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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">IJPDS</journal-id>
<journal-title-group>
<journal-title>International Journal of Population Data Science</journal-title>
<abbrev-journal-title>IJPDS</abbrev-journal-title>
</journal-title-group>
<issn pub-type="epub">2399-4908</issn>
<publisher>
<publisher-name>Swansea University</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.23889/ijpds.v11i5.3499</article-id>
<article-id pub-id-type="publisher-id">11:5:3499</article-id>
<article-id pub-id-type="pii">S2399490821034996</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Population Data Science</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>The impact of early life exposure to green space on mental health-related service use for mood or anxiety disorders in adolescence and early adulthood: A population-based birth cohort study in Ontario, Canada</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author"><name><surname>Mizen</surname><given-names initials="A">Amy</given-names></name><xref ref-type="aff" rid="affil-1"><sup>1</sup></xref></contrib>
<contrib contrib-type="author"><name><surname>Rotenburg</surname><given-names initials="M">Martin</given-names></name><xref ref-type="aff" rid="affil-2"><sup>2</sup></xref></contrib>
<contrib contrib-type="author"><name><surname>Dixon</surname><given-names initials="S">Stephanie</given-names></name><xref ref-type="aff" rid="affil-3"><sup>3</sup></xref></contrib>
<contrib contrib-type="author"><name><surname>Le</surname><given-names initials="B">Britney</given-names></name><xref ref-type="aff" rid="affil-3"><sup>3</sup></xref></contrib>
<contrib contrib-type="author"><name><surname>Rodrigues</surname><given-names initials="R">Rebecca</given-names></name><xref ref-type="aff" rid="affil-4"><sup>4</sup></xref></contrib>
<contrib contrib-type="author"><name><surname>Edwards</surname><given-names initials="J">Jordan</given-names></name><xref ref-type="aff" rid="affil-5"><sup>5</sup></xref></contrib>
<contrib contrib-type="author"><name><surname>Kurdyak</surname><given-names initials="P">Paul</given-names></name><xref ref-type="aff" rid="affil-2"><sup>2</sup></xref></contrib>
<contrib contrib-type="author"><name><surname>Anderson</surname><given-names initials="K">Kelly</given-names></name><xref ref-type="aff" rid="affil-4"><sup>4</sup></xref></contrib>
<aff id="affil-1"><label>1</label><institution>Swansea, Swansea, United Kingdom</institution></aff>
<aff id="affil-2"><label>2</label><institution>University of Toronto, Toronto, Canada</institution></aff>
<aff id="affil-3"><label>3</label><institution>ICES, Toronto, Canada</institution></aff>
<aff id="affil-4"><label>4</label><institution>University of Western Ontario, London, Canada</institution></aff>
<aff id="affil-5"><label>5</label><institution>McMaster University, Hamilton, Canada</institution></aff>
</contrib-group>
<pub-date date-type="pub" publication-format="electronic"><day></day><month></month><year></year></pub-date>
<pub-date date-type="collection" publication-format="electronic"><year></year></pub-date>
<volume>11</volume>
<issue>5</issue>
<elocation-id>3499</elocation-id>
<permissions>
<license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by-nc-nd/4.0/">
<license-p>This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.</license-p>
</license>
</permissions>
<self-uri xlink:href="https://ijpds.org/article/view/3499">This article is available from the IJPDS website at: https://ijpds.org/article/view/3499</self-uri>
<abstract>
<p>Rates of anxiety and depression among adolescents are rising globally. Exposure to greenness is recognised as a determinant of mental health but little is known about its impacts on adolescent mental health on a population scale. We examined the prospective association between residential greenness from birth to age 12 and subsequent health-care contacts for mood or anxiety disorders during adolescence. We conducted a population-scale longitudinal study using linked health, administrative data, and environmental measures for 831,957 individuals in the Ontario Mental Health and Intersectionality Data Surveillance Cohort within a Trusted Research Environment (ICES). The outcome was diagnosis-specific mental health-related service use for mood or anxiety disorders. Exposure was defined as residential greenness within a 250-metre buffer around each participant’s postcode centroid from birth to age 12. Associations between exposure to greenness and mood or anxiety-related service use were estimated using fully adjusted multivariable Cox regression models. In our cohort, 51.3% were female and 422,227 individuals had at least one mood- or anxiety-related service use. Mean greenness exposure was 0.12 (range 0–0.74). Greater exposure to greenness was associated with lower risk of mood or anxiety service use. A statistically significant U-shaped relationship was observed, with the highest risk in quintile 3 (HR 1.09, 95% CI 1.08–1.10) compared with the greenest quintile. Childhood exposure to greenness appears protective against later mood and anxiety-related service use and nonlinear effects warrant further investigation. This evidence can be used by policy and practice for the design of interventions.</p>
</abstract>
</article-meta>
</front>
</article>