In this paper, the city prosperity manifest is analyzed through a logical process and a framework is then proposed for designing healthy buildings in Tehran. The current status of urbanization in terms of the number of people living together and the changes in old behavior and perspectives have resulted in deficiencies to the health and hygiene of buildings apart from their surrounding environment. Consequently, these problems have affected people׳s well-being. This study mainly aims to determine policies and strategies for the architectural design of healthy buildings according to health and safety conditions that influence the quality of internal spaces and external environment of cities. The study is conducted based on logical reasoning and uses focus group and in-depth interviews to assess the final result. The result is a framework that suggests a number of policies that can promote the mental and physical health as well as hygiene of residents through healthy buildings.


City prosperity ; Healthy building ; UN-Habitat ; Policy ; Framework

1. Introduction

The world is experiencing a global crisis because of environmental degradation. The extent of urbanization rate is one of the major culprits of urban pollution and its deteriorating ecology. Population growth and physical expansion of cities have raised concerns regarding the quality of urban spaces and, consequently, the quality of the architecture taking shape within them. However, the UN-Habitat (UN-Habitat, 2012 ) considers urban population growth as a good opportunity for the human and economic development of societies and introduces the “City Prosperity” framework, which discusses a type of balanced development that considers all human, social, economic, and environmental aspects in the scale of a city.

This framework raises the argument that city authorities cannot withhold a group of people from migrating to cities and benefiting from its opportunities. Instead, they should pursue necessary actions to create a balanced city development program where the shared benefits are distributed equally. Considering this type of city development, we understandably must enhance the quality of the city environment. The vast majority of the city area consists of buildings. Buildings can assure their occupants either healthy or sickly living conditions based on the quality of different embedded design strategies. The concept of a healthy building is believed to be a “built environment that encourages positive well-being of human beings” (Ho et al., 2004 ). For decades, researchers have conducted studies to investigate the relationship between human health and the built environment. Different factors in a building affect its safety and hygiene. For example, factors such as lighting, quality of air, thermal comfort, aural comfort, colors, and textures are known to have a positive relationship with a healthy built environment (Rousseau and Wasley, 1997 ). Apart from these physical dimensions, some immeasurable aspects, such as aesthetics, job satisfaction, and social relationships, play important roles in the state of general well-being (Samuelsson, 2000 ). Conversely, buildings are also found to be a probable cause for the sickly conditions of their inhabitants, a condition known as sick building syndrome. Many believe that sick building syndrome is mostly related to indoor air quality (Hedge et al., 1989 ) and psychological factors (Finnegan et al., 1984a ).

The built environment also has a significant impact on human health. The extent of a building׳s impact on human health and the environment depends on the design, materials, and methods used for construction and operation (Vittori, 2002 ). Healthy building is a general concept that must be adapted to the overall condition of a city, given that building factors tend to be dependent on city and time (Ho et al., 2004 ). Studies show that transferring practical experiences from one country to the other is extremely complicated and challenging. This finding is mostly explained by these experiences occurring in a different time and place. Thus, a city must find its own development program based on its unique history, culture, and living conditions (UN-Habitat, 2012 ). The UN-Habitat report shows with convincing evidence that the concept of prosperity and the acquired development decisions must be revised; to be practically useful, they have to adapt to the target society (Stead, 2012 ). In other words, an array of differences in existing living conditions hinders the exact implementation of a successful experience in all countries (Stead, 2013 ).

Investigating the health condition of a building does not limit to the internal quality of living spaces within them. Buildings should further contribute to the health and hygiene of their greater context, that is, the cities. Most studies investigating the relationship between human health and buildings focus on the quality of internal spaces and remain reluctant to include the environment the building is located. In fact, programming and designing for buildings concern both the quality of internal spaces, which affect the health condition of its occupants, and the quality of the surrounding environment, which affects the health condition of citizens on a larger scale. As buildings shape nearly 50% of the total space of a city, compliance with a set of simple principals seems to significantly influence the health condition of the city.

2. Methodology

This study investigates the health and safety impact of a building׳s internal and external environment throughout the strategies driven from the UN-Habitat city prosperity manifest by using a simplified logical argumentation (Fig. 1 ). Policies, indices, and variables introduced by the UN-Habitat for balanced development in the life of cities can be translated into architecture and provide a desirable environment for human living spaces. Thus, some variables and sub-indices are extracted from the manifest for architectural translation. The study first reviews city prosperity manifest alongside relative existing literature concerning its five dimensions. Logical argumentation is used to identify major architectural policies in both the design and programming phase that improves the health and safety condition of buildings. Then, using a focus group discussion with a group of experts in the case of Tehran, we attempted to prioritize the policies for achieving a set of healthy construction policies unique to Tehran. Accordingly, in-depth group and individual interviews were conducted until the experts achieved unity in their opinions. Consequently, some of the policies were admitted or discarded from the original chart, and groups of repeated factors were aggregated into a single category. In the final step, the aggregated policies were categorized into different actions based on their priority and importance. Finally, the perceived strategies were summarized into Tehran Healthy Building design decisions.

Fig. 1

Fig. 1.

Illustration of Methodology.

3. City Prosperity Manifest

Cities have been perceived as the engines of a country׳s economy, creativity, well-being, and development. For decades, economic growth was considered the key factor to development policies. However, city prosperity currently looks beyond this perspective and examines how a city can equitably produce and redistribute its benefits. Promoting economic growth is further emphasized, including social cohesion, environmental sustainability, and quality of life (UN-Habitat, 2012 ). The UN-Habitat report introduces a new statistical instrument, namely, the City Prosperity Index (CPI), to measure prosperity in five dimensions: Productivity, Infrastructures, Quality of Life, Equity and Social Inclusion, and Environmental Sustainability. Five main dimensions exist in the city prosperity manifest. Each dimension consists of some sub-indices and variables employed in measuring the numerical value of CPI. Some of these variables are statistical and cannot be applied to architectural design or programming. Therefore, these variables are excluded from the study (Fig. 2 ).

Fig. 2

Fig. 2.

Variables and sub-indices involved in measuring CPI.

3.1. Productivity

Buildings are considered a national capital because their components consist of the country׳s natural resources. Studies indicate that the maintenance costs of buildings are much higher than their initial construction costs (Talebi, 2003 ). Up to 36% of a traditional building lifetime energy demand is spent for the primary materials, manufacture, transport, and construction costs of a building (Sartori and Hestnes, 2007 ). Therefore, improving the net life cycle of a building seems to be a good strategy for, not only decreasing the demand for new construction, but further reducing the maintenance costs during the utilization period. Furthermore, using vernacular and local materials is believed to play an important role in reducing the production, storage, and transportation costs in the construction sector (Sarja, 2006 ).

To efficiently use the natural resources of a region, city authorities must identify the materials easily produced in the target city, and then export the surplus material to gain economic benefits. Such practice provides several job opportunities while providing essential materials for construction. Adapting new construction technologies can also reduce building costs by increasing the construction speed. This possibility is established while the thermal performance of the building envelope is considered the main factor affecting energy consumption in the building sector, which affects the overall energy consumption in Iran. The building sub-sector consumes 40% of the total energy and has an important effect on the energy economy of the country. Consequently, the role of insulation, especially throughout the wall, is critically vital (Binici et al., 2009 ) and contributes to major thermal energy saving (Fig. 3 ).

Fig. 3

Fig. 3.

Architecturally driven strategies in the Productivity dimension of city prosperity for a healthy building.

3.2. Quality of Life

Quality of life is defined as easy access to amenities and basic human needs in an urban environment (Eiser, 2004 ). It depends on the efficiency of socio-economic and political interactions. Urban quality of life generally focuses on developing a healthy city to provide urban services for all in the framework of sustainability (Harpham et al., 2001 ). In this regard, all the mentioned quality of life sub-indices are analyzed for extracting architectural strategies.

Demand for safety and security includes immunity from the risk of contamination and having private realms (Lang, 1987 ). A community is able to realize its goals and living values or at least protect them from potential threats and vulnerabilities only if it is provided with a safe and secure environment. Crime and lack of safety are referred to as major impediments to physical activity in disadvantaged areas (Ball et al., 2006 ). According to the Lang model, there should be the possibility of surveillance and infiltration over public passages to meet these needs. Accessibility and flexibility further play important roles in providing safe and secure public spaces (Lang, 1987 ). Juxtaposing different zones to provide a secure urban space lies within the urban programming realm. However, the physical characteristics of the buildings play even more important roles in bringing safety and security to public spaces. Furthermore, buildings can psychologically affect the environment and create a different feeling for people passing nearby. From this perspective, constructing buildings on the ground floor and avoiding pilots beside adequate openings and windows to the street and public spaces can enhance the security of the streets and shared spaces (Bauman, 2013 ).

Health care is one of the most important priorities in developed countries. This notion is practically referred to as life expectancy and under-five mortality rate in the UN-Habitat report. Genetic and acquaint causes are two major known factors compromising human health. The built environment fails to have a direct impact on the genetic causes of different diseases in the short term; however, it can create a good platform for the acquaint causes and improvement of human health. Studies show that a hygienic, low-stress environment free from noise can effectively improve occupants׳ health and reduce the amount of diseases (Wong et al., 2009 ). Dark narrow spaces in buildings cause stress and depression, leading to a loss of control over anger in residents (Yau et al., 2009 ). Moreover, providing outdoor playgrounds seems to positively affect the health activities of children (Christian et al., 2015 ), making them more nimble and vibrant (Fig. 4 ).

Fig. 4

Fig. 4.

Architecturally driven strategies in the Quality of Life dimension of city prosperity for a healthy building.

3.3. Infrastructures

Rapid urban growth and huge city migration rate, especially in mega cities such as Tehran, have created difficulties in providing urban services for this massively growing population. According to the UN-Habitat (UN-Habitat, 2006 ), informal settlements are a modern phenomenon that respectively takes over 50% and 20% of the urban population in low-income and middle-income countries. Most rural–urban migrations have failed in Iran, and the surplus population has currently created a degraded urban life around major cities, known as informal settlements. The primitive shacks built in these settlements made from any available material generally lack basic amenities, such as electricity, gas, running water, and sewerage. Such living disorder in a residential texture increases poverty and crime in the community (Vosoughi, 1998 ). For example, homelessness and unstable housing have been associated with an increased risk of HIV infection (Aidala and Sumartojo, 2007 ), (Corneil et al., 2006 ), (Shannon et al., 2006 ), reduced personal safety, higher rates of morbidity and mortality (Riley et al., 2007 ), and increased obstacles to health care access (Lewis et al., 2003 ). A lack of affordable housing results in health and social problems, thereby making housing an urgent public health priority (Krieger and Higgins, 2002 ). The self-help design process should follow a number of fundamental principles. To illustrate, the design and used materials must be technically sound, and the building operations must be chiefly simplified (Abrantes and Ural, 2014 ). The active participation of slum residents in upgrade programs has likewise been praised as the global best practice in slum upgrades (Patel, 2009 ).

Sustainable neighborhood is at the core of a city׳s sustainable development. The quality of built environment, specifically in residential buildings, is an important factor in determining the quality of a neighborhood. Subsidized relocation to improved or newly built housing is assumed to help disadvantaged residents overcome material barriers to obtain better quality accommodation (Benzeval et al., 2014 ). Better quality housing can mean improvements to affordable warmth, ventilation, and exposure to damp (Basham et al., 2004 ), (Clark and Kearns, 2012 ), (Ellaway et al., 2000 ), (Gibson et al., 2011 ), (Harrington et al., 2005 ), (Rugkasa et al., 2004 ), (Thomson et al., 2013 ). Such improvements are theorized to reduce health risks from injury, biological agents, and chemical pollutants (Jacobs et al., 2010 ), (Thomson and Thomas, 2015 ). Controlled variety in the body of a neighborhood, as in buildings, can bring vitality to people and provide them a sense of satisfaction with their surroundings (Barton et al., 2003 ); such quality is one of the main characters in sustainable neighborhoods (Fig. 5 ).

Fig. 5

Fig. 5.

Architecturally driven strategies in the Infrastructure dimension of city prosperity for a healthy building.

3.4. Environmental Sustainability

The global climate system is being affected by the emission of greenhouse gases, of which the most significant is carbon dioxide (CO2 ). The building sector globally accounts for a large share of carbon emission (Gustavsson et al., 2010 ). Elevated CO2 levels affect occupant comfort and indoor air quality. With elevated CO2 levels, occupants may complain of perceived poor air quality and face health problems, such as headaches, fatigue, and eye and throat irritation (Sharmin et al., 2014 ). Poor air quality may reduce the efficiency of the occupants (D. P. Wyon and Wargocki, 2006 ), a loss that can be reduced through a proper design strategy (Wyon, 1996 ). The construction and occupation of buildings are substantial contributors to global CO2 emissions, with nearly a quarter of total global CO2 emissions attributable to energy use in buildings (Metz et al., 2007 ). Considering construction as a whole, further embodied carbon savings can be made by the careful selection of sustainable materials or materials with reduced environmental impact, design and placement of materials within the structure (e.g., mass materials accessible as thermal storage), and on-site waste minimization strategies (Monahan and Powell, 2011 ).

On-site waste reduction has been considered as the most efficient method of waste management (Lu and Yuan, 2011 ). However, prefabrication can also be used as a key strategy to effectively promote construction waste minimization (Lu and Yuan, 2013 ), (Chiang et al., 2006 ), (Yee and Eng, 2001 ), (Aye et al., 2012 ), (Zhang et al., 2011 ), that reduces the difficulty of wet-trade work and contributes to construction waste minimization (Aye et al., 2012 ).

Among various aspects of environmental sustainability, energy efficiency imposes the highest costs to cities (Desideri et al., 2009 ), (Ma et al., 2006 ). A wide range of green features, including green roof technology (Berndtsson, 2010 ) solar system, such as photovoltaic panels (Parida et al., 2011 ), and HVAC system (Perez-Lombard et al., 2008 ), were introduced to implement sustainable development principles in the built environment, especially residential buildings. A climate-responsive or solar-passive building design has a major impact on reducing the energy demand of buildings located in hot and dry climates without compromising modern living standards. Strategies such as new architectural design, technologies, and materials; proper control; and using effective energy management systems by considering factors, such as building orientation and configuration (Glicksman et al., 2001 ), shape, wall–window ratio, insulation; using high-efficiency windows and natural ventilation, are known to be effective in reducing the level of consumed energy (Dawood et al., 2013 ).

Preserving existing natural resources is one of the main concerns faced by a built environment. Hot water collected for drain water heat recovery can be used as gray water for toilet flushing to significantly reduce the demand for potentially costly municipal sources of fresh water (Sharmin et al., 2014 ). Furthermore, choosing the proper form for ceiling in buildings according to climate as well as providing a rain water collection system can play important roles in saving clean water that can be used for plant irrigation.

Different types of air pollutants widely affect human health both in outdoor and indoor environments. The air pollutant concentration in indoor spaces is reported to reach up to 96 times higher than the outdoor space because of toxic and carcinogenic gas emission of materials, equipment, and even the furniture used in buildings (Abbasnejad, 2002 ). Most people spend over 90% of their time inside buildings (Qi et al., 2012 ). Consequently, considering the proposed materials used in different parts of the building structure is essential for a designer (foundation, finish walls, insulation, etc.) and interior design (furniture, coatings, interior lighting, etc.). Apart from building materials, simple activities such as cooking, heating, cooling, and health sanitation within the residential buildings, and different types of machines in office buildings result in a significant emission of toxic gases, including radon, carbon monoxide, nitrogen oxides, hydrocarbons, and particulate matter (WHO, 2003 ). Numerous studies found that indoor air quality and psychological aspects of a building are associated with sick building syndrome (Hedge et al., 1989 ), (Gots, 1998 ), (Finnegan et al., 1984b ). Air pollutants can affect human health by either entering the building through its windows (Zabel and Kiel, 2000 ) or being created by indoor activities. Consequently, ventilation is a key strategy to reduce the amount of inside pollution. Natural ventilation is likewise identified as a more influential, sustainable method than mechanical ventilation (Ho et al., 2004 ). Therefore, considering the juxtaposition of different spaces according to their type of activity and the amount of released pollutants are helpful strategies to reduce the amount of air pollutants via the architectural design process, especially in high-risk activity spaces (Fig. 6 ).

Fig. 6

Fig. 6.

Architecturally driven strategies in the Environmental Sustainability dimension of city prosperity for a healthy building.

3.5. Equity and Social Inclusion

Social equity is the balanced distribution of valuable resources between individuals, whereas inequity is a common and long-lasting aspect of human societies. Individual differences, such as innate abilities, motivation, and desires; and social differences, such as different lifestyles, rights, and more importantly, opportunities, rewards, and privileges granted to individuals by society, cause an unbalanced living condition, which leads to inequity (Chalapi, 1996 ). Different social and political ideologies emphasize equity as a certain right of individuals. Studies indicate that residents of disadvantaged neighborhoods experience more serious health problems, such as chronic diseases (Diez Roux, 2001 ), (Dragano et al., 2007 ), (Chaix, 2009 ), and are more associated with health risks, such as obesity (Van Lenthe and Mackenbach, 2002 ), (King et al., 2006 ), (Matheson et al., 2008 ). Generally, public health policies state that improvements to the residential environment (homes and neighborhoods) can facilitate public health goals of preventing disease and reducing social health inequities by improving the determinants of health for disadvantaged populations (Marmot et al., 2010 ).

Community engagement, stakeholder involvement, and people׳s participation during and before the design stage seem to result in enhanced equity, efficiency, empowerment, and environmental sustainability (Uphoff, 1991 ). Such commitment further empowers women and disadvantaged groups, providing them the voice to participate in building their own living environment (Agarwal, 2001 ). Women taking on decision-making roles have been assisted to build skills, which enhance their status and self-confidence (Prokopy, 2004 ). Sanyal (Sanyal, 2009 ) finds that women׳s participation in micro-credit programs fosters their social capital and normative influence at both the individual and community levels. A neighborhood׳s social environment also affects the physical activity among women living in disadvantaged areas (Timperio et al., 2015 ). A review by Foster and Giles-Corti (Foster and Giles-Corti, 2008 ) suggested that crime-related safety may restrain physical activity among women, although many of the studies included crime in a composite measure of safety. Furthermore, neighborhood disadvantage, incivilities, and crime disproportionately affect a minority of women, discouraging physical activity. A similar scenario frequently happens to young children. Regular physical activity during childhood and adolescence is found to be favorable for physical and mental health in their lifetime (Trost et al., 2005 ). Children with low socioeconomic status tend to engage less frequently in unstructured commercially available programs, such as organized team sports, and tend to spend most of their leisure time at home compared with children from a high socioeconomic status (Ziviani et al., 2008 ) (Fig. 7 ).

Fig. 7

Fig. 7.

Architecturally driven strategies in the Equity and Social Inclusion dimension of city prosperity for a healthy building.

4. Tehran Healthy Building Design Decisions

According to the Statistical Center of Iran (SCI, 2014 ), the rate of residential building construction in Tehran has increased significantly since 1980. The energy consumption per capita for Iranian families is also significantly higher than the ideal average rate for Middle Eastern countries (SCI, 2013 ). The most severe thermal loss in the present residential buildings of Tehran is found to be throughout the windows (50%) and walls (35%), in contrast to the floors (7.5%) and ceilings (7.5%) (Sadegh Zadeh, 2007 ). Therefore, using architectural strategies to consider the insulation of windows and walls results in an impressive reduction in energy costs and, consequently, household consumption. Moreover, avoiding curvature forms and creating shadows on the southern facade of buildings in Tehran result in significant energy saving (Shafiee et al., 2013 ). Conversely, the lack of adequate infrastructures in houses and poor quality of design and construction in low-income areas of the city have led to low-quality buildings, which are commonly houses that fuel the slum expansion. This deficiency would further increase the level of energy consumption each year. Innovative self-help construction methods appear to be a solution to improve housing in these troubled areas.

According to SCI (SCI, 2013 ), the building sector contributes approximately 25% of the overall imposed costs caused by the production of CO2 . In Tehran, an average of 50% of the urban space is dedicated to residential use (Behzadfar, 2011 ). Consequently, 40% of this amount of residential space is dedicated to home yards according to the Tehran municipal construction regulations. Building green spaces in house yards has a strong potential to compensate for the vast household CO2 emission through buildings themselves. This strategy can also be applied to green spaces in front of the building, given that they are eliminated in recent constructions. The strategy of providing a beautiful green vista is expected to have medium-term positive impacts on the physical health of the society and the mental health of occupants.

The building industry is known as one of the major culprits of environmental degradation in most Iranian populated cities, given that two to three buildings per alley are under construction every year. In Tehran, nearly 40% of municipal solid waste is construction waste (SCI, 2009 ). According to the Iran Statistical Center (SCI, 2013 ), buildings consume some 36% of the total energy use in Tehran, the highest consumption rate compared with other sectors (industry, transport, and agriculture). However, the portion of producing renewable energies in the same year by this sector is 0.23%, which is highly negligible (SCI, 2013 ). Improving the energy efficiency of buildings and reducing building energy consumption in Tehran are clearly urgent problems for the construction industry. Improving energy efficiency in buildings demands an extensive discussion, which must focus on how to replace common, easy-to-use, active energy-consuming systems with passive solutions. Considering that over 70% of the building energy consumption aims to support cooling systems in hot climate cities of Iran, such as Tehran, strategies such as the increased southern façade in compliance with Trombe wall and solar space should be encouraged to support passive solar systems in the housing sector (Pour Mirza, 2010 ). Moreover, state interventions proposing strategies to reduce municipal service fees and costs for constructing greenhouses can foster the green development policies and their embodiment within the currently neglected residential buildings in Tehran. Iran is highly lacking on water resources. This problem is more significant in dry-climate populated cities, such as Tehran. Reusing and collecting water resources are relatively vital strategies in such cities. The current water-sewerage system in Tehran fails to separately provide clean drinking water and water used for other purposes, such as cleansing activities. Consequently, researchers suggest that separating drinking water in buildings can save up to 80% of the energy and effort put into providing drinking water for all purposes. Reusing gray water from cleansing activities in kitchens, bathrooms, and so on can also save up to 50% of the total water consumption in Tehran (Moqadasi, 2009 ).

According to SCI (SCI, 2014 ), the under-five mortality rate in Tehran is approximately 2%. A total 12.8% of deaths appear to be caused by different accidents, including road accidents, cutting accidents, and electrical shocks. In fact, electrical shocks are the main cause for under-five deaths related to the building design. Although this amount is incomparable to the major 62.9% infant disorder death causes, such number can probably be completely eliminated via a correct building design. Safety precautions in mechanical and electrical installations, such as installation height of electrical sockets, handrails of stairways, and the height of risers, can significantly reduce this rate.

The overall crime rate in Tehran, especially in low-income disadvantaged neighborhoods, is high (Chehreh et al., 2009 ), which means that fewer opportunities for physical activity exist for young children to play or walk outside their homes. A similar situation exists for women, which deprives them of inexpensive, unstructured forms of physical activity such as walking, as well as opportunities for organized activity, especially at night, resulting in less outdoor activities. Therefore, providing individual buildings or residential complexes with child-based playgrounds filled with sunlight is essential. Furthermore, comfortable territories should be provided for women to play with their children and enjoy the benefit of sunlight.

Providing adequate lighting is a general problem in most Tehran streets and neighborhood alleys that can be improved through buildings. According to an empirical survey, 56% of citizens declared that the lighting of streets in this city is too poor to make them feel safe (Chehreh et al., 2009 ). Considering that Tehran has a hot, mostly sunny climate with less than 14% cloudy days during a year (Tahbaz, 2009 ), utilizing a cheap PV cell converter at the entrance of every building is a design strategy that can provide adequate lighting for street pavements and alleys at night. Avoiding insecure corners, especially in the front yard, as well as creating shared spaces with direct surveillance can lead to safety and security in buildings.

5. Discussion

We analyzed five dimensions of city prosperity and discussed the various factors affecting the overall health and safety condition of building occupants and city residents. The result is a set of policies identifying architectural policies for designing healthy buildings. However, the abstracted policies may be imprecise for Tehran, unless evaluated and examined by a group of experts. Some policies are highly negligible in the case of Tehran and should be taken away from the framework, whereas some others must be aggregated because they nearly address the same issue. Alternately, these policies only reflect the variables generally influencing healthy buildings, with no special hindrance to the current condition of any special city. Moreover, ambiguity still exists as to which policies affect Tehran buildings more severely and to what extent. Consequently, the identified factors and policies should clearly have different priorities in terms of taking decisions while designing in a specific city. Some strategies may be more important to Tehran citizens than, for example, New Yorkers.

Therefore, evaluating all identified policies is necessary to admit or discard them from the framework. In the next step, prioritizing the finalized policies is vital according to the condition of life in Tehran and its construction requirements. Accordingly, a group of seven experts with profound experience in the realms of strategic planning, city planning, project management, architecture, and urban design were gathered to discuss both city prosperity in Tehran and its driven architectural policies for designing healthy buildings. The experts were mainly university professors, with few key authorities from the Tehran municipality.

The first step included a presentation of a brief summary of the main concept and related discussions for the experts. The experts were then asked to express their opinions over the subject by answering questions from the interviewers. Questions on the necessity of healthy buildings, validity of the driven policies, and their contribution to Tehran׳s prosperity were asked in the group. The experts were also asked to discuss their opinions until they achieve unity. Consequently, policies such as “controlled variety in materials” or “street windows” were deducted from the framework. The experts further concluded that items such as “community design,” “proper ventilation,” and “materials with reduced environmental impact” should be merged with existing similar topics. The result of this stage was a set of 25 policies distributed among five dimensions of city prosperity, but still too general for the existing condition of living in Tehran. In the next step, each expert was interviewed individually and was asked to score each dimension of city prosperity as well as architectural policies with specific reference to Tehran. They expressed their assessment of each factor by giving it a priority from 1 (as being the most important factor) to 5 (as the least important factor). The average result of their prioritization is illustrated in Table 1 .

Table 1. Prioritized policies for healthy building design decisions in Tehran.
Dimension Average Priority Policies Average Priority Overall Value
Productivity 4
  • Durable materials
1 4
  • Vernacular and local materials
2 8
  • Low-cost new construction technologies
3 12
  • Mass production of local materials
5 20
Quality of Life 1
  • Increased sense of ownership over the space
1 1
  • Natural lighting
2 2
  • Proportion of space
2 2
  • Noise control
3 3
  • Safety precautions in mechanical and electrical installations
3 3
  • Quality and variety of interior materials
4 4
Infrastructures 5
  • Natural ventilation
1 5
  • Affordable insulation in buildings
3 15
  • Innovating self-help housing construction
3 15
Environmental Sustainability 3
  • Prevent the removal of the building׳s green space
1 3
  • Healthy and non-toxic materials
1 3
  • Optimizing building orientation and configuration
2 6
  • Solar passive systems
3 9
  • Juxtaposition of polluting spaces
3 9
  • Rain and gray water collection system
4 12
  • Prefabrication
5 15
  • Ceiling form
5 15
Equity and Social Inclusion 2
  • Disabled utilities
1 2
  • Community design
2 4
  • Child-based playgrounds
3 6
  • Safety and security of women in public spaces
3 6

To obtain a more vivid idea of what each score actually means and how policies can be reclassified based on their importance, we multiplied the average score of each dimension by the average of each policy. The result is also shown in Table 1 as the overall value. Clearly, the lower the overall value, the more important the policy will be for healthy buildings in Tehran. This method helps to re-organize the table based on the policies׳ level of importance and prioritize further actions. For the final stage, three major gaps in the overall value of the policies are identified and then reclassified into three main steps. This process means it would be best for designers to fulfill these policies, step-by-step, while making decisions. Accordingly, the result is a consecutive framework consisting of various policies that will lead to better design decisions for healthy buildings in Tehran. The ultimate steps to design decisions are illustrated in Fig. 8 .

Fig. 8

Fig. 8.

Consecutive Actions for Healthy Building Design Decisions in Tehran.

6. Conclusion

The quality of the built environment in terms of the choices made by architects during the design process has a significant impact on human health and the surrounding environment of the building. As a systematic process in forming the physical environment via the use of natural resources, architecture is a key actor in the preservation or destruction of the environment and human health. Furthermore, if the spaces are designed correctly, they can reduce the adverse effects caused by mental or physical diseases and motivate the residents for more positive behaviors. The proposed framework is obtained through a combination of logical argumentation and qualitative methods. It introduces some prioritized policies as design strategies to meet the architect׳s needs during the decision making for healthy buildings in Tehran. The proposed framework consists of three main steps that are best taken consecutively to create buildings that improve the well-being of its occupants if applied in the design and decision-making process.


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