Abstract
Research on the health impacts of green environments has mainly been conducted in developed countries. Differences in the urban forms between China and Western countries make it essential to understand the role of greenspace in Chinese settings. From 2014 to 2015, middle school students (n = 5643) in Suzhou, China were enrolled in a study on the health effect of residential greenness. The normalized difference vegetation index (NDVI) and distance to the nearest park were calculated for each home address. Logistic regression was performed to test associations between exposure and self-reported doctor diagnoses of asthma, pneumonia, rhinitis, and eczema, adjusting for important confounders. No statistically significant associations were observed for any seasonal NDVI-based measures. However, the proximity of the participants' residences to the closest park showed an inverse relationship to reported symptoms. The odds ratios for the furthest quartile compared to the closest quartile based on the distance to the nearest park were 0.58 (95% CI: 0.35, 0.99), 0.70 (95% CI: 0.50, 0.96), 0.92 (95% CI: 0.74, 1.15), 0.97 (95% CI: 0.76, 1.24), 0.86 (95% CI: 0.68, 1.10) for current asthma, ever asthma, ever pneumonia, ever rhinitis, and ever eczema, respectively. These findings focused on a single Chinese city and suggest that exposure to natural vegetation in urban areas may affect health through various pathways.