The relationship between buildings and health: A systematic review

© 2018 The Author(s). Published by Oxford University Press on behalf of Faculty of 268 Public Health. All rights reserved. Background The built environment exerts one of the strongest directly measurable effects on physical and mental health, yet the evidence base underpinning the design of healthy urban planning is not fully developed. Method This study provides a systematic review of quantitative studies assessing the impact of buildings on health. In total, 7127 studies were identified from a structured search of eight databases combined with manual searching for grey literature. Only quantitative studies conducted between January 2000 and November 2016 were eligible for inclusion. Studies were assessed using the quality assessment tool for quantitative studies. Results In total, 39 studies were included in this review. Findings showed consistently that housing refurbishment and modifications, provision of adequate heating, improvements to ventilation and water supply were associated with improved respiratory outcomes, quality of life and mental health. Prioritization of housing for vulnerable groups led to improved wellbeing. However, the quality of the underpinning evidence and lack of methodological rigour in most of the studies makes it difficult to draw causal links. Conclusion This review identified evidence to demonstrate the strong association between certain features of housing and wellbeing such as adequate heating and ventilation. Our findings highlight the need for strengthening of the evidence base in order for meaningful conclusions to be drawn

Motivating change: shifting the paradigm

The broader framing of the decision-making processes of stakeholders within the sustainability debate is explored in the context of a paradigm shift that acknowledges the world as a complex, dynamic system. There is merit in adopting a paradigm informed by, and therefore suitable for dealing with, living systems, particularly as the paradigm is founded on holistic and flexible strategies. To move the discussion forward, a key concern examined here is what this different paradigm means for engaging and motivating stakeholders. Through questioning established notions of ‘stakeholder’ as defined in the business literature, and the traditional models of sustainable development, an alternative model of sustainability is presented that is grounded in a different worldview. The implications are considered of how the paradigm’s adoption and the associated model of sustainability would change current practices for motivating social transformation in the built environment through stakeholder engagement. Three major shifts in thinking implicit in such a new model of sustainability are identified and examined: creating effective change in the complex social–ecological system presented by the built environment; how this worldview would redefine current notions of stakeholder engagement; and what the implications would be for mechanisms such as assessment and rating tools meant to change stakeholder behaviour.http://www.tandfonline.com/loi/rbri20hb201