Greenness Surrounding Schools and Visual Impairment in Chinese Children and Adolescents

Yang, Bo‐Yi; Li, Shanshan; Zou, Zhiyong; Markevych, Iana; Heinrich, Joachim; Bloom, Michael S.; Luo, Yihuan; Huang, Wenzhong; Xiao, Xiang; Gui, Zhilun; Bao, Weizhu; Jin, Jing; Ma, Jun; Ma, Yong; Chen, Yajun; Dong, Guang‐Hui

doi:10.1289/ehp8429

Cited by 16 publications

(4 citation statements)

References 47 publications

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“…Previous research has suggested a need for more substantial evidence regarding the association between green space exposure and myopia, primarily due to the identification of cross-sectional correlations [ 11 , 12 , 33 ]. Our study addresses this based on a large cohort of over a million students, but also through a subgroup analysis of about thirty thousand individuals and their genetic and behavioural factors.…”

Section: Discussionmentioning

confidence: 99%

“…For example, during the coronavirus disease 2019 (COVID-19) pandemic, neighbourhood green spaces have become primary recreational and leisure areas for many Chinese residents due to travel restrictions [ 10 ]. Studies have shown that spending time in green spaces may protect against developing myopia [ 11 , 12 ]. Therefore, better understanding this association in the student population could contribute to future urban planning strategies to promote eye health.…”

mentioning

confidence: 99%

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Socioeconomic disparities and green space associated with myopia among Chinese school-aged students: A population-based cohort study

Lu,

Miao,

Yao

et al. 2024

J Glob Health

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Socioeconomic disparities and green space associated with myopia among Chinese school-aged students: A population-based cohort study

Lu,

Miao,

Yao

et al. 2024

J Glob Health

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“…It has been demonstrated that it is not necessary for people to use green spaces to obtain health benefits. For example, one study reported positive health benefits among children and adolescents who did not actually use green spaces for their activities ( 36 ), whereas Yang et al ( 37 ) found that the higher the exposure to green spaces around schools, the lower the risk of visual impairment in Chinese children. Another study in China reported that green space exposure reduces all-cause mortality, to a certain extent, in patients with multi-drug resistant tuberculosis who live in areas with short nights ( 38 ).…”

Section: Discussionmentioning

confidence: 99%

The effects of green space and physical activity on muscle strength: a national cross-sectional survey with 128,759 Chinese adults

Feng

Chao-qun

Wang

et al. 2023

Front. Public Health

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BackgroundMuscle strength is closely related to chronic noncommunicable diseases; specifically, a decline in handgrip strength (HS) is predominant globally. Exposure to green space—built environment components used for health intervention—reportedly decreases the risk of certain diseases and all-cause mortality. However, evidence in this area is limited.ObjectiveWe aimed to explore the association between green space exposure and muscle strength and ascertain the combined effect of physical activity and green space exposure on muscle strength.MethodData from 128,759 participants (aged 20–79 years) were obtained using a complex stratified multistage probability cluster sampling design. The green space was assessed as normalized difference vegetation index (NDVI) data for a 500-m buffer zone based on the geolocation information of sampling sites. We used a questionnaire to investigate transportation, occupation, physical activity, leisure-time exercise behaviors, and sedentary time within a usual week of the preceding year. The outcome was low relative HS, defined as HS-to-body weight ratio, and the percentage of men and women with relative HS in the lower third. We defined adequate physical activity as 150 min of moderate-intensity or 75 min of vigorous physical activity per week and calculated the weighted proportion of participants with insufficient physical activity. Categorical variables of NDVI and physical activity were used as exposure variables and their interrelationship was evaluated in a generalized linear mixed model (GLMM) to estimate the odds ratios (ORs) and 95% confidence intervals (95% CI). We measured interaction on an additive or multiplicative scale using a GLMM to test the interaction between green space exposure and physical activity. All analyses were performed for the total sample and subgroups (urban and rural).ResultThe high NDVI group had a lower risk of low relative HS than the low NDVI group (OR [95% CI]: 0.92 [0.88–0.95]). The sufficient physical activity group had a lower risk of low relative HS than the insufficient physical activity group (OR [95% CI]: 0.85 [0.81–0.88]). There was an interactive effect on the additive scale (relative excess risk owing to interaction: 0.29, 95% CI 0.22–0.36, p < 0.001) between green space exposure and physical activity.ConclusionHigh NDVI and adequate physical activity were protective factors against low relative HS in Chinese adults. Increasing green space exposure and physical activity together may have a greater potentiating effect on muscle strength improvement than these two protective factors individually. Green spaces should be incorporated into city design or built environments.

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“…Previous studies have shown that the greenness level of a campus and the surrounding environment significantly impact students' physical and mental health [ 28 - 30 ]. Recently, researchers have investigated the relationship between school green space and students’ myopia [ 31 - 33 ]. Studies focusing on the outdoor surrounding greenness within or around school boundaries have found a negative association between green space exposure and myopia among the school-aged population [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Greenness on Myopia Risk and School-Level Myopia Prevalence Among High School–Aged Adolescents: Cross-sectional Study

Zhang¹,

Wang²,

Guo³

et al. 2023

JMIR Public Health Surveill

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Background Myopia is a serious public health issue. High school–aged adolescents in Beijing have an alarming prevalence of myopia. Therefore, determining myopia protective factors is essential. Green space has a certain association with myopia protective factors that can protect against myopia. Objective This study aims to examine the effects of green space around schools on individual myopia risk in high school–aged adolescents and the school-level myopia prevalence. Methods Green space was measured using the normalized difference vegetation index (NDVI). A total of 13,380 samples of 51 high schools were selected from a 2021 Beijing Municipal Health Commission survey. Adolescent myopia was defined as a spherical equivalent of ≤–1.00 diopters in the worse eye. Generalized linear mixed models with a binomial error structure were used to analyze the effects of the NDVI on personal myopia risk and adjust them by other factors, such as demographics, exposure time, and outdoor exercise. The effects of the NDVI on school-level myopia prevalence with adjusted demographics and the relative position factors of trees were analyzed through quasibinomial regression. Results The overall prevalence of myopia was 80.61% (10,785/13,380, 95% CI 79.93%-81.27%). Although with a 0.1 increase in the 500 and 1000 m buffer NDVIs adjusted by demographic and other factors, the high school–aged personal myopia risk significantly dropped by 16% (odds ratio [OR] 0.84, 95% CI 0.73-0.97) and 12% (OR 0.88, 95% CI 0.79-0.99), respectively. However, only the adjusted 500 m buffer NDVI (by demographics and the position of trees) with a 0.1 increase significantly reduced the school-level myopia prevalence by 15% (OR 0.85, 95% CI 0.74-0.98). Subgroup analysis showed that the adjusted effects of the 500 m buffer NDVI are significant in schoolgirls (OR 0.82, 95% CI 0.72-0.93), juniors (OR 0.82, 95% CI 0.72-0.94), the Han nationality (OR 0.84, 95% CI 0.72-0.97), 1-year exposure (OR 0.84, 95% CI 0.71-0.99) and 3-year exposure (OR 0.78, 95% CI 0.65-0.94). Conclusions The greenness of a 500 m buffer around schools is associated with a lower personal myopia risk among adolescents and a lower prevalence of myopia in schools. With regard to prevention and control activities, green space within a 500 m buffer around schools is suggested as an independent protective factor for adolescent myopia.

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Greenness Surrounding Schools and Visual Impairment in Chinese Children and Adolescents

Cited by 16 publications

References 47 publications

Socioeconomic disparities and green space associated with myopia among Chinese school-aged students: A population-based cohort study

Socioeconomic disparities and green space associated with myopia among Chinese school-aged students: A population-based cohort study

The effects of green space and physical activity on muscle strength: a national cross-sectional survey with 128,759 Chinese adults

Effects of Greenness on Myopia Risk and School-Level Myopia Prevalence Among High School–Aged Adolescents: Cross-sectional Study

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