Natural vs. built visual urban landscape elements around the home and their associations with mental and brain health of residents: A narrative review
M. Sander, Anne Klimesch, Larissa Samaan, Simone Kühn, Jobst Augustin, Leonie Ascone
Abstract
Urbanization shapes mental health, yet the contributions of specific natural and built landscape elements remain unclear. This review focuses on visual landscape analysis of urban residential space to understand how tangible, geographically defined elements (e.g., streets, trees, building density) influence mental health, such as through sensory pathways (e.g., noise, pollution) or behavioral affordances (e.g., walkability, social interaction). We synthesize research trends, geospatial methodologies, and mediation models to advance the study of residential space and mental health across geography, psychology, neuroscience, and urban planning. Systematic title & abstract searches, combining the terms "urban", "nature", "built", "mental health", and "brain", using PubMed, ScienceDirect, and Google Scholar, identified studies published in English that examined associations between visual urban landscape elements and mental (brain) health. A total of N = 48 studies met the inclusion criteria. Metadata extraction included studied mental (brain) health outcomes, visual landscape elements, geospatial analysis methods, confounder control, and research findings, synthesized via frequency analysis, vote counting, and narrative review. Depression was the most frequently studied outcome (∼40% of studies), while positive mental health indicators were underrepresented (∼10%). Studies on natural elements largely found positive associations, particularly for parks (∼79%) and trees (∼63%) with mental (brain) health, whereas generic green space measures (e.g., indices of vegetation density or overall green space) often showed non-significant results (∼40%). Neuroscientific evidence suggests exposure to urban greenery across different life stages supports structural brain adaptations in stress-regulating and cognitive or behavioral control regions. Built elements showed mixed results—streets, for example, were linked to both positive (e.g., mobility) and negative (e.g., noise-related stress) factors that contributed to mental health outcomes. Geospatial methodologies varied widely in data sources and buffer definitions, limiting comparability. Only ∼30% of studies examined both natural and built elements together. Mediation models were rarely tested and primarily focused on pollution, social interaction, or physical activity. A more systematic, interdisciplinary approach is needed to integrate urban landscape analysis and mental health research. We provide recommendations for standardized geospatial methods, holistic mediation models, and real-time exposure tracking. Advancing data-driven visual landscape analysis will enhance environmental psychology, health-oriented urban planning, and evidence-based policy. • Urban parks and trees show the strongest mental health associations in cities. • Built elements show mixed mental health associations, balancing risks and benefits. • Green exposure is linked to brain regions key to stress regulation and cognition. • Geospatial methods in mental health research lack standardization, limiting insights. • Holistic standardized landscape analysis and mediation models will advance the field.