Neighborhood green spaces, facilities and population density as predictors of activity participation among 8-year-olds: a cross-sectional GIS study based on the Norwegian mother and child cohort study

Relationship between Emotional Support for Parents and Autistic Children's Participation in Social and Physical Activities

The purpose of this study was to determine if parents receiving emotional support is positively correlated with children's participation in physical and social activities and if such a correlation exists between parental emotional support in children labeled as autistic. Data were drawn from 30,501 children aged 6 to 17 years in the 2020 National Survey of Children's Health database and analyzed using a retrospective cross-sectional approach based on multivariate linear regression models. Results showed parental emotional support was statistically significantly correlated with children's physical and social activity in the total sample but was not significant for the emotional support of parents with autistic children. The findings suggest that other issues must be considered as contributing factors for parents of autistic children in relation to social and physical activity participation.

Health and wellbeing benefits of urban forests in winter: a narrative review

Urban trees and green spaces, hereafter, urban forests, are known to contribute to human health and wellbeing. However, research has predominantly focused on warm seasons. To understand whether these benefits extend to winter months, when vegetation is dormant, we conducted a narrative review of the health outcomes associated with urban forests in winter in cities with cold climates. We synthesized findings from 21 studies originating from Asia, Europe and North America. The most studied health outcomes were mental health, physical activity and physiological relaxation, all showing a positive relationship with urban forest exposure. These finding appear similar to those observed in warmer seasons. However, more studies are needed, on a diversity of health outcomes, to draw more robust conclusions in this emerging research field. Future research on urban forests should therefore consider winter and the effect of seasonality to improve health and wellbeing of urban dwellers in all seasons.

Residential Density Is Associated With BMI Trajectories in Children and Adolescents: Findings From the Moving to Health Study

Introduction

This study investigates the associations between built environment features and 3-year BMI trajectories in children and adolescents.

Methods

This retrospective cohort study utilized electronic health records of individuals aged 5-18 years living in King County, Washington, from 2005 to 2017. Built environment features such as residential density; counts of supermarkets, fast-food restaurants, and parks; and park area were measured using SmartMaps at 1,600-meter buffers. Linear mixed-effects models performed in 2022 tested whether built environment variables at baseline were associated with BMI change within age cohorts (5, 9, and 13 years), adjusting for sex, age, race/ethnicity, Medicaid, BMI, and residential property values (SES measure).

Results

At 3-year follow-up, higher residential density was associated with lower BMI increase for girls across all age cohorts and for boys in age cohorts of 5 and 13 years but not for the age cohort of 9 years. Presence of fast food was associated with higher BMI increase for boys in the age cohort of 5 years and for girls in the age cohort of 9 years. There were no significant associations between BMI change and counts of parks, and park area was only significantly associated with BMI change among boys in the age cohort of 5 years.

Conclusions

Higher residential density was associated with lower BMI increase in children and adolescents. The effect was small but may accumulate over the life course. Built environment factors have limited independent impact on 3-year BMI trajectories in children and adolescents.

Transforming leisure time physical activity into a habit through social institutions

Physical activity is a positive health behavior that has been shown to reduce the risk of physical and mental illnesses; There's strong evidence suggesting that Physical activity, as one of the components of a healthy lifestyle, if transformed into a consistent behavior or habit early in life, becomes easier to sustain throughout the lifecycle and leads to valuable outcomes for the society's health in various physical, mental, and social dimensions. Each social institution, considering its unique role and characteristics, can contribute to shaping individuals' behaviors in societies. Consequently, identifying the role of social institutions in the development of leisure-time physical activity (LTPA) as a regular activity and a behavioral habit can result in the selection and implementation of highly effective intervention strategies. Therefore, this research aimed to present a model of the role of social institutions in institutionalizing leisure-time physical activity among Iranian adolescent girls. To collect data, the questionnaires were employed, and for presenting the model, structural equation modeling was utilized. Data analysis showed that the role of three social institutions in the institutionalization of physical activities including habituation, objectification and sedimentation was confirmed, although sedimentation was confirmed in all three institutions at the 0.05 level, which indicates that factors in this area can be investigated. Examining the role of social institutions in institutionalizing behaviors may vary across different ages and genders, which is open to investigation in future studies.

Associations of residential green space with internalizing and externalizing behavior in early childhood

BACKGROUND

Green space exposures may promote child mental health and well-being across multiple domains and stages of development. The aim of this study was to investigate associations between residential green space exposures and child mental and behavioral health at age 4-6 years.

METHODS

Children's internalizing and externalizing behaviors in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) cohort in Shelby County, Tennessee, were parent-reported on the Child Behavior Checklist (CBCL). We examined three exposures-residential surrounding greenness calculated as the Normalized Difference Vegetation Index (NDVI), tree cover, and park proximity-averaged across the residential history for the year prior to outcome assessment. Linear regression models were adjusted for individual, household, and neighborhood-level confounders across multiple domains. Effect modification by neighborhood socioeconomic conditions was explored using multiplicative interaction terms.

RESULTS

Children were on average 4.2 years (range 3.8-6.0) at outcome assessment. Among CANDLE mothers, 65% self-identified as Black, 29% as White, and 6% as another or multiple races; 41% had at least a college degree. Higher residential surrounding greenness was associated with lower internalizing behavior scores (-0.66 per 0.1 unit higher NDVI; 95% CI: -1.26, -0.07) in fully-adjusted models. The association between tree cover and internalizing behavior was in the hypothesized direction but confidence intervals included the null (-0.29 per 10% higher tree cover; 95% CI: -0.62, 0.04). No associations were observed between park proximity and internalizing behavior. We did not find any associations with externalizing behaviors or the attention problems subscale. Estimates were larger in neighborhoods with lower socioeconomic opportunity, but interaction terms were not statistically significant.

CONCLUSIONS

Our findings add to the accumulating evidence of the importance of residential green space for the prevention of internalizing problems among young children. This research suggests the prioritization of urban green spaces as a resource for child mental health.

Perceptions of health among school-aged children living in socially vulnerable areas in Sweden

Introduction

According to the Convention on the Rights of the Child, all children have the right to health. Since good health is a decisive factor for children's future, investing in children's health is important, especially children from vulnerable areas. The purpose of this study was to investigate the perceptions of health among school-aged children from socially vulnerable areas.

Methods

The study has an explorative mixed-method design with a participatory and inductive approach based on focus group interviews with children and youth leaders, respectively, at Multi-activity Centers in three of the vulnerable areas in Malmö Municipality, as well as results from the Multi-activity Centers' own questionnaire. The data has been analyzed with inductive and deductive content analysis.

Results

The children and the youth leaders described health in terms of well-being, participation, and activity. Well-being included feeling good and safe, having a healthy body, and having fun by doing things together with friends and leaders. Participating in activities was described as having a feeling of involvement, being able to have an influence on the organization of the activities and participating on one's own terms.

Discussion

The result of this study shows that participating in activities increases the child's sense of well-being.

Familial and lifestyle factors related to physical activity in elementary school students: a cross-sectional study based on a nationally representative survey in Japan

PURPOSE

The decrease in physical activity (PA) among children has become a global concern. Since the analysis of sociodemographic factors as determinants of exercise habits has been inconclusive, this study investigated the factors related to participation in organized sports and moderate-to-vigorous PA (MVPA) levels.

METHODS

Cross-sectional data from the Sports-Life Survey conducted in 2019 by the Sasagawa Sports Foundation were used. Data on the gender, age, grade, annual household income, family members, and lifestyle habits of elementary school children as well as information on participation in organized sports and MVPA were collected by written questionnaires. Multiple logistic regression models were applied to calculate the adjusted odds ratio and 95% confidence interval for the association of each variable with participation in organized sports and frequent MVPA (≥ 60 min/day for ≥ 5 days/week).

RESULTS

A total of 1,197 participants were included in the analysis. Whereas 1,053 (88.2%) students expressed a like for PA, only 725 students (60.8%) actually took part in organized sports. Organized sports participation was significantly associated with gender, grade, population density, household income, daily breakfast, lower screen time, and frequent exercise with parents (all P < 0.05). We observed that 12.3% of participants met the frequent MVPA level, which was significantly related to lower screen time and exercise habits with parents (both P < 0.05).

CONCLUSIONS

Social and family factors may be strong determinants of engagement in PA among Japanese elementary school-aged children. Parental involvement appears particularly important for promoting PA among youths.

Calcific aortic valve disease: mechanisms, prevention and treatment

Calcific aortic valve disease (CAVD) is the most common disorder affecting heart valves and is characterized by thickening, fibrosis and mineralization of the aortic valve leaflets. Analyses of surgically explanted aortic valve leaflets have shown that dystrophic mineralization and osteogenic transition of valve interstitial cells co-occur with neovascularization, microhaemorrhage and abnormal production of extracellular matrix. Age and congenital bicuspid aortic valve morphology are important and unalterable risk factors for CAVD, whereas additional risk is conferred by elevated blood pressure and plasma lipoprotein(a) levels and the presence of obesity and diabetes mellitus, which are modifiable factors. Genetic and molecular studies have identified that the NOTCH, WNT-β-catenin and myocardin signalling pathways are involved in the control and commitment of valvular cells to a fibrocalcific lineage. Complex interactions between valve endothelial and interstitial cells and immune cells promote the remodelling of aortic valve leaflets and the development of CAVD. Although no medical therapy is effective for reducing or preventing the progression of CAVD, studies have started to identify actionable targets.

Associations between socioeconomic position and young people's physical activity and sedentary behaviour in the UK: a scoping review

OBJECTIVE

To examine the evidence on the associations between socioeconomic position and young people's physical activity and sedentary behaviours in the UK.

DESIGN

Scoping review.

DATA SOURCES

PubMed, SCOPUS and Web of Science databases were searched for articles published up to and including January 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Observational studies in children and adolescents (aged 5-18 years) from the UK that had assessed associations between at least one indicator of socioeconomic position and at least one outcome of physical activity and/or sedentary behaviour.

DATA EXTRACTION AND SYNTHESIS

Data were extracted by one reviewer and 20% were double checked. Indicators of socioeconomic position were tabulated with domains of physical activity and sedentary behaviour.

RESULTS

Fifty-seven publications were included in the review; 37 publications from 19 studies (k=23) of children and 21 publications from 15 studies (k=23) of adolescents. Most studies were cross-sectional. 63% of studies of children, and 40% of studies of adolescents assessed Index of Multiple Deprivation. Eighteen studies measured physical activity in children, 13 measured sedentary behaviour. Eleven studies of adolescents included a measure of physical activity, 10 included a measure of sedentary behaviour. Among children and adolescents, the association between socioeconomic position and measures of either physical activity or sedentary behaviour was highly variable depending on the measure of both socioeconomic position used and the behavioural outcome, with the exception of higher family affluence which was consistently associated with higher reported physical activity among adolescents.

CONCLUSION

Physical activity and sedentary behaviours of children and adolescents in the UK are complex and influenced by multiple indicators of socioeconomic position that are, in most cases, different across age stages, outcomes examined and measurement tools. Greater consistency in the use and measures of socioeconomic position as well as outcomes of behaviour are required for robust country-specific meta-analyses.

Greenness alleviates the effects of ambient particulate matter on the risks of high blood pressure in children and adolescents

Both ambient particulate matter (PM) and decrease of greenness have been suggested as risk factors for high blood pressure (HBP) in children and adolescents. But most evidence were from cross-sectional studies with limited data from prospective cohorts. In this cohort study, we included 588,004 children and adolescents aged 7 to 18 years without HBP from 2005 to 2018 in Beijing (240,081) and Zhongshan (347,923) city of China. The cumulative incidence of HBP was 32.04%, and incidence rate was 14.86 per 100 person-year. After adjustment for confounders, the ten-unit increase in PM₁, PM_2.5, and PM₁₀ exposure was significantly associated with 43%, 70%, and 43%- higher risks of HBP, respectively, but the 0.1-unit increase in NDVI exposure was significantly associated with a 25% lower risk of HBP. The HRs of PM₁ on the HBP risk were 1.486 and 1.150 in the low and the high-level of greenness, and they were 2.635 and 2.507 for PM_2.5, and for PM₁₀ 1.367 and 1.702 in the two groups. The attributable fraction (AFs) of PM₁, PM_2.5, and PM₁₀ on HBP incidents were 13.74%, 40.08%, and 15.47% in the low-level of greenness, which simultaneously was higher than those in the high-level of greenness (AF = 4.62%, 17.28%, and 9.96%). The exposure to higher ambient PM air pollution and lower greenness around schools were associated with a higher risk of HBP in children and adolescents, but higher greenness alleviated the adverse effects of ambient PM₁ and PM_2.5 on the HBP risks. Our findings highlighted a synergic strategy in preventing childhood HBP by decreasing air pollution reduction and improving greenness concurrently.

Associations between Children's Physical Activity and Neighborhood Environments Using GIS: A Secondary Analysis from a Systematic Scoping Review

Regular participation in physical activity is essential for children's physical, mental, and cognitive health. Neighborhood environments may be especially important for children who are more likely to spend time in the environment proximal to home. This article provides an update of evidence for associations between children's physical activity behaviors and objectively assessed environmental characteristics derived using geographical information system (GIS)-based approaches. A systematic scoping review yielded 36 relevant articles of varying study quality. Most studies were conducted in the USA. Findings highlight the need for neighborhoods that are well connected, have higher population densities, and have a variety of destinations in the proximal neighborhood to support children's physical activity behaviors. A shorter distance to school and safe traffic environments were significant factors in supporting children's active travel behaviors. Areas for improvement in the field include the consideration of neighborhood self-selection bias, including more diverse population groups, ground-truthing GIS databases, utilising data-driven approaches to derive environmental indices, and improving the temporal alignment of GIS datasets with behavioral outcomes.

Nature and Children's Health: A Systematic Review

CONTEXT

Daily outdoor play is encouraged by the American Academy of Pediatrics. Existing evidence is unclear on the independent effect of nature exposures on child health.

OBJECTIVE

We systematically evaluated evidence regarding the relationship between nature contact and children's health.

DATA SOURCES

The database search was conducted by using PubMed, Cumulative Index to Nursing and Allied Health Literature, PsychInfo, ERIC, Scopus, and Web of Science in February 2021.

STUDY SELECTION

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In all searches, the first element included nature terms; the second included child health outcome terms.

DATA EXTRACTION

Of the 10 940 studies identified, 296 were included. Study quality and risk of bias were assessed.

RESULTS

The strongest evidence for type of nature exposure was residential green space studies (n = 147, 50%). The strongest evidence for the beneficial health effects of nature was for physical activity (n = 108, 32%) and cognitive, behavioral, or mental health (n = 85, 25%). Physical activity was objectively measured in 55% of studies, and 41% of the cognitive, behavioral, or mental health studies were experimental in design.

LIMITATIONS

Types of nature exposures and health outcomes and behaviors were heterogenous. Risk of selection bias was moderate to high for all studies. Most studies were cross-sectional (n = 204, 69%), limiting our ability to assess causality.

CONCLUSIONS

Current literature supports a positive relationship between nature contact and children's health, especially for physical activity and mental health, both public health priorities. The evidence supports pediatricians in advocating for equitable nature contact for children in places where they live, play, and learn.

Examining Environmental Predictors of Community Participation for Adults with Autism Spectrum Disorder Using Geographic Information Systems (GIS)

A geographic information system (GIS) approach systematically assessed whether population density and distribution of community resources contributed to caregiver reported community participation outcomes for 124 adults with autism spectrum disorder (ASD). Regression analyses examined whether GIS measures predicted community participation in areas of social activities and use of services, while also accounting for adult age, conversation ability, and daily living skills (DLS). Results indicated that in addition to person factors of greater DLS and better conversation ability, access to specific community features, such as bus stops, contributed to improved participation. Unexpectedly, population density where one lived made minimal contribution to participation outcomes, except in getting together with friends outside of organized activities.

When physical activity meets the physical environment: precision health insights from the intersection

BACKGROUND

The physical environment can facilitate or hinder physical activity. A challenge in promoting physical activity is ensuring that the physical environment is supportive and that these supports are appropriately tailored to the individual or group in question. Ideally, aspects of the environment that impact physical activity would be enhanced, but environmental changes take time, and identifying ways to provide more precision to physical activity recommendations might be helpful for specific individuals or groups. Therefore, moving beyond a "one size fits all" to a precision-based approach is critical.

MAIN BODY

To this end, we considered 4 critical aspects of the physical environment that influence physical activity (walkability, green space, traffic-related air pollution, and heat) and how these aspects could enhance our ability to precisely guide physical activity. Strategies to increase physical activity could include optimizing design of the built environment or mitigating of some of the environmental impediments to activity through personalized or population-wide interventions.

CONCLUSIONS

Although at present non-personalized approaches may be more widespread than those tailored to one person's physical environment, targeting intrinsic personal elements (e.g., medical conditions, sex, age, socioeconomic status) has interesting potential to enhance the likelihood and ability of individuals to participate in physical activity.

Virtual Reality Representations of Nature to Improve Well-Being amongst Older Adults: a Rapid Review

Poor well-being amongst older adults poses a serious health concern. Simultaneously, research shows that contact with nature can improve various facets of well-being, including physical, social, and mental well-being. However, nature is not always accessible for older adults due to mobility restrictions and related care needs that come with age. A promising strategy aims at bringing nature inside through pervasive technologies. However, so far, there is little academic understanding of essential nature characteristics, psychological processes involved, and means for implementation in practice. The current study used a three-folded rapid review to assess current understanding and strategies used for improving well-being for older adults through virtual reality representations of nature. Searches were performed across three databases, followed-up by content-based evaluation of abstracts. In total, a set of 25 relevant articles was identified. Only three studies specifically focus on digital nature as an intervention strategy for improving well-being amongst older adults. Although these studies provide useful starting points for the design and (technological) development of such environments, they do not generate understanding of how specific characteristics of virtual nature representations impact social well-being measures in particular, and of the underlying psychological processes involved. We conclude that follow-up research is warranted to close the gap between insights and findings from nature research, gerontology, health research, and human-technology interaction.

Safe environments-Through the eyes of 9-year-old schoolchildren from a socially vulnerable area in Sweden

BACKGROUND

Children are more vulnerable than adults to environmental risks. Also, children have little control over their environment. Unlike adults, they may be both unaware of risks and unable to make choices to protect their health. Children living in especially vulnerable areas might be even more at risk due to socio-economic factors, immigration and high crime rates. Therefore, the aim of this study was to describe the perceptions that schoolchildren from a socially vulnerable area have of safe environments.

METHODS

Fifty-two 9-year-old schoolchildren from a socially vulnerable area participated in this study. The data collection consisted of an environmental walk with photovoicing, followed by rating of the photos and a focus-group discussion elaborating on the photos and ratings. Six focus groups, with six to eight children in each group, were conducted and analysed using inductive content analysis.

RESULTS

The results show that, according to the children, places that they think are bright and beautiful, where they can do fun things with others and do not risk being exposed to danger, create safety. To increase safety, the children suggested cleaning up, making the environment beautiful with grass and flowers and painting it in nice colours. Furthermore, they suggested that building features that increase the opportunities to play and engage in activities together with others would improve safety and enhance protection and surveillance.

CONCLUSIONS

All children have the right to protection and safety. Therefore, it is important to create safe environments for all children by listening to children's own voices.

Objective measurement of children's physical activity geographies: A systematic search and scoping review

This study aimed to systematically identify, map out, and describe geographical information systems (GIS)-based approaches that have been employed to measure children's neighborhood geographies for physical activity behaviors. Forty studies were included, most were conducted in the USA. Heterogeneity in GIS methods and measures was found. The majority of studies estimated children's environments using Euclidean or network buffers ranging from 100 m to 5 km. No singular approach to measuring children's physical activity geographies was identified as optimal. Geographic diversity in studies as well as increased use of measures of actual neighborhood exposure are needed. Improved consistency and transparency in reporting research methods is urgently required.

•

Varied GIS measures of children's physical activity geographies were identified.

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Evidence was heterogeneous and predominantly from the USA.

•

Most research used Euclidean or network buffers ranging from 100 m to 5 km.

•

Larger buffer sizes (i.e., ≥800 m) performed better than smaller buffer sizes.

•

No optimal approach to measuring children's activity geographies was determined.

Disentangling how the built environment relates to children's well-being: Participation in leisure activities as a mediating pathway among 8-year-olds based on the Norwegian Mother and Child Cohort Study

There is scarce insight into the role of the built environment for children's subjective well-being. In an attempt to increase our knowledge on this matter, we conducted a cross-sectional study comprising 23,043 children from the Norwegian Mother and Child Cohort Study. Information about children's leisure activities and their moods and feelings were linked to geospatial data on green space, facilities and population density to assess whether these built characteristics are related to subjective well-being and if participating in leisure activities is a mediator in such relations. We found that children having a park and more playgrounds/sports fields in the neighborhood, as well as those living in more densely populated areas, had more depressive moods and negative feelings. However, participating in leisure-time physical activity, organized activities and social activity with friends mediated these relations and contributed to counterbalancing some of the negative associations observed. The findings suggest that planners and policy makers should focus on ensuring children have neighborhood resources and venues that could support engagement in leisure activities that add positive experiences for their subjective well-being.

The association between spatial access to physical activity facilities within home and workplace neighborhoods and time spent on physical activities: evidence from Guangzhou, China

BACKGROUND

Urban residents from the developing world have increasingly adopted a sedentary lifestyle and spend less time on physical activities (PA). Previous studies on the association between PA facilities and individuals' PA levels are based on the assumption that individuals have opportunities to use PA facilities within neighborhoods all day long, ignoring the fact that their willingness and opportunities to use nearby facilities depend on how much discretionary time (any time when people have a choice what to do) they have. Further, scant attention has been paid to the influence of PA facilities within both residential and workplace neighborhoods in the dense urban context. To address the above research gaps, this study investigated the links between the spatial access to PA facilities within home/workplace neighborhoods and time spent on PA among working adults, focusing on whether results were different when different measures of accessibility were used and whether participants' discretionary time over a week affected their time spent on PA.

METHOD

This study used data from a questionnaire survey (n = 1002) in Guangzhou between June and July 2017 and point of interest (POI) data from online mapping resources. Outcome variables included the amount of time spent on physical activity/moderate and vigorous intensity physical activity (PA/MVPA) over the past week. Home/workplace neighborhoods were measured as different distance buffers (500 m circular buffers, 1000 m circular buffers, and 1080 m network buffers) around each respondent's home/workplace. Spatial access to PA facilities was measured using two indicators: the counts of PA facilities and proximity to PA facilities within home/workplace neighborhoods. The amount of discretionary time was calculated based on activity log data of working day/weekend day from the Guangzhou questionnaire survey, and regression models were used to examine relationships between the spatial access of PA facilities, the time spent on PA/MVPA, and the amount of discretionary time, adjusted for covariates. Associations were stratified by gender, age, education, and income.

RESULTS

Using different measures of accessibility (the counts of and proximity to PA facilities) generated different results. Specifically, participants spent more time on PA/MVPA when they lived in neighborhoods with more PA facilities and spent more time on MVPA when worked in closer proximity to PA facilities. A larger amount of discretionary time was associated with more time spent on PA/MVPA, but it did not strengthen the relationship between access to PA facilities and PA/MVPA time. In addition, relationships between access to PA facilities and PA levels varied by gender, age, education, and income.

CONCLUSION

This study contributes to the knowledge of PA-promoting environments by considering both the home and workplace contexts and by taking into account the temporal attributes of contextual influences. Policymakers and urban planners are advised to take into account the workplace context and the temporal variability of neighborhood influences when allocating public PA facilities and public spaces.

Associations of types of green space across the life-course with blood pressure and body mass index

Green space has been associated with better health and well-being. However, most studies have been cross-sectional with limited long-term exposure data. Further, research is limited in what type of green space is beneficial for health. We conducted a longitudinal study to assess sensitive periods (birth, childhood or adulthood) of exposure to different types of green space in association with adult blood pressure and body mass index (BMI). Using longitudinal data from the New England Family Study (1960-2000) and multilevel regression analysis, we examined associations between time-varying markers of residential exposure to green space, and adult BMI, systolic (SBP) and diastolic blood pressure (DBP) (N = 517). We created three exposure metrics: distance, average area, and green space count in the neighborhood throughout the life-course. In adjusted models, living one mile farther away from a green space at birth was associated with a 5.6 mmHg higher adult SBP (95%CI: 0.7, 10.5), and 3.5 mmHg higher DBP (95%CI: 0.3, 6.8). One more green space in the neighborhood at birth was also associated with lower DBP (-0.2 mmHg, 95%CI: -0.4, -0.02) in adulthood. Finally, average area of green space was not associated with SBP, DBP nor BMI. Analysis by type of green space suggested that parks may be more relevant than playgrounds, cemeteries or golf courses. Our study suggests that the perinatal period may be a critical time-period where living closer to green spaces may lower hypertension risk in adulthood, but not obesity.