Architecture must not do violence to space or its neighbors.
—I. M. PEI
UP UNTIL THIS POINT in the book we have largely looked inside buildings. We’ve explored the physical configurations and mechanical systems that drive performance, and we have demonstrated the ways in which a Healthy Building is a sound investment for owner, tenant, and employees alike. To wit, we’ve focused on two primary objectives: enhancing human performance and enhancing business performance. We are confident that we have shown this to be a winning endeavor. But there is a wider and equally important objective: to serve another key stakeholder in the Healthy Buildings movement—the general public.
The now famous BlackRock letter and other responsible capital trends have forced an expanded conversation about environmental, social, and governance (ESG) measures and the broader purpose of business. For those in the building industry, this has set up a challenging question (and one they must now answer): “What is the social performance of your real estate asset?” If the evidence allows a landlord to answer well, we can open a door to new investment opportunities: investments and investors that are focused on “doing well by doing good.”
In this chapter we will extend our analytical tools beyond a building or two and a handful of large tenants out into the broader world. We will look at the energy efficiency–Healthy Building equation; the contribution of buildings to greenhouse gases; calculation of health benefits at the portfolio or city level; and opportunities in resilience finance.
We opened the book by talking about some of the mega-changes shaping our world, our buildings, and all of us. Perhaps the most important of these mega-changes are the four major forces of population growth, rapid urbanization, resource depletion, and a changing climate. These are altering our natural landscape and creating both challenges and opportunities for people and for fixed assets. With regard to climate change, it’s a straightforward, five-part story:
Buildings are clearly part of the air pollution and climate problem, but Healthy Building strategies can ensure that they are part of the solution, too. Here’s how: Healthy Buildings that incorporate energy-efficiency approaches can offset some of the emissions of air pollutants, thereby providing what is called a health “co-benefit.” To understand how this works, and how it can be quantified in terms of ESG, we need to quickly dive into the science behind air pollution and health.
The famous Harvard Six Cities Study begun in the 1970s and concluded in the 1980s put air pollution on the map, literally and figuratively.3 The study recorded the health status of 10,000 adults and 10,000 children who lived in six different cities across the United States, each with varying levels of PM2.5. Steubenville, Ohio, in the heart of industrial America, had the worst air pollution in the study, and Portage, Wisconsin, 100 miles from the nearest major US city, had the best, with four other cities having levels that fell somewhere in between. This study was the first to show that being exposed to higher levels of PM2.5 was associated with a greater risk of premature mortality. The blockbuster findings became the basis for air pollution limits in the United States, called the National Ambient Air Quality Standards, and for air pollution standards globally.
Since then, the findings of the Harvard Six Cities Study have been replicated many dozens of times. Most recently there was a “600 cities” study, which confirmed, once again, a strong link between PM2.5 and premature mortality, but this time across multiple countries.4 The findings have held over time and across regions of the world. Even more important, perhaps, is research published in 2018 showing that there are still health risks from outdoor air pollution even when the levels are below the most stringent air pollution limits set today.5 Further, in addition to premature mortality risks, along the way we also have learned that PM2.5 is associated with increased risk of hospitalizations,6 asthma attacks,7 chronic absenteeism in schools,8 and hospital admissions for dementia, Alzheimer’s disease, and Parkinson’s disease.9 One study even showed that higher exposure during the third trimester of pregnancy was associated with a higher risk of autism.10
Burning fossil fuels for energy not only releases air pollutants that have an immediate health impact, it also releases air pollutants, such as carbon dioxide, that are causing climate change. We are already seeing the impacts of a changing climate in the United States in the increased frequency and severity of hurricanes, like those that recently devastated Puerto Rico and Houston. We also see this manifested in unprecedented wildfires, like those occurring in California and across the Northwest United States, as well as sea rise flooding in Miami, Norfolk, and Oakland. The risks from climate change also include things we don’t always see directly or so overtly but that we know are happening or are predicted to happen based on scientific research: increases in infectious and waterborne disease; sea-level rise; ecosystem disruption; and impacts on forestry, fisheries, and agriculture … affecting our food security. Buildings, as major consumers of energy globally, are contributing to these health and climate impacts in their construction and in their operations. How can they be better contributors to a solution?
When energy-efficient buildings reduce demand on the energy grid, this leads to a concomitant reduction in emissions of air pollutants since less power is demanded and less fuel needs to be transported and burned. Those averted emissions can be thought of as a health co-benefit of the energy-efficient buildings. This is not just a theoretical exercise; these co-benefits can be quantified. Analysis of co-benefits (sometimes called “multiple benefits”) of energy efficiency upgrades has been used to evaluate policy decisions around power generation. Perhaps most notably, this type of analysis was used to evaluate the co-benefits of the Obama Administration’s Clean Power Plan (a study showed the plan was slated to generate $29 billion in health co-benefits when enacted).11 Joe and his team have now applied this methodology to buildings with a tool they call CoBE, for “co-benefits of the built environment.”12 There are three major outputs of the co-benefits analysis: money saved, emissions averted, and health gained.
The first output of this CoBE tool is hard cash earned through energy savings. This type of economic cost-benefit analysis is easy, has been done for decades, and has been the primary driver of the green building movement and energy efficiency upgrades in buildings. The analysis is straightforward because buildings can be metered and monitored for energy use, the costs of energy are well understood, and the variations from expectations are small. The US Energy Information Administration, for example, reports on the distribution of energy use and production, and the costs for each source, with regional factor variations across the United States. (Individual companies have their own information on historic and projected energy use and cost, of course.) Most building managers and businesses have done this type of energy cost analysis already. For example, your company may have decided to implement a green building strategy that would save energy, such as by super-insulating to minimize air infiltration, installing energy-recovery ventilation systems, or deploying more efficient lighting or dynamic glass. Engineers can calculate the energy savings from those interventions and a payback period or even estimate a return on investment using the first cost and the projected savings.
The CoBE tool’s second output is the air pollutant emissions averted as a result of that reduction in fuel burned. Typically, energy savings can be translated into metrics like “kilotons of CO2 averted,” an important metric in our battle against a changing climate, but one that is largely uninterpretable to all but a handful of sustainability and climate experts. How many of us can quickly interpret what 30,600 kilotons of averted CO2 means to us or the planet? Still, the sustainability movement over the past 20 years or so has demanded that companies report these numbers. So companies dutifully do this and typically report the number in the sustainability section of their annual report (if they even have such a section). But that’s where the analysis usually stops. The measure of carbon averted addresses greenhouse gas and climate change concerns … but stops short of making this directly relatable to the general public.
The third output of CoBE is the key, because it gets directly to the “What does this mean for health?” question. Going beyond the typical analysis that stops with Output 1 (money saved) and Output 2 (carbon averted), Output 3 is where those measures of averted emissions—the kilotons of CO2—can be combined with public health research to estimate the health benefit of those reductions in air pollution. This results in a set of quantifiable, objective metrics that actually mean something perceptible and tangible to real people: number of lives saved, number of missed work days and school days averted, number of asthma attacks avoided.
How do we do this in public health? The big idea is elegant and easy to understand conceptually (in practice, it can be harder). Consider a portfolio of buildings in a country where the decision makers have taken actions and made investments that lead to a reduction of 30 percent in year-over-year energy use compared with a baseline. We use publicly available data from agencies like the aforementioned US Energy Information Administration to discern the fuel mix for each region of the country—be it energy from coal, nuclear, or natural gas power plants in that region. Thanks to required reporting and other scientific studies, we also know how much air pollution each of these different types of power plants emits per unit of energy created and delivered. Scientists then take the emission rate of air pollutants from those sources and put them in atmospheric models that let us estimate the concentration of air pollution that people breathe near, and downwind from, those power plants. With knowledge of weather patterns and how long the chemicals and particles stay in the air, we can even track impact across state lines (and national borders). Last, thanks to great research like the Harvard Six Cities Study and the many hundreds since, we have what are called “exposure-response” functions that allow us to estimate the health risk per unit increase in the concentration of a number of specific air pollutants. For example, some of the newest research on the health impacts of PM2.5 found a 7.3 percent increased risk in mortality rates for every 10 μg / m3 increase in PM2.5.13 This is an exposure-response function.
Combining all of this—energy use and savings in buildings, pollutant emission rates from various power plants, atmospheric modeling, population demographics, and epidemiologic exposure-response functions—is how we can estimate things like the number of lives saved and economic metrics like missed work days attributable to energy savings from a group of buildings. Any health co-benefits accruing outside the four walls of the subject building can then be converted back into monetary savings to round out an economic argument.
To show how this works in practice, we’ll quickly walk you through a study we did about the health co-benefits of the green building movement globally. We ran the global energy savings of green buildings in six countries through the CoBE calculator and found that, in the United States, engineering modifications and building management changes spurred by the 20-year-old green building movement saved $6.7 billion in energy (Output 1). Then we estimated the averted emissions from all of that saved energy (Output 2). We are going to give you the important, but boring and uninterpretable, numbers to drive home the point that this output doesn’t mean much to most people. Those buildings saved 30,600 kilotons of CO2, 1.62 kilotons of methane, 0.32 kilotons of N2O, 36.6 kilotons of SO2, 28.2 kilotons of NOx and 0.39 kilotons of PM2.5. As we said—largely uninterpretable to most people outside a handful of sustainability experts.
Now for Output 3, which we promised was the interesting part. In the United States, adoption of key green buildings methods, as compared with the nongreen baseline, prevented the following:
When converted to economic values, these health co-benefits amount to another $4 billion in health and climate co-benefits, on top of the $6.7 billion in energy savings, for a total benefit of $10.7 billion. On a dollar-for-dollar basis, for every $1 saved in energy in the United States, there was a very significant $0.59 in health and climate co-benefits that were previously unaccounted for (since they don’t inure directly to the building owners and occupants). The impact is even greater in places like India and China, where the dominant fossil fuel source is coal. There, the health and climate co-benefits are more like $10 for every $1 saved in energy—a stunning ratio.14
Think about what that means for a second. The entire 20-year-old green building movement has been based on energy savings, and it turns out that there is a nearly equal social benefit … and as much as a tenfold social benefit savings in developing countries. This additional health co-benefit had never been quantified until our paper was published. Yet now, for the first time, the owners of energy-efficient buildings can quantify the social benefits of the energy choices they’ve made in their buildings; they finally have a way to quantify the social part of ESG.
This research on the effectiveness of the green building movement showcased how a co-benefits analysis could yield a new, and important, metric on Healthy Buildings—their social performance across wide regions. Importantly, the approach can be applied to individual portfolios and individual buildings, too.
We’ll give you two examples so you can see how this could work on a more regional and local scale. Piers MacNaughton, former postdoctoral fellow on the Harvard Healthy Buildings research team and now director of health strategy at View, took our CoBE tool and applied it to Harvard’s portfolio of buildings (about the same square footage as those occupied by Google). Then we also applied this analytical approach to Carrier’s new Center for Intelligent Buildings in Florida.
First, let’s look at Harvard’s data. Harvard undertook an aggressive 10-year energy reduction initiative beginning in 2006. But like everyone else, Harvard fell into the usual format of reporting energy savings (Output 1) and an impressive 30 percent reduction in greenhouse gas emissions (Output 2), without reporting what this means to health (Output 3). To address this, we took Harvard’s energy savings and ran it through the CoBE calculator. Here’s what we found: all of that energy savings led to an additional $12.3 million in savings through health and climate benefits that Harvard had yet to formally capture or quantify. That is, it hadn’t fully explored the benefits of its aggressive energy-conservation efforts to the health of people who live and work in the surrounding community. This is a story worth telling.
This analysis isn’t only suited for a university—we did it at Harvard first because we had easy access to the data. The broader point is that this type of approach can be applied to any portfolio—health-care systems, commercial real estate, government complexes, and cities.
Now let’s look at how this type of health co-benefits analysis can be done with an individual building. Carrier’s new global headquarters, which opened in 2018, was designed, as one would expect, to showcase all of the company’s advanced building component technologies. Perhaps unsurprisingly for one of the global leaders in air-conditioning and building technology, it featured high-efficiency chillers and air-conditioning, building automation systems, and access controls. It was also designed to highlight how the use of Carrier’s high-end products can lead to energy-efficiency gains when compared with other choices. It turns out that the building accomplishes this well, as it is designed to save an estimated $172,000 per year in energy costs over its conventional rivals. As a reminder, that’s a cost savings that goes directly to the bottom line. Now for the health co-benefits part. Our analysis using CoBE revealed that all of that energy savings yielded an additional $83,000 in health and climate benefits, for a combined benefit of $255,000 per year. The big picture here is this: Carrier is doing well for itself with the energy savings while at the same time doing good for the community it joined with the opening of its new building. That’s good business—and a powerful message about being a good community partner.
In Chapter 4 we talked about the supposed energy-versus-health tradeoff. We discussed the need to find the sweet spot between reducing operating costs and spending a little more to enhance ventilation and health. We argued, quite convincingly we hope, that the benefits of higher ventilation rates to both people and the business amply justify the added cost required to increase the amount of fresh air a building brings in. But does this somehow conflict with what we’ve now presented in this chapter? In other words, throughout the book we argue that higher ventilation rates come with an energy cost, yet in this chapter we are talking about the benefits that come from decreasing energy consumption in buildings. Are these positions destined to be in conflict?
The answer is no, they don’t have to be in conflict at all. A Healthy Building can have both higher ventilation rates and lower energy usage than a standard design. We get challenged on this frequently during presentations, so let’s now debunk the myth that having healthier indoor air with higher ventilation rates is somehow incompatible with energy efficiency. Here’s how the system can, and should, work.
The first thing we need to do is stop thinking about individual factors in the building and start thinking about this “problem” holistically. In other words, consider both energy and ventilation at the same time. An example: We previously mentioned an economic analysis Joe and his team performed where they estimated that the high-end cost for doubling ventilation rates was $40 per person per year.15 What if that increase in ventilation were coupled with a holistic strategy to decrease energy?
When you think of these together, some opportunities appear. In that same paper, Joe and his team estimated what would happen if a building simultaneously doubled ventilation and adopted just one energy-saving feature: energy-recovery ventilation (ERV). (This is usually a form of heat exchanger that captures some of the temperature and humidity of exhaust air to warm or cool new intake air.) When buildings employ an energy-saving feature like this, the costs for higher ventilation drop from $40 per person per year to a few dollars per person per year. Essentially, adding the ERV mitigates most of the higher energy requirement for higher ventilation rates. It gets even more impressive if all you are doing is trying to hit a 30 percent increase in outdoor air above the minimum specified ventilation rate. In that case, adding an ERV leads to so much money in energy savings that, even with this 30 percent higher ventilation rate, there is an overall net savings. In other words, using energy-efficient technologies frees you up to make better choices regarding ventilation. It’s one way you can have higher ventilation rates while decreasing overall energy use.
This works even if you’re not building new buildings and can’t retrofit your existing systems to include something like an ERV. Think of the analysis by Lawrence Berkeley National Laboratory that we introduced in Chapter 9 showing that properly commissioning your existing building systems can provide an energy savings of up to 16 percent.16
What if you paired that commissioning work with an effort to enhance ventilation rates? We can go back to our model in Table 4.5 to see what the holistic impacts are on the company. For that example, we have shown energy costs of $30,000 per year. If the company saves 16 percent of costs based on the commissioning, then its energy costs that year will go down to approximately $25,000. If it then doubles the ventilation rate and we take the high-end $40 per person per year cost, the incremental energy cost for this 40-person company is $1,600. So the net effect of this holistic Healthy Building approach with higher energy efficiency and higher ventilation rates is that the company’s energy costs are now $26,600 per year, still a net savings of $3,400. And don’t forget that the higher ventilation rate had the effect of adding nearly 9 percent to the bottom line. This business can have its cake and eat it, too, when it comes to higher ventilation rates, energy savings, and health and climate co-benefits. We just have to tackle the problem holistically.
As we look to where buildings are headed, there will be even more ways to disentangle the false energy-versus-health tradeoff. When we become smarter about when and where we pump in more fresh air—providing air in rooms only when people are there, as opposed to dumping loads of fresh outdoor air into empty conference rooms—then we can keep ventilation rates high even while controlling energy costs. We can also be smarter by using under-floor ventilation, which provides air closer to the breathing zone of occupants than overhead ductwork, and with innovations like demand-control ventilation, which reacts to real-time measurements of rising CO2 concentrations in a room to tell the system precisely when it needs to deliver more air. The solution here is to be smarter about how we ventilate our buildings. (It is formally called ventilation effectiveness.) Essentially, this approach is about using technology to eliminate waste.
Now that we have shown you how buildings are part of the problem (and solution) of air pollution and greenhouse gas emissions, let’s look at the other end of the cycle—the part where buildings can be negatively affected by these factors. We are already seeing that pollution and climate change are having a real impact on real estate. In many parts of the world, outdoor air pollution is so bad that people are warned not to spend time outside because of the severe health risks. Take events in China in December 2018 as but one example. During that time, public health “stay indoors” warnings were issued for 79 Chinese cities that were blanketed with a thick and dangerous layer of air pollution.17 The affected area was wide, covering Beijing and several provinces (Shanxi, Shaanxi, Henan, and Jiangsu). This isn’t an abstraction—it is about deadly, disease-causing, cognition-damaging pollutants that are in the air, affecting health right now.
Now pause and reflect on what that “stay indoors” warning is really saying. It’s saying that the building is a place of refuge from the outdoor air pollution. In many cases, this is true. Think back to our discussion in Chapter 6, where we talked about different filtration levels. The amount of dense outdoor air pollution that penetrates indoors can be significantly reduced with the right level of filtration and proper operation of a building’s mechanical system. In such a scenario, buildings can adapt and effectively respond to changing levels of outdoor air pollution. In other words, they are resilient and responsive. In these situations, the recommendation to stay indoors is a sound one. However, many buildings in the U.S., Europe, China and other developing countries, such as India and Brazil, are not resilient. They do not have these types of filter systems in place, so staying indoors offers some reduction in exposure, but it does not offer the protection that it could. The recommendation to stay indoors is good relative to remaining outdoors, but it isn’t always really good in the absolute sense, and it may give a false sense that the building is more protective than it actually is.
In addition to thinking about how buildings can protect us from the immediate and direct health impacts of air pollution, consider resiliency in the face of threats from a changing climate. The 2018 Intergovernmental Panel on Climate Change report predicts dire consequences under our current energy use trends.18 The investment community is taking note. In 2018 an analysis by Ali Ayoub and Nils Kok at GeoPhy, a company that integrates geographic variables to evaluate investments, looked at the climate risk of buildings in the portfolios of 133 real estate investment trusts (REITs) in the United States—over 36,000 buildings and several billion square feet of real estate.19 They combined historic Federal Emergency Management Agency flood risk data with projected flood risk data to evaluate how much of each REIT’s portfolio was at high risk. What they found is quite interesting—only 2 REITs out of 133 are not exposed to “high” flood risk by the GeoPhy measure. For some REITs, nearly 10 percent of the properties in their portfolios are rated by GeoPhy as high risk. This type of blending of geography, climate, and finance might be new to you and me, but you can bet there are smart, well-informed investors—armed with much more data than we have—making bets on properties today. There is a good chance that health risk will join flood risk on their radar in the near future.
Much of John’s work is about financing resilience in real estate and infrastructure. The type of macro analysis of REIT risk done by GeoPhy is also percolating down to decisions on an individual basis. As an illustration of the concepts, take the example of Mary the business owner and Nancy the bank manager, drawn from one of John’s Harvard Business School teaching cases. Nancy and Mary are fictitious characters, but their dilemma is real.
Consider a simple situation: Mary, the owner of a small shop in Norfolk, Virginia, or Miami Beach or Brownsville, Texas, whose building is self-insured; and Nancy, the manager of a community bank that keeps mortgages on its balance sheet. Mary thinks her building is worth $600,000. Her mortgage is written with the assumption that there is a 1 percent probability of a flood that would destroy the property (a 100-year flood).
Then, a redrawn base flood elevation map in her town indicates that her store has a much higher risk of destruction from flood than was previously believed. The probability of flood risk is reset at 5 percent (a 1-in-20 flood risk). The bank also receives this information. Now, on an expected value (EV) and net present value (NPV) basis, including risk of destruction, Mary is in violation of the loan-to-value clause in her mortgage. At this level of exposure, the market won’t even offer flood insurance.
Should Mary sell, invest to “harden” the building, or just sit tight and hope that the bank doesn’t act and the weather doesn’t harm her property? As far as she can perceive on a day to day basis, nothing has changed.
Nancy holds the mortgage on the building housing Mary’s store. Mary is now in violation of the loan-to-value covenant—and also in violation of the base flood elevation (BFE) rider that was part of her loan approval. Should Nancy foreclose? If not, when Mary’s note comes due, should Nancy refinance? With what terms?
Or should Nancy’s bank offer a financial product that loans to Mary’s business the $50,000 needed to perform resilience and “hardening” work on the building—which would bring the new probability of destruction back closer to 1 percent, as the building would then be able to resist most events that would have crippled it before?
John’s recent Harvard Business Review article, “Climate Change will Transform How and Where We Build,”20 proposes that for properties (and municipalities) facing climate-related weather perils—whether sea rise, river flooding, wildfire, or drought—there are basically five courses of action. These are: reinforce, retreat, rebound, restrict, or rebuild. (The sixth, of course, is “do nothing.”) In Nancy and Mary’s circumstances, a loan to finance reinforcement makes sense. For many other asset owners and even cities, restricting where development happens or retreating from some areas may be the prudent course of action.
This simple example underscores many of the issues being faced today by homeowners, property owners, businesses, banks, and insurance companies in the low coastal cities of the United States. There is near certainty that seas will rise or storms will worsen if we continue down our current carbon path. There will be many more Marys and Nancys. How should the two of them even think about what to do? Will there be an industry to help you invest in making your building demonstrably more resilient in the face of building stresses? We expect there will be a large one.
With all of our focus in this chapter on how buildings contribute to air pollution and climate change through their energy use, and how we need to consider adaptation and resiliency strategies in light of significant potential health and financial risk, we want to be sure that we do not lose sight of the bigger issue upstream. If the fuels used to generate power are cleaned up, then the actual energy consumption becomes less of an issue and the downstream effects of climate change will be significantly reduced.
How will we get to a clean energy future? In our opinion it’s mostly going to depend on the improving economics of renewable energy and the adoption of new technologies. In the United States, the lifetime levelized cost of energy from new-generation facilities running on wind and solar is now lower than the levelized cost of energy from a new power plant that burns coal. On top of this favorable trend, advances in battery and energy storage capacity are mitigating one of the primary weaknesses of wind and solar, and microgrids are letting us have more nimble energy systems that are responsive to local demand conditions. To complement these new sources, the rise of blockchain technology is making it possible to verify that energy purchases are in fact traceable back to renewable sources. This can then be securitized and traded, thus creating and advancing new energy markets.
We are optimistic that the world will decrease its reliance on fossil fuels, so let’s be a bit provocative: if we design buildings to last for 100 years or more, and much of our design constraints focus on energy, what will a Healthy Building look like when our energy grid is clean? That is, when energy consumption has zero external environmental costs? Designing for health without energy constraints opens the door to a whole host of new possibilities. If this energy-penalty-free future doesn’t seem like a reality, consider what New York Governor Andrew Cuomo announced in late 2018: 100 percent carbon-free electricity across the entire state by 2040.21 We’re not that far off from a future of designing places to live, work, shop, and play where we can think of health first, second, and third, and energy a distant fourth or fifth.
Further, if we move to a future with a clean energy grid, does that mean buildings will be off the hook in terms of their contribution to air pollution? It turns out that the answer there is no, and it’s for a surprising reason, on two fronts.
First, many buildings still have on-site combustion of fossil fuels. And it accounts for a larger share of greenhouse gas emissions than you might think. The Environmental Protection Agency estimates that nearly 30 percent of greenhouse gas emissions from residential and commercial buildings come from fossil fuels burned on-site.22 Here’s what we need to do right now. We need an all-out effort to electrify our buildings: gas stoves, hot water heaters, and boilers and burners used for space heating. Everything in our buildings that relies on fossil fuels. Why? If we don’t, the energy grid of the near future that is based on renewables will deliver clean electricity, but we’ll be left burning fossil fuels on a hyperlocal scale—in our buildings.
Second, in addition to air pollution generated from energy use, there is something new happening. It’s what we call the dirty secret of indoor air pollution. (The corollary to the dirty secret of outdoor air pollution we introduced in Chapter 3.)
It turns out that in places doing a good job of ramping down traditional sources of air pollution—like that from coal-fired power plants—the dominant source of outdoor air pollution is now chemicals coming from indoors. In a landmark paper published in 2018, researchers found that emissions of volatile organic compounds (VOCs) from building materials, cleaning materials, air fresheners, and personal care products are migrating outdoors.23 The VOCs then react with traditional outdoor air pollutants, such as nitrogen oxides from automobile exhaust, to generate ozone and particulates. In the 33 industrialized cities studied, these VOCs that started indoors were found to account for the majority of outdoor air pollution.
This is a shocking finding. And it speaks to the continued importance of buildings and building systems to public health outdoors. As we transition from fossil fuels to renewable sources of energy and we electrify our buildings, emissions of VOCs from buildings may become the dominant source of outdoor air pollution. Building owners, managers, tenants, and investors should be prepared for this future—one where emissions of VOCs from buildings will be measured, managed, and perhaps even regulated.
We focused much of our discussion in this chapter on the building-energy-health-climate-resilience nexus as it impacts and takes place in the built environment. Thankfully, there are important efforts under way to make buildings “carbon neutral.” This burgeoning movement, sometimes called net-zero buildings, and with a renewed emphasis on embodied carbon in construction materials, is just getting going.
But beyond energy there is so much more to talk about in looking at the intersection of buildings and health. Buildings influence our health through where they are sited, through their water and resource consumption, and through their waste generation, just to name a few additional factors that impact both the provision of a healthy environment, and the lowering of energy cost. The profound impact of our buildings and development on the natural systems that sustain life on Earth cannot be overstated. As we mentioned in Chapter 2, the situation has become so dire—with human activity causing what has been called the sixth major extinction, which threatens millions of species—that E. O. Wilson, in his book Half-Earth, has declared that we need to immediately dedicate 50 percent of the planet to nature.24
These topics are critically important, but they go beyond the scope of this book. Our aim in this chapter is to make two key points. First, a true Healthy Buildings strategy must consider external impacts. Second, when we do account for these external impacts, we can further expand the circle of those involved in, and invested in, the Healthy Buildings movement.
The now visible impact of the first four mega-changes of population growth, urbanization, resource depletion, and climate change has forced a rapid shift in attention to how we must think about the impact that we, and our businesses, have on the planet. (Recall our tenth mega-change in Chapter 2, changing values.) This attention must be balanced against the reality that we are now an indoor species. We cannot sacrifice our indoor world for the natural world; the two worlds must coexist. With Healthy Buildings as an organizing principle, they can. The big question then becomes, What forces are in play and what levers need to be pushed to ensure that this Healthy Building movement scales beyond a few niche markets?