Biology of Architecture: a public health perspective
By Allan Ochola
SYP, GHMe, 2019
Architecture is Health
When discussing health, architecture is not generally the first thing that springs to mind. Yet its influence on us is inescapable. The term ‘architecture’ often invokes ideas of visual design, buildings, and cities. We move in and out of them, interact with them — we live and breathe in them. However, health exceeds a medical paradigm, engaging in issues such as lifestyle and built environment, which requires a holistic approach. The built environment can be optimized to maximize population well-being. For example, healthy communities will alter a child’s gene function, biochemical processes, cognitive potential, body-mass index, mood, injury rates, and ultimately, their ability to thrive as adults and elderly people (see more here).
Architects play a critical role in shaping the qualities of our environment; they work in collaboration with end-users and they have the power to restore and promote solidarity, mental and physical health and be a source of happiness.
The Built Environment and Non-communicable Diseases
Public health is a broad subject, but the architecture and urban design can deliver concrete, irrefutable solutions to the pervasive and devastating public health challenges such as mental health. Now, with rising rates of obesity and chronic diseases linked to sedentary lifestyles, health experts are looking at new ways to enhance health and ensure that our environment enhances, rather than detracts, from physical well-being, and how we are impacted by the ‘built environment.’
The Built Environment and Infectious Diseases
The built environment can be a setting for exposure to an array of infectious micro-organisms such as viruses, protozoa, bacteria, and fungi. Exposure to these infectious agents can occur via inhalation, including aerosols from premise plumbing or direct contact with fomites. For bacteria, in particular, damp surfaces can serve as a habitat for bio-films, which can amplify certain species, including several pathogens. These exposures are likely to be from a combination of multiple microorganisms, which can affect how the microorganisms impact the human host in a variety of ways, many of which have not yet been studied.
Water-damaged buildings and ‘sick buildings’ results in negative respiratory health effects for building occupants. These respiratory effects are often not directly related to allergy and may also be caused by an irritant or pro-inflammatory components of microbes. Connections between the built environment and a number of non-respiratory health outcomes have been documented, including effects on child development, brain health, and mental health. More recently, synthetic products used as dyes, fragrances, adhesives, paints, preservatives, cleaners and insecticides have been implicated in human disease.
Beneficial effects on health from exposure to microorganisms in built environments have also been reported, particularly for exposures that occur in early life. Additionally, new meta-genomics tools have opened a window into a better understanding of the vast number of microbes that inhabit the human body and the microbial communities that are in the built environment.
Characteristics of the built environment, the microbial community, and human behaviors within that environment may modulate the dose of the microorganism or the compartment exposed, and they may in turn influence whether the microorganism has a beneficial, adverse, or null effect on health. The same community of microorganisms and their cell wall components may benefit human health in some circumstances and be detrimental in others depending on such circumstances as building characteristics, life stage of the person being exposed, exposure route, co-exposures, dose, and genetic sensitivity. For example, a baby who ingests microorganisms while crawling on the floor may respond differently from an adult with asthma who inhales the same microorganisms. Potentially beneficial microbes include primarily microorganisms that train or modulate the human immune, produce small molecules that mediate human health, or enable other functions that improve well-being in a human host.
There is a need to identify a set of critical knowledge gaps in areas such as the impact of climate and climate variations on the built environment, obtaining additional data necessary to support a variety of qualitative frameworks for understanding and assessing built environment and prioritizing research goals to accelerate the application of knowledge about built environment microbiomes to improve built environment sustainability and human health. Additional challenges may also be associated with built environment interventions, health effects, or access for those in substandard housing who are of lower socioeconomic status. For example, people of low socioeconomic status relative to those who are better off may lack access to information about the interaction between microbes and built environment and may have more limited ability to make changes to their buildings, even when such guidance is available.
Where do we go from here?
Design studies to test health-related hypotheses, drawing on the integrated expertise of health professionals, microbiologists, chemists, building scientists, and engineers need to be conducted. Many of the studies investigating how the built environment relates to public health have been conducted in ways that make them difficult to reproduce in other settings.
A variety of further studies will need to be developed and implemented to ensure that the experiments are reproducible and produce results that can be translated into actionable outcomes. As more knowledge emerges about the communities of microbes, environment and health, the question arises as to whether this knowledge might be used to inform building design and operation to create and maintain a more healthful built environment.