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State of health 

Diets inextricably link human health with environmental conditions and sustainability. To feed a future population of ten billion people a healthy, sustainable diet whilst also operating within planetary boundaries requires the transformation of eating habits, improving food production and reducing food waste1.

Human relationships with food, and the impact on our collective and individual health must also be examined. Obesity is the most prevalent major public health crisis relating to food consumption; in 2016, 1.9 billion adults were overweight2 of whom approximately one third were obese. The incidences of obesity close to tripled between 1975 and 20162, and now equates to around 13% of the world’s adult population and continues to rise.

Physical inactivity and sedentary behaviours are risk factors for other non-communicable diseases such as cardiovascular diseases, diabetes, musculoskeletal disorders and some cancers. Physical inactivity is estimated to cause more than 5 million premature deaths annually across the globe, representing 9% of all deaths3. The built environment is one of the many complex factors that influence peoples’ activity levels and lifestyles, and consequently physical health. Research has found that low levels of neighbourhood walkability were positively associated with more sedentary lifestyles4.


Buildings and local community play a supportive role in the healthy lifestyle of occupants, including the reduction of obesity, by designing the space to encourage regular physical activity, reducing barriers to accessibility, availability and affordability.

Strategies across the lifecycle


  • Centrally located, visible and aesthetically pleasing stairwells within buildings and indoor public areas

  • Access to end of trip facilities to promote physical activity before, during and after work (including walking/riding to work, e.g. bicycle parking, changing facilities)

  • Access to public transport to reduce personal car use

  • Urban master-planning prioritising safer street design to encourage heightened personal activity and exercise levels, e.g. connected neighbourhoods with pedestrian footpaths, access to public exercise grounds such as sports fields, outdoor gyms, cycle paths, central cycle parking, etc


  • Active services during work in office buildings (e.g. staircases, standing or treadmill desks in the office)

  • Access to transportation and end of trip facilities to promote physical activity to and from work (including walking/riding to work, e.g. bicycle parking, changing facilities)


  • The WHO recommends that adults should do at least 150 minutes of moderate-intensity aerobic physical activity per week5

  • Urban planners should consider the principles of the Bloomberg Partnership for Healthy Cities and WHO’s Healthy Cities Network

State of health 


Nourishment is essential to good health. A growing body of population-based epidemiological evidence has shown the importance of nourishment in preventing and controlling noncommunicable diseases as well as preventable chronic diseases6. At the same time, changes in the production and distribution of food have meant that highly processed and sugar rich foods are in greater supply. The WHO estimates that globally, most people do not consume the recommended daily amount of fruits and vegetables, and this is leading to over 1.7 million deaths each year7.

‘Food Deserts’ are regions that have lessened access to healthy food, broadly due to socio-economic factors such as income or location. People who live in regions categorised as ‘food deserts’ are recognised as being at a higher risk of diet-related conditions, such as obesity, diabetes and cardiovascular disease8. Sustainable urban planning and operational building policies, to support local communities, can be helpful factors in addressing this socio-economic health issue.


Hydration is of fundamental importance to health and wellbeing as without water humans can survive only for days9. Water comprises of 75% body weight in infants to 55% in elderly people and is essential for cellular homeostasis and life10. Within the built environment, our priority must be to maintain a safe and sustainable supply of clean water, as outlined in Principle 1.2, consumed in necessary quantities to maintain human health and maximise wellbeing. The Institute of Medicine recommends a daily water consumption of approximately 2.7 L for women and 3.7 L for men11.

Social connectivity:

The WHO has demonstrated the link between social interaction and health12. Social connection improves physical health and psychological wellbeing, whereas loneliness is associated with a 26% increase in the risk of premature mortality13. Studies have suggested that strong social connections lead to a 50% increased chance of longevity and people who feel more connected to others have lower rates of anxiety and depression14. Our buildings and communities can be designed in a way that fosters social interaction15.


The built environment actively contributes to the improvement of nutrition, hydration and social connectivity of building occupants and people in the local community, where possible, by supporting healthy food choices and hydration practices, and providing infrastructure for positive social engagement.

Strategies across the lifecycle


  • Communal dining facilities and scheduled meal breaks in workplaces to foster interaction

  • Urban planning to foster inclusiveness and social engagement with central shared areas

  • Infrastructure to ensure clean water provision (see Principle 1.2)


  • The promotion and provision of healthy food options (fruits, vegetables, whole grains)

  • Provision of food preparation areas (refrigeration, heating, storage and utensils)

  • Onsite production of food

  • Buildings operating in less developed communities must strive to address food deserts by increase the availability of healthy food to low-income population

  • Provision of fresh clean water and encouraging hydration


Universal benchmarks for building and urban design specialists to encourage nutrition, hydration and social connectivity on site are not widely available. Practitioners are encouraged to incorporate strategies into projects on a bespoke basis, following local examples where possible.

The wider lifestyle factors that can contribute to reducing the risk of non-communicable diseases and can be implemented at regional policy level are outlined through the Partnership for Healthy Cities principles:

1 EAT. ‘The EAT- Lancet Commission on Food, Planet, Health’: commission/

2 World Health Organization. 2020. ‘Obesity and Overweight- Key Facts’: room/fact-sheets/detail/obesity-and-overweight

3 Marmot, A. & Ucci, M. 2015. ‘Sitting Less, Moving More: The Indoor Built Environment as a Tool for  Change’. Building Research & Information:…

4 Owen, N. at el. 2014. ‘Sedentary Behaviour and Health: Mapping Environmental and Social  Contexts to Underpin Chronic Disease Prevention’. British Journal of Sports Medicine:…

5 World Health Organization. ‘Global Strategy on Diet, Physical Activity and Health. Physical Activity  and Adults’: 

6 World Health Organization. 2002. ‘Global Strategy on Diet, Physical Activity and Health. Diet,  Nutrition and the Prevention of Chronic Diseases, Report of the Joint WHO/FAO Expert Consultation’: 

7 World Health Organization. ‘Global Strategy on Diet, Physical Activity and Health. Promoting Fruit  and Vegetable Consumption around the World’: 

8 Medical News Today. 2020. ‘What are Food Deserts?’: 

9 Popkin, D. et al. 2010. ‘Water, Hydration and Health’. Nutrition Reviews: 

10 Nicolaidis, S. 1998. ‘Physiology of thirst. Hydration Throughout Life’.

11 Institute of Medicine (US). 2005. ‘Dietary Reference Intakes for Water, Potassium, Sodium,  Chloride, and Sulfate’. The National Academies Press

Washington, D.C.: potassium-sodium-chloride-and-sulfate?onpi_newsdoc021104=

12 World Health Organization. 2017. ‘About Social Determinants of Health’: 

13 Cacioppo, J. & Cacioppo, S. 2018. ‘The Growing Problem of Loneliness’. The Lancet:

14 Psychology Today. 2012. ‘Connect to Thrive’: it/201208/connect-thrive

15 Garrin, J. 2014. ‘The Power of Workplace Wellness: A Theoretical Model for Social Change  Agency’. Journal of Social Change:…

The resource lists for each sub-principle are a non-exhaustive set of references provided from the WorldGBC network, peer review panel and industry through the Framework consultation period. A regular update of resource lists will be undertaken by WorldGBC to ensure updated information is available.

WorldGBC supports all certifications and is proud to unite a network that runs over 40 rating tools, plus support the uptake of all tools across the industry. Rating scheme inclusion within the Framework is based on submission from global GBC network and consultation responses, with aim of amalgamating a host of resources for a global audience to offer further detail for users beyond the high-level outline of each principle.

Regarding specific certifications, eg. BEAM or Green Star, there are often a number of versions or tools available for different building types (eg. Design, As-Built, Interiors, Communities). To maintain brevity of Framework document, one building level tool (eg. Design or New Construction) and one larger scale tool (eg. community level) is included within the Resource List of each sub-principle. Users with alternative building projects in mind are encouraged to acquire the appropriate version of the tool for most applicable guidance.