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With the accelerating population ageing globally, disability has become a major public concern. Residential greenness may be one of the influencing factors of disability, but epidemiological evidence in the associations of residential greenness exposures with disability is limited. We aimed to investigate the associations of residential greenness exposures with the risk of disability in the elderly. Data of 8408 residents were obtained from the World Health Organization Study on Global AGEing and Adult Health (WHO SAGE) implemented in China during 2007–2018. Participants were matched to the Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) at their residential address. Disability was measured by the 12-item Chinese version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). The associations were examined using a generalized linear mixed model with stratified analyses by the covariates. We observed significantly negative associations of greenness exposures with the summary WHODAS score [NDVI 500m : −0.290, 95% Confidence Intervals (95%CI): −0.510, −0.070; EVI 500m : −0.453, 95%CI: −0.757, −0.149], and with the score of cognition (EVI 500m : −0.472, 95%CI: −0.881, −0.063), mobility (NDVI 500m : −0.632, 95%CI: −0.965, −0.299; EVI 500m : −0.739, 95%CI: −1.199, −0.280), and participation (NDVI 500m : −0.388, 95%CI: −0.651, −0.125; EVI 500m : −0.530, 95%CI: −0.893, −0.166). People living alone had a more pronounced association in cognition (NDVI 500m : −1.546, 95%CI: −2.471, −0.621). The associations with summary WHODAS score were stronger among participants living in rural areas (NDVI 500m : −0.420, 95%CI: −0.683, −0.157), having less education level (NDVI 500m : −0.618, 95%CI: −0.982, −0.253), and living in northern China (NDVI 500m : −0.381, 95%CI: −0.776, 0.013). Residential greenness may reduce the onset and worsening of disability, particularly for domains of cognition, mobility, and social participation. Because of its stronger influence among people with low socioeconomic status, increasing greenness levels in areas with lower socioeconomic status may promote health equity. • A prospective cohort study to study the association of greenness with disability. • Greenness exposure was negatively associated with the summary WHODAS score. • Greenness had greater associations with cognition, mobility, and participation. • The associations were modified by urbanicity, region, and household sizes. • Increasing greenspace in lower socioeconomic areas may promote health equity. [ABSTRACT FROM AUTHOR]

The impact of residential greenness on incident idiopathic pulmonary fibrosis (IPF) is unknown. We aimed to assess the association between residential greenness and incident IPF, identify underlying pathways, and further evaluate the effect among different genetic subgroups. 469,348 participants in the UK Biobank were included and followed until December 2020. Normalized difference vegetation index (NDVI) within 300-, 500-, 1000-, and 1500-m buffers (NDVI 300m , NDVI 500m , NDVI 1000m , and NDVI 1500m) were employed as indicators of greenness. The polygenic risk score (PRS) was constructed based on 13 independent SNPs. Cox models were fitted to assess the association of residential greenness with incident IPF. Casual mediation analyses were applied to evaluate potential mediators. After a median follow-up of 11.85 years, 1574 IPF cases were identified. We found residential greenness inversely associated with incident IPF. The HRs (95%CIs) for each interquartile increase of NDVI 300m , NDVI 500m , NDVI 1000m , NDVI 1500m were 0.93 (0.87, 0.99), 0.92 (0.86, 0.98), 0.89 (0.83, 0.95), and 0.89 (0.83, 0.95), respectively. The association was stronger among individuals with intermediate or high genetic risk. In mediation analyses, the main mediators identified were PM 2.5 and NO 2 , with proportion mediated estimated to be 31.92% and 40.61% respectively for NDVI 300m. Residential greenness was associated with reduced risk of incident IPF. [Display omitted] • Residential greenness inversely associated with incident IPF. • Greenness and IPF incidence correlated more strongly in those with higher genetic risk. • The effects of greenness were more pronounced in female, nonsmokers, urban dwellers, and those over 60 and retired. • Potential mediators might contribute to the association, especially air pollution. [ABSTRACT FROM AUTHOR]

Studies of residential greenness and depression symptoms among community-dwelling older adults in China are limited. However, understanding the role of greenness in depression symptoms among older adults can inform depression prevention and interventions. This study explored the relationship between residential greenness and depression symptoms among community-dwelling older adults in China. A cluster random sampling method was used to survey 7512 community-dwelling adults aged 60 and above from three towns in Shanghai. Depression symptoms were assessed using the Geriatric Depression Scale (GDS30). Residential greenness was measured using the normalized difference vegetation index (NDVI) and the enhanced vegetation index (EVI). Long-term greenspace exposure was defined as the mean NDVI and EVI in the three years prior to the baseline survey. Controlling for the covariates, the relationship between greenness and depression symptoms was assessed using binomial logistic regression and mixed-effects linear regression. Interaction analysis was conducted to explore which covariates potentially alter the association. We also assessed the mediating role of physical activity. The prevalence of depression symptoms among the participants was 13.72%. Higher residential greenness was associated with lower odds of depression symptoms, after adjusting for covariates. In the logistic regression analysis, the odds of depression symptoms decreased with increasing NDVI and EVI. In linear regression analysis, GDS30 scores decreased with increasing NDVI and EVI. Interaction analyses revealed that higher NDVI and EVI were more protective against depression among male individuals and older adults living with others than among female individuals and older adults living alone. Additionally, physical activity had a masking effect on residential greenness and depression symptoms. Higher residential greenness is associated with lower odds of depression symptoms in community-dwelling Chinese older adults. Increasing urban and neighborhood green spaces may contribute to the prevention and intervention of depression symptoms in community-dwelling older adults. • This study showed a relationship between residential greenness and depression symptoms among older adults in China. • Physical activity mediated the effect of residential greenness on depression symptoms. • This study suggested the beneficial effects of greenness on the mental health of older Chinese adults. [ABSTRACT FROM AUTHOR]

Exposure to greenness has been shown to be beneficial to health, but few studies have examined the association between residential greenness and prostate cancer (PCa) risk. Our main objectives were to identify the determinants of residential greenness, and to investigate if residential greenness was associated with PCa risk in Singapore. The hospital-based case-control study was conducted between April 2007 and May 2009. The Singapore Prostate Cancer Study (SPCS) comprised 240 prostate cancer cases and 268 controls, whose demographics and residential address were collected using questionnaires. Residential greenness was measured by normalized difference vegetation index (NDVI) around the participants' homes using a buffer size of 1 km. Determinants of NDVI were identified using a multivariable linear regression model. Logistic regression models were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of associations between NDVI and PCa risk, adjusting for potential confounders. Having a BMI within the second quartile, as compared to the lowest quartile, was associated with higher levels of NDVI (β-coefficient = 0.263; 95% CI = 0.040–0.485) after adjusting for covariates. Additionally, being widowed or separated, as compared to being married, was associated with lower levels of NDVI (β-coefficient = −0.393; 95% CI = −0.723, −0.063). An interquartile range (IQR) increase in NDVI was positively associated with prostate cancer risk OR = 1.45; 95% CI = 1.02–2.07). Stratified analysis by tumour grade and stage showed that higher NDVI was associated with higher risk of low grade PCa. Our findings suggested that residential greenness was associated with higher risk of PCa in Singapore. Future studies on the quality and type of green spaces, as well as other factors of residential greenness, in association with PCa risk should be conducted to better understand this relationship. • Residential greenness around the participants' homes was measured by normalized difference vegetation index (NDVI). • BMI and marital status were associated with NDVI. • NDVI with a buffer size of 1 km was associated with higher prostate cancer risk, particularly low grade prostate cancer. [ABSTRACT FROM AUTHOR]

Ambient air pollution was linked to elevated risks of adverse cardiovascular events, and alterations in electrophysiological properties of the heart might be potential pathways. However, there is still lacking research exploring the associations between PM 1 exposure and cardiac conduction parameters. Additionally, the interactive effects of PM 1 and residential greenness on cardiac conduction parameters in resource-limited areas remain unknown. A total of 27483 individuals were enrolled from the Henan Rural Cohort study. Cardiac conduction parameters were tested by 12-lead electrocardiograms. Concentrations of PM 1 were evaluated by satellite-based spatiotemporal models. Levels of residential greenness were assessed using Enhanced Vegetation Index (EVI) and Normalized difference vegetation index (NDVI). Logistic regression models and restricted cubic splines were fitted to explore the associations of PM 1 and residential greenness exposure with cardiac conduction abnormalities risk, and the interaction plot method was performed to visualize their interaction effects. The 3-year median concentration of PM 1 was 56.47 (2.55) μg/m3, the adjusted odds rate (ORs) and 95% confidence intervals (CIs) for abnormal HR, PR, QRS, and QTc interval risk in response to 1 μg/m3 increase in PM 1 were 1.064 (1.044, 1.085), 1.037 (1.002, 1.074), 1.061 (1.044, 1.077) and 1.046 (1.028, 1.065), respectively. Participants exposure to higher levels of PM 1 had increased risks of abnormal HR (OR = 1.221, 95%CI : 1.144, 1.303), PR (OR = 1.061, 95%CI : 0.940, 1.196), QRS (OR = 1.225, 95%CI : 1.161, 1.294) and QTc interval (OR = 1.193, 95%CI : 1.121, 1.271) compared with lower levels of PM 1. Negative interactive effects of exposure to PM 1 and residential greenness on abnormal HR, QRS, and QTc intervals were observed (P for interaction < 0.05). Long-term PM 1 exposure was associated with elevated cardiac conduction abnormalities risks, and this adverse association might be mitigated by residential greenness to some extent. These findings emphasize that controlling PM 1 pollution and increasing greenness levels might be effective strategies to reduce cardiovascular disease burdens in resource-limited areas. [Display omitted] • This is the first study to examine the association of PM 1 exposure with cardiac conduction parameters in resource-limited areas. • Long-term PM 1 exposure was associated with increased risks of cardiac conduction abnormalities. • Residential greenness might mitigate the detrimental effect of PM 1 exposure on cardiac conduction abnormalities to some extent. [ABSTRACT FROM AUTHOR]

Current evidence on the relations of residential greenness with glucose homeostasis and type 2 diabetes (T2D) remained largely uncertain. Most importantly, no prior studies have investigated whether genetic predisposition modifies the above associations. We leveraged data from the UK Biobank prospective cohort study, with participants enrolled between 2006 and 2010. Residential greenness was assessed by using the Normalized Difference Vegetation Index, and the weighting T2D-specific genetic risk score (GRS) was constructed based on previously published genome-wide association studies. Linear regression models and logistic regression models were used to investigate associations of residential greenness with glycated hemoglobin (HbA 1c) and T2D prevalence, respectively. Interaction models explored whether genetic predisposition modifies greenness-HbA 1c /T2D associations. Among 315,146 individuals (mean [SD] age, 56.59 [8.09] years), each one-unit increase in residential greenness was associated with reduction in HbA 1c (β: −0.87, 95% CI: −1.16 to −0.58) and a 12% decrease in odds of T2D (OR: 0.88, 95% CI: 0.79 to 0.98), respectively. Additionally, interaction analyses further demonstrated that residential greenness and genetic risk had cumulative effects on HbA 1c and T2D. Compared with individuals who were exposed to low greenness and had high GRS, participants with low GRS and high greenness had a significant decline in HbA 1c (β: −2.96, 95% CI: −3.10 to −2.82, P for interaction = 0.04) and T2D (OR: 0.47, 95% CI: 0.45 to 0.50, P for interaction = 0.09). We add novel evidence that residential greenness has protective effects on glucose metabolism and T2D, and those beneficial effects can be amplified by low genetic risk. Our findings may facilitate the improvement of the living environment and the development of prevention strategies by considering genetic susceptibility to T2D. [Display omitted] • Residential greenness was negatively linked with glucose metabolism and T2D. • Genetic risk modifies the relationship of greenness with HbA 1c and T2D. • Subjects with low genetic risk and high greenness have lower HbA 1c and odds of T2D. [ABSTRACT FROM AUTHOR]

Diabetic retinopathy (DR) is a leading cause of vision impairment and blindness among diabetics. We aimed to explore whether long-term exposure to residential greenness was beneficial to DR. We used data from a large-scale, cross-sectional screening survey conducted in 129 cities of 27 provincial regions of China from 2018 to 2021 among patients with diabetes. We measured residential greenness exposure as the 3-year average of annual maximum Normalized Difference Vegetation Index (NDVI) at a spatial resolution of 250 m. DR was assessed by ophthalmologists based on fundus photographs. The primary outcome was DR, and secondary outcome included DR severity status (i.e., nonproliferative and proliferative), hallmarks of retinal lesions and macular oedema. A total of 484,380 adult participants with diabetes were included in the current analysis, and 15.7% of them were diagnosed with DR. NDVI was inversely and linearly associated with DR prevalence, and an increment of 0.1 NDVI was associated with a 10% (9%–10%) decrease in DR prevalence. Significant and inverse associations were further found for nonproliferative and proliferative DR, hallmarks of lesions and macular oedema. The association between greenness and DR was stronger among participants who were older, obese, lived in the south, had longer duration of diabetes or did not take antidiabetic medications. This large-scale nationwide study provides the first-hand epidemiological evidence on the associations of residential greenness with DR. Our findings highlight the importance of residential greenness in alleviating DR risk especially in an era of aging and urbanization. • The first to examine the relationship between greenness and diabetic retinopathy (DR). • Greenness exposure was almost linearly associated with decreased odds of DR. • Greenness was inversely associated with nonproliferative and proliferative DR. • Greenness was inversely associated with hallmarks of DR and macular oedema. [ABSTRACT FROM AUTHOR]

Both greenness and air pollution have widely been linked with asthma. However, the potential mechanism has rarely been investigated. This study aimed to identify the association between residential greenness and air pollution (fine particulate matter [PM 2.5 ]; nitrogen dioxide [NO 2 ]; ozone [O 3 ]) with nasal microbiota among asthmatic children during the recovery phase. The normalized difference vegetation index was used to assess the extent of residential greenness. Spatiotemporal air pollution variation was estimated using an integrated hybrid kriging-LUR with the XG-Boost algorithm. These exposures were measured in 250-m intervals for four incremental buffer ranges. Nasal microbiota was collected from 47 children during the recovery phase. A generalized additive model controlled for various covariates was applied to evaluate the exposure-outcome association. The lag-time effect of greenness and air pollution related to the nasal microbiota also was examined. A significant negative association was observed between short-term exposure to air pollution and nasal bacterial diversity, as a one-unit increment in PM 2.5 or O 3 significantly decreased the observed species (PM 2.5 : −0.59, 95%CI -1.13, −0.05 and O 3 : −0.93, 95%CI -1.54, −0.32) and species richness (PM 2.5 : −0.64, 95%CI -1.25, −0.02 and O 3 : −0.68, 95%CI -1.43, −0.07). Considering the lag-time effect, we found a significant positive association between greenness and both the observed species and species richness. In addition, we identified a significant negative association for all pollutants with the observed species richness. These findings add to the evidence base of the links between nasal microbiota and air pollution and greenness. This study establishes a foundation for future studies of how environmental exposure plays a role in nasal microbiota, which in turn may affect the development of asthma. • A scarce study assesses links between greenness, air pollution, and nasal microbiota. • Short-term air pollution exposure significantly decreases nasal bacterial diversity. • Lag-time greenness has a significant association with nasal bacterial diversity. • Air pollution and greenness influence nasal microbiota in asthmatic children. [ABSTRACT FROM AUTHOR]

Previous studies have indicated that exposure to residential greenness may benefit the health status of pregnant women, and air pollution may exert a mediating effect. Gestational weight gain (GWG) is an important indicator of pregnant women and fetuses' health and nutrition status. However, evidence concerning the impact of residential greenness on excessive gestational weight gain (EGWG) is scarce, and to what extent air pollution in urban settings mediates this relationship remains unclear. This study aims to explore the association of residential greenness with EGWG, consider the mediating effect of air pollution, and estimate the combined impact of residential greenness and air pollution exposures on EGWG. This population-based cross-sectional study involved 51,507 pregnant women with individual-level data on residential addresses in the Wuhan Maternal and Child Health Management Information System. Two spectral indexes, the normalized difference vegetation index (NDVI) and soil-adjusted vegetation index (SAVI), were used to proxy residential greenness. The air pollution data included six indicators (PM 2.5 , PM 10 , SO 2 , CO, NO 2 , O 3) and used the Ordinary Kriging interpolation method to estimate overall pregnancy exposure to air pollutants. Generalized linear mixed regression models were utilized to explore the relationship between residential greenness and EGWG. Restricted cubic spline (RCS) models were developed to examine the dose-response relationships. Mediation analyses explored the potential mediating role of air pollution in the residential greenness-EGWG associations. Finally, the weighted-quantile-sum (WQS) regression model was used to investigate the association between residential greenness-air pollutants co-exposure and EGWG. Among all participants, 26,442 had EGWG. In the adjusted model, the negative association was found significant for NDVI 100-m , NDVI 200-m , and NDVI 500-m with EGWG. For example, each IQR increase in NDVI 100-m was associated with 2.8% (95% CI: 0.6–5.0) lower odds for EGWG. The result of WQS regression showed that, when considering the six air pollutants and NDVI -100m together, both positive and negative WQS indices were significantly associated with EGWG, PM 10 , PM 2.5 , with SO 2 having significant weights in the positive effect direction and CO, O 3 , NO 2 , and NDVI 100-m having a negative effect. Our results also suggested that SO 2 , NO 2 , PM 10 , PM 2.5, and CO significantly mediated the association between NDVI -100m and EGWG, and our estimates were generally robust in the sensitivity analysis. Exposure to a higher level of residential greenness is associated with a reduced risk of EGWG, in which air pollution may exert a mediating effect. Pregnant women might benefit more in gaining healthy gestational weight when greenness levels increase from low to medium than from medium to high. Given the current cross-sectional study design, large-sale prospective cohort studies are needed to confirm our findings further. • A decreased risk of excessive gestational weight gain (EGWG) was associated with a higher level of residential greenness. • Increasing residential greenness levels from low to the medium was associated with more significant health benefits. • Combined exposure to residential greenness and air pollution was associated with the prevalence of EGWG. [ABSTRACT FROM AUTHOR]

Green space in the living environment has been linked to the development of allergic diseases. However, evidence regarding early-onset allergy in toddlers was limited, and the critical exposure window remained unclear. We aimed to investigate associations between residential greenness with allergic diseases in early life. This prospective birth cohort study included 522 mother-child pairs in Guangzhou, China. We quantified prenatal, postnatal, and early-life (i.e., the first 1000 days of life) residential greenness, estimated from remote satellite data using normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), and tree cover. We identified physician-diagnosed allergic diseases (eczema, atopic dermatitis, urticaria, allergic rhinitis, allergic conjunctivitis, food allergy, and asthma) based on medical records at age 2 years. Generalized linear regression was conducted to examine the associations of greenness with allergic outcomes. The ranges of residential NDVI and EVI values in 500-m buffer during early life were 0.06–0.70 and 0.03–0.46, respectively. We found a 0.1 unit increase of NDVI in 500-m buffer throughout early life was associated with higher odds of any allergic diseases (prenatal: OR [odds ratio], 1.25; 95%CI, 1.02–1.53; postnatal: OR, 1.24; 95%CI, 1.02–1.52; early-life: OR, 1.25, 95%CI: 1.02–1.53) and higher odds of eczema (prenatal: OR, 1.28; 95%CI, 1.04–1.59; postnatal: OR, 1.24; 95%CI, 1.01–1.54; early-life: OR, 1.26, 95%CI: 1.02–1.56). The results were consistent when using EVI as a proxy for greenness. We only observed that prenatal exposure to the highest tertile of NDVI-500 was adversely associated with any allergic diseases (OR, 1.63; 95%CI, 1.03–2.58) and eczema (OR, 1.70; 95%CI: 1.04–2.78) compared with the lowest tertile. This study identified detrimental associations of residential greenness with allergic diseases especially eczema among toddlers, and pregnancy appears to be the critical exposure window. Our findings highlighted the importance of urban planning to develop friendly-green neighborhood to improve maternal and child health. • In this birth cohort, residential greenness was adversely associated with early-life allergic diseases, especially eczema. • Prenatal exposure to greenness had a stronger association than postnatal exposure. • Greenness may predispose toddlers to allergy risk by the effect of allergenic pollen and other allergens. [ABSTRACT FROM AUTHOR]

Greenery in the residential environment and in the hospital has been associated with improved surgical outcomes and recovery. We investigated the association between the level of residential greenness of patients with coronary disease and their heart disease-related Quality of Life (HRQoL) 1-year after a coronary artery bypass grafting (CABG) surgery. Participants in a prospective cohort study who underwent CABG surgery at seven cardiothoracic units throughout Israel during the years 2004–2007 filled in the MacNew HRQoL one day before and one year after surgery. Successful recovery was defined as ≥0.5 increase in the MacNew score between baseline and follow-up. Exposure to residential greenness in 90 m and 300 m buffers around the patient's home was assessed with Linear Spectral Unmixing analysis of Landsat 30 m imagery. The cohort comprised of 861 patients (22% female) with a mean age of 65.5 years, and 59.2% classified as low-income. In the total cohort, higher residential greenness was associated with an improvement in emotional HRQoL (OR = 1.33 (95%CI: 0.99–1.79)), adjusting for demographic and socio-economic factors, living in the periphery/center, presence of diabetes, attending cardiac rehabilitation following surgery, BMI, and change in physical fitness and depression over the 1-year follow-up. Although no association was found between greenness and change in the physical or social subscales, a positive association was specifically observed among the low-income patients for the global HRQoL score, OR = 1.42 (95%CI: 0.97–2.10), as compared to the higher-income patients, p for interaction = 0.03. Residential greenness is associated with improvement in HRQoL 1-year after CABG surgery, but not the physical and social scales, only in low-income patients. Ensuring greenery in the living environment may act as a social intervention that supports human health and disease recovery. • Residential greenness may enhance surgical recovery. • We studied greenness and quality of life post coronary artery bypass graft surgery. • Greenness was associated with improvement in the emotional domain of quality of life. • Greenness was particularly beneficial for low income, female, and sedentary patients. [ABSTRACT FROM AUTHOR]

Long-term exposure to ambient ozone (O 3) and residential greenness independently relate to altered hormones levels in urban settings and developed countries. However, independent and their joint associations with progestogen and androgen were sparsely studied in rural regions. A total of 6211 individuals were recruited in this study. Random forest model was applied to predict the daily average concentrations of O 3 using the satellites data. Residential greenness was reflected by the normalized difference vegetation index (NDVI). Liquid chromatography-tandem mass spectrometry was used to measure serum progestogen and androgen concentrations. Gender and menopausal status modified associations of long-term exposure to O 3 and residential greenness with hormones levels were analyzed by generalized linear models. Long-term exposure to O 3 was negatively related to 17-hydroxyprogesterone, testosterone, and androstenedione in both men and women (premenopausal and postmenopausal); the estimated β and 95% CI of ln-progesterone in response to per 10 μg/m3 increment in O 3 concentration was −0.560 (−0.965, −0.155) in postmenopausal women. Association of long-term exposure to O 3 with serum androgen levels in premenopausal and postmenopausal women were alleviated by residing in places with higher greenness. Additionally, a prominent effect of long-term exposure to O 3 related to decreased serum progestogen and androgen levels was found in participants with middle- or high-level of physical activity or lower education level. The results suggested that long-term exposure to high levels of O 3 related to decreased serum androgen levels was attenuated by living in high greenness places in women regardless of menopause status. Future studies are needed to confirm the positive health effects of residential greenness on the potential detrimental effects due to exposure to O 3. • The associations between O 3 exposure and serum sex hormone levels were explored. • Interaction of O 3 exposure and NDVI on serum sex hormone levels were investigated. • Long-term exposure to high levels of O 3 related to reduced serum sex hormones levels. • NDVI attenuated the negative correlation of O 3 exposure with androgen levels in women. [ABSTRACT FROM AUTHOR]

Studies on the association of greenness with respiratory health are scarce in developing countries, and previous studies in China have focused on only one or two indicators of lung function. The study aims to evaluate the associations of residential greenness with full-spectrum lung function indicators and prevalence of chronic obstructive pulmonary disease (COPD). This nationwide cross-sectional survey included 50,991 participants from the China Pulmonary Health study. Lung function indicators included four categories: indicators of obstructive ventilatory dysfunction (FEV 1 , FVC and FEV 1 /FVC); an indicator of large-airway dysfunction (PEF); indicators of small-airway dysfunction (FEF 25–75% and FEV 3 /FEV 6); and other indicators. Residential greenness was assessed by the Normalized Difference Vegetation Index (NDVI). Multivariable linear regression models and logistic regression models were used to analyze associations of greenness with lung function and COPD prevalence. Within the 500 m buffer, an interquartile range (IQR) increase in NDVI was associated with higher FEV 1 (24.76 mL), FVC (16.52 mL), FEV 1 /FVC (0.38), FEF 50% (56.34 mL/s), FEF 75% (33.43 mL/s), FEF 25–75% (60.73 mL/s), FEV 3 (18.59 mL), and FEV 6 (21.85 mL). However, NDVI was associated with lower PEF. In addition, NDVI was significantly associated with 10% lower odds of COPD. The stratified analyses found that the associations were only significant in middle-young people, females, and nonsmokers. The associations were influenced by geographic regions. Residential greenness was associated with better lung function and lower odds of COPD in China. These findings provide a scientific basis for healthy community planning. • The analysis included 50,991 participants from the China Pulmonary Health study. • Greenness was associated with better lung function. • Greenness was associated with lower odds of COPD. • The associations were modified by age, sex, geographic region, and smoking history. [ABSTRACT FROM AUTHOR]