The built and natural environment includes all physical elements in the environment where people live, work, and play (1), which can indirectly or directly affect mental health. These include air and water quality, sanitation, noise, green space, walkability, and urban decay. Urban decay occurs when a previously functioning urban area experiences deterioration and disrepair, often due to neglect, deindustrialisation, or age (2).
Risk and/or Protective Factor
The built and natural environment can be both protective and a risk factor for mental health.
Green spaces can act as a protective factor for emotional difficulties in children and young people (3) and feeling connected to nature has been linked to lower levels of anxiety and depression (4). On the other hand, a lack of green space can result in less social interaction (5) and therefore negatively affect mental health.
Walkability, in terms of areas that are safe to navigate on foot, can lead to spontaneous social interaction and promotes social cohesion, which is a protective factor for mental health (6).
Urban decay can lead to higher rates of crime; which is a risk factor for mental health difficulties (7). Urban decay can be seen in a lack of high street shop diversity. This has been linked to poorer mental health due to associations with financial insecurity (5).
Pollution is also a risk factor for mental health difficulties. Air pollution has been associated with a higher likelihood of medication for psychiatric disorders, which may indicate worse mental health in these areas (8). Noise pollution and litter, can lead to an impaired quality of life, which has been associated with poorer mental health (5).
Lastly, safe water and sanitation are important for mental health. Worse or unsafe access to safe water has been associated with poorer mental health (9). Furthermore, lacking privacy or safety while using sanitation infrastructure has also been suggested to negatively influence mental well-being (10).
1. Frank LD, Engelke P. Multiple Impacts of the Built Environment on Public Health: Walkable Places and the Exposure to Air Pollution. Int Reg Sci Rev [Internet]. 2005 Apr 26 [cited 2021 Jan 13];28(2):193–216. Available from: http://journals.sagepub.com/doi/10.1177/0160017604273853
2. Urban decay [Internet]. Designing Buildings Wiki. 2020 [cited 2021 May 17]. Available from: https://www.designingbuildings.co.uk/wiki/Urban_decay
3. Vanaken GJ, Danckaerts M. Impact of green space exposure on children’s and adolescents’ mental health: A systematic review. Int J Environ Res Public Health [Internet]. 2018 Dec 1 [cited 2021 Jan 20];15(12). Available from: https://pubmed.ncbi.nlm.nih.gov/30486416/
4. Mental Health Foundation. Nature. How connecting with nature benefits our mental health. 2021.
5. Daly S, Allen J. Healthy High Streets: Good place-making in an urban setting. London; 2018.
6. UCL Institute of Health Equity. Voluntary Sector Action on the Social Determinants of Health [Internet]. London; 2017 [cited 2021 Jan 27]. Available from: www.instituteofhealthequity.org
7. Wilson JQ, Kelling GL. Broken windows. Atl Mon. 1982;249(3):29–38.
8. Oudin A, Bråbäck L, Åström DO, Strömgren M, Forsberg B. Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents. BMJ Open [Internet]. 2016 Jun 1 [cited 2021 Jan 20];6(6):e010004. Available from: http://dx.doi.org/10.1136/bmjopen-2015-010004
9. Slekiene J, Mosler HJ. The link between mental health and safe drinking water behaviors in a vulnerable population in rural Malawi. BMC Psychol [Internet]. 2019 Jul 8 [cited 2021 Feb 1];7(1):44. Available from: https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-019-0320-1
10. Sclar GD, Penakalapati G, Caruso BA, Rehfuess EA, Garn J V., Alexander KT, et al. Exploring the relationship between sanitation and mental and social well-being: A systematic review and qualitative synthesis. Soc Sci Med. 2018 Nov 1;217:121–34.