The role of neighbourhoods in young children’s mental health: What does the evidence tell us?

Amanda Alderton, Karen Villanueva, Meredith O’Connor, Claire Boulangé and Hannah Badland, Australia, October, 2019

Resource Summary

This short article is based on the following literature review:
Alderton, A., et al. (2019). Reducing inequities in early childhood mental health: how can the neighbourhood built environment help close the gap? A systematic search and critical review. International Journal of Environmental Research and Public Health. Read the full article here.

Can the neighbourhood promote children’s mental health?

Young children’s mental health is influenced by their experiences across a wide range of settings, including home, school, and their wider community and neighbourhood environment (Bronfenbrenner, 1979). Features of the neighbourhood such as access to good-quality housing, parks, and local services (Villanueva et al., 2016) can positively shape children’s early life experiences.

A key part of a neighbourhood is the built environment, which includes public parks, housing, and roads (Koohsari, Badland & Giles-Corti, 2013). However, research has given very little attention to the neighbourhood-built environment and how this could be changed to improve children’s mental health. This could be a promising way to promote children’s wellbeing because:

  • any changes to the neighbourhood may impact on large numbers of children
  • it is possible to approach the neighbourhood-built environment in the short term. For example, pop-up parks and temporary street closures allow children to reclaim the streets for play within a short timeframe. (Villanueva et al., 2016)

The neighbourhood environment may help to prevent children’s mental health difficulties (e.g. excessive fears and worries) and to promote positive mental health skills (often referred to as ‘mental health competence’). These skills include positive social and emotional functioning – e.g. building relationships with other children and adults, being ready to try new things, and showing responsibility and respect for others (Kvalsvig, O’Connor, Redmond & Goldfeld, 2014). Negative factors related to neighbourhood housing (e.g. high-rise housing, a lack of affordable housing) can increase both children’s and caregivers’ stress, and degrade sleep quality (Evans, Wells & Moch, 2003).

At the same time, places like parks and playgrounds can provide important opportunities for children to develop skills through positive interactions with other families. They also increase exposure to nature, which has been associated with reduced stress and improved attention (Markevych et al., 2017).

The availability of health, education, and other services in the neighbourhood (often referred to as ‘social infrastructure’) is also important. Research with young families has found that neighbourhood social infrastructure provides crucial opportunities to brush elbows with other families, build social connections, and strengthen families’ support networks (Strange, Fisher, Howat & Wood, 2014). This increases young children’s exposure to positive interactions with other children and families, while also strengthening caregivers’ support through early parenthood.

Unfortunately, research suggests that children’s access to these neighbourhood resources is often socially patterned, with the most disadvantaged children having the least access to nature, high-quality parks and childcare services (Astell-Burt, Feng, Mavoa, Badland & Giles-Corti, 2014; Cloney, Cleveland, Hattie & Tayler, 2015). Interventions at the neighbourhood level that aim to reduce these gaps in access have the potential to help reduce mental health inequalities (Badland & Pearce, 2019).

 

What did the current study do?

The researchers conducted a systematic review of international research literature, investigating how the neighbourhood-built environment relates to young children’s mental health. Early childhood (0-8 years) is recognised as a key time for intervening to improve children’s wellbeing later in life, leading researchers to focus on it for this study. For young children, good mental health is determined by a slightly different set of factors than for older children. For example, young children and their caregivers tend to spend more time closer to home (in their neighbourhoods) than older children, who spend a considerable amount of time at school.

Given the focus on mental health in the early years, only articles focusing on young children (aged 8 years or younger) were included. Three important aspects of the built environment were examined:

  • Housing (e.g. affordability, quality, type of housing)
  • Nature and public open space (e.g. parks, playgrounds)
  • Social infrastructure (e.g. local services and family-related destinations)

 

What were the main findings?

Researchers found 14 studies that examined the relationship between the neighbourhood-built environment and children’s mental health. Most of these studies:

  • focused on nature or public open space in the neighbourhood
  • looked at mental health difficulties, rather than competence
  • came from high-income countries in Europe or North America.

The main findings were:

  • In most studies, children with better access to nature (e.g. living closer to a park, living in a neighbourhood with a larger area of parkland) tended to have fewer mental health difficulties, better competence and increased emotional wellbeing. These findings persisted even after socioeconomic factors were accounted for.
  • Studies that investigated housing and child mental health used diverse measures, which limited their ability to be compared.
  • Only one study was found that examined social infrastructure.

 

Possible future directions

Given that key gaps in the evidence base were found, further research is needed to inform understandings of how these neighbourhood-built features may influence children’s mental health.

This review identified opportunities for future study on:

  • social infrastructure and the quality of local services
  • housing affordability
  • type of housing (e.g. high-rise apartments vs. detached houses)
  • park quality or amenities (e.g. toilets, shade, picnic areas)
  • possible differences in the relationship between the neighbourhood-built environment and children’s mental health in specific sub-groups of children (e.g. children facing socioeconomic disadvantage vs. those from more advantaged backgrounds).

A main limitation of the current evidence base is that many of these studies are cross-sectional. These types of studies cannot definitively say whether the neighbourhood-built environment is the cause of poor or better mental health. However, the evidence includes several prospective cohort (longitudinal) studies, which provide stronger evidence of a relationship. Future longitudinal studies and natural experiments could help strengthen the evidence base.

 

Implications for child mental health practitioners, researchers and policy-makers

Nature and public open space appear important for children’s wellbeing – both in terms of preventing mental health difficulties and building mental health competence. Promoting children’s exposure to nature and public open space in the neighbourhood could be an effective strategy for improving both aspects of young children’s mental health at the same time. Therefore, the social and emotional wellbeing of families is an important consideration in the planning of neighbourhood environments.

 

Conclusions

The majority of current research evidence suggests a link between children’s mental health, and nature and public open space. There is a smaller, emerging body of evidence that suggests a relationship between other neighbourhood features (e.g. housing, social infrastructure) and young children’s mental health, but this important area requires further investigation.

Further reading

  • Alderton, A., Villanueva, K., O’Connor, M., Boulangé, C. & Badland, H. (2019). Reducing inequities in early childhood mental health: how can the neighbourhood built environment help close the gap? A systematic search and critical review. International Journal of Environmental Research and Public Health, 16, 1516. doi: http://dx.doi.org/10.3390/ijerph16091516.
  • Kvalsvig, A., O’Connor, M., Redmond, G., & Goldfeld, S. (2014). The unknown citizen: epidemiological challenges in child mental health. Journal of Epidemiology and Community Health, 68(10), 1004-1008.
  • Villanueva, K., Badland, H., Kvalsvig, A., O’Connor, M., Christian, H., Woolcock, G. … Goldfeld, S. (2016). Can the neighborhood built environment make a difference in children’s development? Building the research agenda to create evidence for place-based children’s policy. Academic Paediatrics, 16(1), 10-19.

References

Astell-Burt, T., Feng, X., Mavoa, S., Badland, H.M., & Giles-Corti, B. (2014). Do low-income neighbourhoods have the least green space? A cross-sectional study of Australia’s most populous cities. BMC Public Health, 14, 292.

Badland, H. & Pearce, J. (2019). Liveable for whom? Prospects of urban liveability to address health inequities. Social Science and Medicine, 232, 94–105. Retrieved from: https://doi.org/10.1016/j.socscimed.2019.05.001

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge: Harvard University Press.

Cloney, D., Cleveland, G., Hattie, J., & Tayler, C. (2015). Variations in the availability and quality of early childhood education and care by socioeconomic status of neighborhoods. Early Education and Development, 27, 384–401.

Evans, G. W., Wells, N. M., & Moch, A. (2003). Housing and mental health: A review of the evidence and a methodological and conceptual critique. Journal of Social Issues, 59, 475–500.

Koohsari, M. J., Badland, H., & Giles-Corti, B. (2013). (Re)Designing the built environment to support physical activity: Bringing public health back into urban design and planning. Cities, 35, 294–298.

Kvalsvig, A., O’Connor, M., Redmond, G., & Goldfeld, S. (2014). The unknown citizen: Epidemiological challenges in child mental health. Journal of Epidemiology and Community Health, 68, 1004–1008.

Markevych, I., Schoierer, J., Hartig, T., Chudnovsky, A., Hystad, P., Dzhambov, A. M., … Fuertes, E. (2017). Exploring pathways linking greenspace to health: Theoretical and methodological guidance. Environmental Research, 158, 301–317.

Strange, C., Fisher, C., Howat, P., & Wood, L. (2014). Creating a village in modern suburbia: Parenthood and social capital. Urban Policy Research, 33, 160–177. Retrieved from: https://doi.org/10.1080/08111146.2014.969399

Villanueva, K., Badland, H., Kvalsvig, A., O’Connor, M., Christian, H., Woolcock, G. … Goldfeld, S. (2016). Can the neighborhood built environment make a difference in children’s development? Building the research agenda to create evidence for place-based children’s policy. Academic Paediatrics, 16(1), 10-19.