Over the past century, advances in infrastructure and the quality of the built environment have contributed to a drastic reduction in infectious diseases in the U.S. However, a coinciding shift toward a more sedentary lifestyle for a majority of Americans has spurred a similarly sharp increase in chronic diseases such as heart disease, cancer, and diabetes - which are now among the most common, costly, and preventable of all health issues. Add the psychological and physiological impacts of increased levels of mental stress and you have health-related productivity losses on the magnitude of $225 billion dollars annually for U.S. employers.

Yet, a significant body of research and historical case studies have demonstrated that the design and quality of the built environment can have a positive impact on population health. As it did for infectious disease a century ago, design must once again be leveraged as an fundamental tool for the creation and management of healthier spaces. This is where Active Design comes in.


What is Active Design?

According to the Center for Active Design (CfAD)Active Design is "an evidence-based approach to development that identifies urban planning and architecture solutions to support healthy communities."

Active Design is grounded in the idea that the design of the built environment can have a profound and positive impact on improving public health. It builds on health research showing that design can impact today's biggest challenges around the physical, mental, and social well-being of communities around the world.

The non-profit CfAD has provided a number of publications and resources to help design teams, policy makers, real estate developers, and clarify the case for, and successfully pursue, Active Design principles in the built environment.

For design teams looking for guidance to realize a comprehensive approach to Active Design in building projects, Fitwel may be a great tool.


Fitwel: A Rating System for Active Design

Fitwel is a high impact building certification designed to support healthier workplace environments and improve occupant health and productivity. The U.S. Centers for Disease Control and Prevention (CDC) and the General Services Administration (GSA) led the development of Fitwel, garnering input from experts in public health and design and reviewing more than 3,000 scientific studies. The CfAD is the operator of Fitwel, leading its widespread adoption and future development.


Fitwel Basics

Fitwel includes 63 evidence-based design and policy strategies that enhance building environments by addressing a broad range of health behaviors and risks. Each strategy within the certification tool is linked by scientific evidence to at least one of Fitwel’s seven Health Impact Categories (see figure below).

The seven Health Impact Categories of Fitwel.

Image property of the U.S. Department of Health and Human Services in the United States.


All strategies are voluntary and are categorized into one of 12 sections ranging from location and outdoor spaces to indoor environments, stairwells, and water supply.

With 144 points total, Fitwel's strategies range in their points value based on the associated strength of the evidence tied to the strategy.

Fitwel certification is based on a three-tiered rating system:

  • One-star (90-104 points): Basic level of health promotion.
  • Two-star (105-124 points): Intermediate level of health promotion.
  • Three-star (125-144 points): Exceptional level of health promotion.


Fitwel has broad applicability within the commercial office sector. Certification is applicable to workplaces of virtually any type and location.


Fitwel Fees

Registration and certification fees are low and predictable. They are $500 and $6,000 respectively regardless of project size.


Fitwel Versus Other Rating Systems

Fitwel occupies a very specific space within the spectrum of building certification systems. Unlike LEED and other rating systems that focus on energy and environmental design or WELL, which focuses on a much more robust scope of human health and wellness, Fitwel provides a clear, concise, accessible framework to help design teams implement Active Design principles in a workplace environment. The certification tool could easily be used as a benchmarking tool for a portfolio.

Over time, Fitwel will expand into other building sectors and I see it as a welcome addition to the marketplace. As such, I recently became the first design professional in Indiana to complete the Fitwel Ambassadors Program - and I hope you will join me. There is a space and a need for Fitwel in the building design and construction industry.


Let's get moving!

Buildings that include highly visible stairs reduce morbidity and absenteeism, increase physical activity, and promote occupant safety. Pictured here is the Irsay Family YMCA at CityWay in Indianapolis, Ind.

Image property of Browning Day Mullins Dierdorf.