Are health-centered communities the future of housing? With interest in the health and well-being of individuals and communities peaking during the COVID-19 pandemic, new ways in which to envision urban living and design are taking shape. Cities have always been health centered, points out Dennis Frenchman, director of the MIT Center for Real Estate & lead instructor for the MIT Professional Education course Developing Health-Centered Communities: The Next Revolution in Real Estate, but the way health concerns are bringing people of all ages and backgrounds together nowadays has been unprecedented. The outbreak has only showed how important it is for hospitals to be able to rely on communities for keeping people healthy and dispersing medical care to residents.
“People value places that support healthy lifestyles and can deliver health care, rather than institutions,” Frenchman said. He pointed out that urban designers and developers can do much more than just add amenities to multifamily communities to promote a healthy lifestyle. USGBC Senior Vice President Melissa Baker also believes that “in the future, there will be greater emphasis on measuring and understanding health objectives as projects consider what strategies will have the greatest impact.”
Designing health-centered communities
Frenchman’s innovative concept—health-centered communities — takes into account people’s various needs when it comes to health care and wellness and uses data measurements to provide more personalized, community-centered care. Through responsive architecture and technology, these projects are meant to ensure healthy living for all age groups and pay special attention to aspects such as aging-in-place, people with special needs and health-care delivery outside clinics. In other words, this type of development can be a place where Millennials and their aging parents can live together.
Health-centered communities are based on elements from real estate, technology, human health and the natural environment, which means that they will be the product of a team of architects, urban planners, real estate developers, physicians, epidemiologists and health-tech entrepreneurs. They will rely on health outcomes that can be measured and will also integrate a series of factors specific to the health-care industry such as digital platforms, artificial intelligence and sensors.
Art, music and creative programming will also play an important role in helping these communities thrive. Andy Altman, principal & co-founder of Washington, D.C.-based Fivesquares Development, believes that healthy living communities need to have a holistic approach to human health. This means speaking to people’s body, mind and soul by “infusing culture, connection and exhilarating experiences into everyday living.” His company’s recent project Liz, as well as the upcoming Strathmore Square, is illustrative of this.
Located on 14th Street in the district, Liz is the company’s signature project, developed in partnership with Whitman-Walker Health. In addition to the 78 residential units, the mixed-use project includes office and retail space as well as cultural space for the Goethe-Institut. According to Altman, Liz was “designed as a living canvas for art and cultural experiences and includes a site-responsive uplifting public installation by Yinka Shonibare.” Although it does not include a Whitman-Walker Health clinic at this point, the development provides affordable housing options and it supports the Whitman-Walker medical mission among the LGBTQ community.
Frenchman expects these communities to thrive, particularly in small towns at first, or in cities that have a large aging population. He pointed out that small-town health-centered communities should not be seen as nursing homes or as places where people isolate themselves. On the contrary, healthy living communities should be seen as places that create opportunities for social interaction. This is one particular aspect that will make them appealing to younger people as well.
Designers do not relate healthy living communities with a rural lifestyle at the detriment of a more dense, urban lifestyle. “The first thing you want to do with an aging population is to create social opportunities in the public realm,” said Frenchman. Moreover, the primary focus of these communities will be to provide healthy living principles as well as access to basic things such as healthy food, and to go as far as bringing medical care into residents’ homes, no matter their location.
Lifestyle and environmental changes in recent years are starting to produce a change in residents’ mentality, which will lead to a transformation in the way communities and homes are built.
“I think at a fundamental level, clean air, clean water, active spaces such as access to open space outside, and a healthy indoor environment are part of what people expect their community to deliver,” Baker told Multi-Housing News.
At the end of last year, USGBC launched LEED Positive, a LEED development roadmap aiming to propose new ways to reduce carbon emissions from buildings, communities and cities. The organization is also working with developers to integrate resilience strategies into project design. Climate change is an important component linked to healthy communities, Baker said. Green building is an effective way to enhance resilience in areas that face extreme weather or are prone to human-made disasters.
“From a health and well-being perspective, we want to see developers and owners consider resilient practices such as the use of durable materials, thoughtful site selection, rainwater collection, demand response, on-site renewables and more as part of their projects,” Baker added.
However, as the concept of health and well-being is continuously adjusting to people’s needs, especially during public health crises such as the one caused by COVID-19, focusing only on site selection and building materials is no longer enough. People are increasingly seeking to decrease emergency room visits and limit hospital stays, which puts emphasis on the need for community-center care.
According to Frenchman, technology can help with these concerns, especially with remotely monitoring patients from their own environment. “There’s a huge pool of resources out there that could be used to establish community health-care centers and other localized places of care and provide support to people in their homes,” he said.
Another way in which technology can play an important role in developing healthy living communities is by measuring the health needs via sensors and digital platforms. Frenchman believes it’s not only the “what” question—what amenities to add—that designers have to take into account but also “how much?”—”how much oxygen” and “how much sunlight?”
Even though people’s interest in healthy living is on the rise, there are still some technical aspects that can prove tricky.
“I think one of the biggest challenges is communicating the health benefits to residents or prospective residents. For those outside the building and construction industry, it can be difficult to understand how some strategies support health,” believes Baker.
Another challenge is using the huge amount of data and measurements available in an effective way. “Health performance will become the yardstick,” Frenchman pointed out.
At the end of 2017, The American Planning Association published a number of healthy planning metrics that can guide decision makers on how to approach the determinants of health within a community: access to healthy food, physical activity and socializing opportunities. The list is anticipated to include new elements in the near future.
“Finding the best way to measure health as it relates to a building or community is a big area of focus for the industry and one that will continue to evolve. I also think creating and fostering partnerships that advance health across communities will become more important, as projects consider what strategies will have the greatest impact,” Baker said.
Also, as public health crises such as the coronavirus pandemic have shown, home design may also need to take into account new scenarios such as sheltering in place as well as technology and new forms of screening. Nevertheless, providing safe spaces for people to interact with each other will remain architects’ main concern.
“Ultimately, urban design will become more scientific and related to health outcomes that have been previously measured,” Frenchman concluded.