COVID-19 Lockdown: Housing Built Environment’s Effects on Mental Health

Abstract

Since the World Health Organization (WHO) declared the coronavirus infectious disease 2019 (COVID-19) outbreak a pandemic on 11 March, severe lockdown measures have been adopted by the Italian Government. For over two months of stay-at-home orders, houses became the only place where people slept, ate, worked, practiced sports, and socialized. As consolidated evidence exists on housing as a determinant of health, it is of great interest to explore the impact that COVID-19 response-related lockdown measures have had on mental health and well-being. We conducted a large web-based survey on 8177 students from a university institute in Milan, Northern Italy, one of the regions most heavily hit by the pandemic in Europe. As emerged from our analysis, poor housing is associated with increased risk of depressive symptoms during lockdown. In particular, living in apartments <60 m2 with poor views and scarce indoor quality is associated with, respectively, 1.31 (95% CI: 1046–1637), 1.368 (95% CI: 1166–1605), and 2.253 (95% CI: 1918–2647) times the risk of moderate–severe and severe depressive symptoms. Subjects reporting worsened working performance from home were over four times more likely to also report depression (OR = 4.28, 95% CI: 3713–4924). Housing design strategies should focus on larger and more livable living spaces facing green areas. We argue that a strengthened multi-interdisciplinary approach, involving urban planning, public mental health, environmental health, epidemiology, and sociology, is needed to investigate the effects of the built environment on mental health, so as to inform welfare and housing policies centered on population well-being.

Psychological, Social and Health-Related Challenges in Spanish Older Adults During the Lockdown of the COVID-19 First Wave

“…Studies have shown that housing conditions are even more predictive than the degree of dependency in predicting abandonment of the home and institutionalization ( 34 ). In line with Amerio et al ( 21 ), our results point to a greater presence of negative feelings during quarantine in participants who do not have open spaces at home. It has been pointed out that housing design strategies should focus on larger living spaces and visible and accessible green areas ( 20 , 21 ).…”

“…Previous works have shown that visual contact with nature has a reliable effect in physiological relaxation ( 18 , 19 ), but the strict confinements due to the COVID-19 crisis have clearly shown the need to direct outdoor exposure and its potential implication for psychological, social and physical health ( 20 ). Amerio et al ( 21 ) studied the relation between mental health and housing conditions, including housing dimension, presence or absence of liveable open space and quality of views, in 8,177 students from a university institute in Milan, Northern Italy, after 3 weeks of strict lockdown. Compared to students with absent to moderate depressive symptoms, students with moderate–severe and severe depressive symptoms lived in smaller apartments, with unusable balconies and poor-quality views from their apartments.…”

A Mixed Approach on Resilience of Spanish Dwellings and Households during COVID-19 Lockdown

“…As various studies on psychological and mental effects related to confinement and the built environment have confirmed [64], there is a direct relationship between poor or bad quality housing and its services or equipment, with a more negative spatial perception, and even a greater potential for development or worsening of mental health [65], and vice versa.…”

Prevalence of anxiety and depression in South Asia during COVID-19: A systematic review and meta-analysis

“…Several studies conducted on people's mental health during lockdown or isolation reported restriction of movement showed that when people are restricted to a certain kind of environment, their mental health is adversely affected [10][11][12][13] . Historically, quarantine has been related to psychological outcomes such as anxiety, depression, panic, irritability, somatic disorder, and insomnia 14 .…”