Toward integrating subjective well-being in environmental health impact assessments for healthy urban living: a conceptual and methodological exploration
Chen, Xuan Hoek, Gerard Frijters, Paul Dyer, Georgia MC Gössling, Stefan Khomenko, Sasha Khreis, Haneen Kolb, Eline Mueller, Natalie Staatsen, Brigit
Chen, Xuan
Hoek, Gerard
Frijters, Paul
Dyer, Georgia MC
Gössling, Stefan
Khomenko, Sasha
Khreis, Haneen
Kolb, Eline
Mueller, Natalie
Staatsen, Brigit
Series / Report no.
Open Access
Type
Journal Article
Article
Article
Language
en
Date of publication
2026-01-16
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Toward integrating subjective well-being in environmental health impact assessments for healthy urban living: a conceptual and methodological exploration
Translated Title
Published in
Environ Int 2026; 208:110067
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.