A systematic review on the relationship between the built environment and children's quality of life.

Background: Evidence of the effects of the built environment on children has mainly focused on disease outcomes; however, quality of life (QoL) has gained increasing attention as an important health and policy endpoint itself. Research on built environment effects on children's QoL could inform public health programs and urban planning and design. Objective: We aimed to review and synthesize the evidence of the relationship between built environment features and children's QoL. Methods: Five research databases were searched for quantitative peer-reviewed studies on children between 2-18 years, published in English or German between 2010-2021. Only primary research was considered. Included studies (n=17) were coded and methodologically assessed with the Joanna Briggs Critical Appraisal Checklists, and relevant data were extracted, analyzed, and synthesized, using the following built environment thematic framework: 1) neighborhood natural environment, 2) neighborhood infrastructure, and 3) neighborhood perception. Results: Green space was positively associated with children's QoL. Infrastructure yielded inconclusive results across all measured aspects. Overall neighborhood satisfaction was positively correlated with higher QoL but results on perceived environmental safety were mixed. Conclusions: Most studies are correlational, making it difficult to infer causality. While the positive findings of green space on QoL are consistent, specific features of the built environment show inconsistent results. Overall perception of the built environment, such as neighborhood satisfaction, also shows more robust results compared to perceptions of specific features of the built environment. Due to the heterogeneity of both built environment and QoL measures, consistent definitions of both concepts will help advance this area of research.