Natural immunity?: Examining relationships between neighborhood disadvantage and youth health risks, and the moderating role of community green space provision

Economic inequality in the U.S. has risen sharply over the past three decades, overlapping with persistent racial, ethnic, and spatial segregation to produce entrenched neighborhood-level disparities in health. Youth are especially vulnerable to these neighborhood effects, facing disproportionate risks from adverse environmental conditions. This study examines whether neighborhood disadvantage is associated with both increased prevalence of youth health risks and lower provision of green infrastructure across four U.S. cities (Houston, TX; Minneapolis, MN; Prince George’s County, MD; San Francisco, CA). We further test whether green space moderates the relationship between disadvantage and youth health. Census-tract analyses show that neighborhood disadvantage is strongly correlated with higher prevalence of obesity, asthma, and poor mental health among youth. Disadvantaged neighborhoods had significantly less park space and tree canopy cover, and areas with limited green space showed higher risks for all three health concerns. Greater tree canopy was specifically associated with reduced obesity risk. Crucially, interaction analyses revealed that higher proportions of park space substantially weakened the negative effects of disadvantage across all health outcomes. Findings underscore systemic underinvestment in green infrastructure in disadvantaged neighborhoods and highlight the protective potential of urban green space as a public health strategy for vulnerable youth.