Enhancing Well-Being and Sustainability: The Role of Green Buildings in Creating Healthy Built Environments
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| Source: nazmanm/elements.envato.com |
At the most basic level, health and well-being are about not damaging people or the environment with shelters meant to protect us. All our decisions have long-term consequences for the health of the people who live and work in the spaces we are designing. This article argues that the creation of safe, beautiful, supportive environments for individuals and society is a professional obligation of design professionals. It explains how our design choices at urban, neighbourhood, site and building scales have long-term effects on human health and well-being. General results from a few post-occupancy evaluation studies on the indoor environmental quality (IEQ) performance of green and non-green buildings are highlighted. Finally, the extent to which existing third-party rating systems address human health and well-being is explored.
Professional Obligation
Health and well-being are fundamental to human survival and foundational to comfort and sustainability. The Preamble to the World Health Organization Constitution defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" [1]. In general, health is a status of an absence of disease, well physiological and psychological conditions, happiness, comfort and well-being.
Many contemporary chronic health issues trace their origin to the failing of the built environment. Every detail and aspect of the built environment affects us physically, psychologically, and subconsciously. It also affects energy performance, the quality of our social interactions, the surrounding community, and the ecosystem.
As sustainable designers, we have the opportunity to consciously design the built environment on every level to reduce stress, improve health, and be beautiful. By doing so, we show empathy and respect for all populations, socioeconomic levels, and racial groups since it is a form of equity that allows everyone accesses to good design benefits. Just as a chain is only as strong as its weakest link, so too, a society only prospers when all its members prosper. We also know that satisfaction with life transfers to how we treat others, which has enormous social implications.
Health and Well-being at Scales
Understanding that all our design choices have long-term effects on the occupants, society, and environment is crucial for integral sustainable design. Understanding the basic principles of personal health and well-being should inform all our choices at every scale.
At the urban scale, creating an environment that is inherently healthy physically, mentally, and emotionally requires considering how to make urban areas more walkable and aesthetically diverse. Studies have shown that people are more willing to walk if their cities have a greater variety of finishes, materials, landscape types, and routes to the same destination.
At the neighbourhood and site scale, allowing residents to live close to where they work and shop with easy access to restaurants and entertainment allows people to walk rather than drive. Having amenities conveniently located is essential and saves on emissions. It also promotes physical, mental, and emotional health.
Strategies employed at the building scale have great potential to increase health and well-being. Thirty years of public health science and building science have demonstrated that buildings play a crucial role in shaping our health.
For example, buildings can create conditions that are harmful to health or conducive to health in the following ways:
- They determine our exposure to outdoor pollutants, by either facilitating the entry of particles of outdoor origin indoors, or acting as a barrier and removing them through enhanced filtration;
- They govern exposure to chemicals of concern, such as volatile organic compounds (VOCs), flame retardants and polyfluorinated compounds, which can be ubiquitous or nonexistent, depending on the decisions we make regarding building materials and products;
- Building either protects us from noise or contributes to the problem through the introduction of indoor sources, poor noise insulation, or poor acoustical design;
- They can induce eye strain or improve alertness through impacts on circadian rhythm, depending on the lighting system;
- Buildings can protect us during heat events, or create environments that magnify the problem through solar heat gain; and
- Buildings can either wall us off from nature or connect us to it.
Studies document increased employee health, well-being and productivity closely tied to the quality of a building's interior environment [2,3]. According to a study on buildings and health, "The indoor built environment plays a critical role in our overall well-being because of both the amount of time we spend indoors (~90%) and the ability of buildings to positively or negatively influence our health" [4].
When looking at the overall business operational costs, 90% of the costs are related to employees' salaries, benefits, and healthcare [5]. Browning et al. [6] verified that human costs are 112 times greater than energy costs in the workplace.
The fact that employees are the most significant expense in a workplace operation has compelled organisations to be concerned about human factors in green building development. Green buildings have focused on energy efficiency and environmental stewardship. More recently, human health and wellness are becoming core considerations. Besides minimising environmental impacts, green buildings aim to improve health, well-being, and productivity via optimisation of workplace environments: daylighting, natural ventilation, thermal comfort, natural view, open space, places of respite, and other comforts.
Green buildings influence human health at two critically important scales: directly at the individual level through providing optimised indoor environments, and indirectly on a population level through reductions in energy use and thus reductions in air pollutants that cause premature death, cardiovascular disease, exacerbate asthma conditions and contribute to global climate change, itself associated with a cascade of adverse human health impacts.
IEQ: Green vs Non-Green Buildings
The literature suggests that indoor environmental quality (IEQ) credits in sustainability rating systems (or SRSs, which are explained in the next section) translate into improved IEQ. A study by the Harvard T.H. Chan School of Public Health [7] that reviewed 17 studies on green buildings and health revealed that overall, occupants report better IEQ and fewer health problems in these buildings than in non-green buildings.
These reviewed studies found lower VOCs, formaldehyde, allergens, nitrogen dioxide, and particulate matter in green buildings, which have been shown to impact health separately. Six of the reviewed studies tracked occupants' health in addition to IEQ, and all six found improvements in green buildings. These include reduced asthma and allergy symptoms in offices, reduced respiratory symptoms, fewer sick building symptoms, better self-reported well-being in public housing, fewer medical errors and decreased mortality in hospitals.
Newsham et al. [8] found an improvement in IEQ, a reduction in symptoms, and better sleep quality in green buildings. A follow-up paper by Colton et al. [9] found that the green-certified public housing development reduced hospital visits and school absences in addition to fewer asthma symptoms.
The Centre for the Built Environment at the University of California, Berkeley, reviewed more than 33,000 surveys of occupant satisfaction in more than 200 buildings, including 16 green-certified buildings [10]. The study showed a statistically significant gain in certified green buildings, compared with those that were not certified, considering air quality and thermal comfort.
In the words of the researchers: "Our results suggest that, on average, the strategies commonly employed in green buildings have been effective in improving occupant satisfaction with air quality and thermal comfort" [10]. Building operators should then ask themselves: What could higher occupant satisfaction do to improve productivity, reduce health costs, lower employee turnover, and improve morale in any organisation?
Google and other large organisations are using well-designed buildings to attract and keep the best talent. Hospitals are doing the same thing because employees are frequently in high-stress situations. The trend towards making hospitals more aesthetically attractive, the introduction of outdoor garden spaces, the improved interior design of spaces, and private rooms with more daylight, are made not just as a marketing strategy to get more patients. Still, it also helps people heal faster and retain staff.
These do provide an economic benefit to the hospital, but they also address, experience, and connect with nature; create equity; and promote the health and well-being of patients and staff. Health and well-being are something that should be considered in every project, not just healthcare projects.
Third-party Rating Systems
Sustainability has been driven primarily by sustainability rating systems (SRSs) in buildings. The presence of green buildings now extends to more than 160 countries, assessed with more than 40 SRSs, as the World Green Building Council reported. Examples of SRS include LEED (U.S), BREEAM (U.K.), Green Mark (Singapore), BEAM Plus (Hongkong), DGNB (Germany), Green Star (Australia) and Green Building Index (Malaysia), to name a few.
In principle, SRSs share a similar approach: a performance evaluation of a building on domains such as site, energy and water consumption, use of natural resources, and IEQ. Apart from assessing the effects on the environment, most SRSs also address human health and well-being within the building to some extent. Increased attention and focus on a healthy interior environment are seen in the expanding role of human health and wellness in these SRSs.
Illankoon et al. [11] identified that in the often-used SRSs, energy remains the most important criterion, followed by IEQ and Water. Notably, the IEQ key credit assesses many topics connected with the occupants' health and well-being. However, the vast extent of different topics that are covered in the SRS that evaluate the sustainability of buildings omits certain topics related to health and well-being.
In contrast to the SRSs mentioned above, unique rating systems have been developed, focusing only on health and well-being due to increasing attention to building-related health problems. These are referred to as "wellness rating systems" as they were developed to promote occupant health and wellness as their primary motivator, which contrasts with SRSs that were developed to promote environmental sustainability as their primary motivator.
Such rating systems are, for example, WELL, launched in 2014 by the International WELL Building Institute [12], Living Building Challenge, created by the International Living Future Institute in 2006 [13]; and Fitwell, launched by the Centre for Active Design [14].
These dedicated rating systems were developed not to replace the existing SRSs that evaluate the sustainability of buildings but to emphasise that special attention is needed within a building to ensure the occupants' health and well-being. However, among them, WELL is the most well-known certification system. It has very carefully developed specific topics and criteria for evaluating the building and extended the scope beyond the physical building's boundaries. It is claimed to be the leading certification scheme for assessing buildings' health and sustainability [12].
McArthur and Powell [15] conducted a systematic review of 11 rating systems (i.e. Fitwel, WELL, Living Building Challenge, BEAM Plus, BREEAM, DGNB, Green Globes, Green Mark, Green Star, HQE, and LEED) and suggest eight themes (and their respective sub-themes) for a health building, as shown in Table 1. They concluded that overall, SRSs consider a significant and differing breadth of credits that have a positive physical, social, and/or psychological benefit to building occupants.
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| Table 1: 8 themes (and sub-themes) for a healthy building Adapted from McArthur and Powell (2020) |
HQE and DGNB have been found to be significant in their coverage of IEQ and social well-being requirements, respectively. LEED has a smaller number of credits focused on health and well-being than WELL, but these credits have been found to be consistent with WELL.
There has been a significant shift towards incorporating requirements for occupant health and well-being in newer versions of SRSs, showing the increasing interest in this area by building designers and end-users. Given this, a review of Malaysia's Green Building Index rating system from a health and well-being perspective will likely greatly value the local building industry.
Conclusion
Building for health is the future paradigm that focuses on ecosystem health (green buildings) and indoor health (healthy buildings). Today, the challenge lies in accomplishing a healthy, comfortable, convenient and safe built environment with low resource consumption.
In Malaysia, it is recommended to create greater public awareness of buildings' health impacts and encourage building codes to place increased emphasis on healthier building practices. Concentrating on energy alone would pose a danger of neglecting the real purpose of architecture, which is to provide for people's well-being. A balance between these requirements is necessary.
Finally, a word or two on perspective. The famous poet Wendell Berry wrote, "No place can be considered healthy until all places are healthy." This phrase serves to remind us of the interconnectedness of these things and the fallacy of describing a building as 'healthy', particularly when we cannot control how a building will be used.
References
[1] World Health Organization [WHO] (2021). Constitution.
[2] Singh, A. & Syal, M. (2010). Effects of green buildings on employee health and productivity. American Journal of Public Health, 100, 1665-1669.
[3] Xue, F., Gou, Z., Siu, S. & Lau, Y. (2016). Human factors in green office building design: The impact of workplace green features on health perceptions in high-rise high-density Asian cities. Sustainability, 8, 1095.
[4] Allen, J.G., MacNaughton, P., Satish, U., Santanam, S., Vallarino, J. & Spengler, J.D. (2016). Associations of cognitive function scores with carbon dioxide, ventilation, and volatile organic compound exposures in office workers: A controlled exposure study of green and conventional office environments. Environmental Health Perspectives, 124 (6), 805-12.
[5] World Green Building Council [WGBC] (2014). Health, Wellbeing & Producitivity in Offices: The Next Chapter for Green Building.
[6] Browning, W., Labruto, L., Kallianpurkar, N., Ryan, C., Watson, S., & Knop, T. (2012). The Economics of Biophilia: Why Designing with Nature in Mind Makes Financial Sense. Terrapin Bright Green LLC.
[7] Allen, J.G. MacNaughton, P., Laurent, J.G.C., Flanigan, S.S., Eitland, E.S. & Spengler, J.D. (2015). Green buildings and health. Current Environmental Health Reports, 2 (3), 250-258.
[8] Newsham, G., Birt, B., Arsenault, C., Thompson, L., Veitch, J., Mancini, S., Galasiu, A., Gover, B., Macdonald, I. & Burns, G. (2012). Do green buildings outperform conventional buildings? Indoor environment and energy performance in North American offices, in National Research Council Canada. Research Report; No. RR-329, National Research Council Canada.
[9] Colton, M., Laurent, J.G., MacNoughton, P., Kane, J., Bennett-Fripp, M., Spengler, J. & Adamkiewicz, G. (2015). Health benefits of green public housing: Associations with asthma morbidity and building-related symptoms. American Journal of Public Health, 105 (12), 2452-9.
[10] Abbaszadeh, S., Zagreus, L., Lehrer, D. & Huizenga, C. (2006). Occupant satisfaction with indoor environmental quality in green buildings. Proceedings, Healthy Buildings, Vol. III, 365-70, Lisbon, Portugal. June.
[11] Illankoon, I.M.C.S., Tam, V.W.Y., Le, K.N. & Shen, L. (2017). Key criteria among international green building rating tools. Journal of Cleaner Production, 164, 209-220.
[12] International WELL Building Institure [WBI] (2020). WELL v2.
[13] International Living Future Institute [ILFI] (2021). Living Building Challenge 4.0.
[14] U.S. General Services Administration [USGSA] (2019). Fitwel.
[15] McArthur, J.J. & Powell, C. (2020). Health and wellness in commercial buildings: Systematic review of sustainable building rating systems and alignment with contemporary research. Building and Environment, 171, 106635.
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