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Associations between neighborhood greenery and birth outcomes: An ecosystem services approach
Citation:
Tsai, W., Tom Luben, AND K. Rappazzo. Associations between neighborhood greenery and birth outcomes: An ecosystem services approach. Society for Epidemiologic Research, Chicago, IL, June 14 - 17, 2022.
Impact/Purpose:
This research will yield a more complete assessment of natural environmental influences on human health and well-being in support of EPA's mission to protect public health and the environment.
Description:
Urban greenery is associated with improved health outcomes. Greenery metrics across studies are designed using various methodologies. This study introduces greenery metrics with designs to identify ecosystem services that may be most relevant to birth outcomes. Metrics that characterize shade and aesthetics in pedestrian environment, large scale ecosystem services, and tree buffering effects for hazard mitigation from busy roadways were generated for a 250m buffer from home using 1m landcover from the US EPA EnviroAtlas project. Greenway density was also used as a measure for local infrastructure. Low birth weight (LBW, birth weight < 2500 grams) and preterm birth (PTB, gestational age < 37 weeks) for singleton births (N=119535) for years 2003 – 2015 were identified from the North Carolina (NC) Department of Health and Human Services for Durham, Orange, and Wake Counties, NC. Logistic regression was performed to evaluate the effect of greenery on the odds of LBW and PTB with adjustment for confounders. Analysis was stratified by race/ethnicity, as many studies reported differences in accessibility to greenery across these groups. Results showed tree cover along street or surrounding homes was associated with decreased odds of LBW and PTB. The association was strongest (i.e., largest decrease in odds for an adverse birth outcome) for the metric that characterized tree buffering busy roadways for hazard mitigation (aOR: 0.979, 95% CIs: 0.964 – 0.995 for LBW and 0.986, 95% CIs: 0.972 – 1.000 for PTB given a 10% increase in tree cover). Stratified analysis by race/ethnicity showed that most of the protective effects of greenery were observed only for non-Hispanic white individuals. Findings from this study suggest that neighborhood greenery may help reduce the odds of LBW and PTB the most through mitigating potential hazardous pollutants from busy roadways. This abstract does not necessarily reflect the views and policies of the U.S. Environmental Protection Agency.