Designing for Well-being: How the Built Environment Can Improve Our Mental Health

May 24

Insights from the Center for Active Design Experts

Mental health conditions are on the rise.

According to a 2023 report out of the U.S. Surgeon General’s Office, the rate of loneliness among young adults has increased every year between 1976 and 2019 — a trend that has only continued, partly as a byproduct of the COVID-19 pandemic. Perhaps unsurprisingly, this rise in loneliness and isolation has had far-reaching impacts on mental health broadly. Anxiety and depression are the most commonly diagnosed of these conditions, and since 2020 we have witnessed a 25% increase in the prevalence worldwide. This May, as we observe mental health awareness month, it is important to recognize the implications this crisis has for holistic health and society at large, and also look towards solutions.

Impacts are far reaching.

This rise in mental health conditions has ripple effects on physical health, social well-being, and even the economy. When it comes to physical health, loneliness and depression are both linked to increased risk of physical ailments, including heart disease, stroke, hypertension, and premature death. Social isolation was also found to be associated with a 29% increase in the risk of heart disease and a 32% increase in the risk of stroke. Meanwhile, increases in anxiety directly correspond to the decline of physical health functioning over a six month period.

On a societal scale, poor mental health can degrade social ties, which protect against both mental and physical ailments. We also see community-wide benefits from addressing loneliness and social isolation, with one study finding that increasing social connectedness was associated with a 21% reduction in murders and a 20% reduction in motor vehicle thefts.

Financially, loneliness and social isolation are associated with an additional $6.7 billion in Medicare spending annually. On top of these costs, depression and anxiety together result in $1 trillion in lost productivity each year, while social isolation costs employers more than $154 billion annually in absenteeism.

As you can see, the research makes clear that the impacts of supporting mental health go far beyond psychological well-being. But what does supporting mental health look like? Fortunately, there are a number of built environment interventions that can support improved mental health and increased social connectedness. While these strategies can vary, from improving indoor air quality to increasing access to outdoor green space, they present concrete solutions to building community connectedness and mental well-being.

Support occupant satisfaction by improving air quality.

While not news to those in the health sector, the COVID-19 pandemic brought to light the enormous impact indoor air quality can have on our physical health. Poor indoor air circulation not only impacts contagious disease transmission, from the flu to COVID-19, but also exacerbates the effects of chronic indoor air pollutants, such as gas stoves (read more of our thoughts on the health concerns around gas stoves here). Beyond these impacts, indoor air quality can also impact our mental health. In workplace settings, occupant satisfaction is often used as a proxy measurement for mental well-being, and research indicates improved air quality can result in a 450% increase in workplace satisfaction. Conversely, poor indoor air quality, or indoor air pollution, has been linked to a variety of mental health conditions such as depression, anxiety, and anxiety depressive disorder. Evidence from China corroborates these findings, estimating that the annual medical expenses attributable to the mental health impacts of exposure to indoor fine particulate matter are around 22.88 billion USD.

The impact of air quality on mental health also holds for outdoor air. The most common everyday source of outdoor air pollution, across settings, is traffic pollution, and evidence indicates traffic-related air pollution significantly impacts mental health. Increases in PM2.5, NOx, and NO2, common combustion chemicals, were found to be associated with 18-29% increased odds of common mental disorders. The same evidence also indicates increases in larger particulate matter, PM10, are associated with a 33% increase of psychotic experiences. The link between air quality and mental health also holds for less common sources of outdoor air pollution, from oil refineries and other industrial activities to wildfires, further reinforcing the connection between air quality and mental health.

Photo courtesy of New York City Department of Design and Construction.

Foster a connection to nature through biophilic design.

Exposure to greenery, whether through outdoor naturescapes or indoor plants, can improve both physical and mental well-being. Findings show that exposure to nature in the office can improve employee satisfaction and reduce stress; on a smaller scale, just five minutes of looking at a potted plant can significantly lower blood pressure and anxiety. These benefits translate to outdoor spaces as well. Outdoors, a relationship between exposure to natural landscapes and improved mental health is well-established. Notably, the difference in depressive symptoms between an individual living near no tree canopy and someone living in an environment with dense tree canopy is larger than the difference in symptoms associated with an individual who is uninsured compared to an individual with private insurance. These impacts are astounding when we consider the rising cost of healthcare globally.

On a community scale, proximity to parks and participating in gardening have also proven to offer mental health benefits, furthering the justification for urban greening. In addition, parks and community gardens also provide opportunities for social connection. Creating spaces for connection and community building plays an important role in addressing loneliness and isolation, as therapeutic landscapes can enhance individual capacity for social connection. Furthermore, these attributes can move beyond parks and gardens to any type of public space, as biophilia can serve as a welcoming invitation for gathering.

“Public spaces can provide meaningful social interaction and opportunities for engagement that result in better psychological and physical well-being," explains Setha Low, Center for Active Design Board Member and Distinguished Professor at the CUNY Graduate Center. She goes on to say, “the quality of the public space needs to offer the possibility of contact, the creation of a public culture, and a positive affective atmosphere. We can design these attributes into our housing environments to improve well being and social relations for all.”

Combat depression with daylight exposure.

The relationship between daylight and mental health and well-being is wellfounded, most notably through seasonal affective disorder (SAD), a form of depression that directly correlates to daylight exposure. Apart from SAD, evidence also supports the relationship between indoor daylight exposure and emotional well-being. In workplaces that utilize glass glazing optimized for daylight access, employees were 77% less likely to report feeling depressed. Furthermore, beyond combating feelings of depression, increased exposure to daylight was found to positively impact productivity, sleep quality, mood, and energy levels. These impacts are further reinforced by evidence that they cannot be replicated by artificial lighting. This association is only stronger for outdoor exposure to daylight. Outdoors, sunlight exposure is so strongly correlated to well-being a popular scientist names it one of the top five actions we can take to support holistic health.

Designing for health.

While many of us still work and live in incredibly isolating environments, much a result of the impacts associated with the COVID-19 pandemic, there are a number of meaningful ways we can make these environments mentally supportive. A Fitwel Certification offers a comprehensive pathway towards addressing the indoor and outdoor built environment interventions that support holistic health. Across asset types, a Fitwel building certification addresses not only air quality, biophilia, and daylight access, but also offers a wide array of other opportunities to support mental and social well-being, from walkability to community destinations, outdoor lighting, farmers market access, and more.

Mental health awareness month is a great time to think about the small changes we can make to the places we live, work, and play to support our mental and physical health. Indoors and outdoors, ensuring we spend time amongst sunlight, fresh air, and greenery can do wonders to combat the growing rates of depression, anxiety, loneliness and isolation. Along the way, we just might build the community our ‘epidemic of loneliness’ indicates we’ve been missing.

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