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How health became the new frontier in building design in 2014

A growing movement connecting public health to planning is founded on the idea that design can make a difference.

The rewards of green design for mental and physical health, often a side effect of the energy and environmental benefits, always have been a little hard to prove — until now.

Green design is closing a year in which the surgeon general addressed Greenbuild, the nation’s largest green building conference, and Dr. Esther Sternberg, a rheumatologist, and two other notable physicians gave keynote addresses to building professionals at the December Building Health forum of the U.S. Green Building Council’s Northern California Chapter (USGBC-NCC).

In November, the design industry also welcomed an official WELL Building Standard, administered by GBCI — the same body that administers LEED. At the same time, competition in the green design and construction industry is inspiring designers to learn more about and disclose more ingredients in their materials in order to meet Health Product Declarations.

“Health is the new frontier in sustainable design,” Sternberg, research director at Arizona’s Center for Integrative Medicine where she works alongside well-known holistic health practitioner Dr. Andrew Weil, explained. “This is a movement across both design and health professions.”

The forum audience, primarily building-design professionals, also included sustainability staff from Google and Facebook, two companies that signed on to USGBC-NCC’s Building Health Initiative, started in October 2013. Adobe, Genentech, and many other businesses have pledged to participate in the initiative through research and disclosure of design and health practices and programs in their facilities. These companies regularly work with biophilia experts, green architects and HVAC engineers to bring in fresh outside air, install HEPA filters normally reserved for hospitals, and secure the perfect amount of light and sound for health, comfort and the highest “user experience” for their employees.

The new standards, programs and research connect health and design in more tangible ways than ever before. “Most people aren’t consciously aware of how the physical environment affects their health,” Sternberg said. Yet there is an undeniable connection between environment and well being; workspaces can stress or calm — an important consideration in light of the fact that healthy, happy people are more innovative and productive.

But Sternberg and other doctors and health officials at the building forum emphasized a public health angle that goes well beyond making Silicon Valley tech workers happy. It’s known that diabetes and obesity are connected to design issues that favor cars over pedestrians, according to Dr. Richard Jackson of UCLA’s Fielding School of Public Health. Jackson deals with what he calls the “macro environment”; he studies how where we place our buildings affects our health.

“Diabetes is code blue,” Jackson said, invoking the hospital code for a medical emergency. “We need to redesign our neighborhoods to encourage people to be physically active. If you drive a lot, you weigh about seven pounds more. … Your risk of heart attack and stress goes up when you are driving.”


Neighborhoods designed to encourage physical activity reduce the risks of stroke and heart disease.

Planners talk about transit-oriented and dense development mostly for energy and environmental reasons. But Solange Gould, senior research associate at the Center for Climate Change and Health in Berkeley, cited a study published in the American Journal of Public Health that found increasing median daily walking and bicycling from 4 to 22 minutes “reduced the burden of cardiovascular disease and diabetes by 14 percent and decreases green house gas emissions by 14 percent.” (Although it increases traffic injury risk by 39 percent because of poor pedestrian and bike-oriented design.)

Climate change is also one of the biggest threats to public health. Currently we experience 150,000 deaths a year from climate change, according to Cynthia Comenford of San Francisco’s Department of Public Health. San Francisco and New York City are operating climate health programs funded by the Center for Disease Control, which find that design can play a significant mitigating role.

Low-income communities are most affected by death, disease and stress from climate issues. There is a cumulative burden of health impacts Gould calls “the climate gap.” Affordable housing is a key aspect of public health because people often will compromise food and healthcare to pay for housing, Gould said. California’s climate policy, AB 32, addresses this gap by requiring cap and trade money to go back into communities for weatherization, renewable energy, affordable housing and other needs, Gould said.

Health and climate will continue to be daunting issues in 2015 and beyond, but a growing movement connecting medicine and public health to planning and building design is founded on the idea that design can make a difference. Energy use, climate change and building health are all related. Energy efficiency reduces carbon emissions, air pollution and asthma, for example.

Designing to prevent climate change involves the very same strategies as designing to prevent diabetes and cardiovascular disease. With hope, Gould looked out at the building professionals and said, “People talk about health and planning in different rooms. Now we're in the same room.”

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