A Multidimensional Analysis of the Relationship Between Urban Physical Environment and Mental Health

Purpose: This study aims to examine how urban physical environmental factors affect residents’ mental health, focusing on four key indicators: suicide risk, depression, anxiety disorder, and perceived stress. While previous studies often targeted a single outcome or specific region, this research adopts a multidimensional approach to identify how different environmental characteristics distinctly influence each mental health indicator. Method: Data were drawn from the 2022 Korea National Health and Nutrition Examination Survey (KNHANES), including responses from 6,265 adults nationwide. A multilevel logistic regression analysis was conducted to examine the relationship between mental health and urban environmental factors, distinguishing between personal-level (Level 1) and regional-level (Level 2) characteristics. Each mental health outcome variable was binarized and analyzed separately. Regional-level variables were categorized into three domains: (1) spatial environment (air pollution level, building density, walkability), (2) land use (land-use mix, green area ratio, residential area ratio, commercial area ratio), and (3) urban planning facility (schools, cultural facilities, sports facilities, welfare facilities, medical institutions). personal-level characteristics were included as control variables. Result: The results showed that urban physical environmental factors had differential effects on mental health indicators. Suicide risk was associated with pollution level, number of schools, and number of medical facilities. Depression was associated with building density, land-use mix, housing ratio, and commercial ratio. Anxiety disorder was not significantly associated with any environmental variables. Perceived stress was associated with walkability.