Neighborhood walkability with children’s mental health in the French ELFE cohort

Background

Although walkability is known to be associated with obesity in adults, there are limited studies evaluating the association with health outcomes in children. Walkability and the built environment may have implications on long-term mental health outcomes, beginning in childhood.

Methods

Data from 10,188 participants in the Etude Longitudinale Française depuis l’Enfance (ELFE), cohort study set in France were analyzed from birth to 5.5 years of age. Neighborhood walkability was defined by three parameters: population density, street connectivity, and diversity of destinations. To approximate walkable areas, 500-meter buffer zones were created around each participant’s address using a geographic information system. Children’s mental health was assessed using parent-reported Strengths and Difficulties Questionnaire.

Results

There was a total of 10,188 children included in the study. Compared to children residing in neighborhoods with low walkability, those living in highly walkable areas were significantly less likely to present symptoms of hyperactivity and inattention (Beta coefficient: -0.17, 95% CI: -0.30 - -0.04; p value: 0.010). Children residing in highly walkable areas were also significantly less likely to report peer relationship problems (Beta coefficient: -0.11; 95% CI: -0.04 - -0.18; p value: 0.003). These findings are confirmed after adjusting for socioeconomic determinants.

Conclusions

This study shows an association between neighborhood walkability and children’s emotional and behavioral difficulties. By better understanding how the environment impacts children’s health, these findings can help inform child-centered urban planning and guide interventions aimed at creating supportive environments that promote children’s psychological well-being.

Key messages

• The built environment directly impacts health. Neighborhood walkability is an emerging concept that can directly quantify the aspects of the living environment on health.

• Most studies on neighborhood walkability focus on adults. However the built environment directly impacts children’s health as well.