| HEALTH | [ WELLBEING ] / DESIGN /
CONTENTS
1.
INTRODUCTION ............................................................................................................................................5
1.1 BACKGROUND | IMPORTANCE OF THE STUDY ................................................................................... 6
1.1.1. Health ............................................................................................................................................... 6
1.1.2 Beauty ................................................................................................................................................ 6
2.
METHODOLOGY ............................................................................................................................................8
1.1.
3.
Overview of factors .................................................................................................................................8
LITERATURE REVIEW ................................................................................................................................. 10
3.1.
Light ........................................................................................................................................................... 10
3.2.
Space ......................................................................................................................................................... 11
3.3.
Surrounding environment – Views ................................................................................................ 11
3.4.
BIophilia- Green Spaces ..................................................................................................................... 11
4.
LEGISLATION- INTERNATIONAL STANDARDS ............................................................................... 12
5.
DISCUSSION ................................................................................................................................................ 13
6.
CONCLUSION .............................................................................................................................................. 14
7.
BIBLIOGRAPHY ............................................................................................................................................ 14
8.
Appendix 1 ..................................................................................................................................................... 16
Health, Wellbeing, Design | Amalia Vranaki
1. INTRODUCTION “We shape our buildings, and thereafter they shape us”, Lavin, 2006 It is widely accepted that the built environment has a profound impact on health and wellbeing. There are several building related factors that can influence health and comfort. Several studies aim to address adverse health effects of the built environment and international standards and legislation, such as BREEAM, LEED or WELL give guidelines and suggest solutions so as to avoid these negative impacts.
•
The World Health Organization (WHO) defines health as not merely the absence of
Within the frame of this report, focus will be
disease or infirmity, but a state of complete
given to mental health; aim of the report is
physical, mental and social well-being.
to investigate whether and how aesthetics
(WHO, 1961).
and architectural design can influence it, by
•
summarizing the existing literature.
Wellbeing is a state of mind; a state of being comfortable, healthy and satisfied.
TABLE 1. STRUCTURE OF THE REPORT OBJECTIVES • • • •
To outline the building-related factors that can affect comfort, health and well-being To distinguish which of them are correlated to architectural design and can influence aesthetics To summarize the existing literature To make suggestions for further research, as well as proposals for designing more pleasing and healthier indoor environments.
SEARCH PROCESS: Using keywords a search was conducted in the following databases: PubMed, UCL library, Science Direct, Web of Science, GEOBASE, JSTOR, SCOPUS, NTUA library, Art Source, AMED
KEYWORDS: health, aesthetics, beauty, architecture, design, mental health, depression INTENTIONAL EXCLUSIONS •
• •
The current review will focus on the aesthetics of indoor and architectural space. Urban planning and design of neighborhoods will be excluded. Nonetheless, some aspects of urban planning that can affect general design of an indoor space (such as the existence of a park in the neighborhood that gives a pleasing view in the indoor space) will be reviewed. The review will focus on architectural strategies that can affect health and wellbeing, but aspects of interior design such as interior lighting or colors will be excluded. The paper will focus on mental problems and depression, excluding physical injuries or illnesses that can be affected by architectural design (such as fall of stairs due to bad design)
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Health, Wellbeing, Design | Amalia Vranaki
1.1. BACKGROUND | IMPORTANCE OF THE STUDY 1.1.1. HEALTH Mental health is defined as a state of
Nowadays, there is a surge in mood disorders;
well-being in which every individual
350 million people suffer from depression (WHO,
realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his
FACTS
can also lead to severe harms and death. 1.1.2 BEAUTY
Years On, Department of Health, 2005)
What is beauty? This question has bothered
cause of death in 15-29 year old (WHO, 2015) More than 5700 people in the UK died by
•
several philosophers and architects from Plato and Aristotle, to Kant and Le Corbusier. Beauty can be perceived as a range of things from people (Image 1). It is impossible to state
suicide in 2010 (Samaritans Information
objectively that something is beautiful, and the
Resource Pack, 2012)
opinions may vary between different people,
Untreated depression is the number one
education levels, cultures, or even eras. In a
risk for suicide among youth. Young males from 15 to 24 years old are at highest risk for suicide (American Association of Suicidology,1996)
•
gastrointestinal disorders and skin diseases and
of death in men under the age of 35 (Five
every year making it the second leading
•
integrally related to physical health problems, such as heart disease, cardiovascular disease,
Over 800,000 people die due to suicide
•
disability worldwide. Mental problems are
community (WHO, 2014)
Suicide remains the most common cause
•
2015;), making depression a leading cause of
The death rate from suicide (11.3 per 100,000 population) remains higher than the death rate for chronic liver disease,
survey of CABE (2010), participants claimed that beauty is connected to happiness, whilst its absence is related to depression. Moreover, a very significant conclusion of the report is the importance of senses when people experience beauty 1; (CABE, 2015). Peter Zumthor in
Alzheimer’s, homicide, arteriosclerosis or
“Atmospheres” attempts to identify architectural
hypertension. (Deaths: Final Data for
features that can create aesthetically pleasing
1998, Center for Disease Control)
spaces, by the creation of multisensory spaces (Table 3). Beauty in Architecture and design is often overlooked in terms of affecting health and well-
being. (Boubekri, 2014; Dougall, Spencer & Baum, 2; Martin et al., 2015). One of the main reason of this is that aesthetics and beauty constitute uncountable variables, i.e. it is impossible to numerically count the exact levels of “beauty” that can influence health.
1
not only is vision important, but beauty is described as a holistic experience where all the senses are involved
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Health, Wellbeing, Design | Amalia Vranaki Image 1: CABE, 2010
Table 2: Space features that can produce beauty Peter Zumthor-Atmospheres The body of Architecture Material Compatibility The Sound of a Space The temperature of a Space Surrounding Objects Between Composure and seduction Tension between interior and exterior Levels of Intimacy The light on things Architecture as Surroundings Coherence The beautiful form
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Health, Wellbeing, Design | Amalia Vranaki
2. METHODOLOGY 2.1.
OVERVIEW OF FACTORS In this section there will be an overview of the most important factors that can affect health and well-being. This will help in distinguishing the ones relevant to architectural design, taking into account the features mentioned in Table 3, 4 and 5.
TABLE 3. The strength of evidence linking housing and health (WHO, 2005; eds Dannenberg, Frumkin & Jackson, 2011)
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Health, Wellbeing, Design | Amalia Vranaki
Table 4. Health Impacts of the Built Environment as identified by Lavin et al., 2011 in Health Impacts of the Built Environment.
The cells noted with red are the ones that are related to space aesthetics and can be prevented by good architectural design
Air quality • • • • •
Radon ETS (Environmental Tobacco Smoke) Cooking Pollutants Volatile organic compounds Asbestos
• • •
Respiratory Diseases Asthma Lung Cancer
• • • •
Cardiovascular Problems Arthritis Mental health Effects Death
• • •
Allergies Respiratory problems Mental health Effects
• • • •
Cardiovascular system effects Depression Strokes Respiratory problems
Daylight
• •
Mental Health Effects Depression
Accidents (falls, trips etc.)
•
Injuries
Limited indoor space Overcrowding
• •
Mental Health Effects Depression
• •
Mental Health Effects Poor well-being
Lack of views Lack of green and common spaces Traffic Lack of neighborhood urban design
• •
Mental Health Effects Depression
Lack of services
• •
Effects on ill-health Effects on mental health
Temperature •
Indoor Temperature
Humidity • •
Mold growth Dampness
Noise
Light • Safety • Space • •
Accessibility Immediate Surroundings • • • • Locality •
Housing Improvements
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Health, Wellbeing, Design | Amalia Vranaki TABLE 5: Features of architectural space outlined in different papers. The study will be structured by selecting characteristics of the following table that were mentioned in the literature as factors affecting health and well-being, and at the same time can produce “beauty”. ARCHITECTURAL CHARACTERISTICS THAT CAN MAKE A BEAUTIFUL SPACE
Atmospheres
Domestic Health and Safety Hazard
Health Impacts of the Built Environment
WELL Building Standard
Light Space Density Contact with Nature Space Layout Colors Scale Furniture, Artwork Existence of common spaces
3. LITERATURE REVIEW “A beautiful and meaningful space in which design aesthetics are expressly considered can have a positive impact on occupant morale and mood.” WELL Standard 3.1 LIGHT Natural light is one of the most important factors that can contribute in making a space pleasing and lively (CABE, 2010). Many post occupancy evaluations have shown that people prefer spaces with windows that let the natural light come into the space (Boubekri, 2014; CIBSE 10). Light directly influences the endocrine and hormone systems, therefore there is a causality between lack of sunlight and mood disorders. Light acts on the production of cortisol, serotonin, and melatonin, three important hormones that affect our mood states, among many other effects. Low levels of serotonin (the daylight hormone) together with a low level of norepinephrine cause depression. Sluggish serotonin secretion may also account for the emotional, appetite, libido, and sleep disturbances associated with depression (WHO, 2004; Bouberki, 2014; Lavin, 2006). The most common disorder related to lack of contact with daylight is seasonal depression -seasonal affective disorder- ((Beauchemin and Hays 1996, cited in Sullivan and Chang, 2011; Boubekri, 2014). In many cases, patients suffering from seasonal disorder have shown improvements in their symptoms and duration of the disease, if working in places with big glazing areas or windows (Sullivan & Chang, 2011).
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Health, Wellbeing, Design | Amalia Vranaki
3.2 SPACE It is hard to define the exact effect that lack of space has on health, but even so, the hazard is ranked after light in Category B of BD 2508 (risk index 62). Space, in other words the perception of density 2 (Dougall et al., 2011) or crowding is highly correlated to mental problems (anxiety, depression etc.) and linked to aggressive behavior (Sullivan & Chang, 2011). These symptoms may not appear in short term, but a report published by Evans (2003) conducted in prisons, student accommodation and housing complexes concluded that there is a significant rise in psychological stress after a period of six months. As density increases, negative feelings of stress and discomfort also increase (Dougall et al., 2011). Individuals living in high-raise buildings, with little proportion of space per person have the tendency to develop depression symptoms (Evans, Wells, and Moch 2003). Experiments conducted in dormitories proved that architectural design can affect the way that people perceive density; during the study of Baum and Valins (1977) residents of corridor-dorms claimed to feel helplessness compared to suite-type residents, despite the fact that density ratio was comparable. Higher densities are also related to lack of privacy, something can also lead to depression (Lavin, 2006; Weich, 2001; CLG, 2008). 3.3
SURROUNDING ENVIRONMENT – VIEWS The existing literature categorizes the views in two main groups: natural and urban views. Direct contact with nature, i.e. contact with any type of plantation or green space seems to have a positive impact on well-being, health and comfort (Chang and Chen, 2005; Day 2008; Kaplan 2001 cited in Sullivan, Chang, 2011). On the contrary, Aries et al. (2010) reported that in their experiment there was, surprisingly, a positive correlation between natural views and psychological discomfort. In the same experiment, though, a better quality view-urban or natural- was positively correlated to increased psychological comfort (Aries et al. 2011; Heschong, 2013). Furthermore, views to natural scenes, help in faster recovery and fewer postsurgery problems in the case of patients, as it helped in reduction of stressful thoughts (Ulrich 1983, cited in Boubekri, 2014; Dougal, Spencer and Baum, 2), as well as in better sleep quality (Aries et al. 2010).
3.4 BIOPHILIA 3- GREEN SPACES The existence of green spaces, or even the use of plants as indoor decoration can affect positively psychological comfort and mental fatigue (Sullivan & Chang, 2011). Access to outdoor green spaces such as courtyards, green rooftops etc., as well as the incorporation of water into the architectural design can limit negative feelings (WELL, 2015). Furthermore, contact with nature reduces stress levels (Frumkin & Fox, 2011), as well as it can be beneficial for children’s development and reduces also the cases of stress, anxiety in the future life of the child (Wells & Evans, 2003).
2
Density is the ratio of individuals in a room to the available area.
Biophilia is the idea that humans have a natural affinity towards the natural world (WELL, 2015) something that is supported by CABE’s survey (2011). 3
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Health, Wellbeing, Design | Amalia Vranaki
4. LEGISLATION- INTERNATIONAL STANDARDS
DAYLIGHT
TABLE 6: Analyzed factors in different standards
SPACE DENSITY
BREEAM
80% of floor area should have an average daylight factor >2%
BS 8206
Average daylight factor >2% For spaces with an average daylight factor >5% then electric lighting will not normally be needed during daytime
CIBSE (and BRE)
UDI-a:300<E<3000lux
LEED 2012/13
Achieve spatial daylight autonomy, where at least 75% of the floor area is illuminated by daylight alone. 300 lux for at least 50% of the annual business hours
WELL BUILDING STANDARD
300 lux for at least 55% of the space for at least 50% of operating hours
BREEAM Housing Act 1985
x area>10m2,
2 persons
8<area<10m², 1.5 persons 6.5<area<8, 1 person 4.5<area<6.5, 0.5 person CIBSE
x
LEED 2012/13
x
WELL BUILDING STANDARD
x
BREEAM
x
BS 8206
x
CIBSE
x
LEED 2012/13
BIOPHILIA
WELL BUILDING STANDARD
SPACE LAYOUT
x Outdoor Biophilia • Features either landscaped grounds or rooftop gardens accessible to building occupants • Consists of, at minimum, 70% plantings including tree canopies (within the 25%)
BREEAM
Indoor Biophilia • Potted plants or planted beds cover at least 1% of floor area per floor • A plant wall per floor, covering a wall area equal or greater than 2% of the floor area, or covering the largest of the available walls, whichever is greater Water feature • At least one water feature for every 9,290m2 in projects larger than 9,290m2 of at least 1.8m in height or 4m2 in area x
BS 8206
x
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Health, Wellbeing, Design | Amalia Vranaki CIBSE
x
LEED 2012/13 WELL BUILDING STANDARD
x Ceiling Height • width< 9m have at least 2.7m height • width> 9m, 2.75m height and an additional 0.15m for every 3m of width Artwork
VIEWS
BREEAM
All positions within relevant building areas are within 7m of a wall which has a window or permanent opening that provides an adequate view out. The window/opening must be ≥ 20% of the surrounding wall area. Where the room depth is greater than the 7m requirement, compliance is only possible where the percentage of window/opening is the same as or greater than the values in table 1.0 of BS 82062.
BS 8206
x
CIBSE
x
LEED 2012/13
Greater than 90% of regularly occupied spaces
WELL BUILDING STANDARD
75% of all desks or regularly occupied seats are within 7.5 m [25 ft] of an atrium or a window with views to the exterior. 95% of all desks or regularly occupied seats are within 12.5 m [41 ft] of an atrium or a window with views to the exterior.
5. DISCUSSION
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Aesthetics and beauty result from the combination of different architectural features. It is extremely difficult to identify in which way and extend “beauty” influences mental health, even if for most people the relation of beauty to happiness is obvious (CABE, 2011).
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The above limitation is reflected in the existing legislation and standards, which fail to include aesthetic rules in a complete way. WELL Building Standard is moving towards this direction, nonetheless it is still incomplete.
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Daylight influences directly mental health by affecting the endocrine system. It is the only factor included in all standards, and also in BD 2508 in second risk category.
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Unexpectedly, most of the International Standards do not include benchmarks for overcrowding, even if the hazard is very important in terms of adverse health effects (CGL, 2008) 4. As concluded from the literature review, the existence of spacious common spaces,
Housing Act of 1985 set limits for overcrowding in houses and BD 2518 gives some suggestions in order to avoid overcrowding as presented in Image 4 4
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Health, Wellbeing, Design | Amalia Vranaki but also intermediate and private ones where individuals can be isolated, should determine architectural design, especially in cases such as multi-family buildings, dormitories, prison and educational institutions. â&#x20AC;˘
There are controversial findings in the literature regarding the effect of natural versus urban views, something that can be used for further research, similar to the one Balling and Falk made (1999) that concerned natural landscapes and how users respond to them in terms of visual pleasure (Balling D. J., Falk H. J., 1999).
6. CONCLUSION
Mental health is very important for the overall well-being of individuals. Due to the current lifestyle there is an increase in mental disorders and depression. Built environment can play a significant role in reducing depression incidents, by the design of beautiful spaces. Adequate lighting, existence of outdoor, common and private spaces room proportions can all play a significant role in making built environment friendlier and more pleasing (De Botton, 2011). It is architecture that can help in making not only buildings, but also neighborhoods and cities more beautiful and hopefully, make people overall happier.
7. BIBLIOGRAPHY Balling D. J., Falk H. J., 1999. Development of visual preference for natural environments. Journal of Composite Materials, 33(10), pp. 928-940. Bond L., Kearns A., Mason P., Tannahill C., Egan M., Whitely E., 2012. Exploring the relationships between housing, neighbourhoods and mental wellbeing for. BMC Public Health, Volume 12, p. 48. Bouberki M., 2008. Daylighting, Architecture and Helath: Building Design Strategies, USA: Architectural Press is an imprint of Elsevier. CABE (Comission for Architecture and the Built Environment), 2010. People and places: Public Attitudes to Beuaty, UK: Ipsos MORI. Connellan K., Gaardboe M., Riggs D., Due C., Reinschmidt A., Mustillo L., 2013. Stressed Spaces: Mental Health and Architecture. Herd, 6(4), pp. 127-168. Department of Communities and Local Government, 2008. Review of Health and Safety Risk Drivers, London: Crown Copyright. Dougall A.,Spencer S., Baum A., n.d. Architecture and Health. In: S. Ayers, ed. Cambridge Handbook of Psychology, Health and Medicine. Cambridge: Cambridge University Press, pp. 23-26.
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Health, Wellbeing, Design | Amalia Vranaki eds. Dannenberg L. A., Frumkin H., Jackson J. R., 2011. Making Healthy Places. Washington: Island Press. Evans, G. W. 2006. “Child Development and the Physical Environment.” Annual Review of Psychology 57: 423–51. Evans, G. W., S. J. Lepore, and K. M. Allen. 2000. “Cross-Cultural Differences in Tolerance for Crowding: Fact or Fiction?” Journal of Personality and Social Psychology 79: 204–10. Evans, G. W., N. M. Wells, and A. Moch. 2003. “Housing and Mental Health: A Review of the Evidence and a Methodological and Conceptual Critique.” Journal of Social Issues 59: 475–500. International WELL Building Institue, 2015. WELL Building Standard, New York: Delos Living LLC. Kaplan, R. 2001. “The Nature of the View from Home: Psychological Benefits.” Environment and Behavior 33: 507–42. Kaplan, S. 1995. “The Restorative Benefits of Nature—Toward an Integrative Framework.” Journal of Environmental Psychology 15 (3): 169–82. Lavin T., Higgins C. ,Metcalfe O., Jordan A., 2006. Health Impacts of the Built Environment: A Review, Dublin: Institute of Public Health in Ireland. Martin D., Nettleton S., Buse C., Prior L., Twigg J., 2015. Architecture and health care: a place for sociology. Sociology of Helath and Illness, 37(7), pp. 1007-1022. Stamps, A. E., 2000. Psychology and Aesthetics of the Built Environment. New York: Kluwer Academic Publishers. Sullivan C. S., Chang C., 2011. Mental Health and the Built Environment. In: H. F. R. J. J. eds. Andrew L. Dannenberg, ed. Making Healthy Places. Washington: Island Press, pp. 106-116. Ulrich RS. View Through a Window May Influence Recovery from Surgery. 1984. Science, (Institute, 2015)World Health Organisation Europe. Fourth Ministerial Conference on Environment and Health, 2004; Budapest. Zumthor, P., 2006. Atmospheres. Basel: Birkhauser.
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8. APPENDIX 1
Reproduced from BD2518, Department of Communities and Local Government, 2008. Review of Health and Safety Risk Drivers, London: Crown Copyright. Suggestions for avoiding overcrowding
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