Built environment features: Predictors or effect modifiers of post-disaster mental health outcomes? A systematic review

Emerging research has examined the mental health impact of built environment features in the context of climate disasters; however, evidence remains fragmented and heterogeneous. While existing reviews have synthesized particular built environment characteristics such as greenspace and housing under extreme weather events, a comprehensive synthesis examining diverse built environment features in relation to disaster-related mental health outcomes is lacking. This systematic review synthesized empirical evidence to assess these associations and identify research gaps and priorities for future study. Drawing upon seven electronic databases: Web of Science, Medline, ProQuest, EMBASE, PsycINFO, CINAHL, and Environmental Complete and following PRISMA guidelines, this review identified a final set of 22 articles. Almost half of the included studies were published between 2020 and 2024; most were cross-sectional studies conducted in the United States. Overall, the association of built environment features with mental health has been examined in diverse disasters, such as hurricanes, drought, heatwaves, and floods. Mental health assessments have focused on a range of outcomes, notably PTSD and psychological distress. We identified 12 studies that examined the role of built environment features in predicting climate disaster-related mental health outcomes, considering urbanicity, land cover, housing type, and characteristics of neighborhood vulnerability. Ten studies examined the role of four features in modifying the direction and strength of the relationship between climate disasters and mental health, namely urbanicity, land cover, neighborhood deprivation, and sky view factor. The synthesized evidence provides new insights into the psychological effect of built environments and policy implications for disaster preparedness and recovery.