A Systemic Review of Healthy-Campus Assessment Tools for Higher Education Institutions and Comparison with Chinese-Relevant Tools

Improving the health supportiveness of the campus built environment is a key strategy for alleviating health pressures in higher education institutions (HEIs). As a complex environmental system, a university campus requires systematic assessment of its environmental health performance to inform science-based design and planning decisions. This study systematically reviews the environmental characteristics of current healthy-campus assessment tools (HCATs) for HEIs and evaluates their compatibility with a Chinese standards context. A three-phase mixed-methods approach identified 12 HCATs, examined their environmental features, and constructed a content framework. Three representative Chinese alternative tools were compared. The results show that: (1) HCATs vary by development context but consistently prioritize physical environmental resources that support health behaviors, such as abundant and reasonable active transportation and fitness facilities and a health-promoting environmental culture, rather than conventional physics performance. (2) Although Chinese tools overlap with HCATs on certain environmental topics, they cannot replace HCATs in terms of environmental integration, coverage, and applicability to HEI settings. (3) Future Chinese HCATs should strengthen environmental support for behavior change and health promotion and improve operability. This study reveals gaps between current Chinese tools and HCATs, underscores the necessity of developing environment-focused HCATs for Chinese HEIs, and provides a foundation for related tools’ development work.