Designing Spaces that Heal

Authored by: Muqadas Jawad

Art by: Kain Wang

Picture this: you take a step outside of your home onto a wide walkway adorned with trees and bushes, hearing the sound of kids playing in the park across the street while you’re on the way to the grocery store, just a short walk away. Or picture the flip side – you step out onto the small sidewalk, immediately assaulted by loud noises, large crowds, and no nature in sight. The nearest grocery is several train stops away, but there’s a fast food chain down the block. When you compare the two, the first scenario seems to be the obvious healthier one. These “little,” overlooked factors in our homes and neighborhoods are powerful in shaping health behaviors.

When you think about your own neighborhood, do you remember sitting in your room with the sound of construction and traffic penetrating your space? Or do you remember stepping out into a relaxed environment, being able to safely get to your destination? Did your surroundings motivate you to go out for a run, or push you to stay in and order takeout for dinner? 

In other words, did your built environment promote development of healthy habits, or hinder it? 

Neighborhoods with walkable paths, cycling routes, easy park access and safe, seamless traffic are naturally more likely to motivate its residents to form healthy habits. These neighborhoods may increase overall physical activity and correlate to a lower BMI [1]. A study in New York City, focusing on physical activity in 5th grade students found an activity decrease in high-crime areas, while activity increased in areas closer to parks. Additionally, closer proximity to fast-food restaurants over fresh produce carrying grocery stores was associated with regional differences in childhood obesity, due to convenience of access [1]. 

According to a study by Putra et al., “green spaces” – areas with nature – are also essential to physical health, especially for children. Consistent access to green spaces was linked to lower triglyceride counts, or a healthier body weight, and even lower diastolic blood pressure, indicative of better cardiovascular health [2]. In general, “quality green space” access showed a decreased likelihood of hospital admissions for children [2]. This is namely due to the fact that green spaces promote child activity levels by providing them a place to play, thus preventing a sedentary lifestyle.

Our built environment not only impacts our physical health, but also our mental wellbeing. Residents of urban areas have been shown to be at an elevated risk of developing psychiatric disorders, potentially due to the social stress and “high pace of life” [3]. One study found that children with limited greenery in their environment were 55% more likely to develop a psychiatric disorder, and urban centers often lack sufficient green spaces [3]. This may be related to the fact that time spent in green space was linked to increased childhood cognitive development, reduced “neural activity linked to psychiatric disorders,” and even enhanced social capabilities [3]. Children in urban areas also experienced higher volumes of noise pollution in youth, and thus, were more prone to develop anxiety, which can reduce student engagement in schools and hinder cognitive development [4]. 

Yet it's not only what’s outside that’s affecting our health – our homes themselves also have a significant impact. A study by Riva et al. measured housing quality based on several parameters, like housing temperature, lighting comfort, noise level, and overcrowding which impact the “indoor environmental quality,” or how healthy a space is for its inhabitants [5]. For example, poor ventilation increases exposure to deleterious allergens, especially for people with respiratory conditions like asthma [5]. Additionally, inadequate indoor temperature can lead to harmful mold growth, which may lead to allergens, irritants, and upper respiratory tract symptoms [5]. Beyond physical wellbeing, poor housing quality is consistently associated with poor mental health outcomes [5]. 

Just as our homes matter, the design of healthcare settings is equally as critical in promoting health. An interesting study by Tronstad et al. was performed, exploring how Intensive Care Unit (ICU) bedspace design can achieve four things – an improved staff experience, improved patient experience, reduced delirium, and improved sleep. Together, these four factors can lead to improved patient health [6]. To test this, two ICU bedspaces were redesigned by creatively reducing sound, optimizing artificial light to mimic daylight, stimulating patient engagement, and more. Although evaluation of results is ongoing, researchers are optimistic to see optimal recovery with this patient-centered design [6]. 

The built environment in our everyday lives is oftentimes taken for granted. We go about our days without questioning how our environment is affecting our health, and how we can change it for the better. Being more intentional about urban and residential design, housing quality, and healthcare infrastructure can make a significant impact and make entire communities healthier. Implementing thoughtful design is the first step in improving population health, as it will allow people to not just become more healthy, but also to truly thrive in their community.

References:

1. Sridhar, G. R., & Gumpeny, L. (2024). Built environment and childhood obesity. World journal of clinical pediatrics. https://pmc.ncbi.nlm.nih.gov/articles/PMC11438925/ 

2. Putra, I. G. N. E., Astell-Burt, T., & Feng, X. (2022). Perceived green space quality, child biomarkers and health-related outcomes: A longitudinal study. Environmental Pollution. https://www.sciencedirect.com/science/article/pii/S0269749122002895

3. Engemann, K., Pedersen , C. B., Arge, L., Tsirogiannis, C., Mortensen, P. B., & Svenning, J.-C. (2019). Residential green space in childhood is associated with ... PNAS. https://www.pnas.org/doi/abs/10.1073/pnas.1807504116 

4. Newbury, J. B., Heron, J., Kirkbride , J. B., Fisher, H. L., Bakolis, I., Boyd , A., Thomas, R., & Zammit, S. (2024). Air and noise pollution exposure in early life and mental health from adolescence to young adulthood | psychiatry and behavioral health | jama network open | jama network. JAMA Network. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819070 

5. Riva, A., Rebecchi, A., Capolongo, S., & Gola, M. (2022). Can homes affect well-being? A scoping review among housing conditions, indoor environmental quality, and mental health outcomes. MDPI. https://www.mdpi.com/1660-4601/19/23/15975 

6. Tronstad, O., Flaws, D., Patterson, S., Holdsworth, R., & Fraser, J. F. (2023). Creating the ICU OF THE FUTURE: Patient-centred design to optimise recovery - critical care. SpringerLink. https://link.springer.com/article/10.1186/s13054-023-04685-2