Architectural Determinants
of Health
Architectural Determinants of Health is a model of spatial design as viewed through an asset-based, health-causing, salutogenic lens as opposed to a pathogenic one. The term acts as an umbrella which encompasses building, urban design, city planning, infrastructure, and industrial design. This model outlines the aspects of spatial design that can be leveraged in order to generate health-causing environments. Understanding the health-causing patterns of placemaking, that generate enhanced human performance buildings and nutrient-rich environments, enables architects to design for optimal human health.
Determinants of Health
Determinants of health is a well-established term in public health, which refers to the non-medical factors in a person’s life that influences their health. Many of these factors depend on the context into which a person is born or where, geographically, they live. The determinants of health are often divided into four main ground – environmental, personal, social, and economic.
The environmental determinants of health are the external, physical, chemical, and biological factors that influence health. These factors include availability and quality of housing, neighborhood safety, air and water quality, exposure to pollutants or hazardous materials, and access to nutritious foods.
The personal determinants of health refer to an individual’s genetic and biological factors, including their personal behaviour, choices, and coping skills.
The social determinants of health are the social factors and living conditions that shape pathogenic outcomes. These factors include income, education, employment, housing, access to services, social connections, experiences of discrimination, and poor living or neighborhood conditions.
The economic determinants of health are the financial and resource-based factors that influence the burden of disease which includes income, wealth, employment, economic policies, access to healthcare resources, and where you live. Generally, the lower a person’s socio-economic status, the worse their health.
Architectural Determinants of Health Model
The determinants of health model views well-being through a pathogenic lens, focusing on what causes poor health and disease. Instead of suggesting ways to avoid or correct one’s health practices, it might serve more beneficial to turn attention to what the human body needs in order to thrive. The model also neglects to acknowledge the role of the built environment in the creation or mitigation of health.
Humans spend more time indoors that most whales spend underwater, highlighting the importance of a functional, inspiring, and health-causing built environment. It is therefore pertinent that the determinants of health model is altered to include architectural determinants of health; acknowledging the importance of constructed space on human health while shifting perspective to a salutogenic point of view. The Architectural Determinants of Health model has been pursued by Tye Farrow throughout his doctoral studies at the University of Toronto, to pursue such an adjustment to the landscape of public health and design knowledge.
What if we could consider the determinants of health that result from what and how we build?
Can we infuse nutrients to accelerate health into the built environment?
Psychological and Physiological Indicators
In order to log the health-causing effects of architectural design, psychological and physiological indicators must be read during body-space interaction. Biological signals that emit from the human body can be read in order to track health-causing conditions created by spatial qualities. Using wearable sensors, it can be understood whether or not and to what extent a building or space can make one feel balanced and regenerated.
The psychological indicators to assess architectural determinants of health include increased neuroplasticity, balanced amygdala activity (accurate stress assessment capability and greater emotional stability), a strengthened prefrontal cortex (better control, focus, and cognitive clarity), temporal lobe engagement (improved memory, facility with language, and processing of emotions), and a regulated limbic system (better ability to manage emotions, motivation, and social behaviour).
The physiological indicators to assess architectural determinants of health include a well-balanced parasympathetic nervous system, eustress (the opposite of distress), raised serotonin levels, low cortisol levels, stable blood pressure, reduced heart rate and increased heart rate variability, deep and slow breathing, relaxed muscles, enhanced digestive function, lower inflammation, and improved sleep quality.
By measuring and tracking psychological and physiological indicators against differing architectural conditions, one can determine how health is generated through specific salutogenic placemaking strategies.
Patterns of Salutogenic Placemaking
The patterns of salutogenic placemaking are not prescriptive elements that when incorporated into architecture assuredly result in health. They are instead similar to ingredients that can be combined in many different ways to deliver nutritional value which still retaining their unique flavours. In essence, the patterns of salutogenic placemaking have a multitude of possible combinations and applications across different cultures and contexts. The primary patterns of salutogenic placemaking are as follows:
Buildings and environments that give more than is asked of them, that communicate a higher aspiration and purpose and possess an inherent dignity.
Places that offer a sense of reality, rootedness, and the passing of time.
Places with positive ambiguity – that is, places that encourage alternative potential meanings and uses by eliciting a sense of curiosity, seeking, and discovery; think of Rubin’s vase where we see both a container and two faces simultaneously.
Places that communicate a way forward and a sense of meaningfulness, agency, and growth.
Places shaped by nature, that use natural forms, light, materials, multi-sensorial analogies, and mid-range dimensional complexity fractal patterns like those found in nature.
Solidness, Silence, Stillness, and Intimacy
Places with an “unplugged” architecture that allows us to listen to our own inner being.
The architectural determinants of health model aims to highlight what parts of the built environment can make people healthy. By consciously applying the patterns of salutogenic placemaking to the design process, neurological experiences can be triggered in order to enhance human well-being and performance.