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Healthy Design: The Call from City Hall

Municipal governments are leading the charge for healthy building design

By Nalina Moses

After accessibility and sustainability, public health is a third wave of change that's reshaping the way architects work. More and more local governments are adopting policies grounded in public health principles to guide civic planning and design. As these policies are translated into legislation and executed in public works and public policy, they are certain to require architects to examine everything they do as an element of public health.

A tale of three cities

Three American cities have recently enacted broad policies integrating public health with physical design: New York City, Washington, D.C., and Portland, Ore.

In January 2010, New York City released the Active Design Guidelines (ADG), a voluntary benchmark that proposes physical and infrastructure design strategies to promote health focusing on four areas: active transportation, active buildings, active recreation, and food access. These topics will affect everything from how architects site buildings to connect to public transit to how they design staircases to encourage visitors to use them. (To explore more about design choices and health impacts, see companion infographic, Designing Communities, Shaping Health) Produced by AIA New York and New York’s nonprofit Center for Active Design (CAD), the design guidelines have been amended several times to include sections on safety, affordable housing, and sidewalk experience.

In January, Washington, D.C., Mayor Vincent Gray signed into law the Sustainable DC Act, which covers health design topics within a broader framework of economic development. Laine Cidlowski, an urban sustainability planner at the D.C. Office of Planning, explains: “We didn't want to only include environmental and health issues in a traditional way, because in D.C. some other challenges are just as pressing.”

The plan includes sections on health and wellness, food, transportation, and the built environment, but also on jobs and the economy, as well as equity and diversity. The law is written as a list of quantitative benchmarks to be achieved by 2032. The health and wellness section consists of two requirements more commonly understood to be under the purview of architects: reducing the obesity rate through infrastructure that encourages physical activity, and incorporating healthy design standards in city housing.

The Portland Plan, adopted in April 2012, emphasizes equity in access to all civic resources. This strategic statement of purpose will have to be enacted with further rounds of legislation (called the Comprehensive Plan Update) yet to be approved. Like D.C., Portland’s agenda examines the built environment and architectural factors as well as social factors that can promote health. Deborah Stein, principal planner at Portland’s Bureau of Planning and Sustainability, says, “We went beyond transportation and zoning to social aspects like education and economics, because everything is connected; we're connecting the dots.”

After education and economics, the Portland Plan’s third fundamental initiative is creating a “Healthy Connected City.” One of the key ideas is to foster “complete neighborhoods” that offer safe, equitable, local access to resources including housing, schools, shops, and parks. This will undoubtedly shape planning and programming, impacting the kinds of buildings permitted to be built in specific neighborhoods. Another key idea is to develop neighborhood greenways and civic corridors: accessible, walkable, and bikeable public spaces that link communities.

Architects as collaborators and advocates

One important variable in the movement for public policy that encourages healthier design is that cities have widely varying degrees of municipal and public support.

New York City has the singular and outspoken support of Mayor Michael Bloomberg, who also serves on the CAD board. And many of his administration's health-related programs, such as developing bike lanes and pocket parks, enjoy strong public support. During design development, CAD staff can work hand-in-hand with the project's architects and planners. CAD Executive Director Joanna Frank emphasizes the group's creative collaborative role. “We can charrette,” she says. “We can get the trace out and sketch.”

Policy into practice

In each city, the path from idea to execution—from policy, through legislation, funding, and implementation—is different.

In D.C., implementation has already begun, through supplementary legislation passed just after the Sustainable DC Act itself. Cidlowski explains: “It's a real variety of different pieces of legislation; there's an omnibus style to it. It's not intended to be holistic, covering all [of] the plan implementation.” The city plans to support the act with additional rounds of legislation. For now, for example, there is a law that permits urban beekeeping and another that does not permit toxic dry cleaners near daycare centers. In 2012, $4.5 million was allocated for innovative sustainability projects related to the act. One project surveyed and analyzed the rooftops of city buildings to determine if they could be better insulated or developed for urban farming.

In June, New York City Mayor Bloomberg issued an executive order requiring all city-funded construction and major renovation projects to incorporate ADG strategies. The city is collaborating with the CAD, where Frank describes her group's role as “translating” between public policy and design. Meanwhile, two upcoming Bloomberg administration–backed bills will explicitly influence the way architects organize circulation in city buildings. One permits some staircase doors to be held open; another requires access to all floors from a single staircase, as well as accompanying signage.

Once approved and enacted, the final Portland Comprehensive Plan Update will impact city zoning and building codes. These new regulations will likely take steps toward implementing planning strategies outlined in the plan, including complete neighborhoods, neighborhood greenways, and civic corridors. They could also revise existing building and planning regulations, such as making it simpler to meet zoning requirements for multigenerational housing and to develop areas of existing housing complexes as outdoor play areas.

A community base and a human scale

In addition to New York, Washington, D.C., and Portland, many other cities have passed legislation to implement public health strategies on a more limited scale. The Seattle Food Action Plan makes locally grown food available to schools and unused city land available for farming. Boston Bikes, established in 2007, is a mayoral initiative to expand and maintain the city's public bike paths. The National Complete Streets Coalition is a nonprofit that offers guidance for shaping safe and engaging streetscapes.

Cities with established health design policies are sharing their knowledge with other cities, both nationally and internationally. The CAD has participated in conferences with planners from London and Rio de Janeiro. Frank believes the CAD guidelines adopted by New York City can be shared with other similarly dense urban communities. But because successful execution requires deep community approval and engagement, the movement maintains a regional focus. As Stein says, “Sharing best practices is always helpful. But there's a bit of risk saying, ‘Do it the Portland way,’ or ‘Do it the New York City way.’”

While the public health movement calls on architects to act collectively at a community scale, it requires them to design individually at the human scale, thinking holistically about the physical and mental well-being of each person. Skye Duncan, a designer at the New York City Department of City Planning, contributed to an ADG supplement called ”Shaping the Street Experience. She feels that designing at the scale of the individual is a key to shaping healthy cities. “Ultimately, health always brings it back to the scale and consideration of the person,” she says. “And if we're not building communities for people, who are we building for?”


Pop-up park at Madison Square in New York City, used as a case study in the Active Design Guidelines. All images courtesy of New York City departments of Design and Construction and Transportation.

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Aerial view of pop-up park at Madison Square in New York City, used as a case study in the Active Design Guidelines.

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Recent Related:

Design as Preventative Medicine

Arkansas Design Center Tackles Problems Omnipresent and Invisible

Building Healthier New Yorkers: Urban Design—Part I

Designing Healthier New Yorkers: Building Design—Part 2


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