Health and Wellbeing Outcome Measures in Environmental Design Research: A Critical Review

Jung-hye Shin (University of Wisconsin-Madison)
Samuel Dennis (University of Wisconsin-Madison)
Hassnaa Mohammad (University of Wisconsin-Madison)

An increasing number of studies in public health recognize the physical environment as a root cause of health issues that are difficult to address within the boundaries of the healthcare system. Given that researchers in the field of Environmental Design Research (EDR) have long focused on the physical environment as the core element of their research, the field has strong potential to contribute to this critical body of knowledge. To better understand the state of the field, we systematically reviewed recent studies in EDR that specifically measured health and wellbeing outcomes as a response to the physical environment. We aimed to: (1) identify major research trends; (2) identify knowledge gaps; and (3) offer future directions. We selected research articles published between 2008 and 2017 using a systematic database search with multiple inclusion and exclusion criteria for quality control of studies reviewed. The multi-staged screening process resulted in 93 research studies reported in 82 journal articles.

General results indicate several trends: (1) disproportionate focus on nature and urban environments and a lack of focus on indoor environments, such as housing, school and work environments; (2) heavy reliance on correlational analysis without clear delineation of research constructs; (3) lack of attention to defining and operationalizing the environment as effector; (4) over reliance on self-reported ratings of mood, emotions and mental stress and lack of consensus on the scales used; (5) disproportionate focus on short-term health effects such as mood and emotion and failure to link to longer term health outcomes. We offer our future directions for each of these findings, drawing from the fields of medicine, public health, and psychophysiology. We conclude bymaking the case for greater consensus so that systematic reviews and meta-analyses are possible in order to improve human health through the planning and design of physical environment.