Shoari Niloofar, Blangiardo Marta, Pirani Monica
MRC Centre for Environment & Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom.
Great Ormond Street Institute of Child Health, Population, Policy and Practice Research and Teaching Department, University College London, London, United Kingdom.
JAMA Netw Open. 2025 Apr 1;8(4):e254470. doi: 10.1001/jamanetworkopen.2025.4470.
The relationship of neighborhood environmental and socioeconomic factors with mental health across childhood and adolescence remains unclear.
To investigate the associations of neighborhood characteristics with mental health at various developmental stages, from early childhood to late adolescence.
DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study used data from the Millennium Cohort Study, including approximately 19 000 children born in the UK from 2000 to 2002. This analysis included individuals in England with complete data on neighborhood exposures at ages 3, 5, 7, 11, 14, and 17 years. Data were analyzed from January to December 2023.
Neighborhood-level air pollution, green space, and socioeconomic status.
Strengths and Difficulties Questionnaire (SDQ) scores linked with exposure to air pollution, green space, and socioeconomic status, measured at participants' residential addresses, were analyzed using a hierarchical bayesian regression model. Hypotheses were formulated after data collection.
The sample included 3595 children and adolescents, with 1826 (50.5%) female; 3012 participants (83.8%) were White and 583 participants (16.2%) were another ethnicity. The mean (SD) SDQ score was 7.1 (5.1). After adjusting for individual and household factors, neighborhood socioeconomic status emerged as the strongest factor associated with mental health. Residing in affluent neighborhoods was associated with improved mental health, with this association magnifying through adolescence. For children of the same age, those in the most affluent neighborhoods had log-transformed SDQ scores 0.73 (95% credible interval [CrI], 0.58 to 0.88) lower at age 17 years compared with their peers in the most deprived areas; at age 5 years, scores were 0.31 (95% CrI, 0.17 to 0.45) lower. Exposure to particulate matter with diameter less than 2.5 μm was associated with poorer mental health during early childhood (age 3 years), with an effect size of 0.15 (95% CrI, 0.08 to 0.22). While green space was not directly associated with improved mental health, a sex-based difference was observed, with males showing more favorable associations (interaction, -0.10 [95% CrI, -0.17 to -0.03]).
In this cohort study of children and adolescents, associations between neighborhood characteristics and mental health evolved from childhood through adolescence. These findings suggest that targeted interventions in disadvantaged neighborhoods and strategies to protect young children from air pollution are essential. A comprehensive approach is recommended to incorporate air pollution, green space, and socioeconomic status not only in residential neighborhoods but also in other settings, such as schools.
邻里环境和社会经济因素与儿童期和青少年期心理健康之间的关系仍不明确。
探讨从幼儿期到青少年晚期不同发育阶段邻里特征与心理健康之间的关联。
设计、背景和参与者：这项基于人群的队列研究使用了千禧队列研究的数据，包括2000年至2002年在英国出生的约19000名儿童。该分析纳入了英格兰地区在3岁、5岁、7岁、11岁、14岁和17岁时拥有完整邻里暴露数据的个体。数据于2023年1月至12月进行分析。
邻里层面的空气污染、绿地和社会经济地位。
使用分层贝叶斯回归模型分析与参与者居住地址处的空气污染、绿地和社会经济地位暴露相关的优势和困难问卷（SDQ）得分。假设在数据收集后制定。
样本包括3595名儿童和青少年，其中1826名（50.5%）为女性；3012名参与者（83.8%）为白人，583名参与者（16.2%）为其他种族。SDQ得分的平均值（标准差）为7.1（5.1）。在调整个体和家庭因素后，邻里社会经济地位成为与心理健康相关的最强因素。居住在富裕社区与心理健康改善相关，这种关联在青少年期更为明显。对于同年龄的儿童，17岁时，最富裕社区的儿童经对数转换后的SDQ得分比最贫困地区的同龄人低0.73（95%可信区间[CrI]，0.58至0.88）；5岁时，得分低0.31（95%CrI，0.17至0.45）。在幼儿期（3岁），接触直径小于2.5μm的颗粒物与较差的心理健康相关，效应大小为0.15（95%CrI，0.08至0.22）。虽然绿地与心理健康改善没有直接关联，但观察到基于性别的差异，男性显示出更有利的关联（交互作用，-0.10[95%CrI，-0.17至-0.03]）。
在这项针对儿童和青少年的队列研究中，邻里特征与心理健康之间的关联从儿童期到青少年期不断演变。这些发现表明，对弱势社区进行有针对性的干预以及保护幼儿免受空气污染的策略至关重要。建议采用综合方法，不仅将空气污染、绿地和社会经济地位纳入居民区，还纳入其他场所，如学校。
