Green infrastructure serving walkable, mixed-use communiities; benign construction materials; durable, day-lit buildings; renewable energy. These are ingrediencts in a familiar prescription for a more sustainable built environment. What the design community now realizes is that it's also a prescription for better public health.
The leading killers of our time are chronic ailments: heart disease, strokes, cancers, and diabetes. They share common risk factors: obesity, physical inactivity, poor diet, and smoking. New collaborations between the health and place-making professions are confirming that most of these conditions, as well as others, respond to a common factor: the built environment.
The impact of design on public health is becoming more widely appreciated–and some observers believe this recognition is long overdue. "Before we prescribe a medicine, it has to be proved safe and efficacious–but if we prescribe a place design, no evidence is required," says Howard Frumkin, dean of the University of Washington's School of Public Health. The result, he says, is "a slow-moving catastrophe."
As obesity and type 2 diabetes rates soar nationally, the city of New York is taking steps to turn this catastrophe around. And in this case, "taking steps" is more than a figure of speech. The city's Active Design Guidelines, released in 2010, aim to foster built environments that promote physical activity, advocating design strategies for neighborhoods, streets, and outdoor spaces that encourage active transportation and recreation, and buildings that allow occupants to incorporate regular physical activity into their daily lives.
Putting these principles into practice is Via Verde, a LEED Gold–targeted affordable housing development in New York's South Bronx that has just opened. "Design is not the sole answer," says William Stein, a principal of Dattner Architects, the authors of Via Verde with Grimshaw Architects and developers Phipps Houses and Jonathan Rose Companies, "but certainly the built environment can have a significant impact."
Via Verde's big move is its massing, descending in steps from a 20-story tower down to a central courtyard, which creates a series of terraced roofs. These roofs are linked with stairs to a fitness center on the seventh floor, and are planted with gardens–vegetable plots, Christmas trees, an orchard–that invite residents to use them. The gardens do not only retain rainwater, improve building energy performance, and mitigate urban heat island effect; they also provide residents with access to fresh food, and integrate nature into their lives.
This integration of nature provides daily doses of what a Dutch research team has called "Vitamin G." In a 2006 study, Peter Groenewegen and colleagues correlated health data from across the Netherlands with access to green space, including household and community gardens, neighborhood parks, and larger natural areas. Their results indicate that people with access to nature are physically and mentally healthier than those without.
The mechanism by which Vitamin G boosts health is still under investigation. It could be the exercise, of course. It could also be the social interactions that result from getting out, walking, or gardening: Ongoing research into social capital and health by Ichiro Kawachi of Harvard University's department of society, human development, and health finds an association between people's health and their perceptions of the trustworthiness of other people in their community. Or it could be an effect of the view itself: A 2001 study by Frances Kuo at the University of Illinois found that, of 145 residents of a Chicago public housing project, those with a view of trees were better able to cope with life's demands than those with a barren view.
Another project integrating nature to support users' well-being is the UCSF Medical Center's new hospital at Mission Bay, in San Francisco. When the facility opens in 2014, the most apparent difference compared with traditional hospitals will be patients' access to daylight, views, and gardens that will enable them "to get away for a while from the burdens of being a patient," says Elena Gates, UCSF chief of gynecology. This trend in health-care design is becoming more common, thanks to studies that indicate that patient rooms with views of nature result in shorter hospital stays and reduced pain.
The UCSF garden design uses native and low-maintenance plants selected to attract butterflies and birds–something already known to be good for the environment–and, wherever possible, privacy is achieved with landscape contouring, shrubs, and trees to offer beauty to patients looking out. The design provides benefits not only to patients: "We all like to work in a beautiful place," says Gates. "We feel it every day."