Earth Day 2012 – Sustainable and therapeutic landscapes

Jupiter Medical Center Photo by Michiko Kurisu, courtesy of Studio Spout.

The retention pond at Jupiter Medical Center in Jupiter, FL also serves as large water feature, viewable from the Cancer Treatment Center. Photo by Michiko Kurisu, courtesy of Studio Spout.

Happy Earth Day!

Human health cannot be treated separately from the natural environment.
– Hippocrates, 4th Century BCE

We at the Therapeutic Landscapes Network believe that the best landscapes for health are those that benefit people and the planet. In the most recent issue of Research Design Connections, an article by Naomi Sachs titled “Landscapes for Health: Therapeutic AND Sustainable Landscapes in the Healthcare Setting,” is featured in the Expert’s Corner.  If you subscribe to RDC, you can log in and read the full article on their website. This article will also become a chapter in a book on therapeutic landscapes by Naomi Sachs and Clare Cooper Marcus, to be published by Wiley in 2013.

Below are some excerpts from the article:

Complementary Approaches
Sustainable and therapeutic landscapes complement each other in myriad ways. Facilities have the opportunity to “feed two birds with one seed” by meshing the two design philosophies. Landscape architects are the architect’s and engineer’s best friend here, because they are trained to see the “big picture” as well as details that will best benefit the site and the people served. In many cases, one strategy comes first and the other follows.

Regardless of which comes first—therapeutic or sustainable—below are examples of how the two design strategies can work together and reinforce each other:

  • Window views of designed gardens and surrounding nature also bring natural daylight into buildings (or to look at it the other way, providing access to natural light creates an opportunity to allow views of nature).
  • Therapeutic gardens, landscaped grounds, and detention and retention ponds dovetail with stormwater management and other low-impact development (LID) practices.
  • Green roofs reduce stormwater runoff and the heat island effect.
  • Green facades help cool buildings and reduce the heat island effect.
  • Trees help shade buildings and pavement, reducing need for AC and reducing the heat island effect.
  • Gardens that are varied and support biodiversity encourage beneficial insects and wildlife.
  • Using integrated pest management practices also encourages biodiversity and a healthy ecosystem.
  • Using native and adaptive plants puts the “right plant, right place” model into practice, reducing the need for chemical fertilizers and pesticides.
  • Native plants also provide a sense of place.
  • Condensate from air conditioners, roof runoff, and grey water can be used to irrigate gardens.
  • Growing or offering healthy food on-site encourages good nutrition, healthy eating, and sustainable farming practices (local, organic, non-GMO, hormone-free). Kaiser Permanente in California is one of several hospitals to offer onsite farmers’ markets for hospital visitors and staff as well as members of the community. At Changi General Hospital, in Simei, Singapore the roof is planted with cherry tomatoes (that yield an average of 440 lbs/year) and herbs for use in the kitchen. In addition to cooling the roof and providing the most local food possible, a composting program uses kitchen and landscaping waste as a natural fertilizer that helps to remediate previously damaged soil.

Potential conflicts, and possible resolutions
Whenever possible, we should strive to merge sustainable landscapes and therapeutic landscapes to create an environment for health that serves both people and planet. The ways in which they intersect and support each other far outweigh potential conflicts, but the conflicts are real, and therefore cannot be ignored. I believe very strongly that in those times when we must choose between one and the other, our #1 priority is to “do no harm” by choosing what supports the patients, visitors, and staff first. In healthcare, this is an ethical imperative. Conflicts and potential resolutions are discussed in the article. 

Where do we go from here?
This is an exciting time for designers and healthcare providers. Both the sustainability movement and the movement toward landscapes that support human health and well-being, emotionally and physiologically, are trickling down to healthcare, an industry that has been, ironically, slow to embrace what would seem to be in everyone’s best interest. For whatever reason, landscape architects who specialize in healthcare design and landscape architects who focus on sustainability have, until recently, stayed in their respective camps. Fortunately, people are realizing that the two usually complement and support each other, and the twain seem to finally be meeting. Next steps are to hone the business case, and to delve deeper into research about what types of landscapes best support people in stressful, harsh environments like hospitals, and to address possible conflicts between best practices for human health and best practices for environmental responsibility. I firmly believe that it can be done, and that we will be all the stronger, healthier, and smarter for trying.

As always, your thoughts and comments are welcome! Happy Earth Day.