title: Adding Natural Areas to Social Indicators of Intra-Urban Health Inequalities among Children: A Case Study from Berlin, Germany.
abstract: Research suggests that there is a relationship between the health of urban populations and the availability of green and water spaces in their daily environment. In this paper, we analyze the potential intra-urban relationships between children's health determinants and outcomes and natural areas in Berlin, Germany. In particular, health indicators such as deficits in viso-motoric development in children are related to environmental indicators such as the natural area cover, natural area per capita and distance to natural areas; however, these indicators are also correlated with social determinants of health. The methodological approach used in this study included bivariate and multivariate analyses to explore the relations between health inequalities and social, socio-economic, and land use parameters. The results on a sub-district level indicated that there was a correlation between natural areas and social health determinants, both of which displayed a certain intra-urban spatial pattern. In particular, a lower percentage of natural area cover was correlated with deficits in viso-motoric development. However, results with percentage of natural area cover and per capita natural area with childhood overweight were not conclusive. No significant correlation was found for percentage of natural area cover and overweight, while significant negative correlation values were found between overweight and per capita natural area. This was identified particularly in the districts that had lower social conditions. On the other hand, the districts with the highest social conditions had the comparatively lowest levels of complete measles immunization. This study may facilitate public health work by identifying the urban areas in which the strengthening of health resources and actions should be prioritized and also calls for the inclusion of natural areas among the social health indicators included in intra-urban health inequality tools.
authors.affiliation: Department of Geography, Humboldt-Universität zu Berlin, Berlin 10099, Germany. nadja.kabisch@geo.hu-berlin.de.|Department of Ecosystem Services, Helmholtz Centre for Environmental Research-UFZ, Leipzig 04318, Germany. nadja.kabisch@geo.hu-berlin.de.|German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Leipzig 04103, Germany. nadja.kabisch@geo.hu-berlin.de.
authors.forename: Nadja
authors.initials: N
authors.lastname: Kabisch
authors.affiliation: Department of Geography, Humboldt-Universität zu Berlin, Berlin 10099, Germany. nadja.kabisch@geo.hu-berlin.de.|Department of Computational Landscape Ecology, Helmholtz Centre for Environmental Research-UFZ, Leipzig 04318, Germany. nadja.kabisch@geo.hu-berlin.de.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Haase
authors.affiliation: Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, Alnarp 23053, Sweden. matilda.van.den.bosch@slu.se.|School of Population and Public Health and Department of Forest and Conservation Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada. matilda.van.den.bosch@slu.se.
authors.forename: Matilda
authors.initials: M
authors.lastname: Annerstedt van den Bosch
mesh_terms: D001604:Berlin; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D005260:Female; D005858:Germany; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D019982:Organizational Case Studies; D050177:Overweight; D000068316:Parks, Recreational; D014504:Urban Health; D014611:Vaccination
keywords: children’s health; cluster analysis; green space; health inequality; intra-urban; measles; overweight