Reducing inequities in early childhood mental health: How might the neighborhood built environment help close the gap? A systematic search and critical review
Improving the quantity and quality of public open space in disadvantaged neighborhoods may help reduce mental health inequities
This systematic search and critical review of the literature investigated associations between the neighborhood built environment and young children’s mental health. The primary goal of the study was to better understand features of the neighborhood built environment that (1) promote optimal mental health in childhood and (2) reduce mental health inequities. Promoting optimal mental health requires attention to both the positive and negative aspects of mental health – that is, to both competence and difficulties. Mental health competence is displayed through such characteristics as emotional maturity, prosocial behavior, self-regulation, responsibility and respect, and a willingness to try new things. Indicators of mental health difficulties include emotional symptoms, conduct problems, hyperactivity or inattention, peer relationship problems or such disorders as Attention Deficit and Hyperactivity Disorder. The fact that the most disadvantaged children tend to display less mental health competence and more mental health difficulties than their more advantaged peers suggests that the environments in which they live provide unequal access to mental health-promoting resources and unequal exposure to mental health risks.
Studies included in this review were based on quantitative research methods, addressed children up to eight years of age living in an urban environment, and assessed one or more of the following aspects of the neighborhood built environment: (a) neighborhood housing quality, density, typology, or affordability; (b) neighborhood public open space quality, quantity, or access; and (c) quality and/or accessibility to local social, health, municipal, or early childhood education and care services. Studies included in the review also assessed at least one dimension of mental health competence or at least one of the dimensions of difficulties. Fourteen articles met the inclusion criteria.
Most of the studies included in this review focused on the nature/public open space dimension of the neighborhood built environment. These studies showed that nature and public open space in the neighborhood was consistently associated with lower mental health difficulties. A smaller number of studies indicated that nature and public open space was also associated with mental health competence. Three of the 14 studies compared associations across socio-economic strata. Two of these studies found that public open space may be more important to the mental health of children from more socioeconomically disadvantaged backgrounds.
The findings of this review support the understanding that the neighborhood built environment plays an important role in the mental health of young children. These findings, along with the fact that more disadvantaged neighborhoods tend to have fewer or lower-quality public open spaces, suggest that improving the quantity and quality or public open space in low-income neighborhoods may help reduce mental health inequities. The findings of this review also highlight a need for more related research, including (1) studies examining associations between neighborhood built environment and mental health competence, (2) investigations into the role of understudied neighborhood attributes like social infrastructure and service quality, (3) studies examining differences in associations between child subgroups, and (4) investigations into the potential for modifications in the built environment to reduce mental health inequities.
Citation
Alderton, A., Villanueva, K., O’Connor, M., Boulangé, C., Badland, H., (2019). Reducing inequities in early childhood mental health: How might the neighborhood built environment help close the gap? A systematic search and critical review. International Journal of Environmental Research and Public Health, 16
