Quality of outdoor environment influence children's health: A cross-sectional study of preschools.

The purpose of this study is to examine how the quality of the outdoor environment in Swedish daycare centres influences children's health and well-being.

The study reveals a statistical correlation between high quality of the outdoor environment at daycare centres measured using OPEC and several positive health aspects among the children at the daycare centres, including healthier body shape, longer night sleep and better well-being. High quality of the outdoor environment was assessed on the basis of (i) total outdoor area, (ii) amount of trees, shrubbery and hilly terrain and (iii) integration between vegetation, open areas and play structures (playhouses, see-saws, swings etc.).

The study concludes that the outdoor environment also has negative aspects, as children from daycare centres with a high-quality outdoor environment have a higher level of stress than children from daycare centres with a lower quality of outdoor environment.

The study concludes that the quality of the outdoor environment of daycare centres influences children's health and well-being, and this should be afforded more attention among health care professionals and community planners. Moreover, the study shows that children in daycare centres with high-quality outdoor environment spend more time in the outdoor environment than children in daycare centres with lower quality outdoor environment.

The study was carried out in Sweden among 172 children between 3 and 6 years in nine different kindergartens in Malmö. The data was collected over a week. The outdoor environment was assessed using the Outdoor Play Environment Categories (OPEC) tool. OPEC focusses on (i) total outdoor area, (ii) amount of trees, shrubbery and hilly terrain and (iii) integration between vegetation, open areas and play structures (playhouses, see-saws, swings etc.). Health data was collected and assessed on the basis of the children's body mass index, waist circumference, saliva cortisol (a measurement of stress), length of night sleep, disease symptoms and well-being. The empirical material relating to health was collected through a questionnaire completed by parents of the children regarding their children's health and well-being. The questionnaire was filled in every night in the week the study took place. The study uses statistical analysis to examine the relationship between goals for quality of the outdoor environment and the well-being and health of the children.

Söderström, M., Boldemann, C. & Sahlin, U. (2013). Quality of outdoor environment influence children's health: A cross-sectional study of preschools. Acta Paediatrica, 102 (1), 83-91.