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Originally published September 14, 2013 at 3:58 PM | Page modified September 16, 2013 at 1:21 PM

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Guest: How the spaces around us dictate our health

The world of design and health care need to converge to create great habitats, according to guest columnists Howard Frumkin and Daniel Friedman.

Special to The Times

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FROM the small scale of rooms to the large scale of metro areas, much of today’s built environment — the places where we live, work, study and play — would have been unimaginable a century ago.

They reflect stunning changes in the materials and technologies we use, and in the ways we live our lives. On the global scale, the flows and cycles of energy, carbon, nitrogen and all the materials and systems that undergird the earth’s function, are also quickly changing.

All of this has implications for our health and well-being.

We are a highly adaptable species, but we are showing signs of stress: depression and anxiety, cardiovascular disease and cancer, attention-deficit and autism-spectrum disorders, asthma and obesity, autoimmune diseases and infertility. Many of these are trending in the wrong direction.

Well-designed places can promote health, and design professionals can create them. Health depends, in part, on wholesome places, not just for individuals, but across entire communities, and health professionals can recognize and support them.

Accordingly, two worlds need to come together: the world of design, in which architects, planners and their colleagues create places; and the world of health, in which doctors, public-health officials and their colleagues fight injury, illness and disability. Together, these two groups can create great habitats in which people of all ages thrive.

The Seattle Design Festival, which started Friday and ends Sept. 22, is dedicated to Design in Health, and exemplifies these partnerships. For information see

What does success look like? Healthy design can help overcome sedentary lifestyles — key to the fight against obesity, high blood pressure and associated diseases. Inviting staircases, walkable communities and excellent transit systems all help promote routine daily physical activity.

One example is Seattle’s bicycle infrastructure. While incomplete, it is offering more and more bike boulevards, protected bike lanes and soon a bike-share program. Together, they promote clean air, physical activity and safety.

Another example is our parks. SAM’s Olympic Sculpture Park seamlessly joins the Elliott Bay Trail and Myrtle Edwards Park. Gas Works Park is a glorious amenity for people in nearby neighborhoods and those using the Burke-Gilman Trail. These parks transformed contaminated brown fields into venues for physical activity, contact with nature, social interaction and beauty.

Likewise, design strategies for better water management can reduce our consumption of water, increase rainwater re-use, conserve water during shortages and control it during surges and floods.

Seattle examples range from green stormwater projects in Ballard, Delridge and other neighborhoods, to the rebuilding of the Elliott Bay seawall.

The human benefits? Not just a more sustainable future, with long-term stewardship of water, but protection during storms — along with beauty, safety, drinking water quality, swimming and recreation.

Healthy design can further society’s interest in fairness and inclusiveness. In Seattle Housing Authority’s High Point community, where children suffered from high rates of asthma, Breathe Easy homes were designed with hard surface flooring, air filtration, low-emission paints and hypoallergenic landscaping to reduce asthma triggers. The result: a 67 percent decrease in emergency-room asthma visits.

Great workplace design can promote employee health, heighten satisfaction and increase creativity. The new Bullitt Center in Seattle is not only the world’s greenest commercial building; the people who work there enjoy natural daylighting, indoor air free of toxic chemicals and an irresistible staircase that lifts the spirit even as it boosts physical activity

Another key principle is universal design, which allows people with disabilities to get where they need to go, and do what they need to do. Such practices benefit vulnerable populations and enable designers to help foster fuller, healthier lives.

To meet these challenges, both art and science play a role. But we need solid, measurable evidence of their combined effectiveness. In health care, we expect doctors to prescribe medications only when data show that they are both safe and effective. In designing the built environment, design professionals need to ground their work in evidence of what makes memorable places safe and healthy.

Here’s some good news: Design professionals are increasingly focused on public health and health professionals are increasingly focused on place. Activity is growing at the intersection. Organizations as diverse as the U.S. Green Building Council, the American Institute of Architects and the Centers for Disease Control and Prevention are helping to lead the way.

As more people learn about the health consequences of the places they occupy, market demand for proven health-promoting design will continue to grow.

The need for healthy places represents a new call to action. If health care is a fundamental human right, then so is the opportunity to live our lives in places that promote health.

Design and health professionals need to team up. If we fail, we incur costs here and now, across the life of our built environments, and imposed on future generations. But if we succeed, we will enjoy, and bequeath to our children, places that elevate, optimize and advance human potential.

Howard Frumkin, dean of University of Washington’s School of Public Health, has a medical degree and a doctorate in epidemiology. Daniel Friedman, Ph.D., is an architect and former dean of the UW College of Built Environments.

Information in this article, originally published at 3:58 p.m. on Sept. 14, 2013, was corrected at 1:20 p.m. on Sept. 16, 2013. Due to an editing error, a previous version incorrectly stated that well-designed spaces can reverse the trend in rising disease rates. Well-designed spaces can promote health.


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