Several years ago, Rachel Hodgdon, an expert in green buildings, was touring a new high school in DeKalb County, Georgia, when she asked teachers how they liked their new building. They loved it. The best part, they told her, was that they no longer went home each afternoon with the “2:30 headache.”
Hodgdon asked them what they meant. “They told me, ‘That’s the term we made up for how sick we feel after a full day at school,’” she says.
At the time, Hodgdon was the director of the Center for Green Schools. As she traveled to meet students and teachers who were moving out of older buildings and into more environmentally friendly ones, she was collecting all sorts of similar stories. Coughs disappeared. Attention improved. Absentee rates dropped.
Hodgdon had stumbled across an idea that architects and public health researchers were also beginning to recognize. Building improvements made in the name of sustainability—things like oversize windows and new, quieter HVAC systems—were benefiting the health of the people inside those buildings. The realization helped spur a movement in architecture generally called “healthy buildings.” Just as structures can be designed for the health of the planet, they can also be designed for the health of their inhabitants.
Over the past several months, the Covid-19 pandemic has sparked a surge of interest in the role that indoor environments—where we spend 90 percent of our time, even in a normal year—play in our health. Suddenly, developers and CEOs are realizing that incorporating health concerns in a building’s design isn’t a luxury. It’s a necessity.
“People are really thinking about, ‘Are these spaces safe? Are they healthy? How could I improve them?’” says Rick Cook, a founding partner of the New York-based architectural firm COOKFOX.
Cook and other architects have been working with the International WELL Building Institute, an organization that’s developing standards for healthy buildings and is now run by Hodgdon. Since the pandemic, the Institute has been registering more than a million square feet of real estate a day in its certification program, putting buildings on the path to wellness.
“That was like a hockey stick growth moment for us,” Hodgdon says.
In our present reality, when we think about staying healthy indoors, our minds immediately go to social distancing and plexiglass barriers, then to factors like ventilation and air quality. But the latter two will remain critical even beyond the pandemic. Not only does fresh air help prevent the spread of the flu and the common cold, studies have shown it also improves attention and increases scores on cognitive tests.
Research has shown that many other indoor environmental factors have quantifiable effects on health. Our immune systems and general well-being are shaped by the places where we spend most of our time. Even things that we might think of as mere annoyances—the drone of an officemate’s phone conversation, the light that won’t stop flickering—impact our health. There’s a reason they’re annoying.
Cook argues that, while modern conveniences like fluorescent lighting and air conditioning offset some of the downsides of nature, moving further from our natural habitat has made us more miserable indoors. Studies have consistently shown that environments that mimic or allow access to the natural world lower blood pressure and cortisol levels, improve concentration, and strengthen the immune system. “Just looking at nature—3.8 billion years of evolution. We should probably be paying attention,” Cook says.
Take something like lighting. When we don’t get enough bright light—or when we get too much of the wrong types of light—during the day, our circadian rhythms are thrown off. We don’t sleep well at night. In the long term, that increases cancer risk. “We now know that not stimulating our circadian rhythm properly is actually a carcinogen,” says Mara Baum, the head of health and wellness at the design firm HOK.
Instead of flickering fluorescent lights that can’t be adjusted, a building designed with health in mind would feature lighting that automatically changes color temperature throughout the day, mimicking the light of the sun—HOK has started using this technology for some of its projects. Or individuals might be able to adjust their own lighting, configuring it for their mood and the type of work they’re doing at the moment.
When we think about architecture, we often think about beauty and form, the things that look good on Instagram or in a glossy magazine. “But what we knew to be true was that we experience our spaces with all of our senses,” Cook says.
Designers like Cook and Baum take into account the array of inputs we perceive through those senses. Beyond lighting, there are factors like temperature, humidity, water quality, views, and security. Design components can influence us to make healthy choices: wide, airy “irresistible” stairs that just seem better than taking a crowded elevator; a main entrance for bike commuters—like at Google’s new New York campus that COOKFOX is designing—rather than through a back door by the dumpster. Intentional room configurations and choice of materials can optimize acoustics, allowing irrelevant conversations to fade and dampening background noise—even the normal decibel level of a traditional office increases the risk of high blood pressure.
Installing sensors can help us understand health risks that are beyond the grasp of our senses—the presence of chemicals like formaldehyde, the level of carbon dioxide. Architects and designers are already seeing increased demand for such monitoring.
“Trust has become so critical between staff and employers,” Baum says. “Having a level of transparency and understanding about what is going on in a building and how it impacts our health has been one of the incredible changes that we've seen over the last nine months.”
Almost as soon as the pandemic arrived, Hodgdon says, companies began asking how they could make their buildings safer. The International WELL Building Institute developed a standard called the WELL Health-Safety Rating, a third-party verified, scientifically backed certification that a space is doing everything it can to keep occupants safe from the virus—putting in place sanitization and emergency preparedness protocols, managing air and water quality, and promoting health-conscious policies, like providing flu shots and being smoke-free. Early adopters include the Empire State Building and Yankee Stadium.
Hodgdon sees a longer-term benefit of the pandemic-focused certification: it could act as a gateway to pursuing a WELL certification that has a more holistic view of health. The institute has a long list of features companies can incorporate into their buildings; include enough of them, and you can get certified. These are factors like improving indoor air pollution and testing for carcinogens in paint and sealants, but also less tangible concepts, like supporting new parents and encouraging civic engagement.
The program takes inspiration from the LEED standard for certifying green buildings, which in the past 25 years has gone from a radical idea to a trillion-dollar industry. Hodgdon estimates that more than a fifth of Fortune 500 companies are now participating in the Institute’s healthy building certification programs—an indicator, she says, of where the market is going. Tech companies like LinkedIn and Genentech have WELL-certified buildings, as do financial groups like Goldman Sachs. Pursuing certification often adds 1 to 2 percent to a project’s budget, but companies have found that happier, healthier employees mean lower absentee rates and higher productivity, saving money in the long run. And the WELL program is flexible—buildings don’t need to include all of the features—making healthy design not just the realm of glitzy mega-projects.
“We believe that spaces can be great equalizers,” Hodgdon says.
The post-pandemic future, Hodgdon argues, is a chance to fight for the things that really make people and communities healthy. “We're not getting rid of handshakes and hugs and sharing pens. We're not going to be sitting six to 15 feet apart forever,” she says. “We should cast them off as soon as we cast off this virus, and focus on the longer-term sustainable things that promote health and health equity.”
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