How do you decide your mode of transport to work? What is it about your local park that makes you feel welcome to the space and likely to interact with your neighbors? Do you feel safe from traffic and crime when going for a walk at dusk?

These are the questions that researchers working at the intersection of design and health are studying, and we are gaining new insights every day. The built environment affects our day-to-day behaviors and all aspects of health. For example, researchers in the UK found that active commuting (walking or cycling) was positively associated with commuters’ psychological wellbeing.

The Center for Active Design (CfAD) acts as a “knowledge broker” in this field, gathering and synthesizing evidence into actionable recommendations. We apply our multi-disciplinary expertise to empower decision makers by providing publications, original research, technical assistance, and certifications for health-focused buildings. Collectively, this work feeds into our mission, which is to transform design and development practice to support health, ensuring communities across the world equitable access to vibrant public and private spaces that support optimal quality of life.

Our organization grew out of the momentum generated by the City of New York’s Active Design Guidelines (ADG) in 2010. The guidelines featured a translation of evidence-based academic research into practical design and operational strategies, setting a precedent for promoting health through design. Since then, we have learned a number of invaluable lessons that propel us towards a systems approach in this work:

 

1. Recognize That Health is Holistic and Far-Reaching

Many of the approaches for shaping our built environment to promote physical activity, as initially outlined in the Active Design Guidelines have also been linked to mental and social aspects of health. These “co-benefits” speak to the inseparable connections between physical, mental, and social well-being.

Four years ago, after recognizing this expansive definition of health, we began to explore the research connecting design with social and civic life. Fresh off the press, CfAD has just published the Assembly: Civic Design Guidelines as a practical and inspiring playbook to empower a diverse cross-section of implementers to use design to support civic life.

 

2. Engage Multidisciplinary Partners

Like the ADGs, which came out of a collaboration between city agencies and a diverse range of partners, the Assembly: Civic Design Guidelines capture the culmination of four years of research and collaboration—with input from 200+ studies, 50+ cities, and dozens of expert advisors from various disciplines and sectors. This tried and true approach to engaging multidisciplinary partners is key to successful translation between research and practice.

These partnerships are also effective for research projects, particularly when conducted in real-world settings, leading to practical, actionable interventions. For example, the recently published Stand Up to Work study in the International Journal of Workplace Health Management was the result of a collaborative research team with backgrounds ranging from architecture and interior design to preventive medicine and public health.

3. Create Targeted Tools, Resources, and Incentives

Evidence-based recommendations serve as a launching point for design practitioners’ decision-making. However, every context is unique, and practitioners operate on different scales. We must know the audience, the different needs and motivations of each, and tailor the message (and messengers) to best meet those needs.

Case studies are a compelling way to demonstrate the application of strategies to specific contexts. Our website features dozens of case studies from around the world, and on the ground, we work directly with developers and communities to guide their decision-making. Earlier this year, partners in Bradenton, Florida enlisted the Center for Active Design to conduct a community-based survey to inform the expansion of the Bradenton Riverwalk. The survey findings illuminated key community priorities to connect with nature, and to showcase local identity through public art. They also revealed the existence of a burgeoning local volunteer corps, with nearly 64% of residents living close to the expansion site expressing interest in volunteering at the Riverwalk.

 

4. Continually Measure and Evaluate

Academic research published in peer-reviewed journals is often a reliable source of evidence. Lessons can also be gleaned from industry best practices, case studies, and expert insights. As projects are implemented, formal and informal evaluation is critical to the evidence-practice feedback loop.

In the conclusion of just about every research paper, the assertion “more research is needed” signifies an ever-growing body of evidence that warrants ongoing translation. This translation must be informed by a diverse group of stakeholders and be sensitive to the variety of contexts and scales that recommendations will be applied.

 

Moving Forward

The ADGs took off to influence New York City, communities across the U.S., and beyond. It is an impressive example of how creating a framework that codifies health-promoting strategies into the design and development of projects can impact the places where we live, work, and play.

Building on this model over the years, we have disseminated the knowledge we’ve distilled via several different avenues. In 2015, we published the Building Healthy Places Toolkit in partnership with the Urban Land Institute to provide the development community with essential principles to create healthy real estate.

This work paved the way for us to launch Fitwel, a healthy building certification that was developed by the U.S. Centers for Disease Control and Prevention and the General Services Administration. Since becoming Fitwel’s operator in 2016, we have expanded the certification from supporting healthy workplaces to also include market-rate, affordable, and senior multifamily residential buildings. Fitwel is the only certification that qualifies access to Fannie Mae’s Healthy Housing Rewards™ program, which provides an interest rate discount to multifamily affordable borrows that invest in the health of their residents.

With the publication of the Assembly Guidelines, we have created a comprehensive roadmap that cities, designers, and developers can now use as a standard to create public spaces that are well-designed, well-maintained, and serve as a force for building trust and healing divisions in local communities.

Our future efforts will expand on these concepts, and we will continue to learn from the implementation of effective frameworks.