Long-term exposure to greenspace and anxiety from preschool and primary school children

Exposure to greenspace has been associated with mental health benefits in children; however, the available evidence for such an association with anxiety is still scarce. This longitudinal study aimed to evaluate that association on a community cohort of 539 children, from Barcelona province, followed from 3 to 11 years. Long-term exposure to greenspace was characterized at both residential address and school as (i) surrounding greenspace based on satellite-derived indexes (normalized difference vegetation index (NDVI) and Vegetation Continuous Field (VCF) across different buffers and (ii) distance to the nearest green space. We characterized anxiety using the Child Behavior Checklist and the Spence Children's Anxiety Scale, and cross-sectionally and longitudinally analyzed the associations between the greenspace exposure and the anxiety, using linear mixed models. Higher greenspace surrounding home and school were associated with lower levels of anxiety. Our findings suggest that increasing exposure to greenspace, specially at schools, could be included in preventive policies to promote mental health in children.