Architects, Doctors and the Importance of Urban and Building Design in Public Health
Architects and the public are waking up to the way building design, urban neighbourhood design and placemaking impact upon health and well-being, but doctors are lagging behind in making the connection, according to research from McGraw Hill Construction sponsored by the American Institute of Architects (AIA), United Technologies Corp. and other partners.
The report, The Drive Toward Healthier Buildings: The Market Drivers and Impact of Building Design on Occupant Health, Well-Being and Productivity, finds that though 18% of homeowners say that doctors are their primary source for information on healthy home products and decisions, only 53% of pediatricians, 32% of family doctors/general practitioners and 40% of psychiatrists believe that buildings even impact patient health.
This is something that design and construction professionals have long been aware of. Smart Growth is an initiative which achieved widespread recognition 20 years ago and champions walkable communities and "complete streets" which encourage vigourous and recreational exercise.
Active Design is an evolution of this. The 2010 Active Design Guidelines: Promoting Physical Activity and Health in Design emphasises the importance of providing stairs, fitness images and spaces for social interaction within architectural designs. It focuses on strategies for creating neighbourhoods, streets and outdoor spaces that encourage exercise, play an active transportation as well as access to healthy food.
The US Green Building Council is developing an Active Design Index for LEED projects and its new Pyatt Credit "Design for Active Occupants" already has been used on 30 projects. The topic is in ascendance. In 2011 an American Planning Association survey found that around 20 local government had adopted health elements as part of their general plans. Los Angeles was amongst them.
Bloomberg is a pioneer and in July 2013 signed New York City's Active Design Executive Order and created the Centre for Active Design.
The Nashville Area Metropolitan Planning Organisation has made active transportation one of the three goals of its 2035 Transportation Plan. It dedicates 15% of urban roadway funds to active mobility, 10 times the national average.
Another good example is north of the border in the Region of Peel in Canada, where multiple public space projects are being piloted that encourage residents to engage in recreation and access healthier food.
According to the Urban Land Institute's 10 Principles for Building Healthy Places, over 500 local US governments have adopted a 'complete streets' policy.
But this growth in awareness is not extending to medical practitioners according to the AIA survey. It finds that even for the most informed – paediatricians – only just over half (53%) are aware of the impact of buildings on their patients' health.
61% of GPs and 57% of psychiatrists/psychologists don't know about the connection.
It may be that they find it difficult to discern the impact of buildings on health from other environmental or lifestyle impacts. Nevertheless the table at the top of this page shows the kind of health impacts reported by all medical professionals which are directly due to poor building design.
Besides the medical professions, the real estate profession is also lagging behind. Brendan Owens, vice president of LEED technical development at the US Green Building Council is trying to encourage the profession to see the relationship by conducting research on how indoor lighting, thermal comfort and noise affects health.
Architect Bob Fox is fond of quoting a study which shows that "while the annual cost of energy savings is about $3 million, increasing the productivity of 5000 occupants by just 1%, or five minutes, gains $10 million. So where would a corporate executive put their money?"
This relates to the findings that absenteeism caused by sickness is directly related to problems in buildings, such as headaches/migraines (19%) and lack of sufficient exercise (59%).
The report is intended to stimulate debate and awareness of the benefits of green building. Amongst the hundreds of statistics in the report are that those building owners, architects and contractors already involved with green building are also using more green products and more influenced by health factors in the design decisions they take.
That's one of the most encouraging statistics is the table below, which shows that many aspects of sustainability, not just surrounding health, are projected to loom large in the decision-making processes of building owners, architects and contractors.
"It's becoming clear from this initial research that doctors and other health professionals must engage with architects and the design community in a major way if we are to be successful in improving public health through design," concludes AIA CEO Robert Ivy, FAIA. "We look forward to furthering that dialogue with physicians and to helping support additional research into this critical public health issue."
