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Urban Design Quality and Clinical Mental Health: A Systematic Review
1Department of Urban Policy & Administration, Incheon National University, Incheon, Republic of Korea.
HERD
|July 24, 2026
Summary
Urban design significantly impacts mental health, influencing conditions like depression and anxiety. Street-level and neighborhood features, alongside environmental exposures, play key roles in shaping psychological well-being in cities.
Area of Science:
- Urban planning and design
- Environmental psychology
- Public health
Background:
- Urban design is increasingly recognized as a key determinant of psychological well-being.
- A standardized framework for evaluating urban design's mental health impact is currently underdeveloped.
Purpose of the Study:
- To systematically review empirical evidence on urban design dimensions affecting clinical mental health outcomes.
- To examine how environmental exposures mediate or moderate these relationships.
Main Methods:
- Systematic review following PRISMA 2020 guidelines.
- Analysis of 19 quantitative empirical studies published through January 2025.
- Examination of relationships between outdoor urban design features and clinical mental health indicators.
Main Results:
- Urban design influences clinical mental health outcomes (depression, anxiety, stress, cognitive decline).
- Street-level features (imageability, enclosure, human scale, complexity) and neighborhood environments (land use mix, density, green infrastructure) are significant.
- Environmental exposures (traffic, noise, air pollution) mediate or moderate these effects.
Conclusions:
- An integrated three-domain conceptual framework is proposed, distinguishing spatial design from exposure mechanisms.
- This framework offers evidence-based guidance for creating mentally healthier urban environments.
- Urban planners and policymakers can utilize this framework to improve public mental health.
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