Socioeconomic disparities and green space associated with myopia among Chinese school-aged students: A population-based cohort study

作者：Congchao Lu, Yuyang Miao, Xuyang Yao, Zinuo Wang, Ruihua Wei, Bei Du, Yifan Liu, Jiayu He, Hongyue Sun, Yuanyuan Liu, Jing Yan, Guowei Huang, Xi Chen, Naijun Tang, Hua Yan · 发表于：Journal of Global Health · 年份：2024 · DOI：10.7189/jogh.14.04140 · 被引用次数：19 · 研究领域：Ophthalmology and Visual Impairment Studies、Urban Green Space and Health、Retinopathy of Prematurity Studies

Background: There is increasing evidence on the link between environmental factors and myopia in children and adolescents, yet with inconsistent conclusions. We investigated the associations between socioeconomic inequalities and green space with myopia in school-aged students participating in the Tianjin Child and Adolescent Research of Eye (TCARE) study. Methods: We obtained data from a population-based dynamic cohort study conducted in Tianjin, China, in 2021 and followed up in 2022. We included 1 245 271 participants from 16 districts with an average age of 11.6 years (standard deviation = 3.3) in our analysis. We synthesized their area-level SES through a prediction model that combined economic, educational, and health care variables and assessed the greenness levels surrounding the school using the Normalized Difference Vegetation Index (NDVI) based on data obtained through satellite remote sensing. We performed generalised linear mixed effects analyses for each myopia outcome separately, with adjustments for students' sex, years of education completed, and the school's geographical location. Results: We observed that students living in low SES areas had the highest prevalence of myopia (60.7%) in the last screening in 2022, as well as a higher incidence of one-year myopia (26.4%) compared to those residing in middle SES areas (22.7%). With a 0.1 increase in the 250, 500, and 1000 m buffer NDVI, the prevalence of myopia dropped by 6.3% (odds ratio (OR) = 0.937; 95% conf...