Public health equity
Why we must regulate for healthy buildings
by Elena Bondareva
Drawn to emerging frontiers, I have been advocating for healthy buildings for a few years. Unlike those who see the environmental and occupant impacts of the built environment at odds, I have always seen them as complementary. Buildings are inherently about people because if people did not need shelter, we would not need buildings and would not incur their crippling impact.
If health used to be defined as an ‘absence of disease,’ the World Health Organization now defines it as the ‘state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.’ Health is increasingly viewed as the mitigation measure for the risk of illness; corporations are appointing ‘chief health officers’ the way they once appointed chief sustainability officers; and the pandemic got society to see the built environment as our first line of defense. There is no remaining doubt that our built environment is a formidable lever of public health.
Best practice
Globally, WELL leads in defining and verifying a healthy building, and, especially as a WELL Accredited Professional and Performance Testing Agent, it has been encouraging to see the buildup to the 4B+ sq. ft. currently registered for a WELL rating around the world.
I have also had the privilege to serve on the Global Advisories of the International WELL Building Council, which resulted in the Health Safety Rating (2021) and, most recently, the Health Equity Rating: the world-first in defining a common language and assessment criteria.
The problem?
The tremendous innovation and leadership in designing for health, it remains optional and, thus, benefits primarily the privileged. The confronting reality is that one’s location is a stronger determinant of health than one’s genetics.
Can you imagine knowing that the building you step into will not collapse – or trap you in a fire – only if that building’s owner happened to care about that sort of thing? Yet, that was the case until building codes stepped in, raising the bar both for the built environment and for the industry that creates and operates it.
Today, not only is “inspector” a profession but it is paid for by the government because lives depend on compliance.
In defining and incentivizing top performance, our “sustainability/green/high-performance building” movement has assumed that nothing that we do (or fail to do) puts people in harm’s way.
While this approach “raises the ceiling”, it is regulation – through building codes, standards, and ordinances – that “lifts the floor”.
The solution?
Now that we know that buildings can compromise or improve health, we must demand it through standard, codes, regulation, and policy. Without this, the most vulnerable are most at risk.
While a challenging task, this is something we have done before: plumbing (invented in response to cholera outbreaks), sidewalks, city parks, underpasses, underground transportation, and the entire fire and accessibility codes illustrate how the built environment has transformed itself to meet public health demand.
We must work together to cement the built environment as a formidable lever of public health.