Toward integrating subjective well-being in environmental health impact assessments for healthy urban living: a conceptual and methodological exploration
Year: 2026
Type: article
Abstract: INTRODUCTION: Environmental Health Impact Assessments (HIAs) can inform decisions about the health effects of policy-related changes in environmental exposures. Conventional health impact metrics, focusing on mortality, morbidity, and disability, neglect subjective well-being. We explored the need and feasibility of integrating well-being indicators such as happiness and life satisfaction into quantitative environmental HIAs. METHODS: Building on a multidisciplinary expert workshop and existing literature, we addressed (1) definitions and indicators of well-being, (2) pathways linking environmental exposures (air pollution, noise, extreme temperatures, and green space) to well-being, and (3) the strength of epidemiological evidence for these associations. We evaluated the challenges of integrating well-being indicators into environmental HIAs, and provided an exploratory example. RESULTS: We argue that including well-being in HIAs offers a more comprehensive view of health, aligning with policy goals focused on enhancing citizen's well-being. The literature identifies plausible pathways linking exposures to well-being, whilst epidemiological evidence for associations between environmental exposures and well-being is limited, but suggestive. We propose conducting exploratory HIAs integrating well-being, especially for green space (n = 16 epidemiological studies) and air pollution (n = 18). We outline two practical integration strategies: (1) report well-being impacts separately as Well-being-Adjusted Life Years, and (2) incorporate well-being into existing health indicators such as Quality-Adjusted Life Years or Disability-Adjusted Life Years. CONCLUSIONS: Inclusion of well-being into quantitative environmental HIAs presents a more comprehensive representation of health and well-being beyond indicators focusing on morbidity and mortality. However, the epidemiological evidence base regarding environmental exposures and well-being warrants further expansion.
Source: Environment International
Authors: Xuan Chen, Gerard Hoek, Paul Frijters, Georgia M.C. Dyer, Stefan Gössling, Sasha Khomenko, Haneen Khreis, Eline Kolb, Natalie Mueller, Brigit Staatsen, Rafael Costa Simões De Vasconcelos, Daniel Saldanha Resendes, Elise van Kempen, Mathew P. White, Roel Vermeulen, Mark Nieuwenhuijsen, Ulrike Gehring
Institutions: Utrecht University, London School of Economics and Political Science, Universitat Pompeu Fabra, Barcelona Institute for Global Health, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Linnaeus University, Vestlandsforsking, Texas A&M University System, University of Cambridge, MRC Epidemiology Unit, Texas A&M Transportation Institute, Texas A&M University, GGD Haaglanden, National Institute for Public Health and the Environment, Unidade Local de Saúde da Região de Leiria, Unidade Local de Saúde de São José, University of Vienna, University of Exeter, University Medical Center Utrecht
Language: English
Subfield: Management, Monitoring, Policy and Law
Field: Environmental Science
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $4,750
Awards: G1175115578, G2064873908, G210041235, G2262748287, G2601397997, THE URBAN BURDEN OF DISEASE ESTIMATION FOR POLICY MAKING, G2819494518, G3005324705, G300979063, G34346518, G3480869486, G3681454997, G4042783231, G425668148, G5080475149, G5195188938, G5833913579, G630635040, G6656126374, G69051668, G7084143925, G7561984395, G8118709007, G8637226926
OpenAlex ID: W7124423042