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Consider the role of psychological stress while evaluating the effect of the exposome, with a focus on the “feedback loop” or two-way dynamic between stress and mental health outcomes.
Investigate the link between self-regulation and childhood mental health outcomes by comparing studies using high-quality standardized psychometric instruments, latent profile/cluster analyses and network models.
Bigger picture
Equal-Life literature reviews found that sleep, stress, restoration and self-regulation/coping are mediators between the exposome and children’s mental health and cognitive development.
These mediators were specifically addressed in Equal-Life in-depth studies and targeted analyses.
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Further findings from more targeted reviews and studies
Stress
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Psychological stress has a mediating effect between exposures and health outcomes.
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Parental stress levels are a mediator on the impact of neighbourhood quality on preschoolers’ mental health.
Sleep
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Poor sleep patterns in childhood often persist into adolescence, and this can lead to mental health problems.
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Traffic noise, nitrogen dioxide levels in the air, and living in a densely populated urban neighbourhood with a lack of green space are associated with sleep problems.
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Having a home garden and good family relations is associated with improved sleep.
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Restoration
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Access to green and blue space during early life was linked to better mental health and well-being.
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The perceived restorative quality of living environments further enhances the positive impact of the greenspace–mental health link.
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Physical activity is consistently linked to better psychological outcomes.
Self-regulation
• Parenting skills and self-regulation are linked to childrens’ self-regulation skills.
• Self-regulation helps children cope with environmental stressors and harmful exposures.
Call to action for researchers
Call to action for community health professionals
Parental support programmes should prioritise establishing healthy sleep patterns at an early age to reduce the risk of later mental health issues and cognitive impairment, and recognise the role of good family relations in promoting healthy sleep.
These programmes should also focus on developing parents’ and caregivers’ skills in co-regulation and support, as this positively impacts children’s self-regulation skills.
Call to action for urban/transportation planners
The built environment is critical when it comes to promoting healthy sleep. Measures could include expanding Low-Emission Zones (LEZs), traffic calming measures, and creating quiet zones and green, restorative spaces in dense urban neighbourhoods to promote healthy sleep patterns.
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