Health Rating Systems Comparison

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Josh Radoff:

With the emergence of health as a driver in planning, design, construction, and operations of built environment projects, a handful of healthy building rating systems to address and measure associated strategies and determinants has developed along side it.

Those in the sustainability field will point out that health has always been a core component of a truly sustainable development project, the absence of which reduces the effort to a de-humanized energy efficiency or resource management endeavor. And the success of LEED as a transformative tool is likely a function of the fact that it always included an “Indoor Environmental Quality” section, with prerequisites prohibiting smoking and requiring adequate ventilation, and introducing the concepts of low-VOCs, daylight, and occupant controllability, and thermal comfort to the building world.

However, as the connection between health and the built environment broadens to areas not covered by earlier versions of LEED (active design, circadian lighting, acoustics, access to healthy food options, biophilia, and potable water quality), the need for a metric that addressed these aspects in a more comprehensive manner has become necessary.

The WELL Building standard, created by Delos, and now managed by the International Well Building Institute (IWBI) was the first to step in and fill this role, but others, such as the emerging Fitwel program, developed by the CDC and now managed by the Center for Active Design, may be important market drivers as well once released.

To help provide clarity and comparison about what each system covers, requires, and measures, YR&G created a Health Rating System Comparison Matrix, and the following conclusions may be drawn:

LEED v4: The new version of LEED – version 4 – seven years in the making, does a good job of upping the health ante, with new credit areas such as interior lighting quality, acoustics, and deeper levels of healthy materials, including transparency via health product declarations (HPDs). However, as mentioned above, the core LEED program lacks any mention of key health aspects such as active design, circadian lighting, access to healthy food, biophilia, ergonomics, and potable water quality, and LEED doesn’t require any onsite testing of health criteria such as indoor air quality (although it is an option in one of the credits). LEED is also relatively light on prerequisites, meaning it is possible to have a certified building at some level that lacks daylight, onsite greenspace, healthy food options, basic walkability, or public transportation access.

LEED v4 Pilot Credits: Several LEED v4 pilot credits have been developed and may be used along with LEED v4 in the capacity of ID credits (meaning thre’s room to insert up to five of them into your scorecard), that fill many of these gaps. There is an Ergonomics / Adjustable Furniture credit, a Walkability credit that picks up some of the really good walkability criteria of LEED-ND, and an Active Design credit, to name a few.

WELL Building: WELL Building fills many of the gaps that exist in LEED and requires a much wider baseline of performance through its 37 health-related “preconditions.” For the vertical building elements, it is the most stringent and comprehensive standard that exists. It requires a much wider degree of onsite performance testing relative to LEED. It also combines New Construction features with ongoing performance and operations features, whereas you need to get into the LEED-EBOM side of things (and full up your ID credit section with them) to access these aspects in LEED.

The primary drawback of WELL is that it can read like the design criteria for a biosphere, emphasizing what the building itself can do for your health, and focusing less on the importance of neighborhood and connectivity (aside from Walk-Score and proximity to green space features). Also, the cost of WELL Building certification is significantly higher than LEED, and many potential projects have avoided it for that reason, albeit WELL certification fees do include assessor fees, which provide the onsite measurement component.

Living Building Challenge: The LBC covers a lot of ground in its 20 required Imperatives (no credits or optional measures), especially through its Health + Happiness and Materials “Petals.” Imperatives focus on natural ventilation, daylight, car-free living, onsite agriculture, material de-toxicity via the “Red List,” biophilia, as well as the more pedestrian low-VOC materials and ventilation levels established by LEED. In its simplicity, it leaves out things like access to public transportation, acoustics, and ergonomics, and speaks obliquely about things like healthy food and access to neighborhood services. And if you consider the elimination of fossil fuel combustion or stormwater runoff as important elements of a healthy building, due to reduced impact on climate change, regional air quality, and waterway quality, then LBC goes further than any of the other rating systems in making this link.

Fitwel: At this point, we don’t know much about Fitwel, other than it’s intended to be based on 100% evidence based weighting, and has been developed by the CDC and will be rolled out and managed by the Center for Active design. We mention it here because it may present another significant option and market driver in addition to LEED or WELL.

Download our 4-page Health and Wellness Rating System Comparison PDF below: