Background
The built and natural environment and health are inextricably linked. However, there is considerable debate surrounding the strength and quality of the evidence base underpinning principles of good practice for built and natural environment design in promoting health. This umbrella review aimed to assess relationships between the built and natural environment and health, concentrating on five topic areas: neighbourhood design, housing, food environment, natural and sustainable environment, and transport.

Many recent major studies, including the IPCC’s Fourth Assessment Report, have attested that energy efficiency is humanity’s prime option to combat climate change in the short- to mid-term. The potential to avoid CO2 emissions cost-effectively has been reported to be significant through efficiency policies. However, the review of global research findings on the quantification of cost-effectiveness of opportunities through improved efficiency has highlighted that there is a major shortcoming in the vast majority of such calculations.

Co-benefits rarely enter quantitative decision-support frameworks, often because the methodologies for their integration are lacking or not known. This review fills in this gap by providing comprehensive methodological guidance on the quantification of co-impacts and their integration into climate-related decision making based on the literature. The article first clarifies the confusion in the literature about related terms and makes a proposal for a more consistent terminological framework, then emphasizes the importance of working in a multiple-objective–multiple-impact framework.