title: Built environment and health: a systematic review of studies in Germany.
abstract: Empirical research on the relationship between the built environment and health is increasing at a tremendous pace. However, findings from Anglo-American countries may not apply to the European context. Therefore, we systematically reviewed the existing evidence on the role of the built environment for leading risk factors and health behavior in Germany.
  
  
  
  Through an extensive search via PubMed and Web of Science, using predefined selection criteria, two independent reviewers identified 25 empirical studies. We described the main study variables (year of publication, study design, data source, sample characteristics), classified the studies according to their respective operationalization of environmental features and health outcomes, and qualitatively summarized the main results.
  
  
  
  The majority of the studies focused on anthropometric measures and physical activity. Access to respective destinations was associated with sports-related physical activity but not with body composition. Also, people living in urban structures tended to show more health-adverse behaviors such as smoking and drinking. Some evidence indicated that higher levels of noise and air pollution were related to higher blood pressure levels. No association was observed between green spaces or street design and health.
  
  
  
  Future research should investigate relationships using a sound theoretical basis and research designs that better account for the complex relationship between the built environment and health.
authors.affiliation: Institute for Public Health and Nursing Research (IPP), University of Bremen, Grazer Straße 2, 28359 Bremen, Germany.
authors.forename: Maike
authors.initials: M
authors.lastname: Schulz
authors.affiliation: Institute for Public Health and Nursing Research (IPP), University of Bremen, Grazer Straße 2, 28359 Bremen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Romppel
authors.affiliation: Leipzig University of Applied Sciences, Karl-Liebknecht-Straße 132, 04277 Leipzig, Germany.
authors.forename: Gesine
authors.initials: G
authors.lastname: Grande
mesh_terms: D000328:Adult; D000397:Air Pollution / Q000009:adverse effects; D000076624:Built Environment; D002648:Child; D036262:Empirical Research; D015444:Exercise; D005260:Female; D005858:Germany; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D009622:Noise / Q000009:adverse effects