*Wahida Kihal 1, Cindy Padilla 1,2, Benoit Lalloué 1,2,3, Marcello Gelormini1, Denis Zmirou-Navier 1,2,3, Séverine Deguen 1,2 1 EHESP School of Public Health–Rennes-France 2 INSERM U1085-IRSET – Research institute of environmental and occupational health. Rennes, France 3 Lorraine University Medical School–Vandoeuvre-les-Nancy-France Background The key question investigated in this work is whether there exists a relationship between green spaces and the spatial distribution of infant mortality risk taking into account neighbourhood deprivation levels in the Lyon metropolitan area in France. Study design & data Design. Ecological study at the French census block scale (IRIS, with a average of 2000 inhabitants). Health data. Infant mortality (714 children under 1 year of age) during the study period from 2000 to Greenness level. Spatial land cover data set for Lyon Metropolitan were sought and processed using ArcMap GIS software (ESRI) to produce the green space index. Our measure represented the geographic area (Km2 ) of green space as a proportion of the total area within a census block. Neighbourhood deprivation level. Socioeconomic and demographic data were obtained from the 1999 national population census conducted by INSEE at a census block level. The deprivation index includes education level, employment and occupation status, and housing characteristics. Few studies considered environmental benefits to explain social health inequalities. Natural environments that contribute to good health might have an effect on socioeconomic health inequalities. Yet, recent literature described the evidence that green spaces have health benefits for urban population is now strong. Recent studies suggest such positive effects on pregnancy outcomes. Aim of the research project Spatial approach & Analysis Strategy Conclusion – Perspectives The study revealed that : Spatial distribution of infant mortality is not randomly distributed. Greenness level and neighbourhood deprivation explain the spatial distribution of infant mortality measured at the French census block level. To better knowledge our results, we develop a framework to explore 3 hypothetical not exclusive pathways relating green spaces to all adverse pregnancy outcomes: (i) a psychological pathway, (ii) a physiological disruption process, (iii) an environmental pathway. This work adds some evidence to the link between access to green spaces and pregnancy outcomes but requires further research for confirmation. We investigated the presence of spatial aggregation of infant mortality using cluster analysis with the spatial scan statistic implemented in SaTScan software. We performed the following spatial analysis : First, unadjusted model were computed to identify the most likely cluster of high risk of infant mortality, Secondly, adjusted model on greenness levels and socioeconomic deprivation were developed. To incorporate covariables in the model, we classified each census block as either high or moderate or low level of greenness level and deprivation index. Table 1. Identification of high risk infant mortality cluster Results Green spaces and spatial analysis of social inequalities in infant mortality in France *Wahida Kihal: Table showing that after adjusting on the greenness level and neighbourhood deprivation level, the most likely cluster became not significant (p=0.12) with a lower log likelihood ratio We found the most likely cluster in the southeast of Lyon metropolitan area, with an infant mortality rate 1.70 higher than in the rest of the study area (northeast area). This cluster was statistically significant. Stage 1Stage 2