Innovative research into the link between the urban environment and health urgently needed

Researchers are calling for more innovative studies into the link between changes to urban neighbourhoods and their impact on residents’ mental health and wellbeing. The research team at the University of Bristol and NIHR CLAHRC West reviewed existing studies on this subject, and found 14 studies.

Even 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 uncontrolled studies over a long period of time.

This demonstrates what a challenging topic this is to research without bias and using existing methodologies.

In their paper, published in the journal Health and Place, the researchers say:

“An important question arising from this review and previous research is why the evidence for the impact of interventions that change the built environment is so poor, and what can be done to strengthen the evidence base? In synthesising the evidence, we have, necessarily, focused on bias relating to study design. And from that work, it appears that some study designs being used seem ill-suited to assess changes to the built environment. So the wider question is how do we promote the use of other types of analysis methods in this field?”

This study aimed to look at the existing academic research on changes to the built environment and their impact on adult residents’ mental health and wellbeing. Mental health and wellbeing are important public health issues, with policymakers looking for ways to improve both in the general population. Research has shown that there are links between measures like improving local green spaces and residents’ wellbeing, but the evidence is generally weak.

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. They 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.”

The research team included two Health Integration Team (HIT) Directors: Dr Suzanne Audrey of Supporting Healthy Inclusive Neighbourhood Environments (SHINE) and Professor Selena Gray of Active People: Promoting Healthy Life Expectancy (APPHLE).

Paper

The effects of changes to the built environment on the mental health and wellbeing of adults: Systematic review
Theresa Moore, Joanna Kesten, José Antonio López-López, Alexandra McAleenan, Sharea Ijaz, Alison Richards, Selena Gray, Jelena Savovic, Suzanne Audrey
Published in Health and Place