Americans, on average, spend around 90 percent of their time indoors, and now the nation’s leading group of architects has found inspiration in this somewhat glum fact. The professionals who design our working and living quarters are starting to see all these confined hours as a major opportunity for them to make a meaningful impact on public health. Today, the American Institute of Architects (AIA) announced its latest effort along these lines—a three-year partnership among 11 architectural schools whose research programs will further explore the notion that building design, city planning and health should go hand in hand.



Participating institutions will examine topics ranging from the microbiome of buildings to "tele-health" for rural communities to reducing stress via design. “We are all familiar with the adage- ‘Healthy mind, healthy body,’” says Sulan Kolatan, professor of architecture at Pratt Institute in New York City, “but we need to add a phrase that goes, ‘Healthy city, healthy mind and healthy body,’ because we're understanding that those things are integrally connected.” Designing for health soon will be as fundamental a responsibility in the minds of architecture students as designing for energy, says Daniel Friedman, chair of AIA's Design and Health Leadership Group.



Leading thinkers in architecture as far back as the Roman architect Vitruvius during the first century B.C. have considered how one’s surroundings might influence health and wellbeing. The concept’s most recent revival came in September 2003 when the American Journal of Public Health published an issue dedicated to public health and the built environment. The topic snowballed from there, Friedman says. Lately sensors and software have advanced such efforts by allowing architects to better track and measure the physiological, social and psychological effects of building use on occupants. “It’s not just ‘walk more, weigh less,’” Friedman says. “This is about the health impacts of design and construction at the scale of room to region with much greater attention to evidence, health data and criteria for well-being.”



The AIA initiative includes Columbia, Texas A&M, Texas Tech and Drexel Universities, as well as the universities of Illinois at Urbana—Champaign, Kansas, Florida, Oregon, Miami, and Arizona, along wih the NewSchool of Architecture & Design in San Diego.



Today, professionals across various fields consider buildings to be a critical tool for combating social isolation, epidemic obesity and depression. The U.S. Centers for Disease Control has published recommendations for creating elementary schools that inspire kids to eat healthier and cities including New York are adopting Active Design guidelines meant to encourage building practices that boost physical activity.



Robert Ivy, CEO of the AIA, recently penned a column highlighting a few examples of research in this vein and the organization published an infographic on six facets of architecture that have been found to intersect with public health—safety, social connectedness, environmental quality, sensory environments, physical activity and access to natural systems. Here are a few examples of the highlighted research and initiatives:



1. Design staircases that people want to use



At the Bullitt Center in Seattle, occupants choose to take its “irresistible staircase” for 75 percent of trips on entering the building rather than opting for the elevator, as compared with the 17 to 23 percent of trips made via stairs in a typical office building, according to results published this year by the Center and lauded by Friedman. While climbing the Bullitt staircase users enjoy panoramic views of Puget Sound and downtown Seattle whereas the elevator is tucked into a back corner of the building and requires a key card to access. “Any engineer can design a staircase to meet code but architects have the design and training to design a stair that beckons use,” Friedman says.



But what about in places with legacy staircases? New York City has posted 30,000 neon green signs with a plea for people to take the stairs in public buildings and facilities. Other examples of built projects that encourage physical activity were highlighted in a 2013 exhibit called FitNation, curated by the AIA.



2. Time lighting to circadian rhythms



A 40 percent rise is expected by 2025 in the number of people age 65 and older with Alzheimer’s disease, a form of dementia. To help, Kyle Konis, professor of architecture at the University of Southern California, proposes a way to assuage symptoms such as sleep disturbances with improvements to indoor lighting. Eyes are sensitive to the brightness and color temperature of light (a property that describes its hue ranging from blue to red ends of the spectrum), and these factors influence our circadian rhythms and the wake–sleep cycle. In a report for a design and health summit organized by AIA Konis cited a finding that exposing Alzheimer’s patients to an hour of bright light (typically using a light box) in the morning can help those with the most severe symptoms to sleep better.



Most senior facilities, though, rely on dim fluorescent lighting. Also, caretakers struggle to convince residents and patients to sit in front of a lightbox for an hour every day. Konis will conduct a three-month pilot study across four treatment facilities for seniors with dementia near Los Angeles to see if moving a group of patients to a sun-soaked room for two hours daily will reduce symptoms and improve cognitive function as compared with a control group that spends the same amount of time under fluorescent lights.



3. Create opportunities for social interaction



The architects at SGPA Architecture and Planning in San Francisco in charge of designing Lincoln Glen Manor assisted-living community in San Jose, Calif., decided to heed previous research showing that a well-designed facility could boost the frequency of visits by family members and, in turn, the residents' well-being.



To make the facility feel more welcoming and foster social interaction, the architects shuffled around the chapel and dining area of the central building to create a more open layout. This change allowed residents to better see one another and encouraged bystanders to join in activities. In what the architects are considering an early measure of success, 90 residents attended this year’s Thanksgiving dinner as compared with 25 in the year prior, according to a report prepared by the firm.



4. Think of buildings as an educational tool—not just a backdrop



A new rural school for K–5 students opened with the start of the school year in 2012 in Buckingham County, Va. The school was designed by VMDO Architects, a firm specializing in schools, with the help of academic partners to encourage healthy eating and physical activity.



The firm installed water fountains in classrooms, age-appropriate nutritional signage, large staircases and a “food lab” where students can learn to prepare food. The lead architects presented preliminary results of a study of the 970 students who attend the new school at AIA’s spring summit. Their results, which are forthcoming in a peer-reviewed journal, hints that the school’s features have helped kids to engage in and enjoy more physical activity while also creating opportunities for staff to organize programs around healthy eating and lifestyles.



5. Continue to design walkable neighborhoods



Most Americans (52 percent) do not get the recommended 30 minutes of moderate activity per day combined with muscle-strengthening exercises. Researchers from the Texas A&M Center for Health Systems and Design tracked 229 residents who moved to a walkable community called Mueller in Austin, Texas. Walkable communities put emphasis on pedestrian rather than vehicular traffic as the primary form of day-to-day transportation by clustering apartments, grocery stores, dining and retail. The team’s analysis revealed that after moving to Mueller the percentage of residents who were achieving that recommendation increased from 34 to 49 percent. The time those residents spent walking and bicycling shot up by 40 minutes and 13 minutes per week, respectively.



In a separate study published this year of residents’ physical activity in three low-income neighborhoods in Detroit over six years, researchers found a positive correlation between exercise and the overall connectedness of neighborhoods, as measured by the ease of movement and efficiency of the street layout.



