Socio-economic gradients in urban green space access and respiratory health

Abstract Background This study investigates social disparities as one of the drivers influencing the access to green spaces and exposure to natural environments, potentially exacerbating disparities in respiratory health in children. Methods Longitudinal ELSPAC birth cohort study data included 4384 complete case participants born in cities of Brno and Znojmo, examined throughout the years 1990-2010. Estimates on socio-economic status (SES) scores of children’s parents and their education were used as socio-economical predictors. Tree cover density (TCD) calculated as mean canopy closure percentage in the individual walking distance neighbourhoods and the ownership and accessibility of a garden were used as indicators of green space accessibility. Multiple logistic regression models were employed to estimate odds ratios for predictors of respiratory health outcomes, controlling for several confounders. Results Parents’ SES was found to be positively associated with neighbourhood TCD, and this effect was even more pronounced for garden owners. Higher tree cover was then significantly negatively associated with development of acute bronchitis (OR 0.88, CI 95 % 0.84-0.94 for 1 SD of tree cover), while not having a garden (OR 1.81, CI 95 % 1.42-2.33) and living in area with lower tree cover (OR continuously decreasing from 1.88 to 1.68 for lowest and highest quartile respectively) was significantly associated with progression of acute bronchitis into chronic bronchitis in a fully adjusted model. Vice versa, higher tree cover was statistically significantly positively associated with development of allergic rhinitis (OR 1.09, CI 95 % 1.03-1.15), suggesting viability of the novel method of estimation of individual neighbourhood greenness. Conclusions The results suggest protective effect of access to urban green spaces against adverse respiratory outcomes in children. The socially uneven distribution of access emphasizes the importance of urban policies in promoting urban health. #NGEU Key messages • There is a significant protective effect of access to green spaces against respiratory diseases and their progression. • There’s an unequal, but varied distribution of access to green spaces, and social gradient in health, highlighting the importance of urban green space distributive politics.