The pursuit of wellness: designing healthy buildings

Take a breath, stop what you’re doing, focus: how are you feeling? Good, energized, at the top of your game? Not so good? Tired, anxious, stressed out?

Have you ever wondered if it’s the workplace you’re sitting in that’s making you feel that way? How is the noise level? Lighting? Air quality? Do you have a view and, if so, of what? And why are you sitting anyway? When was the last time you stood up or took the stairs?

Few would argue with the idea that all of these things — and a great many more — have the capacity to affect not only our health, but also our stress and energy levels, happiness and motivation. Bundle all these hard-to-define factors together, and you have what is fast becoming a hugely significant global trend: wellness.

Wellness is a booming industry, despite — or perhaps because of — the fact that it’s a difficult concept to pin down. The not-for-profit Global Wellness Institute estimates that the wellness economy was worth US$3.7 trillion in 2015, encompassing a sprawling range of sectors from beauty, fitness and nutrition to personalized medicine and wellness tourism. This also includes “wellness lifestyle real estate” worth US$118.6bn, and a US$43.3bn workplace wellness market, at present covering less than a tenth of the global workforce. Both are forecast to grow strongly.

The new sustainability

What this adds up to is huge potential demand for buildings, even whole neighbourhoods, that are designed to make their occupants healthier, happier and more productive. There are already a number of certification programmes for such schemes, including WELL, Fitwel, Reset and the Living Building Challenge; and established sustainability standards such as LEED and BREEAM are now adding wellness criteria too.

Wellness looks very much like the next big thing in building design — the new “green”, as the blurb for University College London’s postgraduate course in Health, Wellbeing and Sustainable Buildings, launched in September 2017, would have it. For decades, environmental considerations have been to the fore in architectural and engineering thinking, the aim being to create highly efficient buildings that used as little energy and water as possible. Now, however, there is a growing concern that a focus on efficiency might have caused designers to lose the plot somewhat. Certainly efficient buildings save money and are better for the planet, but what about the people in them?

“Over the past few decades we’ve spent a lot of time and effort trying to reduce energy use, and there are very good reasons for that,” says John Mlade, director at YR&G, a sustainability consultancy recently acquired by WSP. “But look at it from the point of view of a building occupier. Energy might represent 1% of their expenditure, with another 10% or so going on rent and leases. The rest, the vast majority, goes on employee salaries and benefits.”

This is the killer statistic that has allowed wellness to rise up the agenda far more quickly than sustainability did before it. Saving 1% is all very well, but if you can increase the productivity of the workforce by improving their environment, the potential returns on investment are far, far greater.

“Now you’re talking about something that will really make an impact,” says Mlade. “Sure, the client wants to do the right thing environmentally and they have that responsibility. But as designers we have to focus on our clients’ goals, and we have to recognize that energy is not their primary business.“

Like many others in the field, Mlade has spent most of his career focusing on sustainability and the technologies that can reduce energy consumption and therefore mitigate climate change. He admits that the current refocus towards people has involved a change of mindset, one that has been a long time coming. “Energy hasn’t stopped being important, but we are a lot more competent around it now. A lot of this research on internal environment and productivity has been around for a long time — some of it dates from the 1980s. The design industry has been very slow to pick it up and slow to recognize the benefits.”

Why now?

The game-changer, Mlade believes, has been the introduction of wellness standards, in particular WELL and Fitwel. “You can design with the wellness of occupants at the heart of what you do, but it’s hard to sell that without frameworks to inform the design process — a handle to grab onto, something to show the client. WELL and Fitwel do that, and it’s made all the difference.”

WELL certification is offered by the International WELL Building Institute (IWBI) a public benefit corporation launched in 2013. It is rigorous and relatively expensive, costing perhaps US$40,000 per year for a 100,000ft² building and involving continuing evaluation by an independent assessor.

In addition to monitoring the qualities of light, noise, air and water in a building, the assessor will look into areas less obviously within the purview of building designers — canteen menus and paternity policies, for example, or wearable tech that monitors occupants’ activity and sleep. Certain standards are prerequisites for certification while others are optional and enable buildings to achieve the higher levels of certification, graded silver, gold and platinum.

In contrast, US-based Fitwel, administered by the Center for Active Design, has no prerequisites and is more subjective, relying on feedback from occupants. It also costs much less — perhaps US$5,000 for a 100,000ft² building. “It is not as in-depth as WELL, but is much more accessible,” says Mlade. “Not everyone can afford WELL, which I think will succeed mainly among higher-spec office buildings.”

WELL certainly seems to be taking off. In spring 2016, 107 buildings totalling 22 million ft² were certified. By spring 2018, 753 projects, more than 140 million ft², had been registered in 32 countries. But while such schemes do provide a framework for conversations about wellness, they don’t in themselves explain why this is now becoming a priority for so many building owners and employers.

As so often, the momentum for change seems to have sprung from a timely confluence of several trends, as WSP technical director and wellness specialist Meike Borchers explains: “First, there is a bottom-up driver. These days, occupants — employees — understand how the environment affects them far better. People are very aware, for example, of pollution levels here in London. In China, where it is an even more pressing issue, people pay a lot of money for places with cleaner or filtered air.”

Increasing gym use, wrist gadgets, even the popularity of organic food all testify to our growing preoccupation with health: “So naturally we are also taking more interest in our working environment.”

Borchers says that this is having a big impact on the competitive markets for both corporate occupiers and employees: “The top-down driver is that for building owners, wellness has become a way of attracting big tenants. And for the tenants, occupying a building designed for wellness has become a way of attracting and retaining the best staff.”

Trends in office development bear this out. High-ceilinged, naturally ventilated office space is becoming more popular — for example, developer Derwent London justified the added investment in its recently completed White Collar Factory, which has floor-to-ceiling heights of 3.5m, on the grounds that such buildings let quicker and rent for more.

Wellness can also be a powerful point of differentiation in vibrant but less established property markets. Polish developer HB Reavis has just achieved Europe’s first WELL core-and-shell precertification for the Varso Place tower in Warsaw. It is designed by Foster + Partners and set to be Poland’s tallest building when it completes in 2020, but the developer has chosen to pursue the WELL standard to further set it apart. “We know that almost anyone running a business these days, of any size, is highly concerned about recruiting and retaining talent and about productivity,” says HB Reavis chief executive Pavel Trenka. “So we believe that creating workspaces that keep people healthy, happy and energized is a critical service we should offer.”

The wellness measure

The presumption behind all this is that a happy, healthy workforce is more productive and less likely to take time off through illness or to change jobs than a tired, stressed and unhealthy one. So much is intuitive and hardly new. In the 1870s, George Cadbury helped to set new standards for working conditions in England with his Bourneville Factory near Birmingham. Less clear, however, is which design interventions are the most effective. Working conditions have come a long way since Victorian times and so further improvements inevitably suffer from diminishing returns, which are, furthermore, difficult to calculate. Pay rent on a dedicated meditation space in your uptown HQ for example, and you will struggle to work out whether it has been worth the money.

Does the science really prove the case that wellness design boosts productivity? Research on this topic has a tendency to descend into glibness along the lines of “people prefer to work in nice buildings” or, as one UK university discovered: “Building temperature should be neither too hot, nor too cold.”

“The research ranges from the robust to the frankly somewhat flaky,” agrees Borchers, adding that the most convincing studies tend to focus at a more basic level. Take air quality, for example. In 2015, researchers at Harvard University subjected groups of office workers to three different air-quality environments: conventional, “green” and enhanced. The enhanced group enjoyed air with the lowest levels of carbon dioxide (CO₂) and volatile organic compounds (VOCs) of the type emitted from paint and synthetic materials in carpets and plastics, as well as boosted ventilation generally. This group were found to perform cognitive tests 101% better than those breathing conventional air, while those in the workspace typically found in a green-certified building scored 61% higher. CO₂, VOCs and ventilation rate all had significant, independent impacts on cognitive function.

Do such findings stack up in real-world situations? Other studies suggest they do. One experiment in Delhi, India, involved putting 1,200 plants into a building with 300 occupants. The mixture of areca palm, mother-in-law’s tongue and money plants were chosen because of their particular ability to filter impurities and boost oxygen levels. Indian government researchers reported that the building’s staff benefited from a 34% reduction in respiratory problems and a 20% boost to productivity.

Borchers warns against taking all such findings at face value: “For example, recent research suggests people are generally happier and more productive in green-certified buildings. The inference is that they like the fact that their employer cares for the planet. That may be true, but it may also be that the occupants are reacting positively to the appearance of a smart new building. We can change and measure various factors, but it’s how they work in combination to produce wellness or improve productivity that is important, and that’s much harder to understand or quantify.”

The power of light

A key area, and a controversial one, is lighting. This is the focus of much research that aims to understand the links between increased time spent indoors and the ills that seem endemic in modern society, namely anxiety, depression, stress and insomnia, all of which tend to decrease productivity.

Jay Wratten, a vice president at WSP in Colorado and specialist in lighting design, says that the role has already shifted from simply ensuring sufficient luminance levels to seeking more efficient light sources. “But now we have a new arrow in our quiver: using light to promote wellness.”

The body’s natural circadian rhythm is determined by non-visual photo-receptors in the eye that are sensitive to different intensities and wavelengths of light: “So using certain LED technologies, for example, we can tune the spectrum and brightness to help keep people alert during the day and also help them to relax toward the evening.”

Essentially, this means boosting colder or bluer light after lunch, and decreasing it, along with intensity, towards evening. In this way, the circadian rhythm is maintained. As Wratten says: “Our bodies don’t react in the same way for a 12-hour period, so why should the building?”

The importance of the circadian rhythm to our health, once a niche area of study, has come to be recognized more widely — the 2017 Nobel Prize for medicine was awarded to three US researchers who identified the mechanism by which the body’s clock uses light to regulate itself over a 24-hour period.

The potential for using this mechanism to improve performance has also caught the attention of employers in many fields. Wratten installed spectrally tunable lighting in the locker room of the Atlanta Falcons football team: “The idea is that we can stimulate the players before a game and help them relax afterwards.”

But he also advocates caution when translating research into practical design: “A lot of this technology is pretty new and there’s still much we don’t understand,” he says. “Personally, I feel nervous about dosing people with prescribed amounts of certain light. It’s advisable, where possible, to use natural light to reinforce an awareness of the day outside. With electric light we need to know more about appropriate  application of tunable spectrum technology. Suppose we get it wrong and make people ill? Beyond our goals, both as designers and as humans who use these spaces, there is a professional liability issue.”

Worth the risk?

Legal issues are likely to figure more and more in discussions about wellness — not least because occupiers now have a much clearer picture of the relationship between their health and their working environment. “Wearable tech, phones and cheap plug-in monitors provide people with huge amounts of data,” Mlade points out. “They can measure their activity and blood pressure, monitor light levels and get an app that tells them about air quality. So if they get ill, they might well have the evidence to support a claim against a negligent building owner. If the owner has certification, such as WELL, showing that the building is okay, then that is a defence.”

It follows that such measures could have the potential to reduce insurance premiums for employers and perhaps also their healthcare costs. “In the US, where most Americans with private health insurance receive it through an employer-sponsored programme, there is a particular incentive to embrace wellness and wellness certification,” points out Mark Bessoudo, WSP’s Toronto-based manager of sustainability and energy research.

Institutional investors in real estate have a similar interest in using certification to minimize their risk, he adds. Over the last five years, a growing number have adopted the GRESB — Global Real Estate Sustainability Benchmark — system to assess the environmental performance of their portfolios, he says. “Significantly, GRESB has added a health and wellbeing module for investors who want to know if their assets are addressing wellbeing issues. If they are not, then that is a risk. That’s helping to drive take-up of wellbeing policies and certification.” It certainly represents a great deal of money now seeking better governance: GRESB currently covers 77,000 global assets and 30% of GRESB participants have adopted the health and wellbeing module.

Influence vs control

Of course, there is potentially a more sinister side to wellness. There are already concerns that unscrupulous employers could misuse the tools at their disposal, and these are likely to become more pressing as science and technology in this area progress. Health and productivity, while correlated, are not necessarily the same, Borchers points out: “Employers monitoring their staff’s every move and health level through wearable technology and keeping the blue light on until midnight to keep their workforce working hard — there is line between caring and exploitation that should not be crossed.”

If that sounds alarmist, it is worth remembering that there are already plenty of instances where the built environment is used to manipulate us. Retail environments are meticulously designed to influence the consumer — from maze-like layouts to detain us, to relaxing muzak and smells. Other environments seek not so much to influence as to control. Casinos, for example, seldom have windows, keeping punters oblivious to the passage of time, and the air inside is routinely boosted with oxygen to keep them awake and gambling. To put it another way, they deliberately interfere with the circadian rhythm of the occupants.

Another aspect of this “influence versus control” dynamic arises in relation to the data that wellness technology can generate. “Essentially, it’s a privacy issue,” says Wratten. “The more information you have, the more you can help people. But that involves people sharing information about themselves in order to receive the benefit.”

WSP is testing a workplace productivity tool that cross-references smart building data with how happy or motivated individuals are. At the moment it is fairly basic, comparing building conditions with simple satisfaction ratings, he says. “But I would love to use the kind of data that wearable tech could provide. It would be useful to know how people sleep, when they woke up, how active they are — and then use that to tune the way they occupy the building and how the building responds to them.” But Wratten is keenly aware such data is highly personal: “We would need to anonymize it without losing its value. I don‘t blame people for being cautious.”

Not all employers may be so principled. As Wratten puts it: “That’s a real fear with this kind of solution. We are relying on the occupants of the facilities we design to use them ethically.”

It will be fascinating to see how the wellness megatrend pans out. Starting from the apparently simple, appealingly wholesome desire to make our buildings more comfortable places to be, the pursuit of wellness touches on some of the most sensitive debates of our time, around big data and its power to both control and empower. Navigating this unknown territory is set to be one of the greatest, but potentially most rewarding, challenges of building design for decades to come.