A health creation tool of the future….

Healthy buildings can support healthy people; lessons for practice from a review of existing tools at the Healthy City Design Congress.

How healthy is your building? This may seem a strange question, but in fact, it needs to be asked. On every project. On every redevelopment. On every building design. And more specifically how can healthy buildings promote healthy users?  There is a wealth of information available to help designers and built environment practitioners understand why health is so important when considering building design. But how useful is this information?

Speaking at this year’s Healthy City Design Congress, Mark Drane and Dr Louis Rice from the WHO Collaborating Centre for Healthy Urban Environments at UWE Bristol shared the findings of their review identifying the range of assessment tools available globally that focus on health and building design.  In their talk, Indicators of Healthy Architecture, they discussed how building performance is assessed and how in their open access paper for the Journal of Urban Health that these different tools can be difficult to compare to one another which is a challenge for building owners and others involved in assessing building health.

What do we mean by health? Social? Mental? Physical? Well, the answer is clear, all these and more are attributed to important aspects of being healthy.  The World Health Organisation (WHO) states that ‘health is created and lived by people within the settings of their everyday life’ so clearly this includes our homes, our offices, our schools, and the wider built environment.

The design of the built environment is an important wider determinant of health and needs to be thoroughly considered, especially considering the prevalence of many diseases and illnesses linked to aspects of the built environment that people inhabit every day.  Mark Drane outlined how this review goes beyond the realms of an ordinary literature review using methods of systematic review and deep dive into the evidence base and by using approaches from public health are able to provide an analysis which answers specific health related questions in relation to building design.

When talking about design, buildings, and health, Architecture Health Indices (AHI’s) are used to evidence the effects on human health associated with the design of buildings.  These involve assessing areas such as air quality, lighting levels, acoustics, thermal comfort, and safety. The review identified 105 tools used globally to assess health in design.  Six of these appeared most frequently in the research literature: BREEAM, LEED, SB Tool, CASBEE, Green Star, BEAM Plus.  These were then analysed in more detail including with two more recent tools with a health-specific focus, the Well Building Standard (WELL) and fitwell .  It is encouraging that there are tools being used to better health in the building process, however do they go far enough to address the wider determinants of health?

The answer is open to interpretation and in this review the researchers reported that these indices were found to focus mainly on the avoidance of disease rather than the creation of positive health and wellbeing.  It is clear that the tools can, and need to, go further in assessing health considering not just physical but mental and social wellbeing too, with an emphasis on holistic health of the population.

Beyond the paper….

In their talk Dr Rice and Mark Drane identified that progress has been made: healthy architecture indices continue to be developed, many with their origins in considerations of planetary sustainability.  While planetary and human health are integrally linked, their research does question whether health issues risk getting lost in this wider mix though.  Is there more to be done?  Of course.

A greater focus on transforming healthy architecture indicators towards population health is required. Standardisation of assessment methods allowing comparison and evaluation of results including through post occupancy evaluation seem important to supporting wider stakeholder understanding:  elsewhere at the Health City Design congress investors, funders, and building owners reflected on the myriad of tools available and difficulty in knowing which ones to make use of.  There also remain gaps to bridge in knowledge between built environment practitioners and population health disciplines, namely public health.

Dr Rice concluded noting that the WHO promotes ‘health in all policies’ and reflected on the need for this to be translated to ‘health in all designs’.

Healthy buildings can support healthy people; a change is coming.

Healthy City Design International: Research, Policy, Practice

Healthy City Design International Congress & Exhibition is a global forum for the exchange of knowledge on the research, policy and practice of designing healthy and sustainable cities and communities.  The theme of this year’s congress was: ‘Back from the brink: Designing for climate, community and social value’.

Urban Habitats: thinking | strategy | making

Here at Urban Habitats, working for change is exactly what we aim to do.  We use creative, inclusive, and evidence informed thinking to narrow knowledge gaps, increase understanding, and broaden the scope for the future of healthier places for both people and planet. 

---