The Effect of Built Environment on Physical Health and Mental Health of Adults: A Nationwide Cross-Sectional Study in China

At present, there is a lack of research examining the relationships between the built environment and health status from a social epidemiological perspective. With this in mind, the present study aimed to explore the construct validity of housing/neighborhood conditions and evaluate the associations between the built environment and self-rated health among Chinese residents. To conduct the analysis, data from 4906 participants were derived from the 2016 China Labor-force Dynamics Survey (CLDS). Specifically, we used exploratory factor analysis to identify construct of housing/neighborhood factors and performed principal component regression (PCR) to assess the relationship between the built environment and both self-rated physical health and mental health. This process identified five common factors that corresponded to the built environment, including housing affordability, housing quality, neighborhood services, neighborhood physical environment, and perceived environment. The regression results suggested that housing affordability was negatively related to health status. Meanwhile, the services, physical environment, and perceived environment of neighborhoods were related to positive health outcomes. The influence of housing on health exhibits group heterogeneity: respondents in the 41 to 65 age group were most vulnerable to poor built environments. Whilst the results indicated that housing factors and neighborhood conditions were related to health outcomes, their influence varied across different age groups. Future interventions should be intentionally designed to target housing affordability and neighborhood factors, which may include the provision of housing assistance programs and planning layouts.