The built environment significantly impacts public health, yet its potential as a tool for health promotion remains largely unrecognized. Historically, architects and urban planners have explored the connections between design and health, identifying foundational factors that improve a building's health performance. Built environment professionals possess compelling evidence on how spatial interventions can improve health outcomes, yet health practitioners often lack this perspective. Breaking down these silos is essential in the creation of spaces that promote occupant well-being.
Early efforts to highlight the interplay between built environments and health faced resistance. The idea was considered niche, with limited recognition of how design affects physical and emotional well-being. However, the narrative has evolved with the urban planning industry now acknowledging the emotional and physical impact of spaces. "The pandemic was a wake-up call that showed us how the built environment complements our health. It pushed issues like indoor air quality and trust in spaces of co-existence into the spotlight", Sara Karerat, Managing Director of Center for Active Design clarifies.
The pandemic brought to light the complexity of managing built environments. Stakeholders faced challenges in building a sense trust and ensuring safety within shared spaces. To mitigate this, transparent communication, enhanced cleaning practices, and responsive programming had to be implemented. By prioritizing honest reporting and stakeholder collaboration, these efforts addressed immediate health concerns while setting a foundation for long-term resilience.
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The Future of Work: Sentient Workplaces for Employee Wellbeing"Architects and stakeholders shape our interactions with spaces, influencing both individual and collective health outcomes", shares Karerat. Her professional journey through the nonprofit, public, and private sectors emphasizes the systemic change needed to drive market transformation in real estate—a field with significant implications for daily behaviors, spatial experiences, and community well-being. However, strategic alignment between architecture and public health remains underdeveloped, calling for an interdisciplinary approach to design.
Organizations like Fitwel's Center for Active Design and the Urban Land Institute have championed this cause, gradually bringing public health to the forefront of urban design discussions. The pandemic accelerated awareness around issues such as indoor air quality, emphasizing the need for interdisciplinary strategies to improve occupant health. What was once an emerging concept is now central to conversations about resilience, economic vitality, and asset performance.
Sustainability and Wellness as a Joint Approach
"Too often, sustainability and occupant wellness are treated as separate priorities. This segmentation and siloed thinking prevent practitioners from creating integrated solutions that could both optimize ecological and societal well-being", states Karerat. Historical missteps, such as "sick building syndrome," illustrate the dangers of prioritizing one at the expense of the other. By adopting an integrated approach to sustainability and wellness and seeing them as two sides of the same coin, stakeholders may also be convinced to invest in healthy and energy-efficient buildings.
Frameworks like Environmental, Social, and Governance (ESG) criteria also point to the inevitable interconnectedness of these priorities. While environmental considerations have gained traction, the social aspects of building design are gradually being addressed for their impact on occupant well-being. Building owners may prioritize operational efficiency, while tenants focus on employee satisfaction. The challenge lies in aligning opposing interests through integrated design strategies that demonstrate the long-term value of sustainable, wellness-oriented design.
For instance, addressing the heat island effect through green infrastructure can simultaneously address urban heat, promote mental restoration, encourage outdoor activity, and reduce carbon emissions. Incorporating biophilic design elements—such as natural light, greenery, and improved ventilation—can enhance indoor air quality, boost productivity, and reduce energy consumption. The benefits of environment-led design trickle into occupant wellness, and vice versa.
Equity and Community Engagement in Design
The public health perspective towards architecture recognizes that buildings within broader community ecosystems. Design interventions must therefore consider how individual assets integrate into their surroundings. This approach requires intentionality to prevent exacerbating social and economic disparities.
One strategy is incorporating community-centric elements, such as retail spaces or public amenities on ground floors, to encourage engagement. Mixed-income housing developments and a focus on affordable units serve as positive mechanisms for advancing socioeconomic equity. The development process must involve active listening to community needs and ensure that the project serves the needs of its real constituents.
Repurposing existing structures, for example, is a versatile solution that minimizes carbon footprints, honors historical architectural significance, and ensures compliance with contemporary health and safety regulations. Complementary approaches to infrastructure design that anticipate climate challenges may also safeguard communities and prevent economic disruptions.
To drive systemic change, stakeholders must recognize environmental and wellbeing-led design as a strategic investment rather than an additional expense. Holistic approaches that integrate health, sustainability, and equity can enhance building value, occupant satisfaction, and asset resilience. Adopting a joint approach to these issues enables the real estate and design industries to produce environments that support long-term well-being and economic vitality.
Karerat believes "The future lies in interdisciplinary collaboration. By merging smart building technology with resilient planning and behavioral insights, we can design spaces that are adaptable, equitable, and sustainable." By integrating diverse perspectives, the real estate industry will be poised with a unique opportunity to lead this transformation. By prioritizing holistic design, stakeholders can create spaces that not only meet immediate needs but also contribute to broader societal goals.
Public health and architectural design converge into a pervasive approach to confront contemporary global challenges. Reimagining the built environment as a catalyst for wellness demands interdisciplinary collaboration, breaking traditional professional boundaries, and developing comprehensive strategies that simultaneously consider environmental and community well-being.
