Greenspace and Infant Mortality in Philadelphia, PA

Abstract

Despite mounting evidence that urban greenspace protects against mortality in adults, few studies have explored the relationship between greenspace and death among infants. Here, we describe results from an analysis of associations between greenness and infant mortality in Philadelphia, PA. We used images of the normalized difference vegetation index (NDVI), derived from processed satellite data, to estimate greenness density in each census tract. We linked these data with census tract level counts of total infant mortality cases (n = 963) and births (n = 113,610) in years 2010–2014, and used Bayesian spatial areal unit, conditional autoregressive models to estimate associations between greenness and infant mortality. The models included a set of random effects to account for spatial autocorrelation between neighboring census tracts. Infant mortality counts were modeled using a Poisson distribution, and the logarithm of total births in each census tract was specified as the offset term. The following variables were included as potential confounders and effect modifiers: percentage non-Hispanic black, percentage living below the poverty line, an indicator of housing quality, and population density. In adjusted models, the rate of infant mortality was 27% higher in less green compared to more green tracts (95% CI 1.02–1.59). These results contribute further evidence that greenspace may be a health promoting environmental asset.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. 1.

    United Nations. 2014 Revision of the World Urbanization Prospects 2014. https://esa.un.org/unpd/wup/publications/files/wup2014-report.pdf. Accessed 29 March 2019.

  2. 2.

    Nieuwenhuijsen MJ, Khreis H, Triguero-Mas M, Gascon M, Dadvand P. Fifty shades of green: pathway to healthy urban living. Epidemiology. 2017;28(1):63–71.

    Article  PubMed  Google Scholar 

  3. 3.

    Gascon M, Triguero-Mas M, Martinez D, et al. Residential green spaces and mortality: a systematic review. Environ Int. 2016;86:60–7.

    Article  PubMed  Google Scholar 

  4. 4.

    Triguero-Mas M, Donaire-Gonzalez D, Seto E, Valentín A, Martínez D, Smith G, et al. Natural outdoor environments and mental health: stress as a possible mechanism. Environ Res. 2017;159:629–38.

    Article  CAS  PubMed  Google Scholar 

  5. 5.

    Sugiyama T, Leslie E, Giles-Corti B, Owen N. Associations of neighbourhood greenness with physical and mental health: do walking, social coherence and local social interaction explain the relationships? J Epidemiol Community Health. 2008;62(5):e9.

    Article  CAS  PubMed  Google Scholar 

  6. 6.

    Lanki T, Siponen T, Ojala A, Korpela K, Pennanen A, Tiittanen P, et al. Acute effects of visits to urban green environments on cardiovascular physiology in women: a field experiment. Environ Res. 2017;159:176–85.

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Roe JJ, Thompson CW, Aspinall PA, Brewer M, Duff E, Miller D, et al. Green space and stress: evidence from cortisol measures in deprived urban communities. Int J Environ Res Public Health. 2013;10(9):4086–103.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Veisten K, Smyrnova Y, Klaeboe R, Hornikx M, Mosslemi M, Kang J. Valuation of green walls and green roofs as soundscape measures: including monetised amenity values together with noise-attenuation values in a cost-benefit analysis of a green wall affecting courtyards. Int J Environ Res Public Health. 2012;9(11):3770–88.

    Article  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Nowak DJ, Hirabayashi S, Bodine A, Hoehn R. Modeled PM2.5 removal by trees in ten U.S. cities and associated health effects. Environ Pollut. 2013;178:395–402.

    Article  CAS  PubMed  Google Scholar 

  10. 10.

    Schinasi LH, Benmarhnia T, De Roos AJ. Modification of the association between high ambient temperature and health by urban microclimate indicators: a systematic review and meta-analysis. Environ Res. 2017;161:168–80.

    Article  CAS  PubMed  Google Scholar 

  11. 11.

    Branas CC, Cheney RA, MacDonald JM, Tam VW, Jackson TD, Ten Have TR. A difference-in-differences analysis of health, safety, and greening vacant urban space. Am J Epidemiol. 2011;174(11):1296–306.

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Garvin EC, Cannuscio CC, Branas CC. Greening vacant lots to reduce violent crime: a randomised controlled trial. Inj Prev. 2013;19(3):198–203.

    Article  PubMed  Google Scholar 

  13. 13.

    de Vries S, van Dillen SM, Groenewegen PP, Spreeuwenberg P. Streetscape greenery and health: stress, social cohesion and physical activity as mediators. Soc Sci Med. 2013;94:26–33.

    Article  PubMed  Google Scholar 

  14. 14.

    Coombes E, Jones AP, Hillsdon M. The relationship of physical activity and overweight to objectively measured green space accessibility and use. Soc Sci Med. 2010;70(6):816–22.

    Article  PubMed  Google Scholar 

  15. 15.

    Reidpath DD, Allotey P. Infant mortality rate as an indicator of population health. J Epidemiol Community Health. 2003;57(5):344–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Pickett KE, Wilkinson RG. Income inequality and health: a causal review. Soc Sci Med. 2015;128:316–26.

    Article  PubMed  Google Scholar 

  17. 17.

    Orr ST, James SA, Miller CA, et al. Psychosocial stressors and low birthweight in an urban population. Am J Prev Med. 1996;12(6):459–66.

    Article  CAS  PubMed  Google Scholar 

  18. 18.

    Basu R, Pearson D, Sie L, Broadwin R. A case-crossover study of temperature and infant mortality in California. Paediatr Perinat Epidemiol. 2015;29(5):407–15.

    Article  PubMed  Google Scholar 

  19. 19.

    Son JY, Lee HJ, Koutrakis P, Bell ML. Pregnancy and lifetime exposure to fine particulate matter and infant mortality in Massachusetts, 2001-2007. Am J Epidemiol. 2017;186(11):1268–76.

    Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Collins JW Jr, Hawkes EK. Racial differences in post-neonatal mortality in Chicago: what risk factors explain the black infant’s disadvantage? Ethn Health. 1997;2(1–2):117–25.

    Article  PubMed  Google Scholar 

  21. 21.

    Kihal-Talantikite W, Padilla CM, Lalloue B, Gelormini M, Zmirou-Navier D, Deguen S. Green space, social inequalities and neonatal mortality in France. BMC Pregnancy Childbirth. 2013;13:191.

    Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Agay-Shay K, Peled A, Crespo AV, Peretz C, Amitai Y, Linn S, et al. Green spaces and adverse pregnancy outcomes. Occup Environ Med. 2014;71(8):562–9.

    Article  PubMed  Google Scholar 

  23. 23.

    Dadvand P, de Nazelle A, Figueras F, Basagaña X, Su J, Amoly E, et al. Green space, health inequality and pregnancy. Environ Int. 2012;40:110–5.

    Article  CAS  PubMed  Google Scholar 

  24. 24.

    Markevych I, Fuertes E, Tiesler CM, et al. Surrounding greenness and birth weight: results from the GINIplus and LISAplus birth cohorts in Munich. Health Place. 2014;26:39–46.

    Article  PubMed  Google Scholar 

  25. 25.

    Grazuleviciene R, Danileviciute A, Dedele A, Vencloviene J, Andrusaityte S, Uždanaviciute I, et al. Surrounding greenness, proximity to city parks and pregnancy outcomes in Kaunas cohort study. Int J Hyg Environ Health. 2015;218(3):358–65.

    Article  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Mathews TJ, Driscoll AK. Trends in infant mortality in the United States, 2005-2014. NCHS Data Brief. 2017(279):1–8.

  27. 27.

    Nowak DJ, Hirabayashi S, Bodine A, Greenfield E. Tree and forest effects on air quality and human health in the United States. Environ Pollut. 2014;193:119–29.

    Article  CAS  PubMed  Google Scholar 

  28. 28.

    Jang HS, Lee SC, Jeon JY, Kang J. Evaluation of road traffic noise abatement by vegetation treatment in a 1:10 urban scale model. J Acoust Soc Am. 2015;138(6):3884–95.

    Article  PubMed  Google Scholar 

  29. 29.

    Susca T, Gaffin SR, Dell'osso GR. Positive effects of vegetation: urban heat island and green roofs. Environ Pollut. 2011;159(8–9):2119–26.

    Article  CAS  PubMed  Google Scholar 

  30. 30.

    Gouveia N, Junger WL, ESCALA investigators. Effects of air pollution on infant and children respiratory mortality in four large Latin-American cities. Environ Pollut. 2018;232:385–91.

    Article  CAS  PubMed  Google Scholar 

  31. 31.

    Kihal-Talantikite W, Padilla CM, Lalloue B, Rougier C, Defrance J, Zmirou-Navier D, et al. An exploratory spatial analysis to assess the relationship between deprivation, noise and infant mortality: an ecological study. Environ Health. 2013;12:109.

    Article  PubMed  PubMed Central  Google Scholar 

  32. 32.

    Kawachi I, Kennedy BP, Lochner K, Prothrow-Stith D. Social capital, income inequality, and mortality. Am J Public Health. 1997;87(9):1491–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Pearsall H, Christman Z. Tree-lined lanes or vacant lots? Evaluating non-stationarity between urban greenness and socio-economic conditions in Philadelphia, Pennsylvania, USA at multiple scales. Appl Geogr. 2012;35(1–2):257–64.

    Article  Google Scholar 

  34. 34.

    Nowak DJ, Bodine AR, Hoehn RE, et al. The urban forest of Philadelphia. Newtown Square, PA2016. https://www.itreetools.org/resources/reports/PhiladelphiaUrbanForest.pdf. Accessed 29 March 2019.

  35. 35.

    Freeh R, Wu S. Mayor’s Office of Sustainability. Greenworks Philadelphia 2015 Progress Report. https://www.phila.gov/media/20160419140539/2015-greenworks-progress-report.pdf. Accessed 29 March 2019.

  36. 36.

    Ouyang M, Siegel C, Washington R. Vital statistics report. Philadelphia: 2014. 2017. https://www.phila.gov/media/20181105161044/2014-Vital-Statistics-Report-FINAL.pdf. Accessed 29 March 2019.

  37. 37.

    Kochanek KD, Murphy SL, Xu J, Tejada-Vera B. Deaths: final data for 2014. Natl Vital Stat Rep. 2016;65(4):1–122.

    PubMed  Google Scholar 

  38. 38.

    Weier J, Herring D. Measuring vegetation (NDVI & EVI). 2011; http://earthobservatory.nasa.gov/Features/MeasuringVegetation/. Accessed January 20, 2016.

  39. 39.

    Casey JA, James P, Cushing L, Jesdale BM, Morello-Frosch R. Race, ethnicity, income concentration and 10-year change in urban greenness in the United States. Int J Environ Res Public Health. 2017;14(12)

  40. 40.

    Hijmans RJ, van Etten J. Raster: geographic analysis and modeling with raster data. R package version 2.0–12. http://cran.r-project.org/package=raster. 2012. Accessed 15 March 2018.

  41. 41.

    City of Philadelphia. Philadelphia Vital Statistics Reports; http://www.phila.gov/health/commissioner/VitalStatistics.html. Accessed April 10, 2018, 2018.

  42. 42.

    Rossen LM, Khan D, Schoendorf KC. Mapping geographic variation in infant mortality and related black-white disparities in the US. Epidemiology. 2016;27(5):690–6.

    Article  PubMed  PubMed Central  Google Scholar 

  43. 43.

    Besag J, York J, Mollie A. Bayesian image restoration, with two applications in spatial statistics. Ann Inst Stat Math. 1991;43:1–59.

    Article  Google Scholar 

  44. 44.

    Paciorek CJ. The importance of scale for spatial-confounding bias and precision of spatial regression estimators. Stat Sci. 2010;25(1):107–25.

    Article  PubMed  PubMed Central  Google Scholar 

  45. 45.

    Lee D, Sarran C. Controlling for unmeasured confounding and spatial misalignment in long-term air pollution and health studies. Environmetrics. 2015;26(7):477–87.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. 46.

    Lee D. CARBayes: an R package for bayesian spatial modeling with conditional autoregressive priors. J Stat Softw. 2013;55:1–24.

    Google Scholar 

  47. 47.

    R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.r-project.org/. Accessed 15 March 2018.

  48. 48.

    Matoba N, Collins JW Jr. Racial disparity in infant mortality. Semin Perinatol. 2017;41(6):354–9.

    Article  PubMed  Google Scholar 

  49. 49.

    Miranda ML, Messer LC, Kroeger GL. Associations between the quality of the residential built environment and pregnancy outcomes among women in North Carolina. Environ Health Perspect. 2012;120(3):471–7.

    Article  PubMed  Google Scholar 

  50. 50.

    Schempf AH, Kaufman JS, Messer LC, Mendola P. The neighborhood contribution to black-white perinatal disparities: an example from two North Carolina counties, 1999-2001. Am J Epidemiol. 2011;174(6):744–52.

    Article  PubMed  Google Scholar 

  51. 51.

    Ely DM, Driscoll AK, Matthews TJ. Infant Mortality Rates in Rural and Urban Areas in the United States, 2014. NCHS Data Brief. 2017(285):1–8.

  52. 52.

    United States Census Bureau. American Community Survey. https://www.census.gov/programs-surveys/acs/. Accessed October 5, 2018, 2018.

  53. 53.

    United States Census Bureau. The history of the official poverty measure. 2017; https://www.census.gov/topics/income-poverty/poverty/about/history-of-the-poverty-measure.html. Accessed October 5, 2018, 2018.

  54. 54.

    City of Philadelphia Office of Property Assessment. OpenDataPhilly: Property Assessments. 2018; https://www.opendataphilly.org/dataset/opa-property-assessments. Accessed April 10, 2018, 2018.

  55. 55.

    Bartram's Garden. 2018; https://bartramsgarden.org/about/mission-vision/, Accessed October 5, 2018.

  56. 56.

    Wissahickon Valley Park Train: Pennsylvania. 2018; https://www.traillink.com/trail/wissahickon-valley-park-trail/. Accessed October 5, 2018.

  57. 57.

    South EC, Hohl BC, Kondo MC, MacDonald JM, Branas CC. Effect of greening vacant land on mental health of community-dwelling adults. JAMA Netw Open. 2018;1(3):e180298.

    Article  PubMed  PubMed Central  Google Scholar 

  58. 58.

    Branas CC, South E, Kondo MC, Hohl BC, Bourgois P, Wiebe DJ, et al. Citywide cluster randomized trial to restore blighted vacant land and its effects on violence, crime, and fear. Proc Natl Acad Sci U S A. 2018;115(12):2946–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. 59.

    South EC, Kondo MC, Cheney RA, Branas CC. Neighborhood blight, stress, and health: a walking trial of urban greening and ambulatory heart rate. Am J Public Health. 2015;105(5):909–13.

    Article  PubMed  PubMed Central  Google Scholar 

  60. 60.

    Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. Women Birth. 2015;28(3):179–93.

    Article  PubMed  Google Scholar 

  61. 61.

    Liou SR, Wang P, Cheng CY. Effects of prenatal maternal mental distress on birth outcomes. Women Birth. 2016;29(4):376–80.

    Article  PubMed  Google Scholar 

  62. 62.

    Banay RF, Bezold CP, James P, Hart JE, Laden F. Residential greenness: current perspectives on its impact on maternal health and pregnancy outcomes. Int J Women’s Health. 2017;9:133–44.

    Article  Google Scholar 

  63. 63.

    Casey JA, James P, Rudolph KE, Wu CD, Schwartz BS. Greenness and birth outcomes in a range of Pennsylvania communities. Int J Environ Res Public Health. 2016;13(3)

  64. 64.

    Mitchell R, Popham F. Effect of exposure to natural environment on health inequalities: an observational population study. Lancet. 2008;372(9650):1655–60.

    Article  Google Scholar 

  65. 65.

    Ebisu K, Holford TR, Bell ML. Association between greenness, urbanicity, and birth weight. Sci Total Environ. 2016;542(Pt A):750–6.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the Drexel University Urban Health Collaborative, who helped to prepare some of the data that they used in these analyses.

Funding

This work was supported, in part, by a grant from the Commonwealth University Research Enhancement (C.U.R.E.) program, funded by the Pennsylvania Department of Health, 2015 Formula award SAP # 4100072543.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Leah H. Schinasi.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Schinasi, L.H., Quick, H., Clougherty, J.E. et al. Greenspace and Infant Mortality in Philadelphia, PA. J Urban Health 96, 497–506 (2019). https://doi.org/10.1007/s11524-018-00335-z

Download citation

Keywords

  • Greenspace
  • Urban health
  • Urban landscape
  • Infant mortality
  • Epidemiology
  • Spatial
  • Geospatial