NHS Health Scotland
Outcome Indicators


6.4 Re-housing and regeneration activities will contribute to improved housing conditions, reduced overcrowding and noise. This will, in turn, contribute to an improved physical environment. Improvements in the physical environment will contribute to increased levels of perceived and actual safety.

Improvements in the design of residential care will contribute to a better physical environment for those living in residential care.


There is no highly processed evidence that improving housing/dwelling conditions will contribute to improved mental health outcomes however there is epidemiological evidence that certain characteristics of housing and dwelling types are associated with poor mental health outcomes. A state-of science review undertaken as part of the Foresight Mental Capital and Wellbeing project found that there is evidence of an association between poor housing and poor mental health. Noise, damp and mould, excessive temperatures and high levels of air pollution have been associated with poor mental health outcomes as has crowding and density. There is some evidence that living in accessible dwellings is associated with better life satisfaction and fewer depressive symptoms amongst older people. Investigating the relationships between the physical environment and mental health outcomes is, however, complex: there is a lack of explicit cause and effect relationships and many studies using correlation relationship may not take into account possible confounding variables.[1]

It is plausible that improving housing conditions through re-housing and regeneration will contribute to improved mental health outcomes and there are some studies that have found improvement in health outcome following housing improvements however methodological limitations of these studies make it difficult to specify the nature and size of a health gain.[3] There is also some evidence from primary studies that moving to better-quality physical environments improves mental wellbeing.[1]

There is review level evidence that the physical environment contributes to perceptions and fear of crime.[1]

Residential dwellings and health care facilities
There is review level evidence that the quality of dwelling/health care facilities for people with mental health problems is associated with mental health outcomes and that positive outcomes for individuals with mental illnesses are achieved by improving physical environmental qualities such as safety, autonomy, individuality, dignity, privacy, enjoyment, comfort and ‘homelikeness’[1]. It is suggested in this logic model (model 6) that strategies to improve the quality of residential care accommodation (e.g. for children, people with mental health problems and older adults) through planning and design will also impact on mental health outcomes for residents.


  1. Cooper, R, Boyko, D & Codinhoto, R (2008). State-of Science Review: SR- DR2: The effect of the physical environment on mental wellbeing. The Government Office for Science: London.

  2. Parkinson J (2007). Establishing a core set of national, sustainable mental health indicators for adults in Scotland: Final report. NHS Health Scotland: Glasgow.

  3. Thomson H, and Petticrew M & Morrison, D (2001). Health effects of housing improvement: systematic review of intervention studies. British Medical Journal, 323: 187-190.

  4. Thomson H, Petticrew M & Douglas M (2003) Health Impact assessment of housing improvements: incorporating research evidence. Journal of Epidemiology and Community Health, 57: 11-16.