Identifying built environment multidimensional predictors of urban health outcomes: Designing, constructing, and validating a cross-sectional survey

• Validated survey developed to measure the built environmental impact on health. • Social space with greenery, light, and aesthetics had strongest positive impact. • Mapped direct predictors and indirect contributors to environmental influence. • Identified spatial clusters linked to health and happiness. The built environment significantly affects citizens' mental, physical, and social health, as well as their short- and long-term happiness. Although existing research emphasizes its impact, it lacks specificity about the environmental characteristics and validated measurement tools needed to assess the multidimensional interplay among them. This research aims to develop and validate a survey instrument to measure this complex interaction. This research employed a multi-phase process for instrument development. Survey items were derived from published literature reviews. Following a qualitative pilot phase, the survey was administered to experts to evaluate the instruments' face and content validity. The refined instrument was tested with Norwegian residents. Various SPSS analyses were used to assess internal consistency, performance, and inter- and cross-item correlations. The survey design identified 18 built environmental factors. Both direct and indirect associations among these factors were observed. Nature, small-scale urban greenery, proximity to social spaces, the presence of people, and decorative and advertising lighting were first-level correlates of health and happiness. The environment with the most positive impact included integrated social spaces with man-made greenery, controlled crowding, and open areas, located near residential neighbourhoods with adequate lighting and visual appeal. The results provide clear guidance for architects and urban planners to apply in future urban development and inform targeted strategies and policies to create healthier cities. The validated survey serves as a robust measurement tool across various settings to examine the impact of the built environment on citizens and to support theoretical development.