This document discusses the concept of salutogenesis, which focuses on designing environments to promote health and well-being rather than just prevent disease. It outlines five vital elements for salutogenic design: nature, authenticity, variety, vitality, and legacy. Examples of healthcare projects are provided that incorporate these elements through features like connections to nature, variety of spaces, and designs meant to leave a lasting positive impact on communities. The overall message is that environments should be "designed to thrive" by promoting health and well-being rather than just addressing pathology.

1. Designed to Thrive
Creating salutogenic environments
Tye Farrow
B Arch, M Arch UD, LEED AP, FRAIC, AIBC, SAA, OAA, NSAA, NLAA, Assoc. AIA

2. © BUBBLES-Loisjoy Thurstun

3. © BUBBLES-Loisjoy Thurstun
Appalling?

4. Appalling?

5. How does this
environment affect us?

6. How will this environment
become un-acceptable?

7. . . . cause
health?
Thunder Bay Health Sciences Centre
Salter Farrow Pilon Architects Inc., of which
Farrow Partnership Architects is a successor firm

8. Our pathology-centric world
Agenda for health
How people (really) make decisions
A way forward: Five Vital Elements
Kaplan Medical Center
Farrow Partnership in collaboration with
Uzi Gordon Ltd. Architects and Town Planners

9. Context

10. WE LIVE IN
PATHOLOGY-CENTRIC
WORLD

12. We find what we look for :
“
I learned a lot of pathology,
& a lot about medicines. We were taught
virtually nothing about health.
”
Richard J. Jackson, MD, MPH
Professor and Chair
Dept. of Environmental Health
School of Public Health, UCLA
Former Director,
U.S. Centers for Disease Control & Prevention

14. Seeing
Health?

15. Why do we have a commonly-used
term that refers to origins of disease:
Pathogenic

16. Why do we have a commonly-used
term that refers to origins of disease:
Pathogenic
while the similar term meaning
origins of health is relatively unknown:

17. SALUTOGENIC

18. SALUTOGENIC
. . . time to look for 8,000 ways
to cause health.

19. . . .Cause health

20. . . .Cause health abnormalities
. . .Cause health problems
. . .Cause health risks
. . .Cause ill health

21. . . .Cause health abnormalities
. . .Cause health problems
. . .Cause health risks
. . .Cause ill health
. . .Cause Health?

23. Dr. Lester Breslow & Three Eras Public Health
1st: Communicable diseases
2nd: Non-communicable disease
3rd: Accelerating optimal health
Salutogenesis
Ray Pentecost

24. Communicable disease
Mid 19th century to mid 20th century
1st

25. Urbanization & industrialization
Communicable disease:
TB, cholera, malaria, yellow fever
1st

26. Example:
London chorea outbreak of 1854 &
Dr John Snows discovery of the source
1st

27. Central park & park movement
Urban design set backs
Public transportation
Departments of sanitation
Public health movement
Results: longer life expectancy
& rise of chronic disease
1st

28. Non-communicable disease
Mid 19th century to mid 20th century
2st

29. Changes in our
physical and
cultural
environment
have fueled this
burden of
chronic disease
2nd

30. Changes in our
physical and
cultural
environment
have fueled this
burden of
chronic disease
2nd

31. Reduced daily-life physical exertion
Marketing & manufacturing of tobacco
Changing food quality & distribution
Car centric design suburbs
Biological ability
to avoid
adverse
health compromised
2nd

32. VALUE?
The U.S. consumes
$2.7 trillion in ‘disease care’
spending
70% to 75% relates to
chronic disease
2nd

33. 70% all deaths globally
from chronic disease
1/3 all deaths before sixty years
of age . . . .
one’s most productive years
2nd

35. “
. . . tell me your postal code
I can tell you how long
you will live
First time in modern history that
your children's life expectancy
is shorter than yours
”
2nd

36. Chronic disease
Common source epidemic
2nd

37. Reaction
New Urbanism
UN Noncommunicable disease resolution
(second health resolution in its history)
NYC Department of Planning
Active Design Guidelines
3nd

38. The evolution of “livability” criteria
1931 (U.S.A. )
- literacy rate
- farm electrification rate
- deaths from typhoid fever
- number of lynchings
- teacher’s salaries
source: The Atlantic Cities

39. The evolution of “livability” criteria
2013 (U.S.A. )
- public transportation
- access to hospitals
- affordable housing
- access to parks
- quality of schools
- infrastructure quality
- low crime rate
- social capital
- air quality
- walkability

40. DESIGNED to THRIVE
Best
we
can be
Best of
what we know
Generic solution
Replace
Cope
DESIGNED to SURVIVE

41. The evolution of “livability” criteria
2013
2030
- public transportation
- integrated mobility?
- affordable housing
- health-causing housing?
- quality of schools
- cause health?
- low crime rate
- citizen engagement?
- walkability
- walk worthy?
- access to hospitals
- cause health?
- parks
- diversity of uses?
- social capital
- social capital?

42. DESIGNED to THRIVE
Best
we
can be
Best of
what we know
Generic solution
Replace
Cope
DESIGNED to SURVIVE
cause health
integrated mobility
walk worthy
diversity of uses
public transportation
quality of schools
walkability
affordable housing
literacy
farm electrification
typhoid fever deaths
lynchings

43. WELCOME
to
SALUTOGENESIS

44. Aaron Antonovsky coined salutogenesis
Latin salus = health
& Greek genesis = origin.

45. Aaron Antonovsky coined salutogenesis
Latin salus = health
& Greek genesis = origin.

46. Antonovsky saw a continuum,
rather than either / or.
Pathogenic
Deterioration
Salutogenic
Health activation

47. THE LEAP UPSTREAM
PATHOGENIC
ORIENTATION
GOAL
FOCUS
NORMS
RELIES ON
SALUTOGENIC
ORIENTATION
- better medical interventions
- better quality of life
- cure disease
- cause health
- paternalism, entitlement
- self-reliance, public health
- fixing parts of system
- holistic approach

48. Aaron Antonovsky
Father of Salutogenesis
Why do some people remain healthy,
while some become ill?

49. The mind: How you feel
“Sense of Coherence”
regarding life and its challenges
- comprehensibility
- manageability
- meaningfulness

50. The mind: How you feel
“Sense of Coherence”
regarding life and its challenges
- comprehensibility
- manageability
- meaningfulness
Alan Dilani’s work relating it
to the built environment

51. Pathogenic: Disease prevention
Salutogenic: Health activation

52. Pathogenic: Disease prevention
Salutogenic: Health activation
Cause Health

53. Occurrence
Agent – Environment – Host
Stopping something from happening
or treating it after it occurs
Pathogenic

54. Continuum: encourage health to occur
Filling environment with elements
that accelerate health
Salutogenic

55. “
…I had to begin to learn less about
disease and a whole lot more about the
embedded health in the world around
me if I was to make an impact.
”
Richard J. Jackson, MD, MPH
Professor and Chair
Dept. of Environmental Health
School of Public Health, UCLA

56. “
The function of
protecting &
developing health
must rank even above
that of restoring it
when it is impaired
”
Hippocrates

57. “
In the long run,
housing may be
more important
than hospitals
to health
”
Dr Lester Breslow

58. . . . Intentionally have created silos?
Ministry of health
Ministry of education
Ministry of municipal affairs & housing
Ministry of economic development
3nd

59. . . . Intentionally have created silos?
Ministry of health
Ministry of education
Ministry of municipal affairs & housing
Ministry of economic development
Ministry of health, education, municipal affairs,
housing & economic development
3nd

60. . . . You find what you look for?
U.S. Centers for Disease Control & Prevention
3nd

61. . . . You find what you look for?
U.S. Centers for Disease Control & Prevention
U.S. Centers of Health Creation
3nd

62. Accelerating optimal health:
Salutogenesis
Start of 21st century
3rd

63. Living longer / greater expectations
Life to full potential: designed to THRIVE
Sense of Coherence:
How environments make you feel . . .
perform . . .
& prosper
3nd

64. People make decisions
based on an
emotion level.

65. Change what people SEE
on an emotional level

66. The question:
How healthy is this place?
dis-ease
health

67. Understand:
How healthy?

68. Salutogenesis: Designed to Thrive
Five Vital Elements
Nature
Authenticity
Variety
Vitality
Legacy

69. 1.
Nature
Design that is inspired by the natural world

70. Credit Valley, Farrow Partnership

71. Credit Valley, Farrow Partnership

72. Credit Valley, Farrow Partnership

73. “
Give us
something
that’s alive!
- Cancer patient survey response
Credit Valley, Farrow Partnership
”

74. “
I am in
good
hands.
”
Credit Valley, Farrow Partnership

75. Credit Valley, Farrow Partnership

76. NOC, Port-of-Spain, Trinidad and Tobago
Farrow Partnership and associate architects co-rd Limited

77. NOC, Port-of-Spain, Trinidad and Tobago
Farrow Partnership and associate architects co-rd Limited

78. NOC, Port-of-Spain, Trinidad and Tobago
Farrow Partnership and associate architects co-rd Limited

79. NOC, Port-of-Spain, Trinidad and Tobago
Farrow Partnership and associate architects co-rd Limited

80. 2.
Authenticity
Design that draws on meaningful local influences

81. St Mary’s Hospital

82. St Mary’s
On tack to be LEED Platinum & carbon neutral, completion November 2013
Farrow Partnership Architects
in association with
Busby Perkins + Will Architects

83. Farrow Partnership Architects in association with
Busby Perkins + Will Architects

84. Farrow Partnership Architects in association with
Busby Perkins + Will Architects

85. 3.
Variety
A range of experiences and a sense of discovery

86. Farrow Partnership in collaboration with
Uzi Gordon Ltd. Architects and Town Planners
Kaplan Medical Centre, Israel

87. Farrow Partnership in collaboration with
Uzi Gordon Ltd. Architects and Town Planners
Kaplan Medical Centre, Israel

88. Farrow Partnership in collaboration with
Uzi Gordon Ltd. Architects and Town Planners
Kaplan Medical Centre, Israel

89. Farrow Partnership in collaboration with
Uzi Gordon Ltd. Architects and Town Planners

90. Farrow Partnership in collaboration with
Uzi Gordon Ltd. Architects and Town Planners

91. Mission CRC
Farrow Partnership Architects and
KMBR Architects

92. Farrow Partnership Architects and
KMBR Architects

93. Farrow Partnership Architects and
KMBR Architects

94. Farrow Partnership Architects &
KMBR Architects

95. Farrow Partnership Architects and
KMBR Architects

96. 4.
Vitality
Regenerative space facilitates flow of people and ideas

97. Thunder Bay Health Sciences Centre
w
E
Salter Farrow Pilon Architects Inc., of which
Farrow Partnership Architects is a successor firm

99. Salter Farrow Pilon Architects Inc., of which
Farrow Partnership Architects is a successor firm

100. Abundance
State of mind - feel
Knowledge era
Optimistic
Engage
Captivate
Overflow
Entrepreneurial
Salter Farrow Pilon Architects Inc., of which
Farrow Partnership Architects is a successor firm

101. Salter Farrow Pilon Architects Inc., of which
Farrow Partnership Architects is a successor firm

102. Salter Farrow Pilon Architects Inc., of which
Farrow Partnership Architects is a successor firm

103. Salter Farrow Pilon Architects Inc., of which
Farrow Partnership Architects is a successor firm

104. C
B
A
Colchester East Hants Health Centre, Canada
WHW Architects and Farrow Partnership Architects

105. WHW Architects and Farrow Partnership Architects

106. WHW Architects and Farrow Partnership Architects

107. WHW Architects and Farrow Partnership Architects

108. WHW Architects and Farrow Partnership Architects

109. 5.
Legacy
Design that makes a lasting contribution to health

110. Protea Health Promoting Lifestyle Centres, South Africa

111. Protea
Greek god
that was able to
change
between many forms
Protea Health Promoting Lifestyle Centres, South Africa

112. Farrow Partnership Architects, Clark Nexsen, Ngonyama Okpanum & Associates

113. Farrow Partnership Architects, Clark Nexsen, Ngonyama Okpanum & Associates

114. Centre of influence
Versus
Centre of Excellence
Farrow Partnership Architects, Clark Nexsen, Ngonyama Okpanum & Associates

115. Legacy: Change the way people think about, see health
Farrow Partnership Architects, Clark Nexsen, Ngonyama Okpanum & Associates

116. E’Terra Samara

117. E’Terra Samara

120. E’Terra Samara

121. E’Terra Samara

122. E’Terra Samara

125. SALUTOGENESIS
“Design to Thrive”: environments that:
do their best work
connect with nature
discover their strengths
find shared meaning
develop their capabilities
communicate a sense
of abundance
build a legacy
strengthen social networks

126. How will you cause health?

127. Tye Farrow
B Arch, M Arch UD, LEED AP
FRAIC, AIBC, SAA, OAA, NSAA, NLAA, Assoc. AIA

128. END