The following section outlines first, the findings from the review of the standard documents, and second, an analysis of the dominant themes emerging from the coding of interview data.
4.1. Understanding the Scope of Built Environment Standards
All the standards considered in this study recommend a range of intentions and practices reported to promote different aspects of health and wellbeing. Table 3
highlights the functional scope of the standards, where sustainability and HBE standards often cover multiple scales (individual buildings to community-scale development), building types (commercial offices, residential, and mixed-use sites), and phases of development (design, construction to in-use). All three HBE standards include requirements for POE and verification requirements to assess performance once a building or site is in-use. In total, two sustainability standards, Green Star Communities and Living Building Challenge, encourage developers to assess the impact of financial decisions on sustainability. The HBE standards do not address the impact of financial decisions on health, e.g., how procurement choices can affect local environmental quality or local employment opportunities [36
There is a degree of variation regarding whether the standards require resident or user feedback. In the HBE group, WELL Communities calls for Health Impact Assessments to be carried out with user engagement, and the Fitwel® standards require annual occupant satisfaction surveys regarding perceptions of design, policies, or operations. All the sustainability standards, except the ‘Living Building Challenge’ and ‘Living Community Challenge’, refer to community consultation and other stakeholders in their community-scale standards. Of the building-scale standards, only BREEAM calls for consultation with communities. None of the HBE standards propose a deliberative and inclusive process to identify and prioritise particular standard intentions, nor do they recommend training to help users or occupants engage in the process of implementing a standard (although the standards do refer to occupant training to implement specific standard intentions, e.g., healthy diet).
summarises the health and wellbeing intentions contained in the sustainability and HBE standards, highlighting considerable variation between standards. From comparing the standards, some key insights can be drawn out, in terms of their commonalities and differences as outlined below.
There are overlaps between sustainability and healthy built environment standards, particularly in relation to indoor environmental quality. Building-scale sustainability standards tend to cover fewer health and wellbeing intentions than community-scale versions and they refer less to the impacts on the exterior environment. BREEAM appears to be the most comprehensive sustainability standard for health and wellbeing intentions.
Only BREEAM Communities addresses intentions regarding security of tenure and access to health care services. BREEAM Communities, Green Star, and Living Community Challenge refer to promoting access to employment opportunities.
The Regenerative Ecological, Social, Economic Targets (RESET) standard is currently the most-narrow in scope. It focuses almost entirely on promoting indoor air quality through reducing pollutants (carbon dioxide, volatile organic compounds, particulate matter), and managing temperature and humidity. RESET is prescriptive on which elements to measure, how to measure them, and technical systems that applicants should use. Finally, a key point of differentiation between coverage health and sustainability standards is that HBE standards are more likely to require POE.
4.1.2. Equity and Inclusion
In terms of equity and inclusion there are limited references to these concepts in the sustainability standards, although BREEAM Communities covers inclusive design. The Living Building and Communities Challenge standards calls for provision of universal access to green spaces and adoption of the ‘JUST’ programme (www.justorganizations.com
) which awards credits for organisations that support volunteering in the local community and local sourcing of products. JUST does not raise broader social equity impacts that can occur at different project stages. Regarding questions of equity and inclusion, WELL calls for the adoption of the JUST programme (regarding employment opportunities) or Global Reporting Initiative (GRI) guidelines for construction and real estate sectors. GRI focuses on the terms of employment regarding equal opportunities (e.g., ensuring living wage, gender pay equity). Fitwel®
covers equity and inclusion intentions more broadly than other standards, linking them to various built environment issues (e.g., design, transport, work conditions). Apart from RESET, the HBE standards refer to equity and inclusion intentions that address local access to services and provision of shelter.
4.1.3. Scales of Impact: Ecosystem and Planetary Health
Unlike the sustainability standards, none of the HBE standards have criteria that directly address planetary health, and have limited references to ecosystem services. They principally refer to protecting water, air, and food quality rather than protecting the ecosystems that deliver those qualities. WELL Building has ‘biophilic design’ criteria but only in regard to enhancing the aesthetic design quality, rather than utilising ecosystem services to promote healthy places.
4.1.4. Systems Thinking—Connections between Intentions
The creators of WELL (the International WELL Building Institute, IWBI) and sustainability standards (LEED, BRE, Green Star) have undertaken ‘cross-walk and alignment’ processes highlighting where connections between intentions occur (https://standard.wellcertified.com/well-crosswalks
). The existence of the cross-walk process suggests that IWBI are encouraging clients to meet wider sustainability intentions through those standards. For example, IWBI refer to ecology being covered in BREEAM, but they do not make this connection with ecology in relation to LEED or Green Star, so not all WELL projects that are dual-certified with a sustainability standard will necessarily address ecological intentions. The cross-walk documents do not refer to the need for participation in the selection or prioritisation of standards’ intentions, nor do they address topics regarding planetary health, communicable diseases, or systems thinking in relation to potential interactions between differing intentions.
The next section reports interview participants’ views about the use of built environment standards in practice.
4.2. Perceptions of Sustainability and Healthy Built Environment Standards in Practice
A central concept emerging from both literature and interviews relates to the negotiation
of personal and organisational intentions during the delivery of a built environment project and the use of a standard in shaping that negotiation process. Figure 1
brings together these concepts in a single framework, representing the negotiation process that dominant organisational actors (designers, clients, and/or developers) undertake at different stages of BE projects when prioritising (selecting and weighing up) and consolidating (integrating into practice) different intentions.
The negotiation of different intentions and drivers within a built environment project is both a dynamic and interactive process, as different actors come to dominate the process at different stages. The negotiation process and the central concepts are discussed in the following section, focusing on the extrinsic and intrinsic drivers.
4.2.1. Extrinsic Drivers—Rules, Norms and Culture
Extrinsic drivers, such as legislative rules, were often referred to in relation to how standards were selected and applied. Participants from all countries referred to how normative planning policies, fiscal incentives, and design guidance affected the prioritisation of specific intentions and standards by design teams or developers. Planning and financial incentives were also used to motivate the adoption of particular standards and intentions. For example, in Seattle, developers that adopted a sustainability standard were allowed to build taller buildings:
“There was a standard that was through our incentive zoning, that you could have additional height if you met LEED Silver” (Planning official, USA).
In comparison, a lack of policy requirements could mean that standards and intentions were passed over:
“We actually looked at BREEAM Communities with them, early on ... I don’t think they did it. Again, this was a classic, ‘why should we do it? It’s not in planning. Why do I need to do it?’” (Sustainability consultant, UK).
The effect of market culture seemed to play a stronger role in relation to HBE standards. Participants felt that standards needed to demonstrate clear alignment with market intentions:
“Certification [will] always be a very, very limited part of the whole investment. But in order to achieve the investment, what’s the reward? The reward is just the increase in rental [value].” (Sustainability and engineering consultant, China).
Another participant described how the more traditional competitive market culture amongst landlords (as opposed to collaborative) prevented the WELL standard from being integrated into some building operations:
“There were many landlords that just told us, ‘we’re not doing that, we’re not going to monitor and share information, that’s none of your business.’ There’s a lot of that attitude out in the market place …” (Sustainability consultant, USA).
Noting there were fewer public policies requiring HBE standards, one participant (Sustainability engineer, UK) commented that standards may help to fill policy gaps in key areas, but felt this was a cyclical process, where external requirements grow over time people start to feel there are too many burdens in the market and that people would call for polices and regulations to be “stripped out” again. Then a few years later would people start complaining again about the quality of buildings and call for more regulation. This highlights a push and pull in the competitive market place between the drivers for quality and the drivers for low costs and ease of implementation.
4.2.2. Intrinsic Driver—Temporal Mode of Agency
There was variation in the temporal mode of agency or mindset adopted by designers and developers in relation to negotiation of intentions and whether they were more or less likely to work with a standard. Several participants were critical of clients who they perceived to be overly short-termist (practical evaluative) in their mindset. It was perceived that these clients prioritised immediate organisational concerns (including market differentiation, cost control, quality assurance, and ease of implementation), and had limited ambitions of longer-term implications, such as health-related concerns:
“I think it was just like, ‘what’s the fastest, easiest thing we can do?’ because the process has been lengthy” (Sustainability consultant, USA).
The dominance of clients’ expectations affecting the selection and implementation of standards was frequently referred to:
“It’s sometimes difficult to be able to make an actual difference on those projects and I think that, in some part, has got to come from what the client’s expectations are and what they want for the project.” (Sustainability consultant, UK).
Public clients and planners were felt to adopt a longer-term projective mindset enabling a broader range of intentions to be considered in contrast to private developers. However, even housing associations, often characterised as having a longer-term outlook, could be pragmatic in their attitudes:
“We pitched [BREEAM Communities] to them a couple of times and it was a classic, ‘well, that looks good, but why should we, as a business ... ?’—because they were a housing association, also a business, in the housebuilding business, they wanted to make money to build more homes” (Sustainability consultant, UK).
Others indicated however, that as awareness of health concerns and market interest in HBE standards had grown, a more projective or long-term view was beginning to be adopted by some clients and users:
“I think by the nature of who the client is and they want to be an exemplar project and ... knowing that there was a growing industry, I guess and awareness of health and well-being, that they wanted that to be a focus as well … but also just the people who would be in that building and I think, knowing that they’ve got a bit more of an awareness of health and well-being” (Sustainability consultant, UK).
Designers and consultants also described adopting a projective approach themselves to encourage clients to select standards. Design teams would proactively reinterpret standard requirements and the narratives around them to demonstrate how standards could align with particular project and organisational intentions:
“We presented to the developer a menu of options and said, ‘well, we can pursue Fitwel certification, we can pursue WELL certification and we walked them through what those meant and how some were more rigorous and more verifiable than others ... so that really led them towards creating this sort of combination project where we were not only pursuing LEED certification for the building, but we bundled Fitwel certification into that project as well because it sort of met all of their needs at the price point that they were comfortable with.” (Sustainability consultant, USA).
4.2.3. Intrinsic Driver—Capability
Both design and developer participants sensed that the sector was beginning to acquire knowledge and skills about what a healthy BE meant and how to deliver it, but also recognised that this was somewhat constrained by resources and market perceptions of trendy topics. One designer (UK) described how they were accumulating knowledge through the process of implementing standards, enabling them to demonstrate to developers what could be achieved elsewhere.
Another described their sense of pride at achieving the highest Platinum rating for the WELL standard on one building, describing how this “successful” outcome also encouraged them to enrol further clients to adopt WELL:
“They really tried to achieve the highest rating possible and to do this, they tried to make the healthiest building possible … So if you look up pictures of the building, there is a lot of greenery, fresh air ... outer air supply is 50 m2 of air per person, so it’s really high standards to achieve a healthy office building and it’s worked out, so it’s nice.” (Engineer, The Netherlands).
Some participants referred to how HBE standards helped promote collaborative sharing of knowledge and joint-working, encouraging people to work across silos and building up a greater knowledge base of what is required to create a healthy development:
“We have a lighting consultant here and we were going through the light criteria in WELL and she’s such a marvel, it was just really engaging to talk to her about, ‘What do you think of this study? What do you think of this research? What do you think about this strategy, does it really work, how much does it work? I think it actually knits together the people that are working with health and well-being and all of these experts because we’re having more profound discussions.” (Architect, Sweden).
Participants remained concerned about the level of knowledge about HBE standards however, in what was perceived as a relatively novel area, as one developer pointed out:
“They’re starting to learn more about WELL Certification, but I haven’t met any architects yet that are knowing more about health and well-being than what I do.” (Developer, Sweden).
There was also a perception, that an overreliance on the evidence and research underpinning HBE standards undermined organisational and individual innovation and knowledge creation:
“I guess they’re relying on what the public health science or the information in WELL that’s saying, ‘it’s better to do it this way’ and it’s hard because how can you question those things, you’re like, ‘okay, somebody has done the research and this is the way to do it” (Sustainability consultant, USA).
It was noted that developers made limited investments in research and innovation, and the time constraints involved in projects could inhibit opportunities to build-up knowledge and experience of implementing a standard:
“It’s a lot more stressful because we have a time limit and are trying to get this knowledge out and working with WELL Certification that is very new for a lot of people, so it gets very frustrating” (Developer, Sweden).
Such constraints on resources meant design teams were more likely to promote the adoption of standard principles without necessarily seeking certification against the standard.
4.2.4. Intrinsic Driver—Coherence
The interviews pointed to a particularly strong alignment between organisational intentions or values and the selection and integration of standards. Better integration of a standard and its intentions by an organisation was linked to a number of organisational intentions, including: the “badge” of quality assurance (urban design consultant, UK) that standards provided; ease of use; boost to a company’s profile; creating market differentiation in the face of competition; and increasing real estate value:
“For some clients, they just want to be seen to be at the front of ... the pointy end of the agenda, whatever that agenda is and that, to some extent, makes you look like the good guy in town.” (Sustainability consultant, UK).
The perceived cost and ease with which a standard could be implemented were critical organisational intentions. One sustainability consultant (USA) outlined how WELL requirements for regular checks and ongoing reporting on performance were perceived to be overly onerous by clients and made standard adoption a “difficult sell”. Others highlighted how it was “challenging” for even “progressive” clients to adopt the WELL Standard, as it required significant operational and policy changes at the organisational level. In contrast with those who felt HBE requirements were costly to implement, a couple of participants did feel that HBE standards were easier than sustainability standards to understand however and therefore more likely to be implemented.
If a standard was thought to conflict with organisational intentions, participants would get around this by only selecting those elements they wanted to follow. Some participants would undertake the “bare minimum” requirements (Sustainability consultant, UK) and others would avoid a standard entirely:
“Unless there is some marketable value in you being able to say you are WELL certified, we don’t see much point in you doing it, but we can still help you deliver the principles of it.” (Sustainability consultant, UK).
One participant described how they had avoided a standard not perceived to align with their clients’ intentions, despite the standard being required by the planning authority. They engaged in dialogue with the authorities who agreed to reinterpret requirements rather than requiring implementation of the standard.
4.2.5. Intrinsic Driver—Reflexivity (Learning, Interpretation, and Response)
A number of participants indicated that HBE standards had influenced narrative changes how a ‘healthy’ development is defined. This definition was principally linked to a limited number of more measurable health intentions, such as diet, hygiene, air quality, and thermal comfort. Limited references were made to other issues associated to wellbeing, like fuel poverty and affordability. Some health intentions were entirely missing in participant description of standards, notably regarding: equity and inclusion; ecosystem and planetary health; and systems-thinking.
Few participants considered how HBE standards might affect equity or inclusion, such as in relation to: learning from user experience; promoting coproduction in defining a healthy development; promoting access to education or employment; or enhancing mental health. Participants particularly focused on interior material changes in response to HBE standards, with limited reference to impacts on exterior surroundings, such as access to green spaces and nature. This may, in part be linked to the fact that community-scale standards, such as those by Fitwel® and WELL, are still relatively new and were not discussed by participants in terms of their experiences applying the standards. There was no reference to whether HBE standards encouraged actions relating to ecosystem functioning or planetary health. Such intentions were referred to in relation to the One Planet framework and sustainability standards, where participants felt these frameworks also promoted actions likely to support these wider health benefits. Some participants recognised that a narrow interpretation of health within HBE standards distracted attention from the systems-based mindset that sustainability standards sought to promote:
“So now we have WELL and we have Fitwel and we have all of the very specific, human health standards and rating systems and tools in the market that I think are splitting focus and drawing money and time and energy away from a really big foundation that we’ve been building [through sustainability standards] for a long time” (Sustainability consultant, USA).
There were references to standards altering specific site operations, such as sourcing of soap dispensers and healthy food, and specifications for canteens, gyms, and mediation rooms. Some felt, however, that HBE standards did not lead to more significant changes to organisational-scale practices. Rather, standards were simply designed to fit with ‘business as usual’ practices (sustainability consultant, USA), with clients preferring to do “the same thing over again” (Planning consultant, Australia). Various participants described how the responses to HBE standards could also incur unforeseen conflicts with pre-existing sustainability standards.
“It seemed, at first, like we had won all these battles, with the sustainability conversation for 20 years, that we were finally saving energy and saving water and then, if you read WELL, it looks like they’re asking you to up the energy [consumption] for air and up the energy for light” (Designer, USA) “they had to reorient their cleaning and maintenance policies of things just like the way they order soap, the way it’s dispensed which, again, there is science to back that having it in a cartridge is better than any other way, but then we also found that there was a waste element associated with that, so there were definitely some competing trade-offs and priorities” (Sustainability consultant, USA).