Green spaces and cognitive development in primary schoolchildren

Payam Dadvand; Mark J. Nieuwenhuijsen; Mikel Esnaola; Joan Forns; Xavier Basagaña; Mar Alvarez-Pedrerol; Ioar Rivas; Mónica López-Vicente; Montserrat De Castro Pascual; Jason Su; Michael Jerrett; Xavier Querol; Jordi Sunyer

doi:10.1073/pnas.1503402112

Edited by Susan Hanson, Clark University, Worcester, MA, and approved May 15, 2015 (received for review February 18, 2015)

Significance

Green spaces have a range of health benefits, but little is known in relation to cognitive development in children. This study, based on comprehensive characterization of outdoor surrounding greenness (at home, school, and during commuting) and repeated computerized cognitive tests in schoolchildren, found an improvement in cognitive development associated with surrounding greenness, particularly with greenness at schools. This association was partly mediated by reductions in air pollution. Our findings provide policymakers with evidence for feasible and achievable targeted interventions such as improving green spaces at schools to attain improvements in mental capital at population level.

Abstract

Exposure to green space has been associated with better physical and mental health. Although this exposure could also influence cognitive development in children, available epidemiological evidence on such an impact is scarce. This study aimed to assess the association between exposure to green space and measures of cognitive development in primary schoolchildren. This study was based on 2,593 schoolchildren in the second to fourth grades (7–10 y) of 36 primary schools in Barcelona, Spain (2012–2013). Cognitive development was assessed as 12-mo change in developmental trajectory of working memory, superior working memory, and inattentiveness by using four repeated (every 3 mo) computerized cognitive tests for each outcome. We assessed exposure to green space by characterizing outdoor surrounding greenness at home and school and during commuting by using high-resolution (5 m × 5 m) satellite data on greenness (normalized difference vegetation index). Multilevel modeling was used to estimate the associations between green spaces and cognitive development. We observed an enhanced 12-mo progress in working memory and superior working memory and a greater 12-mo reduction in inattentiveness associated with greenness within and surrounding school boundaries and with total surrounding greenness index (including greenness surrounding home, commuting route, and school). Adding a traffic-related air pollutant (elemental carbon) to models explained 20–65% of our estimated associations between school greenness and 12-mo cognitive development. Our study showed a beneficial association between exposure to green space and cognitive development among schoolchildren that was partly mediated by reduction in exposure to air pollution.

Footnotes

↵¹To whom correspondence should be addressed. Email: pdadvand{at}creal.cat.

Author contributions: P.D., M.J.N., X.Q., and J. Sunyer designed research; M.J.N., J.F., M.A.-P., I.R., M.L.-V., M.D.C.P., X.Q., and J. Sunyer performed research; M.E., X.B., J. Su, and M.J. contributed new reagents/analytic tools; P.D., M.E., and X.B. analyzed data; and P.D. and J. Sunyer wrote the paper.
The authors declare no conflict of interest.
This article is a PNAS Direct Submission.
This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10.1073/pnas.1503402112/-/DCSupplemental.

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