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Diagnosing Design: Evaluating Health in Architecture

Green building rating systems are learning that “sustainable” also means “healthy”

By Nalina Moses, AIA

Public health design strategies challenge designers to think holistically about well-being. But the current ways that green building rating systems measure healthy design means relying on myriad independent, overlapping ratings systems, each with its own philosophy, scale, and focus.

These factors, and how they relate to design and health, are a new focus for the AIA. Last spring’s Design and Health Summit, presented by the AIA Foundation, the AIA, the ACSA, and supported by a grant from the NEA, moved this initiative to the top of the AIA’s agenda. From there, the Institute has refined its design and health focus into examining five factors: safety, sensory environments, physical activity, natural systems (or biophilic design), and environmental (or material) quality.

Perhaps the AIA’s first large-scale, comprehensive effort to codify the ways design specifically benefits users’ health was 2010’s Active Design Guidelines. Though it's structured as a set of recommendations and not as a rating system, the guidelines, developed by the City of New York with AIA New York, has been a landmark achievement in giving architects a tool to measure and improve the health impact of their projects. It’s a concise, health-focused design tool that offers voluntary strategies for planning landscape and building projects that encourage physical activity.

The creation of Active Design Guidelines helped architects put public health on the agenda of the most widely used architectural rating system around: LEED. LEED-certified projects had used active design strategies to earn the LEED Innovation credit for many years, but in 2009 architects and New York City's departments of Design and Construction, and Health and Mental Hygiene approached LEED to help establish a pilot credit for Design for Active Occupants. To qualify for the credit, a building must have one main stair that connects its entrance to all occupied and commonly used floors, and provide occupants access to fitness facilities.

Active design principles are also integrated within other LEED categories: “The [active design] strategies go hand-in-hand with some of the ideas of the transportation-related credits: Get people walking and biking instead of using fossil fuels that contribute to climate change and negatively impact air quality,” says Jacob Kriss, USGBC spokesperson. “The result is better health and less of an impact on the environment.”

LEED is an evolving rating system, and future editions can take up health topics more deeply. For example, in LEED v4 the low-emitting materials credit uses a more holistic approach to testing for VOCs, and includes all finishes in the building. In addition, the new materials ingredient credit incentivizes reporting the contents of building products. During AIA Convention 2014, in Chicago, the USGBC and the AIA collaborated on the Building Materials Data Jam, which convened a small group of cross-industry experts to discuss ways to leverage data to aid the selection of healthy materials for buildings.

In 2011, the USGBC established a rating system for healthcare facilities, LEED for Healthcare. There is no separate category in any of its ratings systems for more general health strategies; instead, credits pertaining to health are integrated throughout many different chapters. Credits are awarded for strategies that shape a healthy environment, reduce toxicants and pollutants, and contribute to global well-being through resource conservation.

Building on LEED

Other organizations have taken inspiration from LEED to establish ratings systems that integrate sustainability with specific health-related concerns. Developed by the American Society of Landscape Architects, the University of Texas Lady Bird Johnson Wildflower Center, and the U.S. Botanic Garden, the Sustainable SITES Initiative shares a format and credit structure with LEED. But rather than a reduction in resource consumption, it’s refocused to evaluate landscapes (with or without buildings), and to encourage environments that are regenerative and healing for both their respective ecosystems and the people that use them. “SITES is meant to be a complementary system to LEED, and also to take it one level further, maximizing benefits of regenerative site development instead of minimizing potential damage,” says Elizabeth Guthrie, staff executive to the Sustainable SITES Initiative.

Released in June, the latest version of SITES (SITES v.2) contains one additional point in the Human Health and Well-Being chapter for food production on-site. In SITES v.2, selective credits achieved in LEED can be carried over into the SITES system. And the organizations that administer SITES are working with the Green Building Certification Institute (GBCI), which maintains LEED credentials and certification, to do the same for SITES.

A future beyond buildings

The Living Building Challenge (LBC), established in 2006, is a comprehensive system that integrates health and sustainability with social and aesthetic concerns. The system was not designed to challenge LEED, and operates on a completely different playing field. Instead of being an incrementalist system with wide commercial appeal, the LBC is the most stringent green building rating system in existence, and is based on a set of absolute technical and non-technical requirements. Projects can qualify as “living buildings” only if they consume net-zero energy and water on an ecologically responsible site and produce net-zero waste. (The program offers three tiers of certification for projects that meet a subset of the overall criteria.) “We thought, ‘How can we respond to the urgency of climate change? How can we change what we as architects do completely, and what will that look like?’” says Amanda Sturgeon, FAIA, executive director of the International Living Future Institute. While she understands that LEED is a vital tool to guide architecture, she says, “[The] Living Building Challenge is thinking about a living future and creating built solutions that test the impossible.”

A health section was added to the 2.0 Living Building Challenge version, released in 2009. This part includes three requirements: operable windows, healthy air quality, and biophilia, which refers to shapes, forms, features, and relationships that promote connection to the natural world.  The idea is that a heightened awareness of daylight, landscape, and flora and fauna strengthens emotional and physical well-being for building users.

As the biophilia imperative suggests, the LBC goes a step further than other rating systems to integrate aesthetics, including a section entirely focused on beauty. Its requirements are assessed through a narrative written by the designers and an evaluation by building users. Sturgeon notes that this part serves not fanciful design gallery ideas and theories, but more fundamental ones about comfort, craft, and materiality, and how these factors shape an occupant's sense of well-being.

The newest version of the Living Building Challenge expands its investment in healthy buildings and people through additional material health criteria. It expands the list of toxic materials banned from LBC-certified projects. It also asks teams to use products approved by the Declare database, which tracks the composition and health ramifications of building materials and products. This version of the challenge also encourages more healthy and sustainable maintenance plans. For example, it asks for cleaning protocols that avoid use of toxic cleaning and maintenance supplies.

In the next several months, Sturgeon says, the Living Building Challenge will spin off a new rating system, the Living Product Challenge, which uses LBC criteria to judge not just building products, but any manufactured product, with the same focus on material health and sustainability.

Putting health first

A new building rating system, the WELL Building Standard is the first to make the physical and mental well-being of building users its top priority. WELL is administered by the International Well Building Institute (IWBI), a public benefit corporation founded to improve human health and well-being through the built environment, and launched at a Clinton Global Initiative (CGI) event. The system is currently being tested with pilot projects, and will be rolled out globally in the fall.

WELL was created to complement existing systems like LEED that focus broadly on environmental well-being. IWBI Founder Paul Scialla explains, “When creating WELL, I asked myself the question, ‘Why stop at building spaces that are good for just the environment? Why not also build these structures so they’re good for the people who live, work, and play in them?’”

The WELL guidelines will be structured similarly to LEED, with points accumulated incrementally across different categories to achieve different levels of certification. In contrast to LEED, a greater concentration of points will be awarded in post-construction evaluation rather than in compliance with design standards. “Compared to LEED, there will be more features in the WELL system based on the performance of buildings measured after occupancy,” Michelle Moore, IWBI senior vice president, says.

WELL includes categories for air, water, nourishment, light, and fitness, whose goals overlap with those of other ratings systems. And it treats health topics holistically in categories for comfort and mind, which focus on emotional and psychological well-being. Goals in these categories include improving acoustics, ergonomics, and immunity, and reducing anxiety and fatigue. For example, one goal is to incorporate current research about circadian light rhythms by designing lighting systems for building interiors that mimic natural light levels to bolster well-being and productivity.

Good and plenty

These ratings systems incorporate health questions while focusing on different overlapping areas. For architects and owners seeking an introduction to healthy design, the Active Design Guidelines and WELL Building Standard are excellent resources. Both focus on health, are written in accessible, non-technical language, and include checklists offering practical guidance. For architects already somewhat familiar with health questions, the LEED and SITES guidelines offer some powerful, specific design strategies to support health in design. And for experienced architects seeking a high level of implementation, the Living Building Challenge offers the opportunity to deeply integrate health issues into building design. Each rating system values community-scale planning strategies that are both sustainable and healthy, like compact urban development and less reliance on cars.

Designers and owners focused on health questions can also integrate ideas and techniques from different ratings systems by reaching for multiple certifications. The new Center for Sustainable Landscapes building at the Phipps Conservatory and Botanical Gardens in Pittsburgh, for example, has a program committed to sustainability, connection to the landscape, and community education. To better embody these principles, it has been designed for both LEED Platinum and Living Building Challenge certification, and for its landscape to qualify for SITES certification. While the WELL Building Standard is being developed with a singular focus on health, it’s likely that established ratings systems will continue to integrate and elaborate healthy design issues, so that all systems will be moving closer to alignment with one another.

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The Center for Sustainable Landscapes at the Phipps Conservatory and Botanical Gardens in Pittsburgh, designed by Design Alliance Architects. This new building and its surrounding landscape were designed to achieve LEED Platinum, Living Building Challenge, and SITES certification. Photo courtesy of Design Alliance Architects.

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A rendering of the central staircase at the New York Police Academy, designed by Perkins + Will. This project is on track to receive a LEED pilot point for Active Design. Image courtesy of Perkins + Will.

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