The impact on mental well‐being of the urban and physical environment: an assessment of the evidence
| Pages | 17-32 |
| DOI | https://doi.org/10.1108/17465729200400010 |
| Date | 01 June 2004 |
| Published date | 01 June 2004 |
| Author | Annette Chu,Alice Thorne,Hilary Guite |
| Subject Matter | Health & social care |
journal of mental health promotion •volume 3•issue 2 •june 2004 © Pavilion Publishing (Brighton) Ltd
The impact on mental well-being of the urban
and physical environment: an assessment of
the evidence
ABSTRACT
In 2001 each primary care trust in England was required to undertake a needs assessment in preparation for the development of a mental
health promotion strategy. In Greenwich, it was decided to include the physical environment as one of the themes. This paper describes the
findings of a literature review undertaken of health, social sciences and architectural research and the preliminary conceptual model
subsequently developed to pull together all aspects of the interface between the urban and physical environment and mental well-being. The
literature review identified five key domains that impacted on this relationship: control over the internal housing environment, quality of
housing design and maintenance, presence of valued ‘escape facilities’, crime and fear of crime, and social participation. That these domains
can be confounded by socio-economic and demographic factors and also interact with cultural factors and housing type suggests the
importance of a public health approach, which focuses on causal systems rather than simply on individual causal factors.
Annette Chu
Intern
King’s College, London
Alice Thorne
Intern
King’s College, London
Hilary Guite
Public health consultant
Greenwich TPCT
Review
In 2001 each primary care trust in England was
required to undertake a needs assessment in preparation
for the development of a mental health promotion
strategy. In Greenwich, we decided to include the
physical environment as one of our themes. Although
evidence exists that commonly discussed topics – high
rise living, defensible space, graffiti, for example – may
be linked to mental well-being, there was no
overarching model to pull together all aspects of the
interface between the urban and physical environment
and mental well-being. We were also aware that
knowledge about this interface was to be found in
disparate places, including the health, social sciences
and architectural literature. Therefore, as a multi-
disciplinary team combining expertise in geography,
architecture and public health, we set ourselves the task
of scanning the health and social science databases to
identify relevant literature relating to the impact of the
built environment on mental well-being, with the
ultimate goal of developing a conceptual model to
inform our needs assessment exercise. This paper
describes the literature review that we undertook and
the preliminary model that we developed.
Methodological issues
The study of the links between mental health and the
environment is still at an early stage. Accurate
descriptions of both the built environment and mental
well-being pose problems. Features of urban
architecture such as housing, parks, roads and bridges,
recreational and other facilities collectively form the
physical framework of cities. In this residential arena,
the relationship formed between a person and their
immediate environment may be complex. Aspects of
the urban environment may contribute towards a sense
of loss of control, vulnerability, confusion, fear and
17
journal of mental health promotion •volume 3•issue 2 •june 2004 © Pavilion Publishing (Brighton) Ltd
Review
The impact on mental well-being of the urban and physical
environment: an assessment of the evidence
anger; it may equally promote social interaction,
enjoyment of the area, comfort or pride.
Two issues arise in examining the literature. First
definitions of both mental health and mental ill health
range widely, from sleeplessness and irritability to
clinical depression and severe mental ill health, and
may be described differently by different researchers.
Second, the link between the urban environment and
mental well-being is further complicated as individuals
may react differently to stimuli such as noise and the
condition of urban areas and perceive them as posing
different levels of stress and risk. People’s mental well-
being can also be affected by socio-economic factors
such as income, employment status and education.
Gender and cultural factors may also generate
differences in readings and understandings of the
environment. In addition, independent factors that
may have a negative effect on mental health can be
difficult to isolate as they are often intrinsically linked
to each other. The identification of direct cause-and-
effect relationships between mental well-being and
environmental stimuli is a highly complex task, and
assessment of the links must be approached with
caution.
Search strategy
The searches were conducted in December 2001.
Papers were limited to the English language and
relating to humans. Publications were searched
manually to identify papers likely to be relevant to our
topic. Papers were excluded if they were not principally
about the impact of the residential built environment
on mental health.
The initial search used the terms ‘mental’ and
‘health’ and ‘environment’, to capture as many papers
as possible that might be relevant to our principal
concern about the impact of the built environment on
general mental health and well-being, rather than
specific mental illnesses. This initial search identified
(by title) a large range of papers potentially relevant to
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TABLE 1
Papers found using the search terms ‘mental’ and ‘health’ and ‘environment’ by
database, December 2001, and numbers selected for further study
Database Years Selected papers Total
Web of Science 1990-2001 69 753
Medline 1966-2002 23 630
Bids 1997-2001 11 11
Psychinfo 1872-2002 11 562
TABLE 2
Search terms that identified further papers by database, December 2001 and
January 2002
Database Years Search terms Selected papers Total
Psychinfo 1872-2002 city and mental health 14 190
Psychinfo 1872-2002 noise and stress 5 36
Psychinfo 1872-2002 overcrowding and stress 2 21
Web of Science 1990-2001 noise and mental health 5 27
Web of Science 1990-2001 personal control and mental health 2 45
Web of Science 1990-2001 temperature and mental health 1 9
Web of Science 1990-2001 housing quality and well-being 1 10
Medline 1966-2002 housing and mental health 4 172
Medline 1966-2002 density and mental health 5 15
Medline 1966-2002 noise and mental health 4 7
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