Can improving the built environment make residents healthier?

The built environment of local neighbourhoods is thought to play an important role in the physical and mental health of residents. The more difficult it is to get to the local shops, library, health centre or park, the harder it is to motivate yourself to go out. This can lead to isolation and loneliness.

Many things can affect whether people can get out and about, including:

  • Pavements that are too narrow or are blocked with cars and bins
  • The neighbourhood looks dirty and uncared for
  • No reliable public transport
  • Busy roads to cross
  • Nowhere comfortable to sit

Some people, particularly older people, might need additional help and reassurance from sign posts, and being able to use benches and toilets.

Some research has shown that changing our local neighbourhoods to make them more pleasant and easier to walk and cycle around reduces worry, fear of crime and encourages people to go out. Changes could include introducing cycle paths, pedestrianised zones, more green space, better access to public transport and signposts showing clearly where facilities such as public toilets can be found.

However, the evidence for these kinds of changes varies in quality and hasn’t tended to show a direct link between these changes and improvements in people’s health.

Project aims

The team looked at the existing academic research on changes to the built environment and their impact on adult residents’ mental health and wellbeing.

What we did

We looked for studies that covered ‘urban regeneration’ and ‘improving green infrastructure’, that reported on quality-of-life or mental health among residents.

What we found and what this means

We identified only 14 studies that matched the search criteria. We found no existing evidence on the effect on mental health from urban regeneration and improving green infrastructure studies. Two studies showed beneficial effects on quality-of-life from improving green infrastructure, and another on this topic reported an improvement in social isolation.

The evidence from these studies was low quality, with five studies at high risk of bias. Only four studies were considered robust in their risk-of-bias assessment. Many were before and after studies or didn’t compare areas where improvements had been made to areas where they hadn’t.

This demonstrates what a challenging topic this is to research without bias, using existing research methods.

The team offer guidance on reducing risk of bias for these kinds of studies in their paper, and are calling for new strategies using innovative methods to improve the evidence in this field.

The team offer guidance on reducing risk of bias for these kinds of studies in their paper, and are calling for new strategies using innovative methods to improve the evidence in this field.

What next?

More research using innovative techniques is required in this field. The researchers conclude:

“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.”

Links and downloads

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

Lead collaborators

CLAHRC West staff

Selena Gray

Professor Selena Gray

  • Professor of Public Health
  • Team Lead
Philippa Davies

Dr Philippa Davies

Jo Kesten

Dr Joanna Kesten

Dr Sharea Ijaz

profile picture Alison Richards

Alison Richards

Partners on this project

University of Bristol

The University of Bristol is internationally renowned and one of the very best in the UK, due to its outstanding teaching and research, its superb facilities and highly talented students and staff. Its students thrive in a rich academic environment which is informed by world-leading research. It hosts the Elizabeth Blackwell Institute for Health Research.