Elsevier

Health & Place

Volume 53, September 2018, Pages 237-257
Health & Place

The effects of changes to the built environment on the mental health and well-being of adults: Systematic review

https://doi.org/10.1016/j.healthplace.2018.07.012Get rights and content
Under a Creative Commons license
open access

Highlights

  • Comprehensive systematic review of built environment interventions & mental health.

  • Weak evidence for the impact of built environment interventions on mental health.

  • Guidance on reducing risk of bias for these studies is provided.

  • Strategies, using innovative methods, are needed to improve evidence in this field.

Abstract

There is increasing interest in the influence of place on health, and the need to distinguish between environmental and individual level factors. For environmental-level factors, current evidence tends to show associations through cross-sectional and uncontrolled longitudinal analyses rather than through more robust study designs that can provide stronger causal evidence. We restricted this systematic review to randomised (or cluster) randomised controlled trials and controlled before-and-after studies of changes to the built environment. Date of search was December 2016. We identified 14 studies. No evidence was found of an effect on mental health from ‘urban regeneration’ and ‘improving green infrastructure’ studies. Beneficial effects on quality-of-life outcomes from ‘improving green infrastructure’ were found in two studies. One ‘improving green infrastructure’ study reported an improvement in social isolation. Risk-of-bias assessment indicated robust data from only four studies. Overall, evidence for the impact of built environment interventions on mental health and quality-of-life is weak. Future research requires more robust study designs and interdisciplinary research involving public health, planning and urban design experts.

Keywords

Systematic review
Urban environment
Mental health
Well-being
Meta-analysis

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