Bringing Healthy Design to the Suburbs

TEXT Tye S. Farrow and Sharon VanderKaay

More than 50 years of dire warnings concerning the long-term effects of dehumanizing, energy-draining design in the suburbs have played out pretty much as feared. Alienating, car-centric environments are widely seen as a major factor in making chronic diseases the plague of this century.

Dismal places that discourage physical and mental activity are increasingly recognized as contributing to a public health crisis with a human face and economic price tag that can no longer be ignored. Preventable medical conditions, such as 80% of cardiovascular disease occurrences, place an estimated extra burden of $24 billion on the Canadian medical system annually, including losses in productivity. Obesity rates for 25- to 34-year-old Canadians have more than doubled since 1978-79. The number of children considered obese and overweight has climbed from 15% to 26% during that same period. A 2009 report commissioned by the Canadian Diabetes Association predicted that the number of Canadians living with diabetes linked to overweight would grow from 1.3 million in 2000 to 3.7 million by 2020. 

 “We are now medicalizing the problems people are experiencing with their environment,” says Dr. Richard J. Jackson, Chair of the School of Health at UCLA and former Director of the US National Centers for Disease Control and Prevention. “If designers and public health professionals work together, we can help treat and prevent chronic diseases with ‘built environment therapy.'”

A Shift in the Market

There is some encouraging light on the horizons of those sickly strip malls and acres of asphalt. Soaring energy costs, resource conservation efforts and evolving lifestyle choices are driving demand for healthier, more liveable suburban communities. Long commutes are shunned by Generation Y, while Baby Boomers want to age in places that feature walkable, diverse and vibrant neighbourhoods. This adds up to a market-driven demand for repurposing and retrofitting underperforming retail, parking lots, big box stores and office parks. Intensified “Eco-Towns” and “Creative Hubs” comprised of arts centres, libraries, educational facilities, big box farms and nursing homes are beginning to appear and spawn ideas for innovative conversions. 

More than 80 examples of such suburban transformations are presented in Retrofitting Suburbia by Ellen Dunham-Jones, AIA, Director of the architecture program at the Georgia Institute of Technology, and June Williamson, Associate Professor of Architecture and Urban Design at the City College of New York/CUNY. Their case studies include a former 100-acre mall in Lakewood, Colorado that has been redeveloped over a 10-year period into 23 walkable urban blocks, publicly owned streets, LEED-certified buildings and sustainable site design. This example has inspired eight of the 13 area malls to move forward with plans for applying urban design principles to their suburban settings. 

Dunham-Jones says that the challenge as this movement gains momentum is to raise public expectations for design quality. Otherwise, suburban renewal eyesores may echo the infamous failed urban renewal projects of the past. 

How to Cultivate Demand for Healthy Design 

Generations of architects who expressed a desire to “educate the public” regarding aesthetic values have had mixed success in creating design quality champions. But there is an alternative way of increasing the demand for better design: research on how adults learn indicates that active, question-based dialogue regarding personally meaningful criteria is the most effective way to build appreciation for new ideas. In essence, to change the minds of developers and others who have traditionally invested in pathogenic places, it is necessary to think together about the many advantages of healthy design and how design quality can be achieved most economically. 

Green design, universal accessibility to public buildings, and banning smoking are three examples of how entrenched attitudes can change when external forces shift and decision-makers see why it is in their personal interest to support a movement. 

To help develop broad-based support for design quality, our visual literacy conversations with clients and the general public are grounded by this fundamental question: Does the design create health or erode health? We further illuminate our ultimate test of creating health in terms of five dimensions, or Vital Signs. These common terms are easier for non-architects to relate to than academic-oriented architectural lingo such as “mixed use” or “sense of place.” 

1. Nature: Does the design make connections with the natural world? 
2. Authenticity: Does the design convey locally inspired character? 
3. Variety: Does the design provide visual interest and support diverse activities?
4. Vitality: Does it convey a sense of energy and stimulate social interaction? 
5. Legacy: Are we creating a design that is beyond “sustainable” in terms of advancing long-term health and prosperity? 

Go for Gut Reactions 

Projects that are considered technically sustainable, walkable and liveable may still be oppressively dreary or disorienting (e.g., fake historical villages, monotonous sheds). Architects have tended to pursue a didactic, intellectual path to enlightening clients regarding gaps in aesthetics. However our experience indicates that engaged citizens can learn to be appalled by poor-quality design. In our view, it is critical for decision-makers to develop an emotional reaction to unhealthy design that is on par with their visceral reaction when they see a mother smoking near her child or when they encounter a polluted river. At one time, the public may have turned a blind eye to these sights, but now people have become sensitized to the associated health consequences. Such emotional reactions are based on deeply held beliefs rather than shallow “buy in” and therefore can be very powerful motivators for action.

Lead the Quest for a Health-Creation Society 

All around us we can see how industrial-era thinking has led to dysfunctional financial practices, unsustainable medical systems, and “angry” citizens with pervasive anxiety and depression; we also experience the consequences of educational models that focus on teaching at the expense of learning, as well as careless abuse of the natural and built environment.

These conventions of the past add up to the unsustainable, pill-popping, illness-coping society we face today. As the overwhelming cost of managing chronic diseases continues to set off calls for drastic solutions, citizens need to ask why, for example, obesity is growing at an alarming rate in contrast to the rare condition it was only 50 years ago. Unhealthy weight must be understood as the symptom of a larger complex problem that has roots in the life-sapping design of our cities, suburbs, office buildings, schools and hospitals. 

Prevention has become the mantra of every health-care organization today, but we cannot rely on our medical system to solve the deeper causes of ill health. Getting serious about making dramatic reductions in health-care spending will entail more than imposing austerity measures on our hospitals and renaming disease-treating medical facilities “health centres.” If we look upstream beyond managing chronic illness to participate in a health-creation society, we can radically reduce unnecessary costs while enhancing long-term prosperity. CA

Tye S. Farrow is a Senior Partner at Farrow Partnership Architects, where Sharon VanderKaay is the Director of Knowledge Development. They both discuss the design process and how innovation
happens on “The Nature of Innovation,” Farrow Partnership’s blog at which includes a video of Tye’s pitch for healthier design at the Mayo Clinic’s Transform 2010 symposium.