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Healthy building refers to an emerging area of interest that supports the physical, psychological, and social health and well-being of people in buildings and the built environment. Buildings can be key promoters of health and well-being since most people spend a majority of their time indoors. According to the National Human Activity Pattern Survey, Americans spend “an average of 87% of their time in enclosed buildings and about 6% of their time in enclosed vehicles.”
Healthy building can be seen as the next generation of green building that not only includes environmentally responsible and resource-efficient building concepts, but also integrates “health, wellness, and human experience in buildings.” These benefits can include “reducing absenteeism and presenteeism, lowering health care costs, and improving individual and organizational performance.” Healthy building encompasses a wide range of concepts and applications that promote human health which include but are not limited to: site selection and construction, occupant engagement, personal control, indoor environmental quality, daylighting, biophilic design, access to potable water, healthy dining options, exercise in the workplace, and smoking restrictions.
Healthy building involves many different concepts, fields of interest, and disciplines. As such, taking an integrative or integrated design approach is essential to successfully creating a healthy building. Forming a diverse and interdisciplinary team early in the process can generate integrated or complementary strategies for improved performance or health impact considerations. An integrated design team can consist of stakeholders and specialists such as facility managers, architects, building engineers, health and wellness experts, and public health partners. Conducting charrettes with an integrated design team can foster collaboration and help the team develop goals, plans, and solutions.
Buildings and health components
There are many different components that can support health and well-being in buildings.
Site selection is an important factor in designing a building and ensuring positive health and environmental impacts. Creating a walkable environment that connects people to workplaces, green spaces, public transportation, fitness centers, and other basic needs and services can influence daily physical activity, “the distances people travel to work, the convenience of purchasing healthy foods, and the safety and attractiveness of neighborhoods for walking.” In particular, proximity to green spaces (e.g., parks, walking trails, gardens, etc.) or therapeutic landscapes can reduce absenteeism and improve well-being.
There are many aspects of a building that can be designed to support positive health and well-being. For example, creating well-placed collaboration and social areas (e.g., break rooms, open collaboration areas, cafe spaces, courtyard gardens) can encourage social interaction and well-being. Quiet and wellness rooms can provide quiet zones or rooms that help improve well-being and mindfulness. Specifically, a designated lactation room can support nursing mothers by providing privacy and helping them return to work more easily. A lactation room is required for offices with more than 50 employees and recommended for all other offices. Another design aspect to consider is biophilic design, which focuses on reconnecting people to the natural environment. Biophilic design has been linked to health outcomes such as stress reduction, enhanced mood, improved cognitive performance, enhanced social engagement, enhanced sleep, and enhanced movement. Ergonomics can also minimize stress and strain on the body by providing ergonomically designed workstations.
Indoor environmental quality
According to the National Institute for Occupational Safety and Health, "Indoor environmental quality refers to the quality of a building’s environment in relation to the health and wellbeing of those who occupy space within it."  Better indoor environmental quality can enhance the lives of occupants and increase the value of the building. Healthy indoor environmental quality is determined by many factors, including indoor air quality, lighting and views, thermal condition, and noise.  By optimizing the environmental factors, the goal of healthy indoor environment quality often focuses on providing comfortable environments for occupants, minimizing the risk of building-related health problems and producing a stimulating environment which increase occupants’ well-being.
Indoor air quality
Indoor air quality is an important determinant of healthy design. Buildings with poor indoor air quality can contribute to the inflammation, chronic lung diseases such as asthma, asbestosis and lung cancer. Occupants who have chronic lung disease have greater risk when they are exposed to indoor pollutants. Indoor air quality should be controlled from design phase, to construction phase and to the final occupancy phase. To maintain a healthy indoor air quality, designers should choose furnishing and building materials with low chemical emissions so as to eliminate the sources of volatile organic compounds (VOCs) and semi-volatile compound (SVOCs) , and not choose material like asbestos, which will lead to serious lung disease. Except for the source control method, another commonly used control strategy is the dilution of the indoor contaminants by ventilation. Well-designed ventilation system should be sufficient to dilute the contaminant, keep the concentrations level below the risk threshold and maintain acceptable indoor air quality (ANSI/ASHRAE Standards 62.1 , 62.2 and 170 ). Building managers also need to respond to the occupants’ health concerns about the air quality by gathering feedback from post-occupancy evaluation.
Lighting and View
Light has a direct effect on human health because of how it affects circadian rhythms. With the development of green and healthy building, daylighting become an important design consideration. Daylighting refers to providing access to natural daylight, which can be aesthetically pleasing and improve sleep duration and quality.  If daylighting is not available, supplemental electric lighting can help ensure occupants receive enough light for the entrainment of circadian rhythms. Window allows the introduction of daylight into the in the indoor environments  and also they can provide a view to the outside environment. View to outside can largely affect human’s physiological and psychological response, such as influencing the recovery from the surgery ,the psychophysiological stress reduction , the induction of positive emotion, etc. Especially, providing a view to nature through a glass window may benefit occupants’ well-being and increase employee’s effectiveness.
Providing access to water and healthy, nutritional food is essential to promoting health and a quality environment. The design of a building should take into consideration proximity to water and nutritional foods via cafeterias, vending machines, local stores and restaurants or farmers’ markets.
Site selection and building design can promote increased physical activity and exercise. Well-lit and accessible stairwells can provide building occupants the opportunity to increase regular physical activity. Fitness centers or an exercise room can encourage exercise during the work day, which can improve mood and performance, leading to improved focus and better work-based relationships. Exercise can also be promoted by encouraging alternative means of transportation (e.g., cycling, walking, running) to and from the building. Providing facilities such as bicycle storage and locker/changing rooms can increase the appeal of cycling, walking, or running. Active workstations, such as of sit/stand desks, treadmill desks, or cycle desks, can encourage increased movement and exercise as well.
While some components of healthy buildings are inherently designed into the built environment, other components rely on the behavioral change of occupants, users, or organizations residing within the building. “Behavioral measures” can be taken to “encourage better public health outcomes: e.g., reducing sedentary behaviors by increasing access to stairways, using more active transportation options, and working at sit-to-stand desks.” Other examples that can promote health and well-being include establishing workplace wellness programs, health promotion campaigns, and encouraging activity and collaboration.
Health and well-being in standards and rating systems
There are several international and governmental standards, guidelines, and building rating systems that incorporate health and well-being concepts:
- WELL Building Standard
- Green Building Initiative Green Globes
- Leadership in Energy and Environmental Design
- ANSI/ASHRAE/USGBC/IES Standard 189.1-2014, Standard for the Design of High-Performance Green Buildings
- United States Department of Defense Unified Facilities Criteria Program
- General Services Administration Facilities Standards for the Public Buildings Service (P-100)
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