Insights from Academia: How Fitwel’s Evidence-Based Design and Public Health Strategies Lead the Way

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Studying Healthy Building Standards

In a recent peer-reviewed article published in Buildings, researchers from Xi’an, China, and Milan, Italy, analyzed the Fitwel Standard alongside three other healthy building certifications to assess their impact on community health. Researchers compared the relative makeup of the public health topics included in each standard’s community-focused scorecard, giving powerful insights into how the Fitwel Standard is viewed and how our most recent updates align with research in the built environment. Although only the v2.1 Community scorecard from Fitwel was analyzed, the research points to interesting directions for the present and future of health-promoting spaces and places and the larger landscape of building certifications. Key findings from the study include:

1. A Holistic Health Focus. Fitwel stands out for its emphasis on holistic health, prioritizing factors beyond the physical environment (e.g. air, water, sound, thermal comfort), as well as "healthy facilities," such as transportation, public spaces, and food access. 

  • While physical environmental factors such as temperature, acoustics, and air quality are well-researched and invaluable to human health inside a project space, the Center for Active Design strives to incentivize project teams to take into account broader, holistic aspects of the built environment that greatly affect health outcomes for occupants. Fitwel’s new v3 strategies that address sustainability and food access exemplify this focus.

  • These broader factors or “healthy facilities” are referred to as the "Social Determinants of Health,” and research indicates that these are just as, if not more important than the immediate healthcare environment in determining population health at scale. These include access to transportation, internet, social connectivity, job opportunities, housing, and more. In our newest update, we incorporate new strategies such as Internet Access and Economically Diverse Housing that aim to address social determinants of health and the creation of health supporting environments.

  • This research reinforces how the larger built environment affects social determinants of health and how these can have a significant health impact at scale. 

2. Strong Evidence Base. The analysis calls out that Fitwel stands out among peer standards for its significant evidence base. 

  • Over 7,000 academic research studies support Fitwel’s strategies, reflecting science-based solutions in the built environment recognized by the U.S. Centers for Disease Control and Prevention as impactful on health. In the recent Standard update, the Fitwel research library has nearly doubled. For more on the scientific basis of Fitwel strategies, we encourage readers to explore the sample evidence citations shared under each strategy in the Fitwel Portal so project teams can learn more about the intent and underlying research behind the Standard.

  • The Standard allows for flexible application to all building types. WIth no prerequisites, as not every strategy fits for every project, Fitwel allows each project to prioritize health in some way.

  • We are excited to see the body of public health research evolving to include studies like this one, which takes another look at the impacts of healthy building standards and provides us with helpful feedback.  

3. Addressing Industry Gaps. The article delved into areas where building standards and certifications could expand to better address public health needs.

  • The study emphasizes the need for certifications to adapt standards to geographic contexts. For example, projects located in different elevations, latitudes and climates will have different exposures to environmental health risks that should be weighted accordingly. Fitwel’s v3 Standard has a heightened focus on climate resilience covering risks like flood and fire-prone zones, which is our first step in addressing location-based health risks and exposures. 

  • The analysis suggests incorporating aspects like sound, local character, hygiene and cleanliness. As only the v2.1 Community Scorecard (and equivalents for other standards) was analyzed, the generalizability of this gap analysis was limited; however, several of these aspects have proven to be impactful in light of the COVID-19 pandemic and have since been incorporated into the v3 update.

  • Fitwel continues to refine its standards, using academic feedback to enhance Fitwel v3, Fitwel Social Performance, and future projects. 

Directions for the Future. As we stay up to date with built environment research, it is especially interesting to us when a peer-reviewed study dives into the strengths and opportunities of healthy building certifications like Fitwel. In this article, we saw validation of the Center for Active Design’s holistic, evidence-based approach as well as a strong alignment with the directions, additions, and expansions that we are pursuing in our work. We continuously integrate the latest research as evidence emerges to ensure Fitwel reflects the most up-to-date health trends and technologies. Engaging with academic insights like this piece strengthens our standards and broadens their impact, and we’re excited to see the ongoing dialogue around healthy building certifications drive industry progress, helping us advance health, sustainability, and resilience across the built environment.

Contributed by Skyler Chin, Grace Dickinson and the Center for Active Design Research Team.

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