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Public health leaders call on policymakers to prioritize buildings as instruments of public health

Date: Sep 26 2023

Contact: Media Relations

Organized by the International WELL Building Institute (IWBI), the global authority on healthy buildings, organizations and communities, a group of renowned leaders in public health delivered an open letter to the nation’s policymakers, including members of Congress, mayors, governors and school superintendents, highlighting a policy opportunity to advance health in buildings. The letter, signed by six former Surgeons General and six executives from many of the country’s leading public health organizations, urges a significant change in how buildings and indoor environments are perceived—from mere structures to critical levers for public health.

In an effort to shift the paradigm of building policy, the sign-on letter draws attention to an often-overlooked policy opportunity—reimagining the nation’s buildings as a prescription for health. It lays out compelling evidence showing the outsized role buildings can play to enhance health outcomes, prevent disease and boost economic productivity.

“Buildings have a profound impact on our safety and well-being. Yet we’re largely missing out on the benefits of healthy building practices because our policymakers aren’t thinking about them as part of a prescription for public health,” said Rachel Hodgdon, President and CEO, IWBI. “This letter shows unequivocally why we need our leaders in government to guide this policy shift and help ensure the places and spaces where we live our lives keep all of us safe, healthy and well.”

The letter helps serve as a wake-up call for decision-makers across the nation. “We hope all policymakers will embrace this new policy paradigm wherein buildings are not seen merely as structures, but as pillars supporting our nation’s health,” says the letter’s signatories, each a nationally recognized public health figure, including:

  • Dr. Richard Carmona, 17th Surgeon General of the United States;
  • Dr. David Satcher, 16th Surgeon General of the United States;
  • Dr. Joycelyn Elders, 15th Surgeon General of the United States;
  • Dr. Antonia Novello, 14th Surgeon General of the United States;
  • Dr. Boris D. Lushniak, former Acting Surgeon General of the United States (2013-2014);
  • Dr. Kenneth Moritsugu, former Acting Surgeon General of the United States (2002 & 2006);
  • Harold P. Wimmer, President and CEO, American Lung Association;
  • Georges C. Benjamin, MD, Executive Director, American Public Health Association
  • Kenneth Mendez, President and CEO, Asthma and Allergy Foundation of America;
  • Colin Milner, CEO, International Council on Active Aging;
  • Rachel Hodgdon, President and CEO, International WELL Building Institute; and
  • William Potts-Datema, DrPH, Interim CEO, Society for Public Health Education.

“Buildings are not just walls and roofs; they are health-critical environments where we spend 90% of our lives,” said Dr. Carmona, the 17th Surgeon General of the United States. “The pandemic showed us that our current building policies are severely lacking in health-focused strategies. We can’t afford to ignore this any longer.”

The sign-on letter underscores the urgency of revising building policies to be in alignment with public health goals. It also highlights the potential for staggering economic benefits.

Key highlights from the letter include:

  • A potential $200 billion annual productivity gain corresponding to a 20% to 50% reduction in Sick Building Syndrome symptoms for office workers in the U.S.
  • An estimated $38 billion in annual economic benefits from increasing minimum ventilation rates in U.S. offices.
  • A return of $3.48 for every dollar companies spend on workplace wellness programs due to reduced medical costs, and an additional return of $5.82 due to reduced absenteeism.
  • An up to 101% improvement in cognitive function, supporting employee productivity benefits up to $7,500 per person per year.

“Over the next 10 years, our federal, state and local governments will invest billions in buildings, including funding for public schools, affordable housing and large federal incentives for commercial buildings,” said Jason Hartke, executive vice president of external affairs and advocacy, IWBI. “The key question is: will these public investments prioritize human health? If, starting right now, our decision-makers begin to embrace sound policy solutions that prioritize healthy building practices, then we can help ensure our public dollars are going to support huge positive public health outcomes.”

The letter comes at a time when the nation faces complex public health challenges, from the enduring effects of the COVID-19 pandemic to the escalating threats of climate change. In light of this, the letter’s signatories also highlight how healthy building solutions play a pivotal strategy in the nation’s preparedness for global health challenges, including the climate crisis and other future health threats, stressing that delay in policy action could increase the health risks to all those inside buildings.

“The time for action is now, not just for the health of our citizens but for the economic prosperity of our country,” added Dr. Carmona.

What the Letter’s Other Signatories Are Saying:

“From a health policy perspective, we have a huge opportunity to accelerate healthy building best practices and make sure all our places and spaces are better positioned to help protect and promote human health,” said Dr. Joycelyn Elders, 15th Surgeon General of the United States. “But it starts with rethinking how we craft building policy at all levels of government, which is made especially urgent in the face of escalating health threats posed by climate change.”

“We know so much more today about the many ways buildings impact and shape human health,” said Dr. Antonia Novello, the 14th Surgeon General of the United States. “It’s time we harness all the available scientific and medical evidence to help transform our building infrastructure in ways that can benefit those people living and working to stay healthy. Whether we walk the halls, or work in the building, or reside in the home, safety, health and well-being will be crucial to incorporate by those who build the next generation of buildings.”

“Our buildings hold one of the keys to a new era of public health—an era where our built environment is seen not just as a collection of structures but as critical infrastructure for well-being,” said Dr. Kenneth Moritsugu, who served twice as Acting Surgeon General of the United States. “Policymakers have a responsibility to recognize the essential role that buildings play in protecting and enhancing our health and take informed actions accordingly.”

“Asthma is the leading chronic disease in children and a leading cause of missed days of school,” said Kenneth Mendez, president and CEO of the Asthma and Allergy Foundation of America (AAFA). “Poor indoor air quality in school buildings is harmful to children – increasing sickness and resulting in missed learning time. It is imperative that policymakers make indoor air quality in schools and other buildings a priority.”

“The buildings we live and work in play a pivotal role in shaping the social determinants, which we know have an enormous impact on human health,” said Georges C. Benjamin, MD, Executive Director, American Public Health Association. “With this in mind, we hope our nation’s policymakers will embrace forward-thinking building policies that prioritize health and well-being and ensure that our future public infrastructure investments in buildings do the same.”

“In the pursuit of a healthier and more resilient future, we must recognize the impact indoor air quality has on our well-being. We spend most of our time inside of buildings, where the levels of some pollutants are often two to five times higher than outdoor concentrations,” said Harold Wimmer, President and CEO of the American Lung Association. "The quality of air in the home can influence the health of its occupants and the healthfulness of air at school affects how children learn and develop. Poor indoor air quality can impact anyone, but children, older adults and people living with lung disease are at a higher risk of harm and require extra protection. We are eager to work with policymakers to improve the health of everyone living in America.”

“More and more, we are realizing how deeply buildings influence and shape our well-being, which is especially relevant to the millions of people who are embracing active aging,” said Colin Milner, CEO, International Council on Active Aging. “That’s why I’m excited to be part of this group of national public health leaders committed to championing important policy opportunities that elevate healthy building practices designed to benefit everyone.”

“Buildings are vital determinants of our health, an important strand in the intricate web of social factors influencing well-being,” said William Potts-Datema, DrPH, Interim CEO, Society for Public Health Education. “Recognizing this, it becomes clear that our building policies should better prioritize health in building design and operations, particularly in places serving our most vulnerable, such as schools and hospitals. Let’s build for health, for now and the future.

About the International WELL Building Institute
The International WELL Building Institute (IWBI) is a public benefit corporation and the world’s leading organization focused on deploying people-first places to advance a global culture of health. IWBI mobilizes its community through the administration of the WELL Building Standard (WELL) and WELL ratings and certifications, management of the WELL AP credential, the pursuit of applicable research, the development of educational resources and advocacy for policies that promote health and well-being everywhere. More information on WELL can be found here.

International WELL Building Institute pbc is a wholly owned subsidiary of Delos Living LLC. International WELL Building Institute, IWBI, the WELL Building Standard, WELL v2, WELL Certified, WELL AP, WELL Portfolio, WELL Score, The WELL Conference, We Are WELL, the WELL Community Standard, WELL Health-Safety Rating, WELL Health-Safety Rated, WELL Equity, WELL Performance Rated, WELL Performance Rating, Works with WELL, WELL and others, and their related logos are trademarks or certification marks of International WELL Building Institute pbc in the United States and other countries.


The American Public Health Association champions the health of all people and all communities. We are the only organization that combines a 150-year perspective, a broad-based member community and the ability to influence federal policy to improve the public’s health. Learn more at