A multi-scalar perspective on health and urban housing: an umbrella review.

Catalina Turcu,Mike Davies,Emma Hutchinson,Kristine Belesova,Melanie Crane,Paul Wilkinson,Simon Lloyd

doi:10.5334/bc.119

Abstract

With more than half the world’s population living in cities, understanding how the built environment impacts human health at different urban scales is crucial. To be able to shape cities for health, an understanding is needed of planetary health impacts, which encompass the human health impacts of human-caused disruptions on the Earth’s natural ecosystems. This umbrella review maps health evidence across the spatial scales of the built environment (building; neighbourhood; and wider system, including city, regional and planetary levels), with a specific focus on urban housing. Systematic reviews published in English between January 2011 and December 2020 were searched across 20 databases, with 1176 articles identified and 124 articles screened for inclusion. Findings suggests that most evidence reports on health determinants at the neighbourhood level, such as greenspace, physical and socio-economic conditions, transport infrastructure and access to local services. Physical health outcomes are also primarily reported, with an emerging interest in mental health outcomes. There is little evidence on planetary health outcomes and significant gaps in the research literature are identified. Based on these findings, three potential directions are identified for future research.

Highlights

The influence of the urban built environment on human health is complex and multifaceted
The urban built environment may be broadly defined at three scales: building, neighbourhood, and the wider urban system encompassing processes that operate across the city and regional levels and extend as far as the planetary level
This paper aims to synthesise the current evidence on the built environment and health nexus, focusing on the urban housing sector as the entry point

Summary

Introduction

The influence of the urban built environment on human health is complex and multifaceted. Material aspects of the built environment give rise to various social processes that may directly and indirectly shape the health of its residents (Rydin et al 2012; Bai et al 2016) This poses difficulties to both conceptualising the relation between health and the urban built environment, and when seeking to design and implement actions to protect and improve health. Multiple health objectives and outcomes, as well as health risks, may be considered simultaneously across the spectrum of policymaking and systematically reflected in decision-making This requires a thorough understanding of the interrelations between the different scales of the built environment in which a policy intervenes, and this reaches beyond the local level and across social and political boundaries. Local-level health considerations should be linked to the health of the wider urban system, including planetary health, whereby environmental processes can both be disturbed by and threaten to disturb local living conditions and health (Rydin et al 2012; Ramaswami et al 2016; Whitmee et al 2015)

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