 20.0%). |
|Richman (1977) ||England||196||Case-control||HOUS-1: Living in high-rise flats. |
HOUS-2: Housing in poor condition (dampness, no electricity, no hot water) (HV).
|MHD: behavior problems (PR and HV)||3 years||No statistical adjustments.|
Comparable SES between cases and controls.
MHD: Children living in high-rise housing had significantly higher behavior problems (30% scored 10+, compared with 14% in overall sample, p < 0.01).
MHD: Of the children with a behavior problem and maternal depression, 27% (12/44) had severe housing problems, compared with 7% (5/75) with no behavior problem or maternal depression (p < 0.01).
|Rijlaarsdam et al. (2013) ||Netherlands||2164||Prospective Cohort||HOUS: Physical home environment: 10-items including cleanliness, central heating system present, cluttered, dark, building is safe, play area outside is safe, neighborhood is pleasant. ||MHD: internalizing and externalizing (PR).||3 years||Child’s sex, child’s age, child’s national origin (non-Western), family low income, maternal education, socio-emotional involvement with parent, maternal depressive symptoms at 20 weeks gestation. ||MHD: NS. |
|Thompson et al. (1996) ||England||1047||Cross-sectional||HOUS: % households with ‘amenities’ (e.g., toilets, hot water) in the child’s ward of residence||MHD:|
behavior problem (yes/no), difficult temperament (yes/no), overactivity (yes/no) (PR)
|3 years||No statistical adjustments. ||MHD: NS. |