By A. Ray Pentecost III, DrPH, FAIA, FACHA, LEED AP
Co-Director, UIA Public Health Work Programme

Introduction

Have you noticed the recent architectural emphasis trending in the world of design?

Designing for health has become a global obsession, gaining momentum among architecture practitioners, researchers, educators, and students in every corner of the world. Designers are waking up to the reality that every building, regardless of type , in every country, impacts the health of the people who use it. It has rapidly transitioned from a breakthrough concept in 1984 with Roger Ulrich’s publication in Science magazine titled , “View through a window may influence recovery from surgery,” (1) to a worldwide movement, complete with international conferences, such as the World Congresses by the International Academy for Design and Health, and highly regarded scholarly publications in the space, such as the Health Environments Research and Design Journal (HERD Journal).

Section 1

The UIA Public Health Work Programme (Public Health Group – PHG) has contributed to the momentum. In 2020 the PHG decided to change its primary focus from design for healthcare to design for health. The shift found the PHG embracing a three-part landscape of design for health that highlighted the ways design can protect health, develop better health, and restore health when it is impaired. The traditional emphasis on healthcare facilities is found in the restoration part of the new paradigm, but with the change the PHG was able to not only broaden its horizon on health design,and built a platform that invited every practitioner in the world to consider health when designing their projects. This was significant because it made the work of the PHG relevant to every aspect of the work of the UIA. No longer was the PHG the group that “designed hospitals;” rather, it was the group that challenged every design professional to incorporate healthy design features in every project they did.

The stage was set for the UIA to lead this global conversation in 2021 when it approved: 2022- The Year of Design for Health, a global proclamation that shone a spotlight on the imperative that the design community make health and wellbeing a design priority.

The International Union of Architects Public Health Group asks the UIA General Assembly to make an international commitment to public health and to declare 2022 The Year of Design for Health, urging all UIA Member Sections to encourage architects and their clients to use evidence-based design to promote health in buildings and cities.
The UIA Commitment to Public Health: Designate 2022 as “The Year of Design for Health” (2)

In addition, the proclamation specifically mentioned the importance of basing the industry priority on evidence-based design. The UIA Council, representing over 100 member nations, approved the proclamation of the Year of Design for Health without a single dissenting vote! Consensus across the nations spoke volumes about the priority that the design community was willing to assign to the issue of designing for health using research. The year 2022 was filled with webinars and related activities, some with aligned organisations like the World Health Organisation, all aimed at challenging the world’s design communities to make their projects healthy. (3)

The Year of Design for Health had its own logo, resulting from a global competition for a graphic that would represent the year-long theme. As 2022 ended two worldwide UIA designs for health projects were underway: 1) A student design competition, and 2) A design awards programme for professionals. The results were a collection of remarkably innovative projects from both initiatives, with winners recognised in July at the 2023 triennial UIA World Congress in Copenhagen. By the end of the Congress, the design for health movement was firmly established in the UIA.

Section 2

Less than one year later, in May 2024, the American Institute of Architects (AIA) held its annual convention. In the annual business meeting, among the many themes and projects vying for attention among attendees, was Resolution 1, a product of the 2024 AIA Strategic Council, and appropriately dubbed: The AIA Health and Wellbeing Policy. Among the key elements of the proposal:
The Board and National Ethics Council will add elements to AIA’s Code of Ethics and Professional Conduct requiring a focus on wellbeing, promoting related discussions with owners, and utilising health and wellbeing-related research pertinent to proposed design interventions.(4)

The Board will modify the Framework for Design Excellence to include Research for Health and Wellbeing as an action.(4)

The AIA will promote the incorporation of design and research for health and wellbeing in all architecture degree programmes with various educational organisations.(4)

The resolution was overwhelmingly approved by a margin of approximately 3 to 1 . The nearly 100,000 licensed architects and affiliated professionals and associated professionals represented by the AIA were now under an official directive to make design for health and wellbeing a priority in the big three “E’s” for the organisation: The Code of ETHICS, Design EXCELLENCE, and Design EDUCATION. This was a transformative moment in time.

The AIA College of Fellows followed with an emphasis on design for health with its 2025 Latrobe Prize research competition. With the theme, Architecture’s Contributions to Human Health, the competition seeks proposals that:
Demonstrate theoretical AND practical connections between the built environment and human health.

Demonstrate how architects are essential to facilitating changes to the build environment to positively affect the health of communities.
AIA College of Fellows announcement of the 2025 Latrobe Prize (5)

The AIA launch of a competition in the world of design for health stands as a strong statement of the importance being assigned to this design priority, but it does not stand alone.

Section 3

The UIA-PHG is building on its three-fold mission considering the ways design of every project can protect, develop, and restore health. Specifically, the PHG is taking a page out of Canadian architect Tye Farrow’s book entitled Constructing Health.(6) In it he questions the possibility of evaluating architecture by its impact on the health of building users and occupants.

What if there was a design award programme that did just that?

The new, soon-to-be-announced 2025 UIA health design award programme will deliver on that possibility. Conceived as a way to challenge architects to view their creations through a slightly different lens, the awards programme will invite architects to submit their work to be reviewed and judged based largely on their success incorporating health design features into the project. The intent of the programme is not to abandon the traditional imperatives of design awards, the things we have come to expect in beauty, performance, efficiency, sustainability, etc. Rather it will recognise those things as “table stakes,” referring to the minimum requirements to enter a game or competition.

It will depart from traditional award programmes by saying to potential entrants, “It is not enough that your building is beautiful. Can you show the jury that the project has a beneficial impact on the people who use it?” It may come as a surprise to some architects to learn that creating beautiful, efficient, affordable, and environmentally sustainable projects will not be enough to win this programme. Perhaps it should not even be enough for the project to be built?

Let’s ask that question again. If the project is not having a beneficial impact on occupants, and the design team has not paid attention to the design features that impact personal health, and if the project might, in fact, actually be harmful to personal health, should it be built as proposed?

Conclusion

The UIA-PHG is making a significant contribution to the worldwide design-for-health movement. The 2022 phenomenon that was the Year of Design for Health immediately made an impact on architecture that is still being felt today, and will continue to be felt for many years to come. The UIA 2025 design for health awards programme will challenge the standards by which architecture is judged, and invite designers to explain the merits of their work regarding how the project impacts the health of building occupants.

Is it time to make “impact on health” a fundamental, standard, non-negotiable element in the so-called “good design?” Do building occupants have a right to ask the design community to show how a building respects and contributes favorably to their health? Should the global architecture community act, as the American Institute of Architects has acted, to prioritise design for health in architectural ethics, design excellence, and design education? The UIA-PHG believes strongly in design-for-health for every building. Is the greater design community up to the challenge? For the good of our health, we certainly hope so.

Keywords: Design for Health, Healthy Design, Public Health, Public Health Group, AIA Resolution One, Health Architecture, Design for Wellbeing, Design Research

References

1. Ulrich, R. S. (1984, April 27). View through a window may influence recovery from surgery. Science, 224(4674), 420-1.
2. Request to the UIA General Assembly, July 2021. The UIA Commitment to Public Health: Designate 2022 as “The Year of Design for Health.”
3. Pentecost, A. R. III (2022, January 2). Are We Ready for “The Year of Design for Health”?, HERD: Health Environments Research & Design Journal, 15(1), 36-38.
4. AIA Annual Meeting – Delegate Information Booklet, June 2024.
2024 AIA Delegate Booklet by AIA – Flipsnack
5. https://www.aia.org/advocacy/research/grants-fellowships/college-of-fellows-latrobe-prize.
6. Farrow, T. (2024). Constructing Health. Aevo UTP.