The effects of the built environment on the mental health of older adults: A case study in Hangzhou, China

Abstract Background and Objectives This study examines the association between the built environment and mental health among older adults by exploring the potential pathways through the perceived built environment, social interaction, and environmental pollution. Research Design and Methods Research data were collected from 1 405 older adults aged 60 years and older in 30 residential neighborhoods of Hangzhou, China, in 2022. The participants’ evaluation of the perceived built environment, social interaction, and environmental pollution were assessed. Mental health was measured by the 12-item Short-Form Health Survey. The built environment was measured through an evaluation of density, diversity, design, destination accessibility, distance to transit, and the age-friendly environment. Structural equation models were established based on 300-m, 500-m, and 800-m buffers from the entrance of residential neighborhoods. The propensity score method was employed for sensitivity analysis. Results With regard to older adult’s mental health, there were significant direct effects of the accessibility of health services, shopping services, and bus stops. A robust mediating effect of perceived built environment was displayed on the relationship between land use mix and mental health of older adults. Social interaction exhibited robust mediating effects between the age-friendly environment, the number of bus stops, and mental health of older adults. Discussion and Implications This study provides empirical experience for related research on the built environment and mental health as well as policy implications for urban planners focusing on community planning.