Appearances can be deceiving. In the 1980s, the US Surgeon General released the first report concluding that the separation of smokers and nonsmokers within the same air space may reduce but not eliminate exposure of nonsmokers to secondhand smoke, an idea that might seem obvious to us today. Spokespeople for the tobacco industry quickly found a clever distraction, calling attention to the “sick building syndrome” which blamed new energy-efficient, airtight office buildings for poor health – not secondhand smoke.
Fortunately, examining the impact of design on health also has a more positive history. The ancient Egyptians, Greeks, and Romans all made significant medical uses of natural light. The ancient Greeks developed the physiocratic school of thought, realizing that health and disease could not be dissociated from particular physical and social environments or from human behavior. Hippocrates was among the first to identify the environment as a cause of illness and a means of healing, including street alignment, sunshine and prevailing winds in his treatise ‘On Airs Waters and Places’. Later, Leonardo da Vinci designed cities as living systems that promoted health and most recently, Friedensreich Hunderwasser incorporated natural features of landscapes in his designs and advocated for more human and environment friendly building aesthetics.
Over a decade after the tobacco industry’s stunt, the US Green Building Council, a private membership-based non-profit, was founded to promote sustainability in how buildings are designed, built, and operated. USGBC launched the Leadership in Energy and Environmental Design (LEED), the most widely adopted green building certification program in the country. Although LEED remains focused mostly on energy efficiency, it is slowly beginning to recognize the importance of integrating health promotion criteria into design. However, with the exception of the “Design for Active Occupants” credit, the few health criteria included in LEED are developed by Delos, whose WELL Building Standard has yet to be validated.
As our society faces a chronic disease epidemic driven largely by preventable lifestyle risk factors, designing for health presents an opportunity to reverse this trend. The Vitality Institute Commission Report recommends strong cross-sector collaborations that generate a systemic increase in evidence-based health promotion and disease prevention across society and a unified message for health promotion. To achieve this goal, the Institute is supporting the American Society for Interior DesignÂ’s leadership in building a roadmap to help designers and architects design for health.
The evidence is clear: better lighting, more opportunities for mobility, reduced harmful environmental exposures, easy access to healthy food, enhanced safety and smoke-free buildings – they all enhance health and, if built into design features, make healthy living the norm.
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