Exploring the Relationships Between Residential Green Spaces and Childhood Allergic Diseases in Chengdu, China

Studies on the association between green spaces and childhood allergic diseases are limited and have yielded inconsistent results across different regions. Furthermore, this relationship remains underexplored in Chengdu, China. In this study, we aimed to investigate the association between the residential greening rate, Normalized Difference Vegetation Index (NDVI), proportion of allergenic plants (proportion of allergenic woody plants, proportion of allergenic herbaceous plants), the closeness-to-nature characteristics of children’s playgrounds, and childhood allergic diseases in Chengdu. Seven representative neighborhoods were selected based on a 2018 database of pediatric patients from West China Hospital of Sichuan University. Through questionnaires in 2025, data on allergic diseases (e.g., atopic dermatitis and allergic rhinitis) were collected for 210 children aged 0–6 years. Logistic regression models were employed to analyze the data. The results indicate that in the overall sample, residential greening rate, NDVI, proportion of allergenic plants and closeness-to-nature characteristics of children’s playgrounds showed no significant association with allergic diseases. However, subgroup analyses revealed that greening rate was positively associated with allergy risk among children aged 0–3 years, whereas the proportion of allergenic woody plants was negatively associated with allergy risk in this age group; residential NDVI was significantly negatively associated with allergy risk in low-to-medium-housing-price neighborhoods (<19,000 CNY/m2), but positively associated in high-housing-price neighborhoods (≥19,000 CNY/m2); the proportion of allergenic herbaceous plants was significantly negatively associated with allergy risk in children only in high-housing-price neighborhoods. The presence of children’s playgrounds, accessibility of natural elements, integration of sites and facilities into the landscape, and use of natural materials in playgrounds and facilities showed a negative trend with allergy risk in low-to-medium-housing-price neighborhoods; the integration of sites and facilities into the landscape was significantly positively associated with allergy risk in high-rise neighborhoods. Collectively, these associations vary based on individual and neighborhood characteristics. Targeted green space planning and design interventions should be context-specific, synergistically optimizing vegetation coverage and plant composition, while enhancing the closeness-to-nature characteristics of children’s playgrounds within neighborhoods. Our results provide empirical evidence that may offer insights into the development of healthy and child-friendly cities.