Document Type : REVIEW PAPER
Authors
Faculty of Architecture and Urbanism, Tabriz Islamic Arts University, Tabriz, Iran
Abstract
Rapid urbanisation has transformed cities into both concentrations of health risks and key arenas for improving population health. Understanding how urban environmental conditions influence multiple dimensions of health has therefore become a central concern for health‑oriented urban planning and design. This study synthesises global scientific evidence on the relationships between urban environmental exposures and health outcomes published between 1984 and 2025 and develops an analytical framework for integrating health considerations into urban planning and design practice.
A systematic review with narrative synthesis was conducted in accordance with the PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta‑Analyses) guidelines. Relevant studies were identified through structured searches in major international and national academic databases. The records were screened using predefined inclusion and exclusion criteria, and eligible studies were systematically coded and analysed. The reviewed studies were classified according to key categories of urban environmental exposure, including green and blue spaces, public and recreational spaces, built form and urban morphology, transport systems and walkability, and environmental risks such as air pollution, noise, and urban heat exposure. Health outcomes were examined across four domains: physical, mental, social, and cognitive health. The findings reveal consistent evidence that access to green and blue spaces and high‑quality public spaces is associated with improved mental health, increased physical activity, and higher overall quality of life. Urban form characteristics—particularly density, land‑use configuration, and walkability—are systematically linked to patterns of physical activity, obesity, and non‑communicable diseases. Conversely, exposure to environmental hazards such as air pollution, noise, and heat stress is strongly associated with mortality and the urban burden of disease. Recent research has also expanded to include cognitive health, child development, healthy ageing, and the mediating roles of perceptual and social factors. Despite these advances, important knowledge gaps remain regarding spatial health equity, the evaluation of urban design interventions, and empirical evidence from low‑ and middle‑income countries. Based on this synthesis, the study proposes a multi‑level analytical framework linking urban spatial structure and design, environmental exposures and behavioural pathways, perceptual and social mediators, and multidimensional health outcomes. The framework provides a conceptual basis for systematically integrating health considerations into urban policy, planning, and design.
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