Adele Houghton: Promoting Health and Creating Value through Co-Benefit Design

Adele HoughtonWhen I was about 13 years old, I was diagnosed with high cholesterol, anemia, and exercise-induced asthma. The previous year, I had started taking weekly shots to combat severe environmental allergies. While I continued to attend school, spend time with friends, and play sports, it was a struggle. So many things were going wrong all at once that it was hard to figure out what I should do first to find my way back to some sort of equilibrium.

It turned out that the answer was to create a list – or a lot of lists. I was asked to keep track of what I ate, how many minutes I exercised each day, how much time I spent outside, how many hours I slept each night, and on and on. I sent each list back to a different specialist. And they each gave me medicine and behavioral advice on how to control the symptoms for one of the conditions I was experiencing.

No one asked me how much time I spent indoors.

The Problem with Tackling Problems One at a Time: An Example from Green Building

In the green and healthy building industry, the statistic that Americans spend over 90% of our lives indoors has become almost a mantra. What it means in practice is that 90% of the air we breathe has been recently breathed by someone else.

In spite of widespread recognition that healthy indoor air quality is fundamental to what makes a green building “green,” ventilation is often presented as a drag on both the building’s overall energy efficiency and the project’s return on investment.

The COVID-19 pandemic has turned that value proposition on its head.

From one day to the next, it seemed, indoor air quality became the only thing that mattered. Staff refused to return to work until their employers could prove to them that the air was safe to breathe. The retail, restaurant, and entertainment sectors shut down or functioned entirely outdoors. Schools were shuttered across the country because they could not provide levels of ventilation, air filtration, and social distancing that were sufficiently safe to protect children and teachers from disease.

Perhaps the most ironic reversal of fortune for energy efficiency’s reputation was the revelation that new, hyper-efficient office buildings were not designed to shut down. So, even though many of them were essentially vacant for months last year, they continued to use up to 80% of the power as when they are fully occupied.

A New Approach: Co-Benefit Design

HKS, Inc., a 1,200 person global architecture firm based in Dallas, Texas, had started thinking about how to expand beyond the traditional real estate value proposition before COVID hit. They understood that, even in normal times, successful design cannot focus exclusively on a single desired outcome. Architects are tasked with translating a client’s vision (and budget) into a physical experience. In order to make that happen, we coordinate multiple trades, reconcile sometimes conflicting regulations, and look for the common thread that will tie it all together into a coherent design concept.

Through my DrPH summer immersion, I was fortunate enough to have the opportunity to help the firm develop a framework for talking with clients and other stakeholders about shared interests. Rather than holding separate, parallel conversations about return on investment, energy efficiency, climate resilience, chronic disease, and mental health, HKS plans to use the framework we developed to facilitate more holistic conversations about how to enhance co-benefits across multiple stakeholder groups.

Taking a co-benefits approach can help expose blind spots – like the fragility of urban office buildings that prioritized energy efficiency at the expense of all other risks, including an airborne virus and an increasing number of power outages caused by climate-fueled extreme weather events.

My experience as a young teenager revealed a similar blind spot. Read separately by a series of specialists who never communicated with each other, each lifestyle diary I created resulted in a separate set of medical recommendations that were designed to treat individual symptoms. It was not until many years later, when I started piecing together my background as an architect, green building consultant, and public health professional that I realized that my body had been responding to the design of the built environment where I lived. Co-benefit design can help shape that environment so that it promotes health, not illness.

Adele Houghton, DrPH ’23, is an architect, green building expert, and public health professional who works at the intersection of climate change, human health, and design.