HEALTHIER LIFESTYLE, DESIGNED (audio)
October 07, 2011 – When the immensely quotable Winston Churchill delivered the line “we shape our buildings; thereafter they shape us” to the English Parliament in 1943, he invoked the built environments’ persuasion in shaping policy and National spirit. Almost 70 years later, in a world beleaguered by escalating healthcare costs and chronic disease, his words resonate with both a sad irony and a profound call to action. Architects must commit to proactively reshaping our buildings to reshape our bodies, lifestyles, and health.
“It’s a question of lifestyle. If you can just hop into a car in the garage of a suburban home and drive to the supermarket and drive back home, one might get less exercise,” says Rick Bell, FAIA, Executive Director of AIA New York’s Center for Architecture. “But it’s also about changing consciousness and I think that is across the board, in large projects and small.”
Urban initiatives like Washington DC or Tel Aviv’s recently implemented bike share programs support Bell’s claim. Public policy at their most basic level, architects and designers are responsible for the complete network of design decisions that inform and materialize the endeavors. By including bike storage spaces in apartment complexes, showers at workplaces, safe and attractive bike shelters on public streets, bicycle ramps along stairs between grades, solar-powered rental kiosks, designating bicycle lanes, and even walk-up windows for coffee shops and banks, architects privilege a healthier lifestyle through design.
Certainly, architects shape the built environment and influence its citizens; health-oriented design strategies represent an opportunity for architects to expand their scope and shape policy. An outgrowth of the Fit City Conferences, AIA New York partnered with the City of New York to create the Active Design Guidelines (2010). Intended to encourage conscientious active design strategies at all levels and between diverse projects, the guidelines provide suggestions and resources to integrate sustainability, active lifestyles, urban design, public policy, etc. to foster a healthier lifestyle, designed.
In the accompanying commentary, Bell discusses the role of the architect and of the Active Design Guidelines in crafting a new health-oriented design agenda; and addresses key issues including evidence-based design, economics, and the expanded scope of architecture.
EVIDENCE-BASED DESIGN: ACCOUNTABILITY
Statistics surrounding global health are both well-published and compelling; according to the Center for Disease Control, 33.8% of America’s adults are obese, suffering increased risk to myriad chronic diseases including diabetes, asthma and some forms of cancer. As architects advocate for health-design strategies in common practice, research metrics will emerge to evaluate the general healthfulness of the built environment against the current health statistics.
In the interim, however, architects can position themselves as authorities on health-oriented design by embracing healthful design in practice, portfolio and personal life. This commitment doesn’t need to be as intentional as forgoing the car or registering the whole firm for a marathon, but designers do need to demonstrate a commitment to health, safety and welfare by challenging sedentary practice.
While a firm’s daily caloric output may not appear in a RFQ, architects can use their experience to leverage conversation about holistically integrating health design strategies. “The consciousness changes—the starting point,” says Bell, "is where architects can be leaders and conveners and enablers of a discussion that wouldn’t otherwise take place.” Operational shifts could encourage modest stair use or bike culture; space planning could foster increased physical movement between departments. In turn, architects can use these and similar design decisions to increase the value proposition of design for the client.
ECONOMICS: FIRST COST
At the 7th World Congress on Design and Health, co-sponsored by the International Academy for Design & Health and the AIA Academy of Architecture in July 2011, myriad cross-industry leaders discussed…the economy. Comparing the steep cost of preventive healthcare—$320M daily toward obesity costs in the US—with the minimal up-front investment in design, these thought leaders argued for investment in transformative, healthy spaces. Increased first-cost investment in health design could, they suggested, recoup cost through reduced sick-days, increased workplace performance, faster healing times, etc.
The shift toward new consciousness, Bell argues, need not be high price. The first steps in defining healthier, more active workplaces can start on meager budgets and in small spaces. At the 12,000 square foot Center for Architecture, which has 17 employees and many more visitors, Bell and the design team incorporated brightly-painted exit stairs into the essential program of their exhibition space. “It didn't take a major project or major financing just to decide to keep the stair doors open. It required a kind of logic of presentation and understanding in terms of those who regulate buildings and construction,” Bell explains.
Privileging the stair in design, through color and clear sightlines encourages the culture that comes with it. Tacitly, a design decision to make stairs a more meaningful part of the design process tacitly encourages dozens of daily visitors to walk two flights of stairs to the below-grade auditorium when they might otherwise take an elevator.
Low-cost, low-effort solutions are the foundation for staging health design as a social issue. Consider the role energy efficient appliances, low-flow toilets and high-performing light bulbs had in shifting the nation’s conscious toward sustainable practice. Today, owners who demand high-performing designs are willing to absorb potentially higher first costs because of the social and economic benefits in time. According to Bell, health-design needs to see the same “consciousness change […] that we’ve seen in the environmental movement that talks about personal health and societal health as a function of building design and urban design.”
EXPANDED SCOPE: POLICY
“Our continuing education talks about the importance of going beyond the things that we learned in school and creating a society that is more healthful.” The spectrum of healthful, however, is immense broad. It encompasses not only ideological notions of physical health, but also codified legal measures—egress, fire safety, HVAC, occupancy—and guidelines to foster improved design—stair width and amenities, space planning, thermal comfort, local food production, bicycle storage etc. It is in the latter that Active Design Guidelines belongs.
“The guidelines themselves bring together both building design and urban design, park design, to talk about the infrastructure and the structures that designers, architects, landscape architects, and urban designers can add to their communities, large or small,” says Bell of the well-illustrated document.
Architects in any size community can use the numerous New York case studies, including the Highline and Immaculate Conception School Play Area, to initiate proactive conversations in their communities to shape the public policy to yield similar projects—neighborhood gardens, Rails-to-Trails, playgrounds, bicycle lanes and shelters, etc.—that contribute to healthier lifestyles, communities and designs.
Active Design Guidelines, Fit City deliverables, and the resources on AIA’s America’s Design and Health Initiative are simply that: resources. They are tools available to architects, public officials and the public to clarify the holistic exchange between design, health and public policy. An example: in recent years, the City of New York has committed to adding benches in public spaces. These benches make the parks more manageable to an aging population who struggles with stamina and mobility, and accommodate low-impact, routine exercise that contributes to the communities general health and lowers healthcare costs.
Once architects illustrate the effectiveness of health design in the economic, health and public policy arenas; once health design is established as “a systemic change that equates public health and the avoidance of proliferating health costs as a non-partisan political issue—that should be a slam dunk.”
In an accompanying podcast, Rick Bell, FAIA, discusses AIA New York’s Fit-City Conferences, Active Design Guidelines, and the ability of the built environment to impact chronic diseases including obesity and diabetes. The podcast is available here. Additional resources and articles can be found at www.aia.org/cvd/.