Last week, I shared some thoughts about designing interiors to support health and wellness for the Spring Breakout event in Columbus, Ohio. And although I usually talk and write about healthcare design, my remarks weren't just meant for healthcare designers.

But the conversation about the physical environment's impact on health outcomes began in healthcare. It was kick-started in 1988 at the First Symposium on Healthcare Design where 500 like-minded healthcare architects, designers, providers, and furniture manufacturers gathered together for the first time.

But it actually began a long time ago.

The First Healthcare Designer

After seeing the effect of the deplorable conditions of the British hospital barracks on wounded soldiers during the Crimean War in the 1850s, Florence Nightingale became a leading advocate for better healthcare environments.

Her views on ventilation, light, noise, temperature, and variety probably make her the first healthcare designer. Among other things, Nightingale believed:

• A person who repeatedly breathed his or her own air would become sick or remain sick, so access to fresh air was crucial (little was understood about contact transmission back then).
• Patients should not be too warm or too cold. Temperature could be controlled by an appropriate balance between burning fires and ventilation from windows.
• Unnecessary noise is cruel and irritating to the patient.
• Color and form changes are important, including bringing the patient brightly colored flowers or plants.

Nightingale also suggested rotating 10 or 12 paintings and engravings each day, week, or month to provide variety for patients. So she was healthcare’s first art consultant!

Her Environmental Theory formed the framework of today’s healing environments, defined as is "a physical setting and organizational culture that is psychologically supportive, with the overall goal of reducing stress." And while this concept originated in healthcare, it is relevant for almost any interior space today.

Healthy Building Movement

And over the past 10 years or so there’s been a growing healthy building movement led by the International WELL Building Institute.

More than 13,000 projects around the world have achieved WELL certification and more than 16,000 individuals have become WELL accredited.

The WELL Accredited Professional credential denotes expertise in the WELL Building Standard, which is based on 10 concepts. And all of them are essential to creating environments that support the health and well-being of people.

And what do you know? Five of those concepts — air, nourishment, light, thermal comfort, and sound were part of Nightingale's Environmental Theory.

Dependency of Human Health on the Environment

But why did it have to take a global pandemic to make people understand that the strong dependency of human health on the environment is very real? That buildings of all types are really front-line caregivers -- because they are the first thing you encounter when you enter a space and they never leave your side.

And, like I’ve been saying for years, that healthcare is where you are -- outside, at home, in the office, at the store, in school, at the restaurant or hotel, in your car or on the plane, at the gym, in the doctor's office or clinic, and of course, at the hospital.

We knew this back in 1993 when we founded The Center for Health Design. That's why we didn't name it The Center for HealthCARE Design. And for various reasons, The Center has remained focused on healthcare, but it also recognizes that healthcare is no longer just provided in a hospital or clinic.

Take Care of the Earth

But here's the thing. We will not have healthy people on an unhealthy planet.  So, designers have to take care of the earth, too.

And think about this. There's also a business case for designing healthy interiors -- for both the building owner and the designer.

Because those seeking funding for new building projects or capital improvements are increasingly coming across investors who consider it important to incorporate their social values and concerns about the environment into their selection of investments. Climate change is one of the biggies.

If you can create interiors that support your client's environmental/social/governance goals, you'll have a competitive advantage. (Check out this article for more about how to do this.)

6 Strategies to Promote Health and Wellness

The six design strategies I think all interior designers and architects should be using to promote health and wellness in their projects aren't rocket science. Healthcare interior designers and architects have been doing most of them for years.

But the design thinking and products continue to evolve.  So here is my list:

1. Incorporate Nature: Use biophilic design principles and elements, such as fractal patterns.
2. Specify Products That Promote Good Indoor Air Quality: Consider the exposed surface area of the product, chemical composition, recommended cleaning protocols, and how stable the product is in wet and dry environments.
3. Design for Infection Control: Rethink waiting spaces, specify flooring that traps contaminated particles, use custom flooring to promote physical distancing by cueing behavior, and specify products with antimicrobial properties (but keep in mind that not all microbes are bad!).
4. Design to Prevent Falls: Consider lighting, type of flooring material, transitions between floor types, and the "shine factor" of surface materials.
5. Provide Positive Distractions: Use artwork, color, access to nature, interactive furniture.
6. Pay Attention to Products' Embodied Carbon Footprint: Consider emissions that come from manufacturing, transporting, installing, and replacing interior materials and products.

For more detail on what I spoke about, watch the recorded video (my presentation starts at about 28 minutes in):

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Photo credit: Kurt Johnson Photography.