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Social consequences and mental health outcomes of living in high-rise residential buildings and the influence of planning, urban design and architectural decisions: A systematic review


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Different types of high-rise residential buildings have proliferated in different countries at least since the 1940s, for a range of reasons. This paper aims to provide an overview of the current state of evidence on how planning, urban design and architectural aspects of high-rise residential buildings may influence social well-being and mental health. A systematic review following the PRISMA guidelines was conducted. Searches for peer-reviewed papers were conducted in MEDLINE, Embase, PsycInfo, Scopus, SciELO, and Web of Science; 4100 papers were assessed. 23 empirical studies published between 1971 and 2016 were included. The review found that house type, floor level, as well as spaces intrinsic to high-rise residential buildings (e.g. shared stairwells) are associated with social well-being and mental health. However, conceptual gaps and methodological inconsistencies still characterise most of the research in this field. We expect that research about and policy attention to this subject may intensify due to its strategic relevance in the face of global challenges such as increasing urbanization and loneliness. This paper concludes by highlighting a number of recommendations for future research.
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Social consequences and mental health outcomes of living in high-rise
residential buildings and the inuence of planning, urban design and
architectural decisions: A systematic review
Paula Barros
, Linda Ng Fat
, Leandro M.T. Garcia
, Anne Dorothée Slovic
Nikolas Thomopoulos
, Thiago Herick de Sá
, Pedro Morais
, Jennifer S. Mindell
Universidade Federal de Minas Gerais, Escola de Arquitetura, Departamento de Projetos, Rua Paraíba, 697, Savassi, Belo Horizonte, MG 30130-141, Brazil
Health and Social Survey Research Group, Research Department of Epidemiology and Public Health, UCL (University College London), 1-19 Torrington Place, London
School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480, Rio de Janeiro, RJ 21041-210, Brazil
Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo CEP 05508-
090, Brazil
Glaux, 95 Mortimer street, London, UK
Center for Epidemiological Research in Nutrition and Health, University of São Paulo, Av. Dr. Arnaldo, 715, Cerqueira Cesar, São Paulo, SP 03178-200, Brazil
Architecture and Urban Planning Department, Uni-BH University Center, Av. Professor Mário Werneck, 1685, Bloco A2, sala dos professors, Estoril, Belo Horizonte, MG
30575-180, Brazil
High-rise housing
Residential building
Mental health
Social well-being
Urban planning
Physical design
Dierent types of high-rise residential buildings have proliferated in dierent countries at least since the 1940s,
for a range of reasons. This paper aims to provide an overview of the current state of evidence on how planning,
urban design and architectural aspects of high-rise residential buildings may inuence social well-being and
mental health. A systematic review following the PRISMA guidelines was conducted. Searches for peer-reviewed
papers were conducted in MEDLINE, Embase, PsycInfo, Scopus, SciELO, and Web of Science; 4100 papers were
assessed. 23 empirical studies published between 1971 and 2016 were included. The review found that house
type, oor level, as well as spaces intrinsic to high-rise residential buildings (e.g. shared stairwells) are associated
with social well-being and mental health. However, conceptual gaps and methodological inconsistencies still
characterise most of the research in this eld. We expect that research about and policy attention to this subject
may intensify due to its strategic relevance in the face of global challenges such as increasing urbanization and
loneliness. This paper concludes by highlighting a number of recommendations for future research.
1. Introduction
Housing has long been associated with health. The World Health
Organization (WHO) has considered housing a determinant of health
from its formation in 1948 (Howden-Chapman, Roebbel, & Chisholm,
2017). Although there is not a consensual cross-disciplinary denition
for health, since the WHO's (2014, p.1) well-known denition of health
as [] a state of complete physical, mental and social well-being and
not merely the absence of disease of inrmity, social well-being, also
known as social health, and mental health have been understood as
essential and inter-related aspects of health.
Dierent denitions and indicators of social well-being and mental
health permeate the literature because they tend to be conceptualized
according to research aims (Hashemi et al., 2016) and, on the other
hand, these are also culture-related. For the purposes of this review,
social well-being is dened as the appraisal of one's circumstance and
functioning in society(Keyes, 1998, p.122), and good mental health as
[] a state of well-being in which the individual realizes his or her
own abilities, can cope with the normal stresses of life, can work pro-
ductively and fruitfully, and is able to make a contribution to his or her
community(WHO, 2007, p.1).
United Nations have directed eorts to promote social well-being
Received 30 May 2018; Received in revised form 16 April 2019; Accepted 9 May 2019
Corresponding author.
E-mail addresses: (P. Barros), (L. Ng Fat), (L.M.T. Garcia), (A.D. Slovic), (N. Thomopoulos), (T.H. de Sá), (P. Morais), (J.S. Mindell).
Joint rst authors.
and mental health because these highly neglected aspects of health are
critical to the achievement of WHO's 2030 Sustainable Development
Goals (United Nations, 2018). Although the health eects of living in
high-rise residential building are still to be fully understood, this house
type has been a common solution for accommodating population
growth across the globe. The report carried out by the Council on Tall
Buildings and Urban Habitat (CTBUH) in 2018 shows that there was a
464% increase in high-rise buildings with total height over 200 m in the
world from the year 2000 (CTBUH, 2019).
Like health, high-rise building, as health and its aspects, has no
internationally accepted denition (Al-Kodmany, 2018). This housing
type includes multi-story buildings that dier in many aspects such as
in their height, primary use (e.g. oce, residential, mixed-use), archi-
tectural design, scale, meaning and market position. Rapid urbanization
and the need to control urban sprawl, whose cost is over 1 US$ trillion
annually (Litman, 2015), are not the only factors that have driven the
construction of high-rise residential buildings. Other forces include
increases in land prices, massive migration from rural to urban areas,
global competition, human aspiration, symbolism, and ego (Al-
Kodmany, 2018).
In addition to the increasing demand for designing and building
high-rise residential buildings, there has been an interest in retrotting
those that have been associated with social isolation, crime, negative
image, poor indoor air quality, and other problems, as the case of
Amsterdam's Bilmermeer high-rise illustrates (Helleman & Wassenberg,
Mental health disorders have a bi-directional relationship with so-
cial well-being and accounted for 57% of disability-adjusted life years,
according to the Global Burden of Disease Study 2010 (Whiteford et al.,
2015). Awareness of that; the rapid growth in the height and numbers
of high-rises; the long life cycle of this building type, the demand for
upgrading aging high-rise residential buildings; the value of residential
spaces to people; and the longstanding associations of housing with
health call for a systematization of what is known about the inter-re-
lationships between high-rise residential building, social well-being and
mental health.
To our knowledge, however, no systematic review of the evidence
has been conducted on this topic, although other types of reviews have
been carried out on living environments, social well-being and/or
mental health (Blair et al., 2014;Clark et al., 2007;Diez & Mair, 2010;
Evans, 2003;Evans, Well, & Moch, 2003;Gong et al., 2016;Julien
et al., 2012;Mair, Diez Roux, & Galea, 2008;Mazumdar et al., 2017;
Moore et al., 2018;Mueller, 1981;Rautio et al., 2017;Renalds, Smith,
& Hale, 2010;Truong & Ma, 2006).
From all these earlier reviews, only one, a critical review carried out
15 years ago by Evans et al. (2003), focused on aspects of high-rise
residential buildings (house type, oor level and housing quality) and
mental health. Evans (2003) concluded that housing does inuence
residents' mental health and discussed the importance of taking into
account moderating and mediating constructs as well as the role of
psychosocial processes, which for the purposes of this research are
under the umbrella of social well-being, as mediators variables (Fig. 1).
With these policy priorities and gap in research, the authors build
on past eorts (notably Evans et al., 2003) to provide an overview of
the current state of evidence on the inter-relationships between phy-
sical and spatial aspects of high-rise residential buildings, social well-
being and/or mental health. As part of an attempt to bring a range of
technical expertise and viewpoints, this review was conducted by a
team covering a wide range of disciplines, including architecture,
planning, urban design, economics, public health and epidemiology.
We hope that the ndings of this review will: (i) help policy makers,
urban planners, urban designers, architects, landscape architects and
public health professionals to take evidence-based decisions that will
contribute towards the enhancement of social well-being and mental
health among those who live in high-rise residential buildings, and (ii)
promote high-quality research on a topic that is key to the quality of life
of a large proportion of the global population in cities.
2. Methods
2.1. Literature search
We performed a systematic review of studies investigating the in-
uence of living in high-rise buildings on social consequences and/or
mental health outcomes (excluding psychotic illness), following the
PRISMA guidelines (Liberati et al., 2009). A systematic literature re-
view is an approach regularly used in the public health eld as an at-
tempt to reduce biases in the process of compiling the available evi-
dence to respond to a specic research question. It therefore involves a
pre-specied, specic research question that results in an extensive
search of several databases using both free text and thesaurus terms,
combined using Boolean operators; selection of relevant studies based
on pre-specied eligibility criteria; extraction of relevant information
within each study under a pre-specied extraction protocol; and the
assessment of the quality and risk of bias of the available evidence
identied. Unlike scoping reviews, another common type of knowledge
synthesis, systematic reviews are not intended to map evidence on a
topic e.g. housing, social connectedness, and mental health so as to
identify main concepts, theories, sources, and knowledge gaps (Tricco
et al., 2018).
MEDLINE, Embase, PsycINFO, Scopus, SciELO, and Web of Science
were searched between August and October 2016. The full search
strategy for each database is available as Supplementary Material 1.We
searched in title, abstract, keywords, and subject descriptors using
combinations of terms in English related to: high-rise residential
buildings (e.g. high-rise, at, apartment, social housing, collective
housing, housing, built environment, high density), plus social out-
comes/psychosocial processes (e.g. social support, community network,
social isolation, loneliness, social capital, social network, social inclu-
sion, social interaction, sense of community, cohesion), and/or mental
health (e.g. agoraphobia, depression, neurotic disorder, psychological
stress, anxiety, mood disorder, depressive disorder, mental health, well-
being). Duplicate records were removed using EndNote7.7.1
(Thomson Reuters, Carlsbad, California, United States).
2.2. Study selection criteria and process
To be included, studies had to be carried out within urban areas; we
had no limits on geographic location. Participants had to be non-in-
stitutionalized people living in high-rise buildings, but no limits on any
demographic or social attribute were set. Initially we sought papers that
investigated all three variables in a single study, given their known
associations, but the lack of such reports led us to also investigate the
separate associations of high-rise residential building and social well-
being or mental health. Therefore, publication content had to include
associations between high-rise residential buildings and social well-
being and/or mental health. Papers that reported only on the associa-
tions between neighbourhoods containing high-rise buildings and social
well-being and/or mental health outcomes were excluded. No limits
were set for publication date, language, or study design. Theoretical
papers and reviews were not included.
We performed a two-phase selection process. First, we assessed
documents based on title and abstract. Then we retrieved and reviewed
the full text of ltered-in papers. All authors participated in both
phases, grouped in pairs from dierent disciplinary backgrounds to
minimise associated bias. In each phase, each pair received a share of
documents to assess; each member independently assessed full-text
articles to check their eligibility. Disagreements between the two re-
viewers about which studies to include were resolved by discussion
and, if not resolved, by involving a third reviewer. We retrieved 4945
records from the electronic database search, from which 4100 were
assessed after duplicates were excluded. 23 studies met the eligibility
P. Barros, et al. 
criteria (Fig. 2).
2.3. Data extraction
We independently extracted data using a collection form pretested
through a pilot review on a sample of papers. A second reviewer revised
the data extraction, and a third reviewer resolved any disagreements.
For each study, we retrieved the following information: publication
attributes (title, authors, year of publication, and main scope of the
source); study objective, setting, and design; sample size and attributes
(both of buildings and people); data collection and analysis methods;
concepts and operationalisation regarding high-rise housing, social
Fig. 1. Factors that inuence the inter-relationship between high-rise residential building and mental health.
Fig. 2. Flowchart of study selection.
Table 1
Quality assessment criteria.
Score Appropriateness of study design Denitions and operationalisation Quality of data
Quality of analysis
Housing Mental health/social consequences
0 Unable to answer their research
No denition of high-riseNo concepts or operationalisation
Poor or not described Poor or not
1 Cross-sectional Number of storeys OR other
attributes described
Concepts or operationalisation described Adequate Adequate
2 Longitudinal or randomised
Number of storeys AND other
attributes described
Validated scale used, if quantitative data Excellent Excellent
Assessed in relation to study type (e.g., quantitative, qualitative, observational, mixed methods, or review), considering factors such as: sampling design, sample
size, response rate, training of interviewer, use of validated survey tools for quantitative study; sampling design, training of interviewer, specied type of data
collection (e.g., interview, focus groups), procedures to limit bias for qualitative study; literature search terms and databases searched for review.
Assessed in relation to study type (e.g., quantitative, qualitative, observational, mixed methods, or review), considering factors such as: descriptive analyses only
or adjusting for potential confounding factors for quantitative study; use of formal analysis software or underlying theory for qualitative study.
P. Barros, et al. 
eects, and/or mental health outcomes; ndings; strengths and lim-
itations; and recommendations for future research, policy and design
Because of the range of study designs and disciplines included, we
created a quality assessment matrix for this review including (i) ap-
propriateness of study design to the research question, (ii) presence of
denitions and operationalization of high-rise residential buildings, and
social eects and/or mental health outcomes, (iii) quality of data col-
lection, and (iv) quality of analysis. One reviewer assigned to that paper
plus an experienced second reviewer (the same person for each study)
evaluated the quality of the studies, scoring each element from 0 to 2
according to the criteria presented in Table 1. Dierences were dis-
cussed and an agreed score assigned. A quality score, ranging from 0 to
10, was generated by adding the scores for each element to create a
composite indicator. Characteristics and quality of the studies are pre-
sented in narrative form, and in total and relative frequencies. Table 2
shows the quality scores for each included study.
3. Characteristics and quality of articles selected
23 papers were included in this review. These studies discuss the
impacts of house type, oor level, and external/internal spaces intrinsic
of high-rise residential buildings on social well-being and/or mental
health. Table 3 and Supplementary Material 2 summarize character-
istics and key ndings of the selected studies. Concerning the year of
publication, the earliest article was published in 1974. Ten papers were
published recently, from 2010 to 2016, suggesting an increasing in-
terest in this topic.
Most of the research was conducted across the Global North, in
high-income countries. The highest number of studies were carried out
in the United Kingdom (eight papers), followed by studies from the
United States (four papers), South Korea (two papers), Canada (two
papers), Netherlands (two papers), Japan (two papers), and Albania,
Brazil and Singapore (one apiece).
The mean quality score for the 23 papers was 6 (standard devia-
tion = 1; quality score ranging from 0 to 10). Nine had a score of 7 or
higher, and only four scored less than 5 (Table 2). Only one study used
a longitudinal or experimental design. Seven studies did not provide a
thorough description of the high-rise residential buildings, whereas
only one did not formally operationalise its outcomes (e.g. social well-
being and/or mental health outcomes).
Almost all papers were evaluated as adequate or excellent in terms
of quality of data collection (n= 20) and data analysis (n = 20). All
papers with a total score of 7 or higher received at least one point in
every criterion. The majority of the research designs lacked controls
(e.g. random assignment to building types) or information on con-
founders (e.g. socio-economic status).
In view of the relatively small number of studies that met the in-
clusion criteria for our systematic review, we did not exclude any study
on the grounds of quality but considered the reliability of overall evi-
dence in relation to the studies' quality. It should be noted that apart
from the study design, low scores primarily reect the lack of in-
formation provided in the paper and are not necessarily a reection of
the quality of the studies themselves.
4. The inuence of physical and spatial aspects of high-rise
residential buildings on social well-being and mental health
4.1. Terminology
Our review is structured in the following categories: semi-public
spaces (e.g. shared entrances, private entrances); oor level (e.g.
ground oor); house type (e.g. high-rise residential building); and
streetscapes. The key ndings related to each of these housing variables
are summarized within Table 3, which lists the included studies al-
phabetically. This section aims to clarify the terms employed in this
systematic review.
High-rise residential buildingdenotes a physical structure with at
least four storeys that necessarily, but not exclusively, contains a
number of private residences (also referred as apartments or ats)
reached via a shared entrance, stairwell and/or lifts. For the purposes of
this systematic review, this terminology also includes mixed-use re-
sidential high-rise developments. The upper oor level benchmark
varies across the included studies. Saito et al. (1993),Kearns et al.
(2012) and Hannay (1981) dene the 15th, sixth and fth storey and
above as upper oor levels, respectively. Kowaltowski et al. (2006)
compares the ground oor with the higher oor levels.
Semi-public spacesembrace those shared spaces intrinsic to high-
Table 2
Quality assessment.
First author Year Global rating Appropriateness of
study design
Denitions and operationalisation Quality of data collection Quality of analysis
Housing Mental health/social outcomes
Gibson M 2011 8 2 1 1 2 2
ZaJ 1998 8 1 2 2 1 2
Angrist S 1974 7 1 1 2 1 2
Ghosh S 2014 7 1 2 1 1 2
Kearns A 2015 7 1 1 1 2 2
Kearns A 2012 7 1 1 1 2 2
Knipschild P 1978 7 1 2 2 1 1
Pojani D 2015 7 1 1 1 2 2
Saito K 1993 7 1 1 2 1 2
Hannay D 1981 6 1 1 1 1 2
Hooper D 1979 6 2 0 1 2 1
Kitchen P 2012 6 1 0 1 2 2
Li X 1994 6 1 1 1 1 2
Masters N 1989 6 1 2 2 1 0
McCarthy P 1985 6 1 1 2 0 2
Asgarzadeh M 2014 5 1 1 1 0 2
Kowaltowski D 2006 5 1 1 1 1 1
Phoon W 1976 5 1 1 1 1 1
Quinn N 2010 5 1 0 1 2 1
Husaini B 1991 4 1 0 2 1 0
Lee J 2011 4 1 0 1 1 1
Jung E 2015 3 1 0 0 0 2
Korte C 1983 3 1 0 1 1 0
P. Barros, et al. 
rise residential buildings or other house types (e.g. shared entrances,
private entrances). Streetscapeis used to refer to all elements (e.g.
buildings, urban furniture, sidewalks) that dene the appearance of a
The overarching category social well-beingincludes a range of
social variables, such as: social contacts, anti-social behaviour, social
network, sense of belonging, sense of community, memberships, sense
of control, social cohesion, social capital and social support.
Mental healthembraces both aective outcomes (e.g. quality of
life, mood, loneliness) and mental illnesses (e.g. clinical neurosis, de-
pression, schizophrenia) that may be directly (or indirectly) inuenced
positively or negatively by high-rise living. Although we occasionally
use terms that suggest causality, such as consequences,outcomes,
and eectsmost researchers have investigated associationsor re-
4.2. Semi-public spaces, social well-being and mental health
4.2.1. Results
Of all 23 included studies, two explored the associations between
semi-public spaces intrinsic to high-rise buildings and social well-being
(Phoon et al., 1976;Pojani & Buka, 2015)(Table 3). Pojani and Buka
(2015) found that narrow, dark staircases and elevators are spaces
likely to inhibit social interactions and, therefore, the expansion of
Table 3
Characteristics and main ndings of the selected studies.
First author Year Country Context Exposure Social well-being Mental health
Angrist S 1974 US Deprived Living in high-rises vs. other housing types Fear (+)
Asgarzadeh M 2014 Japan x Views of high-rises
Views of sky and trees in front of high-rises
Oppressiveness (+)
Oppressiveness ()
Ghosh S 2014 Canada Deprived Living in high-rises Sense of community (+)
Gibson M 2011 UK Deprived Living in high-rises vs. other housing types Sense of control () Well-being ()
Communal spaces vs. private garden Sense of control ()
Safety ()
Privacy ()
Antisocial behaviour (+)
Levels of sociability ()
Well-being ()
Quality of life ()
Positive mood ()
Shared vs. private entrances Sense of control ()
Safety ()
Privacy ()
Quality of life ()
Positive mood ()
Stress (+)
Streetscape Anti-social behaviour (+)
Hannay D 1981 UK Deprived
Living in high-rises vs. other housing types Mental symptoms (+)
Living upper oors vs. lower oors Mental symptoms (+)
Hooper D 1979 UK Varied Living in high-rises vs. other housing types Clinical neurosis (+)
Husaini B 1991 US Deprived
Living in high-rises vs. other housing types Social support () Stress (+)
Depression (+)
Mental disorder (+)
Schizophrenia (+)
Simple phobia (+)
Jung E 2015 South Korea x Pedestrian-friendly streetscape Sense of community (+)
Kearns A 2012 UK Deprived Living in high-rises vs. other housing types Perception of anti-social behaviour (+)
Sense of community ()
Cohesion ()
Social contact ()
Social support network ()
Living upper oors vs. lower oors Social cohesion (+)
Social contact (+)
No social support ()
Kearns A 2015 UK Deprived Living in high-rises vs. other housing types Loneliness (o)
Kitchen P 2012 Canada x Living in high-rises vs. other housing types Sense of belonging () Mental health ()
Knipschild P 1978 The Netherlands Privileged
Living in high-rises vs. other housing types Psychological problems ()
Sedatives and hypnotics ()
Psychosomatic problems (o)
Korte C 1983 The Netherlands x Living in high-rises Social support ()
Kowaltowski D 2006 Brazil Deprived Living in high-rises vs. other housing types Sense of belonging (+)
Living upper oors vs. lower oors Sense of control (+)
Privacy (+)
Security (+)
Lee J 2011 South Korea Privileged Semi-public spaces in high-rises Quality of life (+)
Li X 1994 x Deprived Living in high-rises vs. other housing types Risk behaviours (o)
Masters N 1989 UK Deprived Living in high-rises vs. other housing types Depression (+)
McCarthy P 1985 UK Deprived Living in high-rises vs. other housing types Psychological distress (o)
Phoon W 1976 Singapore Deprived Living in high-rises Social contacts friends & relatives ()
Corridors in high-rises Social contacts with neighbours (+)
Pojani D 2015 Albania Privileged Living in high-rises vs. other housing types Social cohesion ()
Social network ()
Dark and narrow staircases Social network ()
Elevators Social network ()
Quinn N 2010 Scotland Deprived Living in high-rises Social capital (+) Mental health (+)
Saito K 1993 Japan x Living upper oors vs. lower oors Psychological distress (o)
ZaJ 1998 US Deprived Living in high-rises vs. other housing types Sense of community ()
Membership ()
** = Presumably.
X = No information.
o = No evidence of association; + = Positive association; = Negative association.
P. Barros, et al. 
social networks, while Phoon et al. (1976) reported that the large
majority of social contacts in high-rises take place in corridors.
Gibson et al. (2011) found associations between semi-public spaces
and a range of domains of social well-being which, in turn, were re-
ported to be linked to mental health outcomes (Table 3). These ndings
reinforce the importance of exploring social well-being as a potentially
mediating variable between built environments and mental health.
Gibson et al. (2011) found that communal areas behind high-rises
are related to worse social eects (i.e. higher perception of antisocial
behaviour, lower sense of control) which, in turn, are linked to poorer
mental health outcomes than private gardens of houses. Likewise,
shared entrances were reported to be associated with lower sense of
control, safety and privacy, which, in turn, were associated with poorer
mental health than private entrances intrinsic to houses (Gibson et al.,
Lee (2011) found positive associations between physical attributes
of semi-public spaces of high-rise mixed-use housing buildings, which
includes community facilities and commercial area, and quality of life
(Table 3). The ndings of the studies included in this literature review
show that semi-public spaces inherent to high-rises are not necessarily
bad for social well-being and mental health, but that some physical and
spatial congurations are worse than others for social well-being and
mental health.
4.2.2. Discussion and shortcomings
The nding that narrow, dark staircases and elevators are spaces
likely to inhibit the formation of social ties (Pojani & Buka, 2015) and
that corridors accommodate the large majority of social contacts that
take place in a high-rise residential building (Phoon et al., 1976) sug-
gests that if social interactions are too short and infrequent, residents
may not experience a sense of social support, a necessary condition for
the development of more complex domains of social well-being (e.g.
social cohesion).
Semi-public spaces intrinsic to high-rise residential buildings (e.g.
shared entrances) were associated with worse social eects which, in
turn, were associated with poorer mental health outcomes than their
equivalent in houses (e.g. private entrances) (Gibson et al., 2011). This
nding supports the thesis developed by Newman (1972) that those
physical and spatial congurations that inhibit expressions of territorial
claims and oer fewer opportunities for surveillance usually are pro-
The problem of unwanted interlopers in housing with shared en-
trances was a theme that recurred frequently, and was described as
causing extreme stress, fear and disturbed sleep. By contrast, private
entrances provided respondents with defensible space which permitted
them to monitor and control entry to their property. Increases in
privacy and security provided by private entrances impacted on aec-
tive outcomes such as well-being, quality of life, stress levels and mood
through the psychosocial process of control (Gibson et al., 2011, p.565).
The marking of territoriality by personalization, however, does
much more than aording the emergence of so called defensible
spaces(as proposed by Newman, 1972). As a mode of communication
(Bentley et al., 1985;Hall, 1966), personalization of spaces also fosters
a sense of attachment and belonging (Mehta, 2014). In addition, the
embellishment of the semi-public spaces also may impact on their
maintenance and attractiveness (Mehta, 2014). By placing plants and
paintings in front of the main entrance of their apartments, for example,
dwellers extend a sense of control and identity to the corridor.
4.3. Floor level, social well-being and mental health
4.3.1. Results
Two studies reported six associations between oor level and social
well-being (Kearns et al., 2012;Kowaltowski et al., 2006)(Table 3).
Upper oor levels were consistently associated with better social ef-
fects. Kearns et al. (2012) found that certain social outcomes (e.g. social
cohesion, social contact) were better higher up the building while
Kowaltowski et al. (2006) found that the residential ground oor was
potentially problematic due to the lack of control, privacy and safety.
Hannay (1981) found that primary care patients living on the fth
oor or above faced a twofold ratio of mental health symptoms com-
pared with those on lower oors. Saito et al. (1993), on the other hand,
reported no association between oor level and psychological distress.
4.3.2. Discussion and shortcomings
Fig. 3 summarizes the key ndings about oor level and social well-
being and mental health. Results of the research conducted by Kearns
et al. (2012) and Kowaltowski et al. (2006) reinforce each other and
provide support to the hypothesis that residents living on higher levels
tend to be insulated from the negative eects lower down the building
(e.g. lack of privacy). In the view of the authors, those semi-public
spaces intrinsic to high-rise residential buildings identied as
Fig. 3. Key ndings (oor level).
P. Barros, et al. 
problematic (Newman, 1972) and situated on the ground oor (e.g.
communal area and shared entrances) may explain, at least partially,
why the lower oor levels are associated with worse social eects.
If we take social outcomes as mediators, better mental health out-
comes would be expected among those living higher up. However, of
the two studies that examined associations between oor level and
mental illness (Hannay, 1981;Saito et al., 1993) a positive association
was reported by one and no association by the other. The former un-
expected nding may be explained by self-selection bias, i.e. people
with mental problems may choose to live on higher oor levels, a
methodological problem previously raised by Evans (2003).
The absence of association between oor level and mental health
reported by Saito et al. (1993), on the other hand, may be elucidated on
the basis that the inter-relationship between oor level and mental
health may also be strongly inuenced by culture. The divergent results
may also be explained on the basis that the high-rise residential
buildings investigated presented dierent types of oor levels.
4.4. House type, social well-being and mental health
4.4.1. Results
All four studies that investigated the associations between high-rise
residential building and dierent domains of social well-being found
signicant associations between these variables (Ghosh, 2014;Korte &
Huismans, 1983;Phoon et al., 1976;Quinn & Biggs, 2010). The ndings
show that high-rise residential buildings, even in deprived areas, are
not necessarily associated with poor social well-being. Quinn and Biggs
(2010), for example, reported a signicant association between high-
rise residential building and social capital which, in turn, was related to
positive mental health outcomes in an area of high deprivation in
A total of 13 associations and one nonsignicant association be-
tween living in high-rise versus alternative housing types and dierent
domains of social well-being were tabulated (Table 3). Of all associa-
tions, the large majority (12) shows high-rise residential buildings to be
associated with worse social outcomes than alternative housing types.
Focusing on the divergent ndings, Kowaltowski et al. (2006) re-
ported that apartment dwellers tend to experience a stronger sense of
belonging than those who live in houses and explained that house
owners in the context of low-income housing development in the region
of Campinas (Brazil) value very much their individual lot. Li et al.
(1994) found no association between house type and adolescent risk
behaviour (e.g. drug tracking and substance abuse). The evidence
shows that risk behaviours are actually associated with parental mon-
itoring, social support and perceived risk exposure (Li et al., 1994).
Two of the included studies examined the associations between
living in high-rise residential buildings versus alternative housing types
and specic sub-domains of social well-being as pathways to mental
health (Gibson et al., 2011;Kitchen, Williams, & Chowhan, 2012).
These studies found high-rise residential buildings to be associated with
poorer social well-being and mental health than alternative housing
types. Kitchen et al. (2012) found a signicant association between
sense of belonging and mental health, while Gibson et al. (2011) re-
ported that sense of control mediates mental health. Evidence, there-
fore, conrms the importance of taking into account dierent domains
of social well-being as possible explanatory mechanisms for mental
Overall, the results of the included papers indicate that house type
and mental health are associated. A total of 13 statistically signicant
associations and three nonsignicant associations between housing
type and mental health were mapped (Table 3). Based on the results
obtained by the studies included in this review, the large majority (11)
of associations were in the expected direction: high-rise residential
buildings were (directly or indirectly) associated with worse mental
health outcomes than alternative housing types (Table 3).
The divergent results came from McCarthy et al. (1985) and Kearns,
Whitley, and Ellaway (2015), who reported no association between
housing type and psychological distress and loneliness, respectively.
They found that mental illness correlated less strongly with the type of
housing rather than with where it was located.
To increase the generalizability of these conicting ndings, how-
ever, future empirical research needs to select cases that are better
distributed geographically and take into account the potential inuence
of contextual factors. Knipschild (1978) reported that dwellers of high-
rise buildings tended to have fewer psychological problems and use
fewer sedatives and hypnotics than those people living in houses, while
no dierences in psychosomatic problems were found.
According to Knipschild (1978), some possible explanations for
these unexpected ndings are: (i) unlike previous studies, the apart-
ments studied were better constructed than the houses, (ii) people
mistakenly may say that their problems are caused by their living
conditions rather than other factors (e.g. their families situation), (iii)
people who live in apartments, for some reason, may be less likely to
see a doctor for mental problems, although they may actually occur,
and (iv) most of the apartment dwellers did not live there for more than
ve years and it is possible that harmful health eects may occur after
longer periods of exposure.
4.4.2. Discussion and shortcomings
Overall, the evidence shows that although high-rise residential
buildings, even those located in deprived contexts, are not necessarily
associated with poor social well-being and mental health, high-rise
residential buildings are related to worse social eects and mental
health outcomes than alternative types of housing (e.g. Angrist, 1974;
Hooper & Ineichen, 1979;Husaini, Moore, & Castor, 2008,Masters &
Birtchenell, 1989;Za& Devlin, 1998)(Fig. 4).
It is important to bear in mind, however, that of all studies that
analysed high-rise residential buildings versus alternative dwellings,
the majority included dwellers that lived on lower oor levels. In the
view of the authors, the inclusion of this group is problematic since
these dwellers have to deal with negative social eects commonly as-
sociated with shared entrances and other semi-public spaces located in
the ground oor.
Based on the general shortage of empirical research, unbalanced
geographical distribution of the cases studied as well as the methodo-
logical inadequacies (e.g. research designs lacked adjustment for con-
founders), we oer an alternative hypothesis to explain why high-rise
residential buildings were associated with worse social eects and
mental health outcomes than other types of buildings.
We note rst, that the majority of papers included in this review
report results of research carried out in North America and Europe,
where a large number of high-rise residential buildings were developed
by the public sector after the Second World War in deprived areas
(Verhaeghe, Coenen, & Putte, 2016). Secondly, from the 1970s, high-
rise residential buildings in these continents became associated with a
negative image (Pereira, 2017). Bearing these two facts in mind, it is
plausible to hypothesize that stigmatization might explain the negative
social eects and, in turn, the mental illness associated with this type of
house in the context of North America and Europe (Evans et al., 2003).
4.5. Streetscape, social well-being and mental health
4.5.1. Results
Of the 23 included studies, three examined the social eects and
mental health outcomes associated with streetscapes shaped by high-
rise residential buildings (Asgarzadeh et al., 2014;Gibson et al., 2011;
Jung, Lee, & Kim, 2015)(Table 3). Gibson et al. (2011) found that
streetscapes framed by high-rises are a better predictor of anti-social
behaviour (or perception of anti-social behaviour) than those framed by
Jung et al. (2015) reported that pedestrian-friendly streetscapes
enclosed by high-rises provide a stronger sense of community that those
P. Barros, et al. 
that are car-oriented. Asgarzadeh et al. (2014) reported that opportu-
nities to view sky and trees in front of high-rises tend to attenuate the
sense of oppressiveness associated with streetscapes walled by this
building type.
4.5.2. Discussion and shortcomings
The results of the studies in this review suggest that streetscapes
intrinsic to high-rises are associated with lesser sense of control and
increased perception of anti-social behaviour that those enclosed by
other house types (Gibson et al., 2011). This is to be expected, as they
tend to oer lower external visibility compared with streetscapes as-
sociated with other buildings types.
The ndings of the research conducted by Jung et al. (2015) and
Asgarzadeh et al. (2014) show that streetscapes shaped by high-rises
are not necessarily associated with negative social eects or mental
health outcomes. The evidence indicates that the urban design of
streetscapes does matters to public health, or rather, the design and
arrangement of high-rise residential buildings and some micro-scale
physical elements along the streets (e.g. trees) are likely to inuence
social well-being and mental health.
5. General discussion and shortcomings
The methodological inadequacies mapped by Evans et al. (2003)
more than 15 years ago still feature in the large majority of the em-
pirical studies included in this systematic literature review. First, no
standard ontology of terms and research approaches exists: dierent
studies adopt dierent conceptualizations, operationalisations and
scales to measure what appears to be the same construct.
In addition, the research design and analysis of the large majority of
the included researches did not take into account moderators (e.g.
personal variables), mediators (e.g. social control) nor confounders
(e.g. socio-economic status) (Supplementary Material 2). Additional
research on how dierent domains of social well-being mediate the
linkage between high-rise and mental health, as previously pointed out
by Evans et al. (2003), is still on needed.
This systematic review has some limitations. Although it included
documents available in six major databases, we could not capture all
potential valuable evidence from the grey literature. In addition, we did
not scan the reference lists of the included papers. Therefore, there is a
possibility that some publications may have been overlooked.
Thus, more rigorous research is needed. Although causality cannot
be assumed because almost all the studies are cross-sectional, this re-
view reveals that although there is no consensus on how dierent
housing variables impact on social well-being and mental health, they
are inter-related. The results of the included studies also show that al-
though living in high-rise residential buildings is not necessarily bad, it
tends to trigger worse social eects and mental health outcomes than
other types of housing (e.g. low-rise residential buildings). As part of an
attempt to provide a framework for future research, it is important to
highlight that evidence also shows that other environmental aspects
(e.g. noise) can have a direct eect on the residents' mental health
(Evans, 2003)(Fig. 5).
Our review shows a need for a deeper understanding of how plan-
ning and the quality of the urban design and architectural solutions
moderate the harmful eects associated with high-rise residential
buildings (Fig. 5). In this regards, the included studies explored the
social eects and mental health outcomes associated with generic
high-rise residential buildings. To deeper our understanding of the
processes underlying the connections between housing variables, social
well-being and mental health, the authors, building on Evans et al.
(2003) previous critical review, suggest a dierent focus and diagnosis.
Perhaps living in high-rise residential buildings is associated with
worse social eects and mental health outcomes due to the poorer
quality of their semi-public spaces (e.g. shared entrances, communal
spaces, corridors). From the results of the studies selected, it is plausible
to hypothesise that design quality moderates the inter-relationships
between housing and social well-being which, in turn, inuences
mental health.
None of the research included investigated, for example, how dif-
ferent types of ground oor level (e.g. with vs. without pilotis), corri-
dors (e.g. with vs. without nice panoramic views) or perceptual
Fig. 4. Key ndings (housing type).
P. Barros, et al. 
qualities (e.g. human scale, legibility, permeability) may moderate the
inter-relationship between high-rise residential buildings, social well-
being and mental health. These gaps in the literature reinforce the need
for interdisciplinary research, since designers can contribute towards
the operationalization of these variables.
A further strength of this review has been its cross-disciplinary
nature. Working across disciplines challenged the authors' assumptions
and outlooks, leading to a more holistic appraisal of the available lit-
erature. For example, the architects noted the lack of denition of high-
risein most of the papers reviewed, while those with epidemiology
expertise were better able to provide critiques of the study methods and
the extent to which each study was capable of answering its own re-
search question(s). All the shortcoming and gaps revealed by this lit-
erature review, however, clearly indicate opportunities for further re-
The conclusions of this review may not be applicable to all cities
worldwide for three main reasons: (1) the denitions of high-rise
housing as well as of the myriad of concepts classied as social well-
beingand mental healthare culturally bound; (2) many studies ex-
amined the social eects and mental health outcomes of high-rise re-
sidential building on specic social groups, such as the aged; and (3)
cultural attitudes and norms regarding high-rise dwelling vary sub-
stantially depending on country and context.
6. Avenues for future research agenda on impacts of high-rise
residential buildings on social well-being and mental health
We see a number of prospects for research into the positive and
negative eects of high-rise residential buildings on social well-being
and mental health and how planning, urban design and architectural
decisions inuence these.
1. The complexity of the topic requires more inter- and trans-dis-
ciplinary work. Collaboration between dierent disciplines, such as
architecture, psychology, urban planning, urban design, public
health, epidemiology, sociology, human geography and ecology,
holds the promise of oering new perspectives. Learning and
adapting methods across disciplines are expected to increase
knowledge and help policy makers, planners, urban designers and
architects to take decisions that are more inclusive and evidence-
2. It is important that future studies bring clearer denitions and op-
erationalisations of high-rise housing, social eects and mental
health outcomes. As far as the denitions of high-riseand higher
oor levelare concerned, the adoption of parameters based on our
sensory apparatus may be more universally accepted. Taking into
account how human senses inuence perception and behaviour
(Hall, 1966), four storeys can be chosen as a threshold, since above
44 ft (13.5 m) people on the ground cannot be recognized or con-
tacted (Gehl, 2010). Once a more standardized ontology of terms
and research approaches exists, a meta-analysis approach may
provide an invaluable synthesis.
3. Accepting that personal variables are moderators, it is likely that
dierent groups experience dierently some specic physical-spa-
tial congurations in high-rise buildings. Thus, it should be ad-
dressed systematically whether the outcomes identied are mostly
due to design of the high-rise residential buildings or to social class,
life cycle stage, gender, or other moderators.
4. The large majority of papers assessed in this review provide evi-
dence from studies carried out in high-income countries in the
Northern hemisphere. An urgent shift of scientic focus to low- and
middle-income countries, where most of the urban population
growth is concentrated, is needed. This will enable researchers to
discover whether the negative outcomes frequently associated with
living in high-rise buildings are cross-cultural or related to a specic
5. Future research needs to take into account multiple confounding
variables (e.g. socio-cultural-economic position), moderators (e.g.
neighbourhood quality and personal variables), and mediators (e.g.
social support and social control) to deepen our understanding of
the potential roles of urban design and architectural solutions on
enhancing social well-being and mental health of those who live in
high-rise residential buildings.
6. This literature review reveals that there is a need to carry out studies
on how high-rise housing may yield positive mental health out-
7. Conclusions
The ndings of this literature review call for a re-examination of
housing policies from a multidisciplinary perspective that takes into
account public health concerns together with more empirical research
to guide evidence-informed decisions. More needs to be known and
the evidence put into practice of how the design of high-rise re-
sidential buildings can inuence social relations and, in turn, positive
mental health in cities across the globe, not the least for vulnerable
population groups (e.g. low-income communities and the elderly).
In addition, the evidence, although not consistent, tends to support
the imposition of height limits by planning authorities in contexts
where higher levels are associated with poorer mental health, as well as
Fig. 5. Key conceptual issues.
P. Barros, et al. 
the architectural design of spacious, attractive and naturally well-lit
semi-public spaces (e.g. corridors and shared entrances) that facilitate
personalization and support social interactions. From this review, it can
also be suggested that the design of the interfaces between the private
and semi-public (or public) spaces should aord inter-visibility to en-
hance the dwellers sense of control.
Supplementary data to this article can be found online at https://
Declaration of Competing Interest
This collaboration arose from discussions at a British Council
Newton Fund Researcher Links workshop held at the Federal University
of Minas Gerais, Brazil (204496092, P.I. JM) in June 2016. The dis-
cussions were continued in London in June 2017 at a meeting funded
by UCL's Grand Challenges Human Wellbeing fund (156425 Grand
Challenges, P.I. LNF). LG acknowledges funding from the National
Council for Scientic and Technological Development (402755/2015-
4). ADS thanks São Paulo State Foundation (FAPESP) for their nancial
support - as part of FAPESP-ESRC-NOW Joint Call for Transnational
Collaborative Research Projects: Accessibility, Social justice and
Transport emission Impacts of transit-oriented Development strategies
(ASTRID) project FAPESP 2015/50128-9 Fellowship 2016/08826-3.
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P. Barros, et al. 
... The places in which we live and work are planned, designed, and built in a way that is increasingly associated with rising incidences of cardiovascular disease, chronic stress and anxiety, and social isolation (Barros et al. 2019;Rautio et al. 2018;Sallis et al. 2020). According to the Global Burden of Diseases and Injury study, mental and addictive disorders affect more than one billion people and are responsible for 19% of all years lived with disability in 2016 (Naghavi et al. 2017;Rehm and Shield 2019). ...
... Our study responded to calls for more holistic explorations of living environments (Ucci & Godefroy, 2020;Wierzbicka et al., 2018), including how the architectural design of apartments impacts on inhabitants (Barros et al., 2019), and addressed the lack of research exploring the impact of policy-specific measures of apartment building design (Foster et al., 2020). We examined the associations between apartment design and residents' mental wellbeing by exploring: (1) the implementation of requirements derived from Australian apartment design policies; (2) residents' perceptions of apartment design and amenity; and (3) the inter-relationships between these variables. ...
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Comprehensive apartment design policies have been legislated by Australian state governments to address concerns about poor design in residential buildings. These policies aim to improve apartment design and promote good health. This study examined whether: (1) residents living in apartments that implemented more minimum design requirements perceived better apartment design and amenity; and (2) increased implementation of minimum requirements and better perceptions of design were associated with positive mental wellbeing. Apartment complexes (n = 114, built 2006–2016) were sampled from Sydney, Perth, and Melbourne. Building plans and elevations were used to measure and score apartments for their implementation of 96 quantifiable policy-specific requirements and residents (n = 1072) completed a self-report survey on their apartment design and health. Multi-level linear regression models were used to account for clustered data. Residents in apartments with greater implementation of requirements for solar and daylight, indoor space, private open space, communal space and parking had more positive perceptions of their apartment in terms of natural light and winter thermal comfort, indoor space and layout, private open space, communal area quality, and parking, respectively (all p < 0.05). Perceptions of natural ventilation, summer thermal comfort, indoor space, and communal area quality were independently associated with positive mental wellbeing (all p < 0.05), but the objective implementation scores had no direct association. When implemented as intended, minimum requirements had a positive impact on perceptions of design, which were associated with mental wellbeing. The study underscores the importance of planning instruments and design review processes that increase industry uptake of minimum policy standards.
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The outbreak of COVID-19 has drawn wider attention from residents with growing demand for outdoor space in residential areas because of restrictions on residents’ mobility, especially in China. However, the high-rise residential complex in China is featured with a high population density along with less outdoor space per household. This means that the current status of outdoor space in residential areas is far from satisfying residents’ growing needs. This is consistent with our preliminary survey that highlights general low satisfaction of residents with outdoor space. According to the hierarchical theory of needs, a literature review, and a questionnaire survey, a framework is proposed in this study to examine the universal value system of high-rise residential outdoor space using the Yangtze River Delta Area as a case study. This framework consists of six dimensions, i.e., space physical comfort (physical environment and space size), space function (functional complexity and scale, age-range, and time-range), space safety (daily, social, and hygiene safety), space diversity (spatial layerings, forms, and scales diversity), accessibility (spatial attraction and concentration and path clarity) and sustainability (cultural, social, ecological, and financial sustainability). Consequently, a questionnaire was designed according to the framework and 251 valid questionnaires were received. Then, structural equation modeling (SEM) was undertaken to examine the impact of each dimension on the value of outdoor space and the framework was optimized into four dimensions, i.e., space physical comfort, space function, space safety, and DAT (space diversity, accessibility, and sustainability). Finally, the mechanism of how outdoor space quality influences the high-rise residential complex is analyzed. These findings provide useful input for the future planning and design of high-rise residential areas.
The shift towards higher density living in Australia, with the compact and shared spaces inherent to apartments, has prompted considerations of residents' social outcomes. This study tested whether communal area design in apartment buildings impacts residents' neighbouring and loneliness. Apartment developments (n = 113) in Sydney, Melbourne and Perth were assessed for objective building and policy-related measures of communal area design and quality, and residents' perceptions and use of communal areas. Behavioural and subjective factors had the strongest impact. Use of outdoor areas was positively associated with neighbouring and poorer perceptions of outdoor areas predicted lower neighbouring. Equally, residents who did not use indoor areas were more likely to be lonely while neighbouring was protective against loneliness. Objective measures had indirect impacts (i.e., communal area design quality impacts use, which in turn predicts neighbouring and loneliness). Our findings have policy and design implications, suggesting that communal areas are significant for social outcomes.
In the context of planning moves to densify Australian cities, an apartment building boom attracting many families with children, and a regulatory regime which ignored the design challenges posed by this cohort, a mismatch has emerged between apartment design policy and the needs of families. This paper reports on research exploring how Australia and other countries transitioning to high-density living could provide more child-friendly apartment design guidelines. The unmet needs of families in apartments highlighted in the international literature was synthesised with international good-practice to inform recommendations for family-friendly apartment design guidelines. These best-practice recommendations have Australian and international application.
Apartment living is on the rise in major cities across the world, thus it is increasingly important to consider building designs that support resident wellbeing. In this study, we used a mixed methods approach to explore how apartment communal spaces can foster social connectedness and, subsequently, promote social wellbeing. The study consisted of an audit of communal spaces in apartment buildings and a qualitative case study analysis of one complex in the City of Melbourne. Unique findings revealed how the interplay between the physical design of spaces, resident and Owner’s Corporation factors, along with the overarching policy environment. Played a role in creating apartment communal spaces which fostered residents’ social wellbeing. However, these spaces were often lacking in the overall audit of Melbourne buildings. Given the health benefits, future design guidelines should recommend communal space design that can better promote social connectedness.
Globally, compact city policies promote increased density to sustainably house urban populations. In Australia, the recent proliferation of apartments challenges an enduring cultural preference for detached housing, calling into question apartment residents' satisfaction with this housing form. We examined associations between apartment residents' (n = 1082) housing satisfaction and perceived dwelling and building design attributes in 115 apartment developments in Perth, Melbourne and Sydney, and explored area-level disadvantage and city differences. Five design attributes (apartment space layout/function, acoustic and visual privacy, natural ventilation, and building security) were found to be significantly positively associated with satisfaction after adjustment for residents' demographic attributes, dwelling/neighbourhood self-selection factors and housing preferences, irrespective of area disadvantage or city. Moreover, residents who lived in their preferred housing type (e.g., they preferred a low-rise building and lived in this housing typology) reported significantly higher satisfaction than others (p ≤0.001). However, few apartment dwellers lived in their preferred housing type, with the majority preferring a detached/semi-detached house. Our findings make a notable contribution to the evidence-base, indicating that apartment design policies with internal dwelling requirements that emphasise spacious, flexible layouts that promote comfort, privacy and security could better match the needs of apartment residents, leading to improved satisfaction.
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Choosing the proper research methods can pose a challenge for novice urban planners and designers. This study aimed to develop a more effective process for assisting urban planners and designers in selecting appropriate research techniques. The study used bibliometrics, systematic reviews, meta-analyses, and storytelling techniques as examples of urban planning and urban design research techniques. The results of this study provide techniques and procedures that can help urban planners and designers to conduct research reviews and follow the previous documented works published in the field. By utilizing suggested techniques and procedures, conclusive conclusions in urban planning and design research can be formed on the basis of compelling evidence. This study recommends developing a further innovative research methodology based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses by improving documentation and dissemination of research reviews.
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In the 21st century, traditional construction activities exert a severe negative influence on the environment and ecology. To mitigate the negative influence of construction, green buildings have received increasing attention worldwide. Compared with conventional buildings, green buildings have significant advantages for environmental conservation and public health. Although green buildings bring excellent benefits, the development status of green buildings in China is still unsatisfactory. To enhance the understanding of green buildings and promote green building development in China, this study was undertaken to conduct a systematic review of green building development in China. The PRISMA protocol was used as the primary procedure for article screening and selection. This review was conducted between March 2022 and May 2022. In this study, 186 articles were reviewed, and the definition, development trends, evaluation standards, importance, and hindrances of green buildings in China were summarized and discussed through the systematic review. Moreover, the benefits, challenges, and future directions of green building promotion and development in China were discussed and analyzed. This study can promote public familiarity with the current situation of green buildings in China to boost their development. In addition, this study can also provide practical advice to green building stakeholders on the future direction of green building development in China.
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High-density living and heatwaves are increasing, at the same time as the population is ageing. The aim of this literature review was to examine the intersection between older and/or vulnerable people, who live in high-density/high-rise situations, and their health during heatwaves. Using electronic databases, the literature was examined. Articles were included if they were: (1) published in English, (2) examined the relationship between building, health, and extreme heat, and (3) included older or vulnerable populations. A total of 241 articles were identified of which 15 were duplicates and 209 did not meet the inclusion criteria. Of the 17 studies included in the review, 4 were conducted following heatwaves in Chicago and Europe. These identified a relationship between age, vulnerability, and floor of residence, in people who died because of the heatwave. High-rise living is increasing globally, and residents are getting older. This, in combination with increased heatwave intensity and frequency, highlights the risk of morbidity and mortality in this group, particularly where there is no access to air-conditioning because of power grid overload in the heat. This research benefits older and vulnerable people who live in high-rise buildings, the health professionals who care for them, architects, urban planners, and policy makers.
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There is increasing interest in the influence of place on health, and the need to distinguish between environmental and individual level factors. For environmental-level factors, current evidence tends to show associations through cross-sectional and uncontrolled longitudinal analyses rather than through more robust study designs that can provide stronger causal evidence. We restricted this systematic review to randomised (or cluster) randomised controlled trials and controlled before-and-after studies of changes to the built environment. Date of search was December 2016. We identified 14 studies. No evidence was found of an effect on mental health from 'urban regeneration' and 'improving green infrastructure' studies. Beneficial effects on quality-of-life outcomes from 'improving green infrastructure' were found in two studies. One 'improving green infrastructure' study reported an improvement in social isolation. Risk-of-bias assessment indicated robust data from only four studies. 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.
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Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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As cities cope with rapid population growth-adding 2.5 billion dwellers by 2050-and grapple with expansive sprawl, politicians, planners, and architects have become increasingly interested in the vertical city paradigm. This paper reviews and examines shortfalls of tall buildings found in the literature to inform future developments. The paper gathers a vast amount of fragmented criticism and concerns, and organizes them around the three pillars of sustainability: social, economic, and environmental. Mapping out the "unsustainable" aspects forms the foundation for addressing them in future research and tall building developments.
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Developing World Health Organization international guidelines is a highly formal process. Yet the resulting guidelines, which Member States are encouraged, but not required to adopt, are a powerful way of developing rigorous policy and fostering implementation. Using the example of the housing and health guidelines, which are currently being finalised, this paper outlines the process for developing WHO guidelines. This includes: forming a Guidelines Review Group that represents all regions of the world, and ensures gender balance and technical expertise; identifying key health outcomes of interest; commissioning systematic reviews of the evidence; assessing the evidence; and formulating recommendations. The strength of each recommendation is assessed based on the quality of the evidence, along with consideration of issues such as equity, acceptability, and feasibility of the implementation of the recommendation. The proposed housing guidelines will address: cold and hot indoor temperatures, home injuries, household crowding, accessibility and access to active travel infrastructure.
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A growing literature has indicated a relationship between social capital and certain aspects of the built environment with contributions from various disciplines, including environmental psychology, urban design, and health geography. In this systematic review and research synthesis, we summarize the literature in this domain using existing sociological and design frameworks to ascertain the effect of specific built environment domains on social capital. Our review shows that there is a significant relationship between social capital and the built environment, specifically between social cohesion and access to destinations/walkability. Positive relationships exist between social capital, design, and diversity, whereas the effect of population density on social capital is negative and unclear. We find significant methodological limitations and gaps in the published literature, including the absence of longitudinal studies and the use of a plethora of social capital and built environment measures.
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This paper presents a study on quality of life and sustainability indicators relating to site-planning parameters for lowincome public housing projects in the region of Campinas, Brazil. The study is based on a post-occupancy-evaluation (POE), conducted in five housing developments. Most of these housing projects are based on a repetitive model and are devoid of urban infrastructure. Users act on their own in providing for some elements considered necessary to create an identity and community spirit. Results show that the population relates quality of life to economic factors and sustainability is associated to reduce utility bills. Houses are preferred to apartments and satisfaction with the present housing conditions is high, despite low feelings of security in the neighbourhood. This work is part of a broader study, which aims to develop design evaluation tools. Most sensitive quality of life and sustainability indicators related to siteplanning should permeate these tools and establish design guidelines. The inclusion of a large number of qualitative design issues into the decision-making process and the questioning of existing standardized solutions are seen as essential means to increase local housing quality.
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Unlike some European countries, high-rise housing estates have been quite neglected within the Portuguese research agenda. This is partially explained by one of its main national specificities: as many of these estates were developed by the private sector, their major target was the broad spectrum of the middle classes. Therefore, it was not identified as a research priority in the same way as social or illegal housing. Nevertheless, as an emblematic housing type of Lisbon’s suburbanisation that boomed in the (1974) Revolution period, its longitudinal study is an important tool to further knowledge of the social and urban history of contemporary Portugal. This article explores high-rise housing in Portugal (the context of its appearance, development and specificities) through the study of a paradigmatic case: Portela in the north periphery of Lisbon. This case is a contrast with the most visible trajectory of high-rise estates, marked by decay and embraced by stigma: therefore the article also focuses on analysing the factors, dynamics and indicators of its positive trajectory. Here, the analysis explores the context in which the estate developed, the social profile of its inhabitants, their perceptions of it and their daily-life practices by means of both quantitative and qualitative research methodologies.
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The urban environment has become the main place that people live and work. As a result it can have profound impacts on our health. While much of the literature has focused on physical health, less attention has been paid to the possible psychological impacts of the urban environment. In order to understand the potential relevance and importance of the urban environment to population mental health, we carried out a systematic review to examine the associations between objective measurements of the urban environment and psychological distress, independently of the individual's subjective perceptions of the urban environment. 11 peer-reviewed papers published in English between January 2000 and February 2012 were identified. All studies were cross-sectional. Despite heterogeneity in study design, the overall findings suggested that the urban environment has measurable associations with psychological distress, including housing with deck access, neighbourhood quality, the amount of green space, land-use mix, industry activity and traffic volume. The evidence supports the need for development of interventions to improve mental health through changing the urban environment. We also conclude that new methods for measuring the urban environment objectively are needed which are meaningful to planners. In particular, future work should look at the spatial-temporal dynamic of the urban environment measured in Geographical Information System (GIS) in relation to psychological distress.
Background and aims: The notion that environment affects mental health has a long history; in this systematic review, we aimed to study whether the living environment is related to depressive mood. Methods: We searched databases of PubMed, Scopus and Web of Science for population-based original studies prior to October 2016. We included studies that measured depressive symptoms or depression and had measures of urbanization, population density, aesthetics of living environment, house/built environment, green areas, walkability, noise, air pollution or services. Results: Out of 1,578 articles found, 44 studies met our inclusion criteria. Manual searches of the references yielded 13 articles, resulting in 57 articles being included in the systematic review. Most of the studies showed statistically significant associations with at least one of the characteristics of living environment and depressive mood. House and built environment with, for example, poor housing quality and non-functioning, lack of green areas, noise and air pollution were more clearly related to depressive mood even after adjustment for different individual characteristics. On the contrary, the results in relation to population density, aesthetics and walkability of living environment, and availability of services and depressive mood were more inconsistent. Conclusion: Adverse house/built environment, including poor housing quality and non-functioning, lack of green spaces, noise and air pollution are related to depressive mood and should be taken into account during planning in order to prevent depressive mood.
While the construction of high-rise buildings is a popular policy strategy for accommodating population growth in cities, there is still much debate about the health consequences of living in high flats. This study examines the relationship between living in high-rise buildings and self-rated health in Belgium. We use data from the Belgian Census of 2001, merged with the National Register of Belgium (N = 6,102,820). Results from multilevel, binary logistic regression analyses show that residents living in high-rise buildings have considerable lower odds to have a good or very good self-rated health in comparison with residents in low-rise buildings (OR 0.67; 95 % CI 0.67–0.68). However, this negative relationship disappears completely after adjusting for socioeconomic and demographic variables (OR 1.04; 95 % CI 1.03–1.05), which suggests that residents’ worse self-rated health in high-rise buildings can be explained by the strong demographic and socioeconomic segregation between high- and low-rise buildings in Belgium. In addition, there is a weak, but robust curvilinear relationship between floor level and self-rated health within high-rise buildings. Self-rated health increases until the sixth floor (OR 1.19; 95 % CI 1.15–1.24) and remains stable from the seventh floor and upwards. These findings refute one of the central ideas in architectural sciences that living in high buildings is bad for one’s health.