Architecture for Health in a Changing World

ARC3018HF (LEC0105)
Instructor: Stephen Verderber

Introduction

Transactions between ecological and human health have been a core concern in medicine since Galen (129-216AD) developed the theory of the four humours. Galen explained disease as a dialectic between bodily constitution and environmental determinants of poor health. By the mid-19th century, the rise of germ theory and causative theories of sickness and disease resulted in the rise of public health as a formal discipline. The Victorian Era saw the reappraisal of many ancient Greek theories—now applied to combat the deleterious impacts of toxic Industrial Age factory towns, leading to an entirely new discipline—epidemiology. Currently, in the Anthropocene, new questions and narratives have emerged with respect to how humans and the planet must ecologically co-exist, with important lessons to be learned from indigenous societies. Posthumanism accepts an uncertain and unpredictable future, a condition contradicting the premeditative art and process of making a human-centric building—as an artifact presumably built to stand the test of time, space/place.

For centuries, builders worked from the fundamental premise of exerting total control over their physical world. Planners and architects are taught to build a better world premised on a vision of things being better than at present—an idealized narrative the practicing professional strives to attain while tacitly acknowledging the reality of climate change and ecologically adverse feedback loops— impacts that are challenging the core premise of architecture as a stabilizing cultural force.

By 2050, demographers, climatologists, and regional planners estimate nearly 80% of the world’s population will reside in low lying coastal zones. In addition, societies around the globe are aging at an unprecedented rate while birthrates fall. The World Health Organization (WHO) recently called for research and action-based policies to promote resilient health-centric facilities to effectively function in natural disasters, pandemics, and in associated adverse events. Architects, collectively, have yet to effectively respond to these challenges. In the arena of design for healthcare, a particular need exists for environments that equitably afford therapeutic and restorative support for the medically underserved.

Biophilia and Posthumanism

The everyday built environment impacts our moods, health and wellbeing. Its quality influences our ability to communicate effectively with others, to heal and recover from stressful conditions and situations. In a recent comprehensive report, “14 Patterns of Biophilic Design”, Browning, Ryan and Clancy (2014) conceptualized biophilia in design as comprised of three principal categories: Nature in Space Patterns (specifically visual connection with nature, non-visual connection with nature, non-rhythmic sensory stimuli, thermal and airflow variability, presence of water, dynamic and diffuse light, connection with natural systems); Natural Analogue Patterns (specifically biomorphic forms and patterns, material connection with nature, complexity and order); and Nature of the Space Patterns (prospect, refuge, mystery, risk/peril). Browning et al. (2014) put forth evidence in support of how these patterns foster stress reduction, enhance cognitive performance, emotional-mood, and aid in overall human physiology.

Kellert (2008) had previously defined the main tenets of biophilic design as having two primary dimensions: Organic or Naturalistic; and Place-based or Vernacular.  Within these, six biophilic design elements are further defined: environmental features; natural shapes and forms; natural patterns and processes; light and space; place-based relationships; and evolved human-nature relationships. Each of these biophilic design elements was then variably examined in relation to the compendium of design patterns by Browning, Ryan and Clancy’s. Kellert’s dimensions, elements or attributes, are considered general descriptions, or observations. They are presented without the added specificity, or reinforcement, that would accrue had they been connected to, for example, case studies of specific sites, buildings, cost/trade-off ramifications, climatic determinants, ramifications of new construction versus renovation/addition scenarios, or multiple functional program type variants—all of which are significant drivers of architectural design outcomes.

Health researchers are exploring posthumanism with respect to the meanings, place-attachments, and far broader identities individuals and populations associate with health, illness, and healthcare itself. This approach differs from the longstanding positivist research tradition in health services research, a tradition squarely focused on identifying precise determinants (causes) of disease, illness, and access (or in-access) to healthcare resources. The conventional emphasize has been on how humans and humans alone rationally experience and prioritize their own health apart from other living species and inanimate things.

“Relational humanism” in public health has focused on a commitment to phenomenology, existentialism, idealism, and hermeneutics, particularly in the fields of medicine and nursing. These worldviews coexist uneasily although much health research attention is currently being devoted to biosocial and neuro-social research, physical mobility, and animal/human relations, among the many fields impacted by qualitative research methodologies in the health professions that directly or indirectly impact architecture for health.

The Fall 2026 Architecture + Health Pre-Thesis Graduate Seminar at the University of Toronto will address the intersection between posthumanism, architecture, and health inequities. The rise of agentic AI will also be discussed in relation to creative thinking and problem-solving, cognitive skill sets that cannot be automated (yet).

Specifically:

Aesthetic Expression—Composition, massing, ambiance, visual imagery and human scale in accord with eco-humanist-inspired, therapeutic built environments that breathe and foster human restoration.

Residentialism—Residential spaces and exterior environs that promote safety, maximize personal health, foster dignity and self-empowerment.

Nature/Landscape Engagement—Multiple options for residents, staff, family and visitors to engage nature indoors and outdoors vis-à-vis salutogenic design, biophilia concepts/best practices, and architectural theraserialization.

Ecologically Regenerative Design—Moving beyond merely sustaining existing nonrenewable resources but instead focusing on salutogenic design that foster plus-net-zero realities.

Connectivity with Context—Connecting individuals and groups with broader community contexts by means of walkable infrastructure and therapeutic connections with nature.

Advocacy in Architecture—being committed to a topic of importance in alleviating health inequities locally, regionally, and beyond.

The focus is your independent thesis prospectus, leading to your independent research-design thesis studio project in Winter 2027—a topic and project of your choice centered in the broad subdiscipline of architecture for health.

The fall seminar provide the foundation for the two-term thesis experience, with invited external reviewers periodically contributing expertise in pre-design review sessions. Readings will be drawn in part from Architecture and Health Equity in an Imperiled World (Baltimore: Johns Hopkins Press, 2025). A field trip to the UK is tentatively planned for the Winter 2027 term, subject to University of Toronto and international public health travel policies.

I look forward to the upcoming academic year as a thesis seminar and studio professor. FYI--I am retiring from fulltime teaching at U of T in June 2027.