From systematic review to an evidence network: structuring the urban exposome for planning

Background

The urban environment is a major determinant of health through a range of exposures and living conditions encompassed by the concept of the urban exposome. Although a growing body of evidence links urban planning to health, this knowledge remains fragmented across disciplines and difficult for urban planning practitioners to access and apply. This study synthesises and structures current evidence to support evidence informed territorial planning through a systemic representation of urban environment and health relationships.

Methods

An umbrella review of literature syntheses published between 2005 and 2020 was conducted using PubMed, focusing on post industrial urban populations in Europe, North America, and Asia. Fifty two reviews met the inclusion criteria. Data extraction identified and categorised relationships between urban planning parameters, health determinants, and health outcomes, which were subsequently organised into a network based knowledge representation.

Results

The review identified 387 relationships, including 212 complete relational chains linking planning parameters, health determinants, and health outcomes. Air pollution, noise, green spaces, and active mobility emerged as central components of the network, while successive mediation mechanisms highlighted the interconnected nature of health determinants. These relationships were translated into an interactive mapping tool to support cross domain exploration and evidence informed planning.

Conclusions

By representing scientific evidence as an evolving network, this study moves beyond conventional evidence synthesis to provide an operational framework for urban planning stakeholders. The proposed tool facilitates the identification of intervention levers, potential co benefits, and research gaps, supporting a more systemic integration of health evidence into urban planning and decision making.

Key messages

• A network representation of the urban exposome reveals the complexity of relationships linking urban planning, health determinants, and population health.

• An interactive evidence network transforms fragmented research into an operational resource that supports evidence-informed urban planning and healthier cities.