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2026 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 208, article id 110067Article in journal (Refereed) Published
Abstract [en]
Introduction: Environmental Health Impact Assessments (HIAs) can inform decisions about the health effects of policy-related changes in environmental exposures. Conventional health impact metrics, focusing on mortality, morbidity, and disability, neglect subjective well-being. We explored the need and feasibility of integrating wellbeing indicators such as happiness and life satisfaction into quantitative environmental HIAs.
Methods: Building on a multidisciplinary expert workshop and existing literature, we addressed (1) definitions and indicators of well-being, (2) pathways linking environmental exposures (air pollution, noise, extreme temperatures, and green space) to well-being, and (3) the strength of epidemiological evidence for these associations. We evaluated the challenges of integrating well-being indicators into environmental HIAs, and provided an exploratory example.
Results: We argue that including well-being in HIAs offers a more comprehensive view of health, aligning with policy goals focused on enhancing citizen's well-being. The literature identifies plausible pathways linking exposures to well-being, whilst epidemiological evidence for associations between environmental exposures and well-being is limited, but suggestive. We propose conducting exploratory HIAs integrating well-being, especially for green space (n = 16 epidemiological studies) and air pollution (n = 18). We outline two practical integration strategies: (1) report well-being impacts separately as Well-being-Adjusted Life Years, and (2) incorporate wellbeing into existing health indicators such as Quality-Adjusted Life Years or Disability-Adjusted Life Years.
Conclusions: Inclusion of well-being into quantitative environmental HIAs presents a more comprehensive representation of health and well-being beyond indicators focusing on morbidity and mortality. However, the epidemiological evidence base regarding environmental exposures and well-being warrants further expansion.
Place, publisher, year, edition, pages
Elsevier, 2026
Keywords
subjective well-being, life satisfaction, health impact assessment, urban environment, wellbys, air pollution, noise, green space, extreme temperature
National Category
Public Health, Global Health and Social Medicine Environmental Sciences
Research subject
Natural Science, Environmental Science; Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-144879 (URN)10.1016/j.envint.2026.110067 (DOI)001675648000001 ()41570774 (PubMedID)2-s2.0-105028066775 (Scopus ID)
2026-02-092026-02-092026-02-26