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The Built Environment and Child Health: An Overview of Current Evidence

Abstract

Urbanization and the shaping of the built environment have provided a number of socioeconomic benefits, but they have also brought unwanted side effects on health. We aimed to review the current epidemiological evidence of the associations between the built environment, closely related exposures, and child health. We focused on growth and obesity, neuropsychological development, and respiratory and immune health. We used existing review articles and supplemented these with relevant work published and not included in existing reviews. The present review shows that there is good evidence for an association between air pollution and fetal growth restriction and respiratory health, whereas for other exposure and outcome combinations, further evidence is needed. Future studies should make efforts to integrate the different built environment features and to include the evaluation of environments other than home, as well as accessibility, qualitative and perception assessment of the built environment, and, if possible, with improved and standardized tools to facilitate comparability between studies. Efforts are also needed to conduct longitudinal and intervention studies and to understand potential mechanisms behind the associations observed. Finally, studies in low- and middle-income countries are needed.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. World Health Organization. Children’s environmental health. Environmental risks [Internet]. Available from: http://www.who.int/ceh/risks/en/.

  2. Tamburlini G, von Ehrenstein O, Bertollini R. Children’s health and environment. A review of evidence [Internet]. Copenhagen; 2002. Available from: http://www.euro.who.int/en/publications/abstracts/childrens-health-and-environment.-a-review-of-evidence.

  3. Jackson RJ, Kochtitzky C. Creating a healthy environment: the impact of the built environment on public health [Internet]. Washington; available from: http://medanthro.net/academic/docs/kochtitzky.pdf.

  4. National Center for Environmental Health, Division of Emergency and Environmental Health Services. Impact of the built environment on health. Healthy community design. Fact sheet series. [Internet]. 2011. Available from: http://www.cdc.gov/nceh/publications/factsheets/impactofthebuiltenvironmentonhealth.pdf.

  5. Rao M, Prasad S, Adshead F, Tissera H. The built environment and health. Lancet. 2007;370:1111–3.

    Article  PubMed  Google Scholar 

  6. Handy SL, Boarnet MG, Ewing R, Killingsworth RE. How the built environment affects physical activity. Am J Prev Med. 2002;23:64–73.

    Article  PubMed  Google Scholar 

  7. Lavin T, Higgins C, Metcalfe O, Jordan A. Health impacts of the built environment: a review [Internet]. Dublin; 2006. Available from: http://hiaconnect.edu.au/old/files/Health_Impacts_of_the_Built_Environment.pdf.

  8. Keddem S, Barg FK, Glanz K, Jackson T, Green S, George M. Mapping the urban asthma experience: using qualitative GIS to understand contextual factors affecting asthma control. Soc Sci Med. 2015;140:9–17.

    Article  PubMed  Google Scholar 

  9. Nieuwenhuijsen MJ. Urban planning, environmental exposures and health [Internet]. United Cities Local Gov. 2014. Available from: http://www.uclg.org/en/media/news/urban-planning-environmental-exposures-and-health.

  10. WHO. Controlling the global obesity epidemic [Internet]. Available from: http://www.who.int/nutrition/topics/obesity/en/.

  11. Bousquet J, Anto J, Auffray C, Akdis M, Cambon-Thomsen A, Keil T, et al. MeDALL (Mechanisms of the Development of ALLergy): an integrated approach from phenotypes to systems medicine. Allergy. 2011;66:596–604.

  12. Centers for Disease Control and Prevention (CDC). Attention-deficit/hyperactivity disorder (ADHD). New data: medication and behavior treatment [Internet]. Available from: http://www.cdc.gov/ncbddd/adhd/data.html.

  13. Gascon M, Morales E, Sunyer J, Vrijheid M. Effects of persistent organic pollutants on the developing respiratory and immune systems: a systematic review. Environ Int. 2013;52C:51–65.

    Article  Google Scholar 

  14. Grasser G, Van Dyck D, Titze S, Stronegger W. Objectively measured walkability and active transport and weight-related outcomes in adults: a systematic review. Int J Public Health. 2013;58:615–25.

    Article  PubMed  Google Scholar 

  15. Janssen I, King N. Walkable school neighborhoods are not playable neighborhoods. Health Place. 2015;35:66–9.

    Article  PubMed  Google Scholar 

  16. Mecredy G, Pickett W, Janssen I. Street connectivity is negatively associated with physical activity in Canadian youth. Int J Environ Res Public Health. 2011;8:3333–50.

    Article  PubMed  PubMed Central  Google Scholar 

  17. D’Haese S, Van Dyck D, De Bourdeaudhuij I, Deforche B, Cardon G. The association between objective walkability, neighborhood socio-economic status, and physical activity in Belgian children. Int J Behav Nutr Phys Act. 2014;11:104.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Duncan DT, Sharifi M, Melly SJ, Marshall R, Sequist TD, Rifas-Shiman SL, et al. Characteristics of walkable built environments and BMI z-scores in children: evidence from a large electronic health record database. Environ Health Perspect. 2014;122:1359–65.

    PubMed  PubMed Central  Google Scholar 

  19. Hsieh S, Klassen AC, Curriero FC, Caulfield LE, Cheskin LJ, Davis JN, et al. Built environment associations with adiposity parameters among overweight and obese Hispanic youth. Prev Med Rep. 2015;2:406–12.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Hsieh S, Klassen AC, Curriero FC, Caulfield LE, Cheskin LJ, Davis JN, et al. Fast-food restaurants, park access, and insulin resistance among Hispanic youth. Am J Prev Med. 2014;46:378–87.

    Article  PubMed  Google Scholar 

  21. Penney TL, Almiron-Roig E, Shearer C, McIsaac J-L, Kirk SFL. Modifying the food environment for childhood obesity prevention: challenges and opportunities. Proc Nutr Soc. 2014;73:226–36.

    Article  PubMed  Google Scholar 

  22. Cetateanu A, Jones A. Understanding the relationship between food environments, deprivation and childhood overweight and obesity: evidence from a cross sectional England-wide study. Health Place. 2014;27:68–76.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Vogel C, Parsons C, Godfrey K, Robinson S, Harvey NC, Inskip H, et al. Greater access to fast-food outlets is associated with poorer bone health in young children. Osteoporos Int. 2016;27:1011–9.

    CAS  Article  PubMed  Google Scholar 

  24. Dadvand P, Sunyer J, Basagaña X, Ballester F, Lertxundi A, Fernández-Somoano A, et al. Surrounding greenness and pregnancy outcomes in four Spanish birth cohorts. Environ Health Perspect. 2012;120:1481–7.

    Article  PubMed  PubMed Central  Google Scholar 

  25. 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;71:562–9.

    Article  PubMed  Google Scholar 

  26. Markevych I, Fuertes E, Tiesler CMT, Birk M, Bauer C-P, Koletzko S, 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 

  27. Hystad P, Davies HW, Frank L, Van Loon J, Gehring U, Tamburic L, et al. Residential greenness and birth outcomes: evaluating the influence of spatially correlated built-environment factors. Environ Health Perspect. 2014;122:1095–102.

    PubMed  PubMed Central  Google Scholar 

  28. 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;218:358–65.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Lachowycz K, Jones AP. Greenspace and obesity: a systematic review of the evidence. Obes Rev. 2011;12:e183–9.

    CAS  Article  PubMed  Google Scholar 

  30. Hartig T, Mitchell R, de Vries S, Frumkin H. Nature and health. Annu Rev Public Health. 2014;35:207–28.

    Article  PubMed  Google Scholar 

  31. Gascon M, Triguero-Mas M, Martínez D, Dadvand P, Forns J, Plasència A, et al. Mental health benefits of long-term exposure to residential green and blue spaces: a systematic review. Int J Environ Res Public Health. 2015;12:4354–79. Multidisciplinary Digital Publishing Institute.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Dadvand P, Nieuwenhuijsen MJ, Esnaola M, Forns J, Basagaña X, Alvarez-Pedrerol M, et al. Green spaces and cognitive development in primary schoolchildren. Proc Natl Acad Sci U S A. 2015;112:7937–42.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  33. Rook GA. Regulation of the immune system by biodiversity from the natural environment: an ecosystem service essential to health. Proc Natl Acad Sci U S A. 2013;110:18360–7.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  34. Lovasi GS, Quinn JW, Neckerman KM, Perzanowski MS, Rundle A. Children living in areas with more street trees have lower prevalence of asthma. J Epidemiol Community Health. 2008;62:647–9.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  35. Lovasi GS, O’Neil-Dunne JPM, Lu JWT, Sheehan D, Perzanowski MS, Macfaden SW, et al. Urban tree canopy and asthma, wheeze, rhinitis, and allergic sensitization to tree pollen in a New York City birth cohort. Environ Health Perspect. 2013;121:494–500.

    PubMed  PubMed Central  Google Scholar 

  36. Fuertes E, Markevych I, von Berg A, Bauer C-P, Berdel D, Koletzko S, et al. Greenness and allergies: evidence of differential associations in two areas in Germany. J Epidemiol Community Health. 2014;68:787–90.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Ruokolainen L, von Hertzen L, Fyhrquist N, Laatikainen T, Lehtomäki J, Auvinen P, et al. Green areas around homes reduce atopic sensitization in children. Allergy. 2015;70:195–202.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  38. Dadvand P, Villanueva CM, Font-Ribera L, Martinez D, Basagaña X, Belmonte J, et al. Risks and benefits of green spaces for children: a cross-sectional study of associations with sedentary behavior, obesity, asthma, and allergy. Environ Health Perspect. 2014;122:1329–35.

    PubMed  PubMed Central  Google Scholar 

  39. Sbihi H, Tamburic L, Koehoorn M, Brauer M. Greenness and incident childhood asthma: a 10-year follow-up in a population-based birth cohort. Am J Respir Crit Care Med. 2015;192:1131–3.

    Article  PubMed  Google Scholar 

  40. Dick S, Friend A, Dynes K, AlKandari F, Doust E, Cowie H, et al. A systematic review of associations between environmental exposures and development of asthma in children aged up to 9 years. BMJ Open. 2014;4:e006554.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  41. Goldizen FC, Sly PD, Knibbs LD. Respiratory effects of air pollution on children. Pediatr Pulmonol. 2016;51:94–108.

    Article  PubMed  Google Scholar 

  42. WHO. WHO air quality guidelines for particulate matter, ozone, nitrogen dioxide and sulfur dioxide—global update 2005|summary of risk assessment [Internet]. Geneva: World Health Organization; 2006. Available from: http://www.who.int/phe/health_topics/outdoorair/outdoorair_aqg/en/.

  43. Gasana J, Dillikar D, Mendy A, Forno E, Ramos Vieira E. Motor vehicle air pollution and asthma in children: a meta-analysis. Environ Res. 2012;117:36–45. This is a meta-analysis including 19 studies on the respiratory health effects of air pollution in children. The study consistent evidence of an association and highlights the role of air pollution on development of respiratory diseases.

    CAS  Article  PubMed  Google Scholar 

  44. Smarr MM, Vadillo-Ortega F, Castillo-Castrejon M, O’Neill MS. The use of ultrasound measurements in environmental epidemiological studies of air pollution and fetal growth. Curr Opin Pediatr. 2013;25:240–6.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Rich DQ, Liu K, Zhang J, Thurston SW, Stevens TP, Pan Y, et al. Differences in birth weight associated with the 2008 Beijing Olympics air pollution reduction: results from a natural experiment. Environ Health Perspect. 2015;123:880–7.

    PubMed  PubMed Central  Google Scholar 

  46. Suades-González E, Gascon M, Guxens M, Sunyer J. Air pollution and neuropsychological development: a review of the latest evidence. Endocrinology. 2015;156:3473–82.

    Article  PubMed  PubMed Central  Google Scholar 

  47. McConnell R, Gilliland FD, Goran M, Allayee H, Hricko A, Mittelman S. Does near-roadway air pollution contribute to childhood obesity? Pediatr Obes. 2016;11:1–3.

    CAS  Article  PubMed  Google Scholar 

  48. WHO. Night noise guideline for Europe [Internet]. Copenhagen; 2009. Available from: http://www.euro.who.int/__data/assets/pdf_file/0017/43316/E92845.pdf?ua=1.

  49. van Kamp I, Persson Waye K, Gidlöf-Gunnarsson A. The effects of noise disturbed sleep in children on cognitive development and long term health. J Child Adolesc Behav OMICS Group; 2015;03.

  50. van Kamp I, Davies H. Noise and health in vulnerable groups: a review. Noise Health. 2013;15:153–9. Medknow Publications and Media Pvt. Ltd.

    Article  PubMed  Google Scholar 

  51. Hohmann C, Grabenhenrich L, de Kluizenaar Y, Tischer C, Heinrich J, Chen C-M, et al. Health effects of chronic noise exposure in pregnancy and childhood: a systematic review initiated by ENRIECO. Int J Hyg Environ Health. 2013;216:217–29.

    Article  PubMed  Google Scholar 

  52. Fatima Y, Doi SAR, Mamun AA. Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis. Obes Rev. 2015;16:137–49.

    CAS  Article  PubMed  Google Scholar 

  53. Ristovska G, Laszlo HE, Hansell AL. Reproductive outcomes associated with noise exposure—a systematic review of the literature. Int J Environ Res Public Health. 2014;11:7931–52.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Xu Z, Etzel RA, Su H, Huang C, Guo Y, Tong S. Impact of ambient temperature on children’s health: a systematic review. Environ Res. 2012;117:120–31.

    CAS  Article  PubMed  Google Scholar 

  55. Li S, Baker PJ, Jalaludin BB, Guo Y, Marks GB, Denison LS, et al. Are children’s asthmatic symptoms related to ambient temperature? A panel study in Australia. Environ Res. 2014;133:239–45.

    CAS  Article  PubMed  Google Scholar 

  56. Dadvand P, Basagaña X, Sartini C, Figueras F, Vrijheid M, de Nazelle A, et al. Climate extremes and the length of gestation. Environ Health Perspect. 2011;119:1449–53.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Auger N, Naimi AI, Smargiassi A, Lo E, Kosatsky T. Extreme heat and risk of early delivery among preterm and term pregnancies. Epidemiology. 2014;25:344–50.

    Article  PubMed  Google Scholar 

  58. Martine G, Marshall A. State of world population 2007: unleashing the potential of urban growth. UNFPA; 2007.

  59. Brown LR. Chapter 9. Redesigning cities for people: car-centered urban sprawl. Eco-Economy build. An econ. Earth [Internet]. Earth Policy Institute; 2001. Available from: http://www.earth-policy.org/books/eco/eech9_ss3.

  60. Frank L, Kavage S, Devlin A. Health and the built environment: a review [Internet]. 2012. Available from: http://www.wma.net/en/20activities/30publichealth/30healthenvironment/Built_Env-Final_Report-August2012.pdf.

  61. U.S. Department of Energy. Effects of the built environment on transportation: energy use, greenhouse gas emissions, and other factors [Internet]. 2013. Available from: http://www.nrel.gov/docs/fy13osti/55634.pdf.

  62. Expert group on the urban environment. Towards a local sustainability profile: European common indicators [Internet]. Luxembourg: Office for Official Publications of the European Communities; 2001. Available from: http://ec.europa.eu/environment/urban/pdf/local_sustainability_en.pdf.

  63. Annerstedt van den Bosch M, Mudu P, Uscila V, Barrdahl M, Kulinkina A, Staatsen B, et al. Development of an urban green space indicator and the public health rationale. Scand J Public Health. 2016;44:159–67.

    Article  PubMed  Google Scholar 

  64. Annerstedt M, Ostergren P-O, Björk J, Grahn P, Skärbäck E, Währborg P. Green qualities in the neighbourhood and mental health—results from a longitudinal cohort study in Southern Sweden. BMC Public Health. 2012;12:337.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Millward H, Spinney J, Scott D. Active-transport walking behavior: destinations, durations, distances. J Transp Geogr. 2013;28:101–10.

    Article  Google Scholar 

  66. Mueller N, Rojas-Rueda D, Cole-Hunter T, de Nazelle A, Dons E, Gerike R, et al. Health impact assessment of active transportation: a systematic review. Prev Med. 2015;76:103–14.

    Article  PubMed  Google Scholar 

  67. Villanueva K, Badland H, Kvalsvig A, O’Connor M, Christian H, Woolcock G, et al. Can the neighborhood built environment make a difference in children’s development? Building the research agenda to create evidence for place-based children’s policy. Acad Pediatr Elsevier. 2015;16:10–9. The authors discuss the importance of exploring the effect of the neighborhood built environment on child development as a crucial first step toward informing urban design principles to help reduce developmental vulnerability in children and to set optimal child development trajectories early.

    Article  Google Scholar 

  68. Vrijheid M, Slama R, Robinson O, Chatzi L, Coen M, van den Hazel P, et al. The Human Early-Life Exposome (HELIX): project rationale and design. Environ Health Perspect. 2014;122:535–44.

    PubMed  PubMed Central  Google Scholar 

  69. Frank LD, Saelens BE, Powell KE, Chapman JE. Stepping towards causation: do built environments or neighborhood and travel preferences explain physical activity, driving, and obesity? Soc Sci Med. 2007;65:1898–914.

    Article  PubMed  Google Scholar 

  70. Hanibuchi T, Nakaya T, Yonejima M, Honjo K. Perceived and objective measures of neighborhood walkability and physical activity among adults in Japan: a multilevel analysis of a nationally representative sample. Int J Environ Res Public Health. 2015;12:13350–64.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Giles-Corti B, Wood G, Pikora T, Learnihan V, Bulsara M, Van Niel K, et al. School site and the potential to walk to school: the impact of street connectivity and traffic exposure in school neighborhoods. Health Place. 2011;17:545–50.

    Article  PubMed  Google Scholar 

  72. Centers for Disease Control and Prevention (CDC), Division of Community Health (DCH). The built environment assessment tool manual [Internet]. [cited 2015 Nov 20]. Available from: http://www.cdc.gov/nccdphp/dch/built-environment-assessment/.

  73. Spoon C. Free online course for assessing the built environment for physical activity. Active living research [Internet]. 2012 [cited 2015 Nov 20]. Available from: http://activelivingresearch.org/blog/2012/09/free-online-course-assessing-built-environment-physical-activity.

  74. Rahmanian E, Gasevic D, Vukmirovich I, Lear SA. The association between the built environment and dietary intake—a systematic review. Asia Pac J Clin Nutr. 2014;23:183–96.

    PubMed  Google Scholar 

  75. Sallis JF, Saelens BE, Frank LD, Conway TL, Slymen DJ, Cain KL, et al. Neighborhood built environment and income: examining multiple health outcomes. Soc Sci Med. 2009;68:1285–93. This is an international study that highlights the importance of potential of the urban design to contribute to improve physical activity.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Wood L, Shannon T, Bulsara M, Pikora T, McCormack G, Giles-Corti B. The anatomy of the safe and social suburb: an exploratory study of the built environment, social capital and residents’ perceptions of safety. Health Place. 2008;14:15–31.

    Article  PubMed  Google Scholar 

  77. Sallis JF, Cerin E, Conway TL, Adams MA, Frank LD, Pratt M, et al. Physical activity in relation to urban environments in 14 cities worldwide: a cross-sectional study. Lancet. Elsevier; 2016.

  78. Reyer M, Fina S, Siedentop S, Schlicht W. Walkability is only part of the story: walking for transportation in Stuttgart, Germany. Int J Environ Res Public Health. 2014;11:5849–65.

    Article  PubMed  PubMed Central  Google Scholar 

  79. United Nations Department of Economic and Social Affairs. World urbanization prospects—the 2014 revision—highlights [Internet]. New York: United Nations; 2014. Available from: http://esa.un.org/unpd/wup/Highlights/WUP2014-Highlights.pdf.

  80. Gluckman PD, Hanson MA. Living with the past: evolution, development, and patterns of disease. Science. 2004;305:1733–6.

    CAS  Article  PubMed  Google Scholar 

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Correspondence to Mireia Gascon.

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Mireia Gascon, Martine Vrijheid, and Mark J. Nieuwenhuijsen declare that they have no conflict of interest.

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Gascon, M., Vrijheid, M. & Nieuwenhuijsen, M.J. The Built Environment and Child Health: An Overview of Current Evidence. Curr Envir Health Rpt 3, 250–257 (2016). https://doi.org/10.1007/s40572-016-0094-z

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Keywords

  • Built environment
  • Physical activity
  • Child health
  • Transport planning
  • Urbanism