Neighborhood built environment is associated with health outcomes, including mental health symptoms. Existing evidence is largely based on adult populations and mental health associations have primarily focused on neighborhood greenness. However, children may interact differently with their neighborhoods, and neighborhood environments are complex interactions of multiple built features beyond greenness.

This study aims to estimate the association of neighborhood typologies and mental health symptoms in children aged 5 to 12 years.

The All Our Families birth cohort (Calgary, Canada) measured parent-reported symptoms of anxiety, depression, hyperactivity, and inattention using the Behaviour Assessment System for Children at ages 5, 8, and 12. Clinical cut point of at-risk or higher was defined as outcome. Neighborhood was defined as 500m buffers from the participants dissemination area (the smallest census area, 400-700 people) representative point. Neighborhood typologies were developed using principal component analysis and k-means cluster analysis.

Generalized estimating equations adjusted on household characteristics, maternal characteristics, and neighborhood deprivation, were used to estimate adjusted risk ratios (aRRs) for the full cohort and sex-stratified analyses.

Five neighborhood typologies in Calgary were identified (Figure 1).

The study sample is 1,467 children (52% male) and 3,059 observations. Preliminary results suggest that compared with males who have the most access to useable parkland (Cluster 1), males living in low-density suburban neighborhoods (Cluster 2) and those with a higher proportion major roads (Cluster 5), have higher aRRs for anxiety (1.59 [95% CI: 1.02,2.51] and 1.82 [95%CI: 1.12,2.96], respectively). No significant associations for depression, inattention, hyperactivity or in females are observed.

Neighborhood typology is associated with elevated RRs in neighborhoods with low-density suburban form and major transportation corridors.