Architecture for Health and ‘Ordinary’ Architecture

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Architecture for Health and ‘Ordinary’ Architecture: Reacting to Natural and Artificial Light as a Conduit for Wellness.

MMU ID: 23763542

Auri Natalia Gómez Olavarría

Introduction

Wellness, or health, is affected by a wide variety of factors; biological, psychosocial, lifestyle-related and environmental (NCHHSTP, 2019) Architecture has an undeniable influence over some of these. In a society as hyper-focused on productivity as ours, it is to be expected that the health of the user and creating a suitable space in agreement with their physical and psychological characteristics would be specifically considered (Gavgani, 2013).

Artificial light and natural light operate differently. This means that a shift in the predominancy of any of these will cause a change in the way users’ health is affect by architecture. With the introduction of artificial light in the 18th century, natural light’s role has forever been changed. It has steadily creeped into ordinary architecture since its nascency. This essay aims to explore this relationship.

1. Departure from Architecture for Health

In the article posted under the RIBA’s website titled ‘Architecture for Health’, the author states that ‘the way architects have used light is key’ (楠 周, 2016). The author of this article explores a variety of examples of architecture whose function is directly related to health. That is, their typology is located nearer to hospitals and wards than residential or office architecture, which are of a less extraordinary use.

A primary example they explore is Penoyre & Prasad’s Sir Ludwig Guttmann Health and Wellbeing Centre in the Olympic Village in London. Via a four-floor atrium that the author of the article describes as ‘dramatic’, the interior is awash with sunlight. The result is a ‘sense of space’ and empowerment. The light also encourages ‘patients and staff to use the stairs and be active and healthy’ (Penoyre and Prasad, 2017). These designers tend to make use of light in their health-oriented buildings, which results in them usually being described as ‘light-filled’ (Penoyre and Prasad, 2021).

Perspective drawing (by author).

Nevertheless, one could argue that solely focusing on this building classification results in a narrow perspective and does not paint a proper picture of how health can be improved via architecture more commonly used by the greater population (楠 周, 2016) For simplicity’s sake, I will refer to the latter type of architecture as ‘ordinary’ architecture. Some argue that ‘the history of architecture is synonymous with the history of the window and of daylighting’ (Phillips, 2004). It is clear that the way architects have historically used light as a medium for health and comfort goes beyond this denominated ‘architecture for health’. And so to discuss the role of artificial light in comparison to natural light, we need to diversify the examples we include in our analysis.

Figure 1 Sir Ludwig Guttmann Health and Wellbeing Centre. Credits: Penoyre & Prasad. The opening takes up the majority of the structure’s height
Draft showing the ways artificial and natural light are used in the reception area (by author).

2. Silent perpetuity of Natural Light in Architecture

Phillips’ statement also puts into perspective the everlasting relationship between architecture and light. It emphasises the fact that it must not be neglected. Light in architecture is key, and despite this, light’s perceived importance has suffered fluctuations. This is not to say that its true importance has changed. As Prior stated, ‘hospital plans are essentially archaeological records which encapsulate […] medical knowledge’ (Prior, 1988) The importance given to light by designers is a reflection of the medical knowledge at the time, in most cases. Again, we can generalise and claim that we can find these archaeological records sprinkled throughout ‘ordinary’ architecture.

When we talk about health in relation to architecture, we usually refer to light, air circulation, temperature and safety; in order of least to most detrimental over the same period of time. Although now it is not rare to find a building that does not comply with the current safety requirements, these features have always been considered regarding health when sculpting spaces. The amount of natural light is among these main architectural considerations.

3. Light Through the Late Modern Period to Today

The general population’s view on light throughout the decades is as unstable as their perception on the rest of architectural considerations. What is considered ‘late modern period’ in this case is an ongoing source of confusion. Academics such as Hindrichs mark down its

start in the year 1928 (Hindrichs, 2011), while Ostade includes the eighteenth century within the Late Modern Period in her discussions regarding literature (Ostade, 2009). In order to make matters easier, the Late Modern Period will be considered to start in 1801 and end in 1945, which is the time period most commonly employed – used by history channels and our most ubiquitous online encyclopaedia (Late Modern Era, 2021).

3.1 Nineteenth century

During the early 19th century, air circulation was considered the most important factor in terms of health in architecture. The spacing of beds, the isolation of wards, ventilation, heating installations, circulation of air, cost per patient, and mortality rates were studied systematically and compared to international criteria (Mignot, 1983).

When the belief that sunlight could get rid of bacteria became popular, light’s importance outside architecture for health skyrocketed. It became a primary factor in residential and other ‘ordinary’ architecture. When antibiotics came in, light lost predominance in favour of easier flow of staff in architecture for health.

Another example - from this period of time - of symbiosis between architecture and natural light that is most commonly given is the Crystal Palace by Sir Joseph Paxton in 1851. The proposal demonstrates an attempt to reinstate a habitat that was healthy and that would oppose the environment of the growing industrial cities (Schoenefeldt, 2008).

Figure 2. Diagrammatic cross section. Credit: Henrik Schoenefeldt.
Perspective showing the openness of the space and the fenestration. Natural light floods the interior (by author).
Figure 3. Diagrammatic cross section. Taken from: Wellcome Images.

However, we may want to consider Hector Horeau’s submission for an iron and glass structure for the same competition in 1849 (Middleton and Watkin, 1980: 369). Middleton and Watkin define Horeau’s career as ‘constantly frustrating’. And this is because his suggestions for an architecture that would use light as its main motor continuously fell flat. ‘Most of his buildings have been demolished’ (Stevens Curl, 2006). One could suggest that this rejection shows that the western world was not ready for such an introduction at this point.

Artificial light variations did not have much of a role in this situation, with instances of its use for health and user commodity not appearing until the 21st century. Artificial light, until then, was solely used as a means to provide visibility, not ensure user satisfaction or improve their health.

3.2 Twentieth century

The denominated ‘Tuberculosis Sanatoria’ started to arise in England, as a response to the disease’s spread, which resulted in it being ‘the single greatest killer of adults in Europe and the United States’ during the end of the 19th century and the start of the 20th century (Bryder, 1988). It began in 1903. when Rollier started his work using sunlight in the context of surgical tuberculosis in the Swiss Alps (Masten, 1935). Example 20th century. Zonnestraal Sanatorium (Masten, 1935). During this time, the increasing worry regarding health in relation to sunlight had led designers to prioritise maximisation of sunshine via strategic orientation (Overy, 2007: 119)

Alvar Aalto considered the psychological needs should be included in the design, and so he ‘studies the lighting, both natural and artificial’ (Quecedo, 2012). He was able to further explore these elements in his Paimio Sanatorium.

During the end of the Late Modern Period, modernism, which can be understood to have existed between 1910 and 1960, was at its zenith (Bordeleau and Patterson, 2008).

Architecture that uses natural light as a device for wellbeing tends to fall under the biophilic architecture umbrella. This design movement is considered to have been generalised in the western world during the nineties (Hitchins, 2020).

3.3 Twenty-first century to today

Now, we know a lot more about light. We are aware that ‘natural light stimulates production and recovery’ (Christele Harrouk, 2020). We know that it has benefits on the social and psychological aspects of our health as well as the psychological.

Artificial light is viewed similarly, with Sholanke, Fadesere and Elendu (2021) stating that it has seen an evolution from spatial illumination to a means to passively communicate non-verbally. This communication, according to them, can ‘evoke emotion and affect people psychologically’. That is the conclusion that the authors of this literature arrived to after examining several publications, the majority of which were findings from studies. Such a discovery demonstrates its importance has settled and evolved past the physiological.

Today, there are parameters to determine how much light is ‘good light’. In architecture, a daylight factor (DF) is the ratio of the light level inside a structure to the light level outside the structure. It is defined as: DF = (Ei / Eo) x 100%, and its ubiquitousness demonstrates how natural light has become vital. Large windows contribute to an average daylight factor of 3.8%. Smaller widows, however, provide an approximate daylight factor of 0.3%. For historical areas where fenestration is not adequate due to the aforementioned fluctuations, 2 to 5% is considered satisfactory. There are software plugins, such as Sephora in AutoCAD that can help calculate these now crucial percentages.

Figure 4 - Paimio Sanatorium, Gustaf Welin. Alvar Aalto Museum.
Diagram of interior communal space in Paimio Sanatorium (by author).

4. Examples of Applications in Actuality

4.1. Physical

Hospitals are making the transition from traditional artificial lighting to new systems. That is, institutional lighting systems from the past are being mended to include luminaries that can give users soft, indirect light, such as LED fixtures (Axis Lighting, 2021). UVC LEDs have been found to have the potential to reduce growth of bio-film when incorporated into showerheads (L. Cates and Torkzadeh, 2019).

It has been shown that light has a variety of benefits. Looking at some examples will provide insight into how exactly these benefits can be maximised.

Natural light in today’s era is still used in tuberculosis centres around the world. An example is the Medical Centre for Tuberculosis Treatment in Port-au-Prince, Haiti. The objective was to design a space that can accommodate patients in the most dignified way possible (MASS, 2015). Of similar objective was the Medical Centre for Cholera (Testa, 2017: 55). Among many aspects, they considered natural light, resulting in wide openings and rooms that are awash with sunlight, as can be seen on the visualisations below. This, as seen from the history of Tuberculosis Sanatoria, can benefit the patients’ health.

Openings can be seen on both sides, with the only area that is closed off from views being the ‘división de enfermedades graves’, which translates to ‘severe illness unit’ or ‘medical intensive care unit (MICU)’. This area is labelled as ‘5’ on the plan.

Figure 6. Credits: Iwan Baan Edited by author. Light enters the structure from every angle.
Figure 5 Floor plan, ground floor. Credits: MASS Design Group. Edited by author.

.2 Psychological

In the United Kingdom and Hong Kong, Maggie’s Centres are ‘a series of buildings’ specifically designed for those that have been diagnosed with cancer, as well their friends and relatives (Martin, Nettleton and Buse, 2019). Psychological support as well as information about the condition is provided to users, as well as a holistic care programme (Butterfield and Martin, 2016). It is safe to say that, like the methods employed in these centres, the architecture is centred around improving the users’ psychological state.

The Maggie’s Centre in Manchester, otherwise known as The Robert Parfett Building (The Christie Hospital NHS Foundation Trust) is an exemplar instance. Clerestory voids are used to let light into the interior spaces but not rain (Jencks, 2017)

Figure 8. Credits: Foster + Partners Taken from The Architects’ Journal. Floor plan of Maggie Centre Manchester
Figure 7. Credits: Norman Foster. Edited by author. From: ‘Maggie’s Architecture: The Deep Affinities Between Architecture and Health’. The annotations show that the openness and amount of light were crucial factors to be taken into consideration.
Light comes in from a variety of angles due to the building’s thin floor plan (by author).

4.3 Social

Co-working spaces are primary examples that can show how lighting can be used to enhance interpersonal communication. In ‘Co-working spaces: Understanding, using, and managing sociomateriality’, Design-Studio is a pseudonym used for a co-working space in Beijing. In this case, lighting is used in ‘a more modest lighting scheme’ in order ‘to balance interaction and distraction’ (Bouncken, Aslam and Qiu, 2021).

9. Credits: Bouncken, Aslam and Qiu. Taken from ‘Co-working spaces: Understanding, using, and managing sociomateriality’, The inclusion of socialisation areas in the floor plan programme shows that light will affect users in a social context.

Diagrammatic perspective showing the ways artificial and natural light are used in the Design-Studio (by author).

Figure

5. Artificial Light and Circadian Rhythms

Blume, Garbazza and Spitschan (2019) state that light, apart from allowing us to see colour and motion, has nonvisual effects on circadian rhythms. Hilditch and FlynnEvans (2021) go on to state that ‘light is the most potent synchronizer of the circadian rhythm’. The study by Wever, Polášek and Wildgruber (1983) found that light above the melatonin threshold has a strong influence on human circadian rhythms. They are some of the many academics that agree that light is crucial to this human cycle. This is crucial to this discussion since circadian rhythms govern flow patterns, both in behaviour and the physiology of the majority of beings (Vitaterna, Takahashi and Turek, 2001). Circadian rhythms have a primary role on health, and they branch into our physical and psychosocial states.

Artificial light also has the ability to interfere with circadian rhythms, to the extent that it is believed that ‘artificial light has caused an ‘unnatural’ shift in human sleep’ (Aulsebrook et al., 2018). The way this can be achieved is via circadian lighting. LED technology is employed to change the colour of light across the course of the day, from orange to blue. Melatonin production rates are affected by the colour of light as well as its absence or abundance. Circadian lighting takes advantage of this and uses a range of colours, from orange to blue-hued, mimicking the different colours of natural light during the day.

An example of use of circadian lighting in ‘ordinary’ architecture is The Edge Amsterdam’s workspace. The lighting system makes it possible for employees to adjust the temperature and intensity of light in order to maximise comfort (Ubels, 2015). Moreover, the building’s shape is ‘chiselled to optimise daylight’ (‘The Edge, Amsterdam, The Netherlands – PLP Architecture’, 2017).

6. Conclusion

It seems that the role of artificial light is to assist natural light in improving the users’ wellbeing, including their physical and psychological health. Artificial light can be used to influence the circadian rhythms of people habiting the space, and it can also be used as a means to disinfect specific areas that tend to host pathogens that can be a direct threat to one’s health. Nevertheless, the part they play on the psychological state of those exposed is yet to be determined, while natural light has been proven to be a key requirement in what has been defined as ‘good architecture’; architecture that ‘acts positively on crucial aspects of our life’, such as health (Testa, 2017). It is also undeniable that natural light has a longer history than artificial light, and so the inertia of its accumulated accomplishments makes it difficult for artificial light to be able to take over.

With the rise of space tourism and the rising ubiquitousness of sustainable architecture, we can expect that artificial light’s role in relation to architecture for health and ‘ordinary’ architecture to shift.

Draft showing the ways artificial and natural light are used (by author).
Figure 10. Credits: PLP Architecture Edited by author. Large openings allow light to enter.
Figure 11. Credits: PLP Architecture. Axonometric drawing, The Edge, Amsterdam
(Portela, 2013)

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Sources of Illustrations

Figure 1. Penoyre & Prasad website. Available at: https://www.penoyreprasad.com/project/sir-ludwig-guttmann-health-and-wellbeing-centre/

Figure 2. Henrik Schoenefeldt. Available at: https://doi.org/10.1017/S1359135508001218

Figure 3. Wellcome Images. Available at: https://wellcomecollection.org/works/rtq53k3j

Figure 4. Gustaf Welin, Alvar Aalto Museum https://navi.finnisharchitecture.fi/paimio-sanatorium/#&gid=1&pid=6

Figure 5. MASS Design Group. Available at: ‘Arquitectura Sostenible (Architettura Sostenible)’, p. 57.

Figure 6 Iwan Baan. Available at: ‘Arquitectura Sostenible (Architettura Sostenible)’, p. 58.

Figure 7. Norman Foster. Available at : https://onlinelibrary.wiley.com/doi/epdf/10.1002/ad.2154?saml_referrer

Figure 8. Foster + Partners. Available at: https://www.architectsjournal.co.uk/buildings/exclusive-building-study-maggies-manchester-by-fosterpartners

Figure 9. Bouncken, Aslam and Qiu. Available at: https://www.sciencedirect.com/science/article/pii/S0007681320301257

Figure 10. PLP Architecture. Available at: https://plparchitecture.com/the-edge/

Figure 11. PLP Architecture. Available at: https://plparchitecture.com/the-edge/ (Wever, Polášek and Wildgruber, 1983)

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