Why We're Not All Living and Working in Healthier Spaces

We in the built environment sector have long understood that healthier buildings are better buildings. We know intuitively—and increasingly, scientifically—that clean air, good lighting, and thermal comfort lead to better outcomes for the people inside. We have the engineering know-how to deliver these spaces. So, why isn't every new and retrofitted building a bastion of health and well-being?

The answer, as is often the case, lies in the numbers. Not the parts-per-million of CO2, but the dollars, pounds, and euros on a balance sheet. To transition healthy buildings from a "nice-to-have" to a "must-have," we need to establish a robust economic case that resonates with the individuals responsible for financial decisions—the investors, asset managers, and business owners.

This is the central challenge we explored in a recent episode of the Air Quality Matters podcast with guest Stefan Flagner . A researcher with a PhD in economics and health sciences, Stefan was a co-author of the recent paper, 10 Questions Concerning the Economics of Indoor Environmental Quality in Buildings. He brings a crucial economic lens to a field often dominated by engineering, and our conversation dug into the complex task of quantifying the value of a healthy building.

Learning from the Green Building Blueprint (And Its Limits)

A major theme of our discussion was the comparison to the green building movement. For over two decades, the case for energy efficiency has been refined into a clear business proposition: invest in efficiency, reduce your energy bills, and see a direct return on investment. This has been bolstered by regulations, internationally recognised standards like LEED, and a mature language around metrics like embodied carbon.

As Stefan points out, the healthy building movement is arguably where the green movement was 20 years ago. The challenge is that the primary benefits are human-centred—improved health, productivity, and well-being. Unlike an energy bill, these outcomes are far more difficult to monetise. How do you put a precise dollar value on a 5% increase in cognitive function or a 10% reduction in absenteeism? This question becomes even more complex when you consider different building types. As Stefan notes, "productivity in a manufacturing hall is completely different than in a service company which has offices, which then again is completely different than in a school."

The Data Deficit: A Case of "Thin Evidence"

While there are compelling studies—many performed in controlled laboratory settings—that demonstrate the power of good indoor air quality, Stefan argues that from a rigorous economic perspective, the real-world evidence is still "very thin." This was one of the most compelling and challenging points of our conversation.

For an economist or an asset manager to build a predictive model, they need vast datasets of real-world information. They need to see, across hundreds or thousands of buildings, a clear and consistent correlation between specific indoor environmental quality (IEQ) metrics and tangible business outcomes, like rental premiums or measurable productivity gains. While data on outdoor air pollution is becoming more accessible, allowing for property valuation models based on location, we simply don't have this level of data for the indoor environment.

This lack of hard, empirical field data forces many of the current economic arguments to rely on estimations and extrapolations from lab studies. As we discussed, while these estimations are powerful in theory, they can be difficult to stand over when pitching a multi-million-dollar investment to a sceptical business owner. The nuance of this data gap, and why it represents such a significant hurdle, is something Stefan explains with incredible clarity in the full episode.

A New Language for Value: Risk, Resilience, and Interdisciplinary Collaboration

If a direct, line-item ROI is proving elusive, perhaps we need to frame the conversation differently. Stefan suggests that the language of risk mitigation and resilience—terms well understood in finance—could be a more effective entry point. For instance, if outdoor air pollution is a known risk to property values in a certain area, can a building with superior filtration and ventilation be positioned as a more resilient, lower-risk asset?

This approach requires breaking down silos. The solution, Stefan argues, lies in deep, interdisciplinary research that brings together engineers, health scientists, and economists to tackle the problem from all angles. By merging the financial world's understanding of materiality and risk (particularly the "S" for Social in ESG) with the engineering and health science expertise of the building industry, a more robust and holistic business case can emerge. Hearing Stefan articulate this need for a shared language underscores how fragmented our current approach is.

The conversation made it clear that we are at a critical threshold. The potential is enormous, but to unlock it, we need to move beyond simply stating that healthy buildings are valuable. We need to prove it in the language of the people who write the cheques. To truly grasp the complexities of building this business case—from the nuances of different IEQ factors like thermal comfort and lighting to the challenge of split incentives—hearing Stefan articulate these challenges in his own voice provides a depth that a summary simply can't capture.

For the ful discussion on what it will take to build the definitive economic case for healthy buildings, we highly encourage you to listen to the complete episode. Share it with colleagues in finance, real estate, and asset management who need to be part of this crucial conversation.

One Take: Quantifying the Health Cost of Poor Housing

In our shorter One Take segment, we delved into a recent paper that puts hard numbers on a problem we often only discuss in general terms: the health impact of poor housing conditions. The paper, "The Burden of Respiratory Disease from Formaldehyde, Damp and Mould in English Housing," attempts to quantify the real human cost of these common indoor pollutants.

Using a public health metric called Disability-Adjusted Life Years (DALYs)—where one DALY equals one lost year of healthy life—researchers estimated the impact of these exposures. In 2019, damp and mould alone were associated with approximately 2,800 years of healthy life lost in England, linked to thousands of new cases of asthma and lower respiratory infections.

However, the paper's most powerful insight lies in a data discrepancy. These calculations are based on the English Housing Survey, which finds a significant damp and mould problem in just 4% of homes. But when residents are asked directly, some surveys suggest the figure could be as high as 27%. If this self-reported figure is closer to the truth, the authors note the real health burden could be three to eight times higher than their primary estimate.

This isn't just a statistical curiosity; it's a social justice issue. The data clearly shows that households in the lowest income brackets and those from minority ethnic backgrounds bear a disproportionately higher burden. The paper provides a stark, data-driven reminder that the quality of our housing isn't just about comfort—it's a fundamental, and quantifiable, issue of public health and equity.

The Air Quality Matters Podcast in Partnership with

Farmwood - Eurovent- Aico - Aereco - Ultra Protect -

The One Take Podcast in Partnership with

SafeTraces and Inbiot

Do check them out in the links and on the Air Quality Matters Website.

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