Wang Huaqing, Huang Xucheng, Hao Hua, Chang Howard H
Department of Landscape Architecture and Environmental Planning, Utah State University, Logan, Utah, USA.
Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA.
Environ Health Perspect. 2024 Dec;132(12):127001. doi: 10.1289/EHP14571. Epub 2024 Dec 4.
Residential greenness is linked to birth outcomes. However, the role of greenspace morphology remains poorly understood. Additionally, evidence is lacking regarding whether these relationships vary by subpopulation.
We examined the association between preterm birth and residential greenspace morphology, including percentage, shape, connectedness, aggregation, closeness, and fragmentation.
We analyzed 2,063,444 singleton live births between 2001 to 2016 in Georgia, USA. Thirty-meter resolution landcover data from National Land Cover Databased (2001-2016) were obtained to calculate greenspace morphology metrics for 1,953 census tracts in Georgia. A two-stage logistic regression examined associations between each greenspace morphology metric and preterm birth at individual level. Stratified analysis was conducted by maternal race, ethnicity, education, urbanicity, poverty rate, and greenspace percentage.
Higher greenspace percentage, aggregation, closeness, shape complexity, connectedness, and lower fragmentation were linked to a lower risk of preterm birth. After adjusting for poverty rate, associations with morphology attenuated, except for fragmentation [odds ratio (OR) = 1.014; 95% confidence interval (CI): 1.0001, 1.026] across the entire population. Strongest associations were found among black mothers and in high-poverty areas. Specifically, the odds of preterm birth in the highest quartile of greenspace percentage were 0.962 (95% CI: 0.933, 0.991) times the odds in the lowest quartile. Additionally, a lower risk of preterm birth was associated with higher greenspace aggregation (OR = 0.969; 95% CI: 0.947, 0.992), and a higher risk of preterm birth was associated with higher fragmentation (OR = 1.028; 95% CI: 1.009, 1.047), both in the black mothers group. In tracts with a high poverty rate, a lower risk of preterm birth associate with higher greenspace percentage (OR = 0.953; 95% CI: 0.910, 0.999), aggregation (OR = 0.976; 95% CI: 0.955, 0.997), and lower fragmentation (OR = 0.976; 95% CI: 0.958, 0.994). The association with greenspace morphology was most pronounced in census tracts with a medium level of greenspace percentage.
Our study complements other studies by showing the importance and protective effects of greenspace morphology. The observed effects are particularly prominent in census tracts characterized by a moderate level of greenspace percentage, high poverty rates, and among black women. Our findings suggest the need for tailored greenspace planning strategies based on varying levels of greenness in different areas. For locations with low greenness, increasing the greenspace percentage may be prioritized. In areas with a medium level of greenness, strategic enhancement of greenspace morphology is recommended. For areas with high greenness, the focus should be on improving spatial closeness of greenspace. https://doi.org/10.1289/EHP14571.
居住环境的绿化程度与出生结局相关。然而，绿地形态的作用仍未得到充分理解。此外，关于这些关系是否因亚人群而异的证据也很缺乏。
我们研究了早产与居住绿地形态之间的关联，包括绿地百分比、形状、连通性、聚集度、邻近度和破碎度。
我们分析了2001年至2016年间美国佐治亚州的2,063,444例单胎活产。从国家土地覆盖数据库（2001 - 2016年）获取30米分辨率的土地覆盖数据，以计算佐治亚州1,953个人口普查区的绿地形态指标。采用两阶段逻辑回归分析个体层面上每个绿地形态指标与早产之间的关联。按母亲的种族、民族、教育程度、城市化程度、贫困率和绿地百分比进行分层分析。
较高的绿地百分比、聚集度、邻近度、形状复杂度、连通性以及较低的破碎度与较低的早产风险相关。在调整贫困率后，除了破碎度外，与形态的关联减弱（在整个人口中，破碎度的优势比（OR）= 1.014；95%置信区间（CI）：1.0001, 1.026）。在黑人母亲和高贫困地区发现了最强的关联。具体而言，绿地百分比最高四分位数组的早产几率是最低四分位数组的0.962倍（95% CI：0.933, 0.991）。此外，在黑人母亲组中，较高的绿地聚集度与较低的早产风险相关（OR = 0.969；95% CI：0.947, 0.992），而较高的破碎度与较高的早产风险相关（OR = 1.028；95% CI：1.009, 1.047）。在贫困率高的数据普查区，较高的绿地百分比（OR = 0.953；95% CI：(0.910, 0.999)）、聚集度（OR = 0.976；95% CI：0.955, 0.997）和较低的破碎度（OR = 0.976；95% CI：0.958, 0.994）与较低的早产风险相关。与绿地形态的关联在绿地百分比中等水平的数据普查区最为明显。
我们的研究通过展示绿地形态的重要性和保护作用，对其他研究进行了补充。观察到的影响在以中等绿地百分比、高贫困率为特征的数据普查区以及黑人女性中尤为突出。我们的研究结果表明，需要根据不同地区的绿化程度制定有针对性的绿地规划策略。对于绿化程度低的地区，可优先考虑提高绿地百分比。在绿化程度中等的地区，建议从战略上改善绿地形态。对于绿化程度高的地区，应着重提高绿地的空间邻近度。https://doi.org/10.1289/EHP14571
