Michael Gleenwood


The growing recognition that design can and should play a central role in addressing today’s complex health challenges has catalyzed architects and public health officials to explore potential solutions. Fourteen new research reports issued by the AIA—and authored by participants of the Design and Health Summit hosted by the AIA, the American Institute of Architects Foundation (AIAF), and the Association of Collegiate Schools of Architecture (ACSA) in April—examine how design and public policy can shape healthier environments, both built and natural environments. The reports document successful design interventions and proffer strategies for creating active, connected, toxin-free, optimized, and equitable spaces for the 21st century.

In September, and building on the momentum from the April summit, the AIA, AIAF, and ACSA launched a research consortium on design and health comprised of university teams that will develop opportunities for funded research, publications, and resources. Inaugural consortium members, set to be announced in early December, will identify unexplored and underrepresented areas of knowledge in underscoring how the design process and product can positively impact our communities. Beyond adding new data and insights to the discussion, the reports and the consortium are intended to equip and compel architects to take action.

“We’re moving into a new era of collaboration with increased focus on translation of health research into practice,” says Dr. Matthew Trowbridge, associate professor at the University of Virginia School of Medicine and co-author of two of the reports. “Working from this perspective, I strongly believe my own built environment and health research is not truly complete until my architect, planning, and other designer friends know what to draw.”

Trowbridge and his research partner, Terry Huang, professor at the CUNY School of Public Health, collaborated with Charlottesville, Va.–based VMDO Architects to study how health-promoting educational design strategies can reduce incidence rates of childhood obesity. The team leveraged its evidence-based research in the design of Buckingham County Primary and Elementary School in Dillwyn, Va., with the primary goal of supporting healthy eating and physical activity.

The partnership inspired the development of “Healthy Eating Design Guidelines for School Architecture,” available free for download from the Centers for Disease Control and Prevention (CDC). “We wanted to translate our hands-on collaboration into a practical tool that architects can use,” Trowbridge says. “While it’s focused on school environments, we really meant it to serve as a template for use in a variety of contexts.”

Health and wellness within dementia care facilities is the focus of a report authored by Kyle Konis, AIA, assistant professor of architecture of the University of Southern California, working in collaboration with the USC David School of Gerontology and the Irvine, Calif.–based Silverado dementia care facilities provider. The team hopes the research spurs the development of empirically based environmental lighting requirements and performance criteria to guide the design and operation of these specialized environments.

Another report, by Omar Youssef, a doctoral candidate in sustainable environments at the University of Arizona, proposes the framework of a design index for therapeutic architecture. This matrix would be used as a benchmark to help architects create environments that optimize luminous intensities for human health and performance.

At the Neighborhood Scale
It is not enough to say that how we design impacts our quality of life. Regional and local factors demonstrate that correlations between design and health define a broader spectrum of causality.

“In the United States, your ZIP code is a fundamental determinant of the length of your life,” says Susan Rogers, assistant professor at the University of Houston and director of its Community Design Resource Center. “That says something about how the neighborhoods in which we live actually impact our opportunities to be healthy.”

Rogers led a team that studied four low-income Houston neighborhoods to identify the determinants of health that can be impacted by design, including education, economic opportunity, environmental justice, food security, neighborhood stability, public space, safety, and amenities.

“We looked at what it would mean to focus investments in these neighborhoods to improve the public infrastructure and resilience,” she says. “The goal is to reinforce the areas of a neighborhood that are already working well as a means to build on that success so it will ripple through the rest of the neighborhood.”

Inspired by the allotment gardens that are prevalent throughout Europe, another report proposes redeveloping the sites of abandoned retail centers into permanent residential communities of 100 to 300 modestly scaled garden homes.

“One of the benefits of this concept is that it allows you to hang on to some of the essential ideals of the American Dream: your own piece of land, your own home, and the ability to grow your own food,” says Greg Tew, associate professor in the School of Architecture + Design at Virginia Tech, who co-authored the report.

The proposal introduces a healthier, more affordable alternative to the two dominant living arrangements in the United States: urban multifamily dwellings and suburban single-family homes.

“Working together and learning together, we can start to re-establish a culture of food growing, a true sense of agriculture rather than the agribusiness model that we’ve evolved to,” Tew says. “To be outside, breathing the fresh air and engaging with neighbors, is a more holistic solution to some of our culture’s most significant problems, all of which directly impact the quality of our health.”

And a research group at Texas A&M University studied the actual health impacts of moving into walkable communities, using focus groups and online surveys to examine the degree to which individuals increased their physical activities, interactions, and social cohesion after relocating to the Mueller neighborhood in Austin.

Through a systematic review of LEED 2009 documentation, one research team discovered a lack of clarity and consistency in health-related language and outcomes, including numerous nontraditional terms from a public health perspective.

“As green building has matured as a movement, it is now necessary to become more intentional about the health and wellness component of our reference guides and tools,” says Trowbridge, who co-authored the paper alongside researchers from the U.S. Green Building Council. “Any time you start a truly new cross-disciplinary dialogue, you find that there’s a need to understand each other’s language.”

Another team surveyed publications of the National Academy of Sciences’ Institute of Medicine and National Research Council to highlight relevant themes that have informed science, policy, and practice. Its aim is to help unite design and health practitioners around the shared goal of shaping public policy to improve wellness.

All participants at the April Summit contributed to an interactive exhibit at the AIA to explore the topic of a common vocabulary. Over the two-day event, architects and designers learned from the health professionals, and vice versa, to establish a new level of discussion about design and the public’s well-being.

Aside from the AIA, AIAF, and ACSA research consortium, the other outgrowth of the April summit is the AIA’s health-focused policy framework (currently in development) to positively influence building codes, rating systems, housing issues, and zoning challenges. The AIAF also plans to launch a communities initiative that builds upon the AIA’s 47-year history of the Regional/Urban Design Assistance Team program to encompass community-based solutions that focus on healthier outcomes for the public who interact with those spaces. In the end, making the case for design’s impact on health has to be a collaborative and data-drive effort. The goal is to make the two words synonymous, even if they individually encompass distinct histories.

Learn more about AIA’s Design and Health initiative at www.aia.org/designhealth.