‘Architectural Epidemiology:’ Centering Public Health in Urban Design

A new book asks, what if cities were designed around health equity?

2 minute read

July 10, 2025, 8:00 AM PDT

By Diana Ionescu @aworkoffiction


Intersection with sign for Gillett Square in East London, UK with brick buildings with ground floor storefronts.

Gillett Square, East London. | Gillett Square by Alan Hughes, CC BY-SA 2.0, via Wikimedia Commons / Wikimedia Commons

“What if buildings and neighborhoods were planned with health and climate risks in mind, just like businesses use financial data to guide their decisions?” Liz York poses this question in an op-ed for Next Cities, leaning on the findings in Adele Houghton and  Carlos Castillo-Salgado’s new book, Architectural Epidemiology.

Just as a doctor might diagnose a patient based on symptoms and environmental exposures, Houghton and Castillo-Salgado’s framework helps designers, developers and policymakers diagnose the health of a place.

The process uses place-based data about health and climate to inform customized development strategies. In the South Bronx, one of New York City’s most environmentally burdened neighborhoods, an affordable housing development “took an indoor-focused strategy” to improve air quality for residents. “With no regulatory leverage to reduce nearby traffic or emissions, the project team instead designed a protective shell: a high-performance building envelope, mechanical exhaust and ventilation systems, low-VOC materials and a no-smoking policy. These features directly addressed local respiratory and cardiovascular risk data, providing a sanctuary of clean air in a polluted context.” 

Other, larger projects have the opportunity to be part of a broader health equity initiative. In East London’s Hackney borough, a project called Gillett Square that dates back to the 1980s transformed a former parking lot and surrounding area into a square surrounded by workspaces and retail prioritized for local businesses and cultural groups. “Importantly, these design moves responded to both immediate and long-term public health concerns identified in the Architectural Epidemiology framework: exposure to air pollution, heat vulnerability, mental health stressors and pedestrian safety risks.”

Monday, July 7, 2025 in Next City

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I love the variety of courses, many practical, and all richly illustrated. They have inspired many ideas that I've applied in practice, and in my own teaching. Mary G., Urban Planner

I love the variety of courses, many practical, and all richly illustrated. They have inspired many ideas that I've applied in practice, and in my own teaching.

Mary G., Urban Planner

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