Architects Aim for a Pandemic of Health

By Tye Farrow, FRAIC

The National Oncology Centre, Port of Spain, Trinidad and Tobago connects patients to serene, natural respite, which soothes the mind and thereby heals the body. Image courtesy of Farrow Partnership Architects Inc.

The word health, unfortunately, has become synonymous with healthcare deficiencies and austere cost-reduction measures. Heated debates over medical care insurance reform have obscured the bigger question of how to reduce overall use of and dependence on medical services.

For answers to our most dire chronic disease problems, we need to look outside the field of medicine. Many doctors would be the first to admit that their education taught them a lot about the causes of disease—pathology—and very little about creating health. Moreover, the assumption is that current conditions are likely to get worse.

In this culture of negative health, it’s no wonder that costs are out of control.

Who will teach the public how to cause health instead? This gap in knowledge creates an enormous opportunity for architects. The profession is in a premier position to create “pandemics of health,” that is to say, widespread outbreaks of health-causing design, which should be the essential focus of every city plan and the design of our schools, office buildings, and homes.

Now is the time for architects to claim and clarify their role in humanizing the places people live, work, play, and learn.
And it’s time to work with project decision makers to connect the dots between physical places, our state of mind, and our state of health. Chronic disease, alienation, and depression should not be seen primarily as personal deficiencies but rather as the result of unhealthy physical and social environments.

Architects can be the leaders in redirecting the $750 billion that are spent each year in America on unnecessary medical services, using that money instead to heal the built environment.
While the traditional standard of care for doctors has been to “do no harm,” the current burden of chronic disease, alienation, and depression will require a bigger agenda: accelerate a vast change in public demand for salutogenic (health-causing) design.

The first step in this quest is to recognize that we live in a world that has traditionally been fixated on pathologies and negative health anxieties. While ongoing research aimed at pinpointing what’s bad for us will continue to yield crucial medical breakthroughs, it’s time to balance pathology-oriented discoveries with an entirely different pursuit. To minimize the burden of illness on society, we need to launch a quest to create salutogenic places.

The fact that few people have ever heard the term salutogenic, while pathogenic is more common, tells us a lot about where the traditional focus of society has been. Salutogenic is the antithesis of pathogenic. It’s a big word for a simple idea: understanding what kind of environments make us feel better—humanized places that give whole communities the energy and motivation to lead healthier lives.

Humanizing changes in our built environment are beginning to break through everywhere, from small community projects to major city developments. But this humanizing movement needs more people who can analyze the difference between salutogenic and pathogenic places.

Generations of architects have tried to educate the public regarding how we create positive environments that feed the spirit. Five diagnostic vital signs can help any member of the public understand the most basic elements that contribute to healthy design. These plain-language questions have been created so that citizens and policy makers can look at their surroundings with a critical eye, then demand more from their built environment.

Five vital signs of healthy design

1.  Nature: Does the design include elements from the natural world?
2.  Authenticity: Does it reflect the values and deeply held beliefs of the people who live and work there?
3.  Variety: Does the design provide visual interest and support diverse activities?
4.  Vitality: Does the design convey energy and stimulate social interaction?
5.  Legacy: Does the design go beyond sustainability to advance long-term health and prosperity?

In the same way that public health awareness has now moved beyond the baby steps of designated smoking rows on airplanes, every citizen must come to demand the Five Vital Signs of salutogenic design for their cities and neighborhoods.

This is a golden opportunity for our profession to take a leadership role in minimizing the burden of illness on society by accelerating a quest to discover and apply the causes of health.

Tye Farrow delivers the keynote address on advancements in salutogenic design at Architecture Exchange East 2012, November 7-9, in Richmond. For more information on the annual conference and additional continuing education opportunities, visit www.archex.net.

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