College can be a breeding ground for unhealthy behaviors and mental health issues, with campuses offering a plethora of easy-to-access fatty foods while forgoing windows to promote beneficial movement and exercise. According to a 2017 study by the American College Health Association, over 60 percent of college students reported feeling overwhelming anxiety and almost 34 percent are overweight or obese.
Upali Nanda, Assoc. AIA, is associate principal and director of research at HKS, and one of her goals is to reinforce how design can alter behavior. In 2016, she produced a report—funded in part by an AIA Upjohn grant—called “Healthy Choices = Healthy Campuses.” It found that supporting healthy behaviors on college campuses doesn’t have to be comprehensive or costly. In fact, it should be neither.
“At the core of healthy living are the choices you make around diet and movement,” Nanda says. “That’s when the conversation began between architecture and public health, and how we stumbled upon point-of-decision design.”
The Centers for Disease Control and Prevention (CDC) have used point-of-decision prompts to incentivize healthy choices, such as reducing tobacco use by limiting advertising at the register and steering people toward the stairs rather than the elevator by making stairwells more appealing. Those choices are instantaneous, and design has to work hard in obvious and subtle ways to combat habits and routines. But, as the saying goes, people can change—even in a split second. Point-of-decision design (PODD) is a framework Nanda proposes to focus on design at critical moments amid the myriad choices on typical college campuses. Ideally, students will make better choices without even realizing it.
This framework has numerous potential applications on campuses, where many students are making choices on their own for the first time. Nanda and her research team—with input from policymakers, planners, designers, and students—determined 14 points of decision where design could provide a helpful nudge, such as classrooms, courtyards, and even digital spaces like the ever-present smartphone. They also offered 24 design strategies that may influence positive behaviors, including an interactive app with geotagged healthy spaces, tree-lined walkways, community gardens, and dinnerware designed with portion control in mind.
“We mapped out not only personas of numerous college students but also how you’d organize a campus around their desires and these points of decision,” she says. “One thing we recognized was that students will always go for coffee. So what if you take a coffee shop and put a hydration station there as well, or more green space, or a healthy food truck? What if you make the common routes to that shop more appealing and walkable? More than anything, we wanted to avoid thinking of design in isolation.”
Nanda noted that because student health is linked closely to academic achievement, there is an appetite for these strategies among many administrators. Yet, as is often the case, it comes down to money. Her findings implore designers to take a reasonable, person-centered approach to campus design, but convincing all the school’s decision-makers to go along isn’t always easy.
“There are going to be challenges with relationships already in place,” Nanda says, “with food vendors, with the transportation network, and with the city. It is not a solution that can be crafted in isolation. But the power of PODD, especially on a limited budget, is that it helps prioritize where you put your money. Where are we going to be most effective with a design intervention? And as you get traction and see better outcomes, you will hopefully get more money for better, healthier environments going forward.”
Bringing Health to the Forefront
You might think that the connections between design and health are clear by now. AIA has certainly made the topic a pillar of their sustainability portfolio. But if you ask Michelle Eichinger, a member of Nanda’s research team, she would be forced to disagree.
“It can be a difficult conversation with some firms,” she says. “I’ll be in a meeting with designers, to discuss public health and design, and they’ll say, ‘We’re not here to build a hospital.’ Well, I’m not talking about just a hospital. Let’s talk about making neighborhoods healthier. Let’s talk about connectivity to places, or creating an environment that supports walking or running or biking or access to healthy food.”
Eichinger is a public health adviser who specializes in how the communities we’re a part of impact our well-being. As her career has advanced, she’s realized public health can accomplish only so much. Collaborating with other sectors is paramount to enacting real change in healthy behaviors, and no sector is more valuable to her than architects and designers.
“It’s a relief sometimes to find an architect who gets it,” she says. “A lot of architects don’t, and it’s not because they don’t care. It’s just not on their radar, or they are more concerned with the bottom line.”
How design can impact health is glaringly obvious to Eichinger, often in the small ways Nanda also preaches. Beyond the work the CDC did with tobacco cessation and stairs promotion, there’s putting healthy food up front at grocery stores. There’s encouraging movement of any sort, whether it’s walking from point A to B or highlighting bike paths. It’s just a matter of emphasizing the right elements, especially if they’re already present.
“Designing for health may feel like a risk, because it’s not what many architects are used to, and they aren’t sure about the long-term investment,” Eichinger says. “But we are seeing, especially with Millennials, that they want to have more walkability. They want to live in communities that foster healthy behaviors. There is a market for it.”
Which brings the conversation back to college campuses and Nanda’s research. Eichinger believes the campus is the perfect breeding ground for building healthy behaviors, mostly because it is the center of a student’s universe.
“This is not just their academic environment,” Eichinger says. “This is their living environment. This is their social environment. If we talk about the whole student, and show them that their well-being is really our concern, that will speak volumes.”
“We are trying to make the healthy choice the default,” she adds. “Then it becomes no longer a choice; it becomes a habit.”
The Gold Standard in San Diego
Though every college and university would support the abstract idea of healthier and more productive students, following through is less guaranteed. Yet, if you look to the University of California, San Diego, you’ll see a school that is making health a priority in ways large and small.
Matthew Smith is an architect and project manager at UC San Diego currently working with Nanda. “We agree with Upali, beyond intuition, that the built environment has a profound effect on individuals’ well-being,” Smith says. “And a designer can study and deliver desired outcomes through evidence-based design.”
Fortunately, this thought process does not lead to many uphill battles at UC San Diego. The university has a vision of transformation, where the campus becomes both a destination and a socially dynamic space within the campus as well as the greater San Diego community. Nowhere is this clearer than the North Torrey Pines Living and Learning Neighborhood, a project that broke ground in June 2018. It will be the new home of the university’s Sixth College, but its aims are considerably more impressive than a loose grouping of buildings.
“When we developed the detailed project program with our partners,” Smith says, “we included more qualitative and aspirational information than a typical programmatic document. We worked to communicate how the faculty, staff, and students envisioned their social and intellectual futures, and how the built environment can facilitate that transformation. We also contemplated a measurement and verification research study that affirmed goals like activated ground plane transitioning into contemplative spaces, promoting serendipitous interaction.”
The detailed ask was answered by a team led by Clark Construction, including HKS and Safdie Rabines Architects. “They responded to each of our guiding principles, describing how the design they’re proposing will achieve our aspirations,” Smith says. “They leaned on Upali for that.”
The intention is to turn the 1.6 million-square-foot neighborhood into a living lab. Beyond concepts that focus on general wellness—such as a centrally located market with an anaerobic digester, significant amounts of bike parking, common kitchen facilities in all residential buildings, and operable windows everywhere for natural ventilation—the design teams plans to collaborate with the university in a longitudinal study to validate if the nudges they’re incorporating really do improve the well-being of UC San Diego students, faculty, and staff. It’s a massive endeavor, far beyond the scale Nanda advocates in her research, but the LEED Platinum project is an opportunity to test these ideas in a supportive environment and apply outcomes to the university’s ongoing transformation.
“You do need to have operational buy-in,” Smith notes. “It starts with the culture of a research-focused university and the commitment of all the constituent parts— housing, dining, and hospitality; the divisions of Social Sciences and Arts and Humanities, Sixth College, Facilities Management—to realize UC San Diego’s vision of transformation. And, of course, a design team that can deliver.”
Nanda recognizes that UC San Diego has unique DNA; most schools are not growing with these ideals in mind. But there is an understanding that this is a chance to infuse a neighborhood-scale project with small-scale strategies that can be adopted in campuses everywhere—at little cost.
“Transformative design doesn’t have to cost more.” Smith notes. “With a clear vision, open collaboration with stakeholders, and an intentional process, you can achieve desired outcomes.”
It is Nanda’s mantra from Smith’s mouth, with more available resources but the same thoughtful approach. It is a too-rare chance to both push healthy behaviors and then test the outcomes, with a broader importance that Nanda cannot stress enough.
“If college campuses take these design ideas and apply them when students are asking themselves how to get to class or what to eat,” Nanda says, “we could—without a whole lot of money, without drugs, without healthcare—perform a real public service.”
This article first appeared on the website of MFE sister brand ARCHITECT.
