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More carrots, fewer sticks: Fitwel’s mission to drive design for human health

Twenty-five years after the formation of the US Green Building Council, even the laypeople among us understand that buildings impact the health of our planet. But how do they impact the health of their inhabitants? Fitwel, a certification system operated by the New York–based Center for Active Design (CfAD), allows users to find out — and then create healthier spaces. The system utilizes a scorecard weighing so-called strategies, such as whether public transit is accessible nearby, how many rooms are lit by natural daylight, and where the staircase is located (is it placed invitingly in the lobby, or hidden away in a stairwell, an obvious afterthought to a gleaming elevator?).

Writer Rachel Dovey sat down with Joanna Frank, CfAD’s president and CEO; Liz York, chief sustainability officer with the Centers for Disease Control and Prevention (CDC), which helped create the system; and Tiffany Broyles Yost, an Arup associate who’s also a Fitwel ambassador, to discuss the certification’s history, how it’s unique from LEED, and how to apply a holistic notion of health to zoning regulations and building codes.

What’s the backstory of Fitwel’s creation? How did the CDC become interested in a health-based certification process?

York: The idea of translation has been key to this entire effort: looking at how to take the stacks of public health studies showing us what changes behavior and turn them into something that architects can understand and use. Around 2010, a group formed — made up of the General Services Administration (New York Federal Buildings), the New York City Department of Health and Mental Hygiene, and the CDC — and we began the process of determining what the strategies were going to be. We tried to build on the success of LEED, looking at what it does well and what users wanted us to improve. It was great to have someone else go before us so we could see how the market was responding. 

Frank: CfAD was awarded the exclusive license to operate Fitwel in May of 2016 after a competitive selection process. We’ve since expanded it beyond workplaces to multifamily residential buildings in conjunction with Fannie Mae, which has created a new loan called Healthy Housing Rewards.

Fitwel rates buildings on a scale of one to three stars. Have any of you scored your own buildings?

Broyles Yost: We have two-star certification for our New York office, and the Boston office has a three-star rating. The Boston office scored higher because we were renovating it around the time we did the scoring, and there were a few things that were easier to do from scratch. Our New York rating looked simply at the existing space. If we’d done things like purchase adjustable work stations, we could have scored more points, but we really wanted to see how the rating applied to an existing space without any changes.

York: Our chronic disease center only scored two stars at first, so we looked at some of the low-cost things we could do to push it over the edge — even just putting up signage here and there. We made a few changes and when we went back to the scorecard, we had three stars.

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Three ways to make your building healthier:

  • Encourage use of the stairs: Two minutes of stair climbing per day is enough to prevent average, middle-age weight gain.

  • Improved work spaces: In addition to active work spaces, employees benefit from natural daylight and other biophilic design choices.

  • Indoor air-quality policy: Indoor air pollutants are on average two to five times greater than outdoor pollution levels.

Liz, you said earlier that Fitwel was built on the success of LEED. Can you elaborate on that?

York: LEED gets people excited about doing these really hard things by giving them a prize level — silver, gold, or platinum. It’s a competition. So we also wanted to give people benchmarks that they could aim for.

But LEED is complicated. It brought a whole bunch of building science knowledge to the table and taught a lot of engineers, architects, designers, and owners about sustainable construction. We didn’t want to teach everyone about public health science — we just wanted to give them the strategies and then have them implement the strategies however they wanted. Another goal was to have Fitwel be a kind of everyman’s certification system, in that any building could get better. So we took out the prerequisites because we didn’t want anyone to say, “Oh, I can’t meet prerequisite number one, and so therefore I’m not even going to try.”

Broyles Yost: One example of a prerequisite within LEED is that no project would be able to meet certification if it were built on previously undeveloped land. That’s an incredibly reasonable and well-thought-out policy. In Fitwel, though, the goal is to improve. There’s nothing that says you must obtain this certain level within your building. It doesn’t say that there can be no smoking anywhere within the campus or near the building — it says there’s a health benefit to not smoking and you can get a lot of points by making your building smoke-free. There’s more carrots and fewer sticks within this system.

In its focus on the environment, LEED already covers public health in a sense. Why is it important to have another certification program for the more personal side of public health?

Broyles Yost: There’s a health epidemic in our country related to lack of activity and exercise that can’t just be medicated away. And we’re in buildings 90% of the time. That epidemic is something we should all be working on. And designing for individual health is incredibly relatable. It’s difficult in some ways to talk about climate change, which is a very large, global program that is difficult to understand and happens in the future. But if you tell me that the way I’m living and the things I’m doing daily give me the health of a 55-year-old woman when I’m not a 55-year-old woman, that resonates directly with me immediately.

York: Health has always been one of the things that architects have been charged with. We are supposed to protect the health, safety, and welfare of the general public. Most of our building codes and zoning regulations are based on that idea. But I think that architects in recent years have lost the health charge in our focus on safety. Fitwel is a call to put health and well-being front and center again. 

Earlier Liz mentioned testing the market response to Fitwel. Can anyone elaborate on how they’ve seen LEED change the marketplace and how they anticipate Fitwel doing the same?

Broyles Yost: I think one really basic and concrete way within LEED is the recycling of construction waste. When I started working on LEED projects in New York in 2001 or so, it was very difficult to get contractors to sort and recycle construction waste. Within 10 years, we didn’t have to think about that because there was a market for crushed concrete and recycled rebar, and a cost-benefit to contractors to sort through those things.

With Fitwel, I think the active design strategies are really relevant. We see more active and interstitial stairs than we used to. And a lot of Class A office spaces are starting to implement active work stations as a standard within their spaces. Five years ago, a standing desk was kind of odd. 

Frank: To add to what Tiffany said, we’re seeing demand for health-promoting environments coming from both the workplace and residential sectors, because the occupants of both are prioritizing health when deciding where to work or live. That’s borne out by recent data relating to businesses’ rates of retention and housing developers’ pricing. There are many studies connecting increased value in real estate with health-promoting environments, proximity to transit, and well-maintained parks. Ultimately, we want to bring about a market transformation in all aspects of the building industry around health, and that feels like a realistic goal.

Questions or comments for Joanna Frank, Liz York, or Tiffany Broyles Yost? Contact joanna@centerforactivedesign.org, lby8@cdc.gov, or tiffany.broylesyost@arup.com.