buildings
Review
The State of the Art in the Biophilic Construction of Healthy
Spaces for People
Natividad Buceta-Albillos * and Esperanza Ayuga-Téllez
Citation: Buceta-Albillos, N.;
Ayuga-Téllez, E. The State of the Art
in the Biophilic Construction of
Healthy Spaces for People. Buildings
2024, 14, 491. https://doi.org/
10.3390/buildings14020491
Academic Editor: Paulo Santos
Received: 28 November 2023
Revised: 24 January 2024
Accepted: 30 January 2024
Published: 9 February 2024
Copyright: © 2024 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
Buildings 2024, 14, 491. https://doi.org/10.3390/buildings14020491
Buildings, Infrastructures and Projects for Rural and Environmental Engineering (BIPREE), Universidad
Politécnica de Madrid, José Antonio Novais 10, 28040 Madrid, Spain; esperanza.ayuga@upm.es
* Correspondence: natividad.buceta.albillos@upm.es
Abstract: Human beings need a connection to nature for their overall well-being, as highlighted by
numerous publications. Housing is an extension of people’s lives. Confinement due to the COVID-19
pandemic, the rise of sustainability, longevity and the digital society are placing value on more
sustainable and healthy construction for people’s well-being and quality of life. These premises
motivate this study of the state of the art of biophilic design with a therapeutic and social approach.
The main objective of this research is to investigate the evolution of the concept of biophilia in
healthy buildings for people and the environment, analysing the current situation and identifying
the main theories, models and applications. This research employs the six-step methodology for
state-of-the-art analysis (SotA), using the process of reflexivity throughout this study. There are very
few scientific studies that measure the positive impact of biophilic design on people’s well-being, and
they tend to take the form of scientific discussion rather than evidence; this is their main limitation.
Our recommendation is to identify new quantitative research on the biophilic impact on humans of
healthy spaces in order to evaluate their effects.
Keywords: healthy spaces; sustainability; well-being
1. Introduction
Human beings have been connected to the natural environment since their origin as
Homo sapiens, according to the Savanna Principle [1]. People are particularly attracted to
the natural environment and to natural light, which brings important physiological and
psychological benefits [2]. Being in connection with the environment, the immune system
is related to the nervous and hormonal systems, so the relationship with the environment
conditions physical feelings and emotions [3].
During the COVID-19 confinement, people felt the need to turn to the natural envi-
ronment as a restorative response to the cognitive, psychological and physiological states
produced during the pandemic. The current context is that the outcome of the pandemic
demonstrates that people place value on natural spaces [4,5]. More than 90 days of con-
finement is enough to appreciate the benefits of being in contact with nature and to reflect
on the place in which one lives [6]. Edward O. Wilson, who in 1984 [7] highlighted the
importance for people of being in contact with nature, defined biophilia as the tendency to
seek a connection with nature.
The urban population is expected to grow from 56% of the global total in 2021 to 68%
by 2050 [8]. Although in the early phases of the COVID-19 pandemic, there was a trend
towards living in rural areas, which were perceived to be safer, this does not alter the course
of global urbanisation, according to the World Cities Report 2022 [9].
Most of the sources studied confirm that we spend more than 90% of our time in indoor
spaces. According to a Velux study, ‘Let Nature back into your life’ [10], 52% of Spaniards
spend less than one hour a day in contact with nature. The absence and disconnection
from green areas has had a major impact on quality of life, as became evident during the
pandemic, and there are now more cases of depression and anxiety [11].
https://www.mdpi.com/journal/buildings
 Buildings 2024, 14, 491 2 of 15

Buildings 2024, 14, 491 2 ofevident

15
connection from green areas has had a major impact on quality of life, as became
during the pandemic, and there are now more cases of depression and anxiety [11].
The current post-COVID-19 understanding of health-related well-being and quality
of life lookspost-COVID-19
The current at healthy spacesunderstanding
for people, of health-related
and well-being
the construction and quality
of biophilic designof has
life looks at healthy spaces for people, and the construction of biophilic design has
emerged to enhance well-being through mental and physical health. Biophilic design isemerged
to enhance
based well-being through
on the concept mental and
of biophilia [7],physical
which ishealth. Biophilic
applied to thedesign is basedsector
construction on to
the concept of biophilia [7], which is applied to the construction sector to achieve the
achieve the best health outcomes thanks to the benefits of being in contact with nature best
health outcomes
[12]. thanks
That is the to theresearch
principal benefitshypothesis
of being infor contact with nature [12]. That is the
this study.
principal research hypothesis for this study.
The main objective of this research is to investigate the evolution of the concept of
The main objective of this research is to investigate the evolution of the concept
biophilia in construction in the current climate of interest in people’s well-being and im-
of biophilia in construction in the current climate of interest in people’s well-being and
provements in their quality of life. Additional goals are to identify the common aspects of
improvements in their quality of life. Additional goals are to identify the common aspects of
biophilic design and the main gaps, applications and evidence of its benefits for
biophilic design and the main gaps, applications and evidence of its benefits for well-being,
well-being, as well as new lines for future study.
as well as new lines for future study.
2. Materials
2. Materials and Methods
and Methods
The methodology
The methodology applied
applied in qualitative
in this this qualitative research
research is based
is based on theon six
thesteps
six steps
of of
state-of-the-art analysis (SotA) [13]. The SotA method promotes awareness
state-of-the-art analysis (SotA) [13]. The SotA method promotes awareness of the subject of of the subject
of thiswith
this study study with a spirit
a critical criticaland
spirit andnew
opens opens new horizons
horizons forlines
for future futureof lines of research.
research.
This SotA method supports the analysis of the evolution
This SotA method supports the analysis of the evolution of biophilic designof biophilic design
withwith a
a reflexivity process, providing important benefits for this topic. The SotA method is is
reflexivity process, providing important benefits for this topic. The SotA method
summarised
summarised in Figure
in Figure 1 below
1 below (figure
(figure created
created by thebyauthors).
the authors).

Figure 1. The1.six-step
Figure methodology
The six-step for state-of-the-art
methodology analysis
for state-of-the-art (SotA).
analysis (SotA).

Reflexivity is used
Reflexivity is as a tool
used as for the for
a tool analytical process,process,
the analytical especially for the discussion
especially and
for the discussion
conclusions of this research. Reflexivity involves a concrete, critical, subjective and
and conclusions of this research. Reflexivity involves a concrete, critical, subjective anddynamic
awareness
dynamic of the research
awareness ofobjective and objective
the research helps in and
the identification of the appropriate
helps in the identification of the ap-
literature and the interpretation of the data [14,15].
propriate literature and the interpretation of the data [14,15].
A review of the existing literature is necessary to gain a better understanding of the
A review of the existing literature is necessary to gain a better understanding of the
context and the research question.
context and the research question.
Firstly, a study was carried out of the existing bibliography on the benefits for human
Firstly, a study was carried out of the existing bibliography on the benefits for hu-
well-being of contact with nature, identifying a long list of scientific articles, books and
man well-being of contact with nature, identifying a long list of scientific articles, books
journals of interest (more than 3700 documents were found, of which 240 were selected
and journals of interest (more than 3700 documents were found, of which 240 were se-
and 121 analysed).
lected and 121 analysed).
Secondly, a search for more specific information was conducted in relation to the
Secondly, a search for more specific information was conducted in relation to the
biophilic design of healthy spaces for people (76 documents analysed and referenced in
biophilic design of healthy spaces for people (76 documents analysed and referenced in
this manuscript). Some recent studies review the subject of biophilic construction using
this manuscript).
the PRISMA Some recent
method [16–19], studies review
and include the subject
a new SotA method of biophilic construction
to identify future linesusing
the PRISMA
of research. method [16–19], and include a new SotA method to identify future lines of
research.
Tables 1 and 2 show the data summary of the literature review, which was the source
of the firstTables 1 and 2searches.
and second show the data summary of the literature review, which was the source
of the first and second searches.
Buildings 2024, 14, 491 3 of 15

Table 1. First search: benefits of contact with nature for human well-being; 3700 documents found,
240 selected, 121 analysed.

Sources %
Main Journal % References in Source
(121 Documents) References
Elsevier 25% Journal of Environmental Psychology 86%
Spain Journals 19% Revista de investigaciones geográficas 44%
MDPI 9% Sustainability 88%
Taylor & Francis 7% Journal of Ecosystem Health and Sustainability 50%
Other sources 40%

Table 2. Second search: the biophilic design of healthy spaces; 76 documents related to the
research objective.

Sources of 76 Documents References

Conferences and Congresses 9%
Web 9%
Books 7%
WHO 5%
Buildings 5%
Journal of Environmental Psychology 4%
Sustainability 4%
GBCe 4%
Cambridge: Harvard University Press 3%
Terrapin Bright Green 3%
Journal of Cleaner Production 3%
ONU Habitat 3%
Other journals 13%
Other bibliography 29%

3. Results
The results of each of the six phases of the methodology applied for the state-of-the-art
analysis for the objective of this study are detailed below (Table 3).

Table 3. The six steps of the state-of-the-art analysis (SotA) applied to the research topic.

SotA Step To the Topic

3.1. Determine initial research question and field of review
3.2. Determine timeframe
3.3. Finalise research question to reflect timeframe
3.4. Develop search strategy to find relevant manuscripts
3.1.a. Question to be answered: the contribution of biophilic design to
holistic well-being.
3.1.b. Field of action: healthy buildings.
3.2.a. Scope of the research: to determine the factors that influence
healthy construction in contact with nature.
3.2.b. Key milestones in the evolution of biophilic designs.
3.2.c. How does the evolution of biophilia in building justify
its study?
3.3.a. How can the scope of the research change the initial
research question?
3.3.b. How does the information sought actually answer the question?
3.4.a. How far am I from knowing the current situation of the target
of the study?
3.4.b. Do the information sources help to answer the question posed?
Buildings 2024, 14, 491 4 of 15

Table 3. Cont.

SotA Step To the Topic

3.5.a. Main articles consulted
3.5.b. Common points
3.5.c. Assumptions
3.5.d. Main gaps
3.5. Analyses
3.5.e. Contradictions
3.5.f. Applications
3.5.g. Current reference models
3.5.h. Future research lines
3.6. Interpretation of the results 3.6.a. Evolution and current situation of biophilic construction.

3.1. Determine the Initial Research Question and Field of Review, in Two Actions
3.1.a. Question to be answered: the contribution of biophilic design to holistic well-being.
3.1.b. Field of action: healthy buildings.

3.2. Determine the Timeframe in Three Phases

3.2.a. Scope of the research: to determine the factors that influence healthy construction
in contact with nature.
International agencies are focusing on the promotion of healthy environments to
ensure the health of the population, especially in the wake of the COVID-19 pandemic [20].
The WHO’s approach to the causal model of urban green impact on health and well-being
can be seen at the local level with the design of urban environments that produce health [21].
Integral health (physical, mental and social) depends on where people develop, grow, live
and work. Therefore, the aim of the research is to identify, understand and assess the factors
that determine whether a building can be considered healthy in contact with nature.
3.2.b. Key milestones in the evolution of biophilic design
As long ago as 1850, the British nurse Florence Nightingale [22] demonstrated how
elements related to nature, such as the pleasant arrangement of space, have a physical and
psychological effect on patients’ recovery process.
Some years later, in 1898, the British urban planner Ebenezer Howard wrote the
utopian Garden City model entitled “To-morrow: A Peaceful Path to Real Reform”,
reprinted in 1902 as “Garden Cities of Tomorrow”. The Garden City is an urban con-
cept created with the “three magnets” theory, based on the outcomes of human relations,
green areas and the town [23,24]. Howard contributed a new more sustainable urban model
in the early 20th century.
The American architect Frank Lloyd Wright in 1954 created a new organic philosophy
of architecture in his book “The Natural House” and is considered a pioneer of green
architecture [25]. These principles were developed based on the relationship with nature
and the quest for indoor comfort in harmony with nature and the environment. Wright’s
construction model is recognised as the concept of bioclimatic architecture.
The healing effect of being in contact with nature was defined by Ulrich in 1984 [26] in
the recovery of patients in rooms overlooking natural environments.
In 1984, Edward Wilson developed the concept of biophilia and, together with Stephan
Kellert, enunciated the biophilia hypothesis [27]: our natural tendency towards biophilic life
is the very essence of humanity and connects us with all other species, as has subsequently
been confirmed by numerous researchers [28]. However earlier, in 1972, Erich Fromm
previously used the term biophilia to describe a passion for all living things, as a biologically
normal instinct [29].
The WHO (World Health Organization) in its Ottawa Charter in 1986 [30] at the First
International Conference on Health Promotion based its strategy on the creation of healthy
environments. These are areas where natural spaces such as gardens, parks and urban
Buildings 2024, 14, 491 5 of 15

forests can function as therapy and health prevention by facilitating contact with nature,
social relations and exercise.
According to Kaplan’s 1989 theory of attention restoration [31], mental fatigue caused
by daily activities can be restored in contact with the natural environment. Furthermore,
in agreement with Ulrich’s 1991 stress reduction theory [32], contact with green areas
produces a restorative effect by generating positive emotions, thus managing the emotions
and stress transmitted by urban environments [33,34].
Today, after a busy day, relaxed listening to the sounds of nature can improve psycho-
logical recovery by up to 37% [35].
Recovering the balance with nature by integrating it into the spaces where people live
was the aim of Ralph Rapson in 1945 [36] when he created his Greenbelt House project, the
predecessor of biophilic design, which considered nature as an active part of the space.
However, in the bibliography, Stephen Kellert is recognised as the pioneer of biophilic
design; in 1995, he integrated nature into construction, seeking to satisfy human needs and
providing an enriching multi-sensory environment in both direct and indirect experience.
He identified more than 70 ways to generate a biophilic experience [37]. Some authors
named the architect Yeang as a predecessor of biophilic building [38].
In 2012, the company Terrapin Bright Green [39] published its report entitled “The
economics of biophilia” highlighting the value of biophilic design for people’s well-being
and the construction of healthy environments. Two years later, in 2014, Terrapin Bright
Green developed 14 patterns of biophilic design to improve health and well-being in
the built environment [40], based on previous studies. Its aim is to guide and advise
on the biophilic design of buildings in order to incorporate the natural world into the
built environment based on experience. The patterns help to identify a space and create
a relationship with its natural surroundings, seeking a visual and non-visual connection
with nature, sensory stimuli associated with nature and thermal variations. The presence of
water is a key aspect, along with dynamic light, the reference to forms present in nature and
the incorporation of natural materials available in the local environment. Also important
are an open and pleasant panoramic view and a place of refuge from daily activities.
In this line, Timothey Beatley created a framework of biophilic cities and, in 2016,
published the “Handbook of Biophilic City Planning & Design” [41], oriented to biophilic
urbanism, its adaptability and resilient results.
The European Green Capital Award was created in 2010 as an initiative of 15 European
cities to recognise the good work of cities that adopt healthier and more sustainable
lifestyles. The slogan of the award is “green cities: open to life” [42]. A network of biophilic
cities has also been created, which includes a series of resources related to nature in cities,
the influence of COVID-19, and changes and advances in biophilic urban planning [43].
Nikos A. Salingaros developed the Biophilic Index B to predict the positive health
effects of a building [44]. Ten factors can be used to estimate the biophilic impact on
emotional and physiological health, although this index cannot determine the weight
of each factor. This biophilic index could be useful for building renovation. Another
instrument created by Berto and Barbiero, the Biophilic Quality Index [45], helps architects
integrate nature in design and promote restorative environments.
Biophilic urbanism is also evolving towards regenerative actions in public spaces or
abandoned buildings [46,47].
Figure 2, created by the authors, shows the evolution of biophilic design from its
earliest beginnings.
3.2.c. How does the evolution of biophilia in building justify its study?
The current perception, which has been accelerated by the COVID-19 pandemic in
relation to public-health-related difficulties, highlights the importance of the sustainability
of our planet for our own well-being. Thus, health and sustainability need common
approaches. This will mean rethinking the entire urban system in the coming years, in order
to face major challenges such as the demographic transition with the ageing population
and the epidemiological transition together with the growth of large cities, environmental
Buildings 2024, 14, 491 6 of 15

pollution and climate change. Biophilic design, which is barely three decades old since
it was started by its pioneer Stephen Kellert, is slowly taking off, driven by the current
concerns of architects, urban planners and international organisations. It may be the answer
to the need for a healthy human habitat, integrated with nature and recovering the link with
Buildings 2024, 14, 491 the natural environment. Green infrastructure must be part of a healthy human habitat. 6 of 15
Investing in nature can therefore improve our health and our cities.

Figure 2. The
Figure 2. The timeline
timeline of
of the
the evolution
evolution of
of biophilic
biophilic design.
design.

3.3. Finalise the Research Question to Reflect the Timeframe, in Two Questions
3.2.c. How does the evolution of biophilia in building justify its study?
3.3.a. How can
The current the scope which
perception, of the research
has beenchange the initial
accelerated by theresearch question?
COVID-19 pandemic in
The studies show how the design of spaces influences people’s lives. Biophilic
relation to public-health-related difficulties, highlights the importance of the sustainabil- de-
sign conceives the space as somewhere where people live and work in contact
ity of our planet for our own well-being. Thus, health and sustainability need common with na-
ture, integrating the natural world in an attractive and pleasant way and
approaches. This will mean rethinking the entire urban system in the coming years, in generating
positive
order toemotions.
face major challenges such as the demographic transition with the ageing pop-
Encouraging healthy lifestyles at all stages of life by improving healthy environments
ulation and the epidemiological transition together with the growth of large cities, envi-
will have a direct impact on people’s lives. In addition, outdoor activities in contact with
ronmental pollution and climate change. Biophilic design, which is barely three decades
nature encourage ecological behaviour [48], so that people safeguard nature and nature
old since it was started by its pioneer Stephen Kellert, is slowly taking off, driven by the
protects our health.
current concerns of architects, urban planners and international organisations. It may be
3.3.b. How does the information sought actually answer the question?
the answer to the need for a healthy human habitat, integrated with nature and recover-
A range of tools and systems show the potential benefits of biophilic environments,
ing the link with the natural environment. Green infrastructure must be part of a healthy
although more factors of biophilic quality are studied than measurable indicators [49]. A
human habitat. Investing in nature can therefore improve our health and our cities.
major gap in the bibliography is the need for an approach to consider the interconnecting
factors that affect human health.
3.3. Finalise the Research Question to Reflect the Timeframe, in Two Questions
3.3.a. How
3.4. Develop can Strategy
a Search the scope toof theRelevant
Find researchManuscripts
change the initial research question?
The studies show how the design of spaces
The methodology has been applied as an iterative influences
processpeople’s lives.the
to approach Biophilic de-
study area,
sign conceives
in two questions: the space as somewhere where people live and work in contact with na-
ture,3.4.a.
integrating
How fartheamnatural
I fromworld in anthe
knowing attractive and pleasant
current situation way
of the andofgenerating
target the study?pos-
itive emotions.
Encouraging healthy lifestyles at all stages of life by improving healthy environ-
ments will have a direct impact on people’s lives. In addition, outdoor activities in contact
with nature encourage ecological behaviour [48], so that people safeguard nature and
nature protects our health.
3.3.b. How does the information sought actually answer the question?
A range of tools and systems show the potential benefits of biophilic environments,
Buildings 2024, 14, 491 7 of 15

In the current post-COVID-19 era, new methodologies are emerging that look at
biophilic design from a holistic perspective for environmental health, sustainability and
wellness living [50].
3.4.b. Do the sources of information help to answer the question posed?
Biophilic design is becoming increasingly highly valued [51]. There is a need for
buildings that are integrated with nature [52]. New research reinforces the idea of the
positive impact of biophilic design on people’s health and well-being, a concept that is
currently evolving and developing [28]. However, there is still very little literature on
biophilic design and its impact on health. More indices such as the Salingaros Index [44],
which estimates the biophilic impact on emotional and physiological health, are needed to
understand in detail which biophilic factors influence people’s overall well-being and to
quantify the impact of each factor on the health benefits.

3.5. Analyses in Eight Phases (See Table 3)

3.5.a. Main articles consulted in the references mentioned in this manuscript and
included at the end of the article.
The main techniques applied in the bibliography are case studies (22%) and litera-
ture reviews (20%). Qualitative studies represent the majority methodology (56%), while
quantitative studies are less commonly used (14%). Surveys are the most common method-
ology in the primary studies. Table 4 shows a summary of the methodology analysed in
the bibliography.

Table 4. The methodology applied in the bibliography analysed.

Methodology % Research
Semi-structured interview 1% Qualitative
Focus groups 2% Qualitative
Scenarios 2% Qualitative
Observation 4% Qualitative
Statistical methods 4% Quantitative
Neurosciences 4% Qualitative and quantitative
Reflexivity 5% Qualitative
Surveys 10% Quantitative
Secondary studies 10% Qualitative and quantitative
Experiences and experiments 16% Qualitative and quantitative
Literature reviews 20% Qualitative
Case studies 22% Qualitative

3.5.b. Common points

The various sources cite many elements as common characteristics of a biophilic space,
including natural lighting, views of nature, vegetation in the spaces and the incorporation
of natural materials and water. Rooms with views, spaces with indoor plants and green
walls generate high levels of creativity and can reduce stress. Places that offer a view of
landscaped areas therefore have a positive impact on the value of the space. Natural light
and airy environments induce well-being and motivation.
Biophilic design is based on three fundamental aspects that can be applied at the city,
building and room level:
1. Nature in space: natural elements of the space.
2. Natural analogies: designs inspired by nature.
3. Nature in the environment: the spatial configuration of nature, open spaces.
3.5.c. Assumptions
The scientific publications that have appeared over the last forty years show the
importance of the connection to nature in our daily lives [53].
Biophilic design can help reduce stress, improve cognitive functions, increase cre-
ativity and productivity and contribute to well-being and recovery. People seek better
 3.5.c. Assumptions
The scientific publications that have appeared over the last forty years show the
Buildings 2024, 14, 491
importance of the connection to nature in our daily lives [53]. 8 of 15
Biophilic design can help reduce stress, improve cognitive functions, increase crea-
Buildings 2024, 14, 491
tivity and productivity and contribute to well-being and recovery. People seek better en-
8 of 15
Buildings 2024, 14, 491 vironmental quality, and biophilia is an essential component in contributing to good 8 ofen-15
1. Nature in space: natural elements of the space.
vironmental, air, water and soil quality and to health and well-being.
2. Natural analogies: designs inspired by nature.
Buildings 2024, 14, 491 Direct contact with natural vegetation has a stronger physiological impact than ofthe
3.environmental
Nature in the quality, and biophilia
environment: is an configuration
the spatial essential component of nature, open spaces. to8 good
in contributing 15
incorporation of artificial vegetation [54]. The use of natural materials such as wood cre-
1.environmental,
Nature air, water
in space: andelements
natural soil quality andspace.
of the to health and well-being.
ates a3.5.c.link Assumptions
with nature.
Direct
2. Natural contact
analogies:
The scientific with natural
designs
publications vegetation
inspired by
that have appeared has
nature. a stronger
over physiological
the last forty impactshow than the the
Nature is changeable, so incorporating the natural environment intoyears
the design will
1.
3.incorporation
Nature
importance inoftheartificial
space:
of theofconnection vegetation
natural
environment: elements
the [54].of
spatialThe
the use
space.of
configuration natural ofmaterials
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open as wood
spaces. creates
avoid the impact inactivity,to nature in
resulting in our
more daily lives [53].
pleasant and dynamic spaces.
2.a linkNatural
with
3.5.c. nature.
analogies:
Assumptions
Biophilic design designs inspired by nature.
According to the can help reduce
Department stress,Health
of Public improve cognitiveUniversity
at Harvard functions, [55], increase crea-
a healthy
3. Nature is changeable,
in the environment: so incorporating
the spatial the natural
configuration environment
ofthe
nature, intoyears
open the design
spaces. show will
tivityThe
building andisscientific
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characterised publications
andby that
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the following:have appeared
to well-being over
and recovery.last People
forty seek better the
en-
avoid3.5.c.
importance the impact theof
Assumptions
ofquality, inactivity,to
connection resulting
nature in our
more pleasant and dynamic spaces.
vironmental and biophilia is aninessential daily lives [53].
component in contributing to good en-
• Guaranteed
According toair the quality,
Departmentfree of of pollutants
Public and with
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Harvard level between
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a healthy
The
vironmental, scientific
Biophilic design
air, publications
water can
and help that have
soilreduce
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health and the last
cognitive forty years
functions,
well-being. show
increase the
crea-
60%.
building is characterised by the
importance
tivityDirect of the connection
and productivity
contact withand to following:
nature
contribute
natural vegetation in well-being
to ourhas daily lives
and [53].
a stronger recovery.
physiologicalPeopleimpactseek better
than en- the
•• Water quality
Guaranteed air and a good
quality, freewater purification
of pollutants and system.
with a cognitive
humidity level between 30 andcrea-60%.
Biophilic
vironmental
incorporation design
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of can biophilia
and
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vegetation stress,
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an The improve
essential use component
of natural functions,
in contributing
materials suchincrease
asto good
wood en-
cre-
•• Thermal
Water comfort.
quality and a good water purification system.
tivity and
vironmental,
ates productivity
a link with air,nature. and contribute to well-being
water and soil quality and to health and well-being. and recovery. People seek better en-
•• Natural
Thermal lighting,
comfort. the use of energy-saving light bulbs.
vironmental
Direct
Nature quality,
contact
is changeable, andnatural
with biophilia is an essential
vegetation
so incorporating has component
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the
•• Decoration
Natural inspired
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use nature.
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vironmental,
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avoid the impactair, water
of artificial and
of inactivity, soil
vegetationquality
resulting and
[54].in Theto use
more health ofbulbs.
pleasant andand
natural well-being.
materials
dynamic spaces. such as wood cre-
•• Insulation
Decoration ofinspired
rooms from noise pollution and humidity.
by nature.
ates Direct
aAccording contact
link with nature.
to the with natural
Department vegetation
of Publichas Healtha stronger
at Harvard physiological
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healthy the
•• Building
Insulation security.
of rooms from noise pollution and humidity.
incorporation
Nature is of artificial
changeable,
building is characterised by the following: vegetation
so [54].
incorporating The the use of
natural natural materials
environment such
into the as wood
design cre-
will
•• Proper
Building cleaning to protect rooms from dust, dirt and pests.
•ates
avoid withsecurity.
aGuaranteed
link
the impact nature.
of inactivity,
air quality, resulting
free in moreand
of pollutants pleasant
with aand dynamic
humidity spaces.
level between 30 and
•• The
Properuse of noble
cleaning materials
to protect such
rooms asfrom
wood, dust, corkdirtand andstone.
pests.
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According
60%. is changeable,
to the so
Department incorporating
of Public the
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Harvard Universityinto the
[55],design
a healthy will
• The A recent
use study
of noble shows that
materials natural
such green
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cork on
and stone. building fronts also increases
avoid
building
•citizens’ the
Water impact
is of
characterised
quality and inactivity,
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a good water purification system. pleasant and dynamic spaces.
well-being
A recent study [56].
shows that
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3.5.d.
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at Harvard building
humidity fronts
University
level also aincreases
[55],
between healthy
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citizens’
building well-being
is characterised [56]. by the following:
• 60%.
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Patterns lighting,
of biophilic the use of energy-saving light bulbs.
design are evolving as new studies and research are incorpo-
3.5.d. Main gaps
•rated.Water
Guaranteed
quality
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inspired quality,
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water
by nature. purification andsystem.
with a humidity level between 30 and
Patterns of biophilic design are evolving as new studies and research are incorporated.
• 60%.
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Insulation
While comfort.
of rooms from noise pollution and humidity.
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there is is aa large
large bodybody of of literature
literature on on thethe impact
impact of of green
green infrastructure
infrastructure on on
•human Water
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Building quality
lighting,
security. and a
the good
use water
of purification
energy-saving system.
light bulbs.
human well-being,
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zones such such as as lakes,
lakes, rivers,
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lagoons and and coastal
coastal zones
zones havehave beenbeen
•less studied.
Thermal
Decoration comfort.
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to protect rooms from dust, dirt and pests.
less studied. This This alsoalso affects
affects biophilic
biophilic designs.
designs.
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of of
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from
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cork bulbs.
humidity.
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integration of of aa building
building in in the natural
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environment, an an in-depth
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•mustDecoration
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carried inspired
security.
study
out shows
of the by nature.
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local climate, green
flora decoration
and fauna. on building fronts also increases
must be carried out of the local climate, flora and fauna.
•citizens’
Insulation
Proper
well-being
Sustainability of rooms
cleaning [56].
involves from
to protect noise
rooms
recovering pollution
from anddirt
dust,
thismanagement
management humidity.
and pests.
Sustainability involves recovering this ofofnatural
natural conditioning
conditioning factors
factors so
•so that Building
The
3.5.d.use
Main security.
of noble
gaps materials such as wood, cork and stone.
that thethe biophysical
biophysical matrix
matrix onceonceagainagain becomes
becomes thethe preferred
preferred source
source of local
of local resources
resources for
for• building,
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of biophilic
taking to protect
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areuse from
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as and
new and onpests.
studies building
and fronts also
research are increases
incorpo-
building, taking intointo account
account the the
use of of space
space and individuals’
individuals’ behaviour.
behaviour.
•citizens’
Thewell-being
rated.3.5.e. use of noble
Contradictions materials
[56]. such as wood, cork and stone.
Contradictions
A
Forrecent
3.5.d.
While Main
some study
there is shows
gaps a largethat
researchers, body natural
nature’s green decoration
ofinfluence
literature on onpeople
the impacton building
is of green fronts also increases
infrastructure on
nature’s influence on people is nothing
nothing more than a statement
of citizens’
human well-being
anPatterns
well-being,
innate affinity [56].
of biophilic
blue design
that zones
has beensuchare asevolving
known lakes, as new
rivers,
for centuries. studies
lagoons and and research
coastal zones arehave
incorpo-
been
rated. 3.5.d.Applications
less studied.
3.5.f. MainThisgaps
Applicationsalso affects biophilic designs.
Patterns
While
For a good
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is astudy
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consulted
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the benefits
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of thezones
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design in such as
climate,
design lakes,
flora rivers,
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fauna.
in the construction
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eachare
space coastal
space zones have
are as follows:
as follows: been
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less studied. This is
Sustainability also a large
affectsbody
involves of literature
biophilic
recovering designs. on the impact
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into affects
the local
account biophilic
climate,
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flora
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evidence of correspondence
evidence correspondencebetween betweenbiophilicbiophilic office
officedesign
designandand employee
employee health [58].
health
For a Contradictions
good integration
Sustainability
3.5.e. involves of a building
recovering in management
this the natural environment, an in-depthfactors
of natural conditioning study
According to the Human Spaces report [59], workers
[58]. According to the Human Spaces report [59], workers in offices with natural in offices with natural elements
must
so thatbethe
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researchers, local
matrix climate,
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report
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report higher
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higher arepeople
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creative. This through
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landscaped areas,
so that theApplications
3.5.e.
3.5.f. biophysical matrix once again becomes the preferred source of local resources
Contradictions
the use
outdoor of natural
views, thematerials
use of natural and outdoor
materials spaces. According
and outdoor to a 2018
spaces. study to
According byaCBRE 2018
for building,
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[60],nature’s
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innate affinity
benefits
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more been known
design
energised, 78% for
in the centuries.
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happier and 65%ofhealthier.
each space are as follows:
 For 3.5.f.some
Hotels: researchers,
Applications
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Guests would nature’s
increases,
pay 23% influence
more forona people
productivity increases
room with is nothing
by 8%, more
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perceive
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is
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biophilic design of biophilic
attributes design
in their in the construction
accommodations
evidence of correspondence between biophilic office design and employee health of
[61].each space are as follows:
 Offices: According
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[58]. to a study
Creativity
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increases, Oliver
improve
Human Hearth
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concentration
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ADHD
natural re-
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(attention deficit
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and biophilic
ahyperactivity
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higher level in
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and increase
to well-being,
illness is reduced of each
are student
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learning
1.6% are as follows:
by 20–25%.
each year.
productive There
and are is
 Offices:
evidence
15% moreCreativity
Hospitals: With
ofcreative. increases,
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correspondence productivity
between
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naturalby 8%, iswell-being
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health
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crease
[58]. indoor
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outdoor andplants
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Human
of reduce
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due
Spaces andand
to illness
report
materials increase
is[59], painspaces.
reduced
workers
outdoor tolerance
by 1.6% [51].year.
each
in offices
According Theto
with positive
There is
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a 2018
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elements biophilic
of design
correspondence
a 15% patterns
higher levelinof
between healthcare
biophilic
well-being, spaces
are has
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design
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and showing
employee
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health
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directmore
[58].
15% experience
According toofthe
creative. nature isisachieved
Human
This more effective
Spaces report
throughthan simulated
[59], workers
natural natural analogues
in offices
lighting, [62].
with natural
landscaped areas,
elements reportthe
outdoor views, a 15% higher
use of naturallevel of well-being,
materials and outdoorare 6% more According
spaces. productivetoand are
a 2018
15% more creative. This is achieved through natural lighting, landscaped areas,
outdoor views, the use of natural materials and outdoor spaces. According to a 2018
 For a good
for building, integration
taking of a building
into account the use ofinspace
the natural environment,
and individuals’ an in-depth study
behaviour.
must3.5.e.
be carried out of
Contradictions the local climate, flora and fauna.
Sustainability
For involvesnature’s
some researchers, recovering this management
influence on people is of natural
nothing conditioning
more factors
than a statement
so an
of thatinnate
the biophysical
affinity thatmatrix onceknown
has been again for
becomes the preferred source of local resources
centuries.
Buildings 2024, 14, 491 for building, taking into account the use of space and individuals’ behaviour.
3.5.f. Applications 9 of 15
3.5.e. Contradictions
According to a study by Oliver Hearth [57] and other works consulted in this re-
Forthe
search, some researchers,
benefits nature’s
of biophilic influence
design on people is of
in the construction nothing more are
each space thanasafollows:
statement
of
 anOffices:
innate affinity
Shopping: that increases,
Creativity
Integratinghas nature
been known
into newfor urban
productivity centuries.
increases by 8%,
areas makes well-being
retail values
spaces more in-
attrac-
3.5.f.
crease Applications
tive [63]. Shoppers
by 13%, in shops on green
and absenteeism due tostreets
illnesscould spendby
is reduced 25% more
1.6% eachand would
year. There payis
According
between 8%
evidence oftocorrespondence
a study
and by Oliver
12% more for Hearth
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and
biophilicandoffice
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shops and
have natural
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[58]. benefits
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biophilic
increase design
by Human
the 40% more. in the report
Spaces construction of each space
[59], workers are as
in offices follows:
with natural
 Offices:
Housing:Creativity
elements report increases,
Green aspaces
15% higher productivity
contribute
leveltoof increases
anwell-being,
area’s areby
6%8%,
tranquillity by well-being
lowering
more values
crime
productive in-
ratesare
and by
8%.
creaseHouse
by values
13%, and could rise
absenteeism by 4%
due to
to 5%, with
illness is some
reducedsources
by estimating
1.6%
15% more creative. This is achieved through natural lighting, landscaped areas, each this
year. figure
There is
to be as views,
evidence
outdoor high asthe
20%.
useInofaddition,
of correspondence homebuyers
between
natural and would
biophilic
materials pay 7%and
office design
outdoor spaces. more for homes
employee
According with
to health
a 2018
excellent
[58]. landscaping,
According 58% more
to the Human for those
Spaces reportfacing
[59], water
workersandin127% more
offices withfor those
natural
facing thereport
elements sea. a 15% higher level of well-being, are 6% more productive and are
15%
The benefitscreative.
more This may
of the design is achieved through
be different natural
depending onlighting,
the final landscaped areas,
green construction
outdoor
options [64]. views, the use of natural materials and outdoor spaces. According to a 2018
3.5.g. Current reference models
The need for international standards to guide and recognise biophilic reference de-
signs has led to the creation of two international reference standards: the WELL Building
Standard [65] and the Living Building Challenge [66]. Both standards aim to promote the
well-being and health of people in the built environment.
• The WELL Building Standard integrates natural patterns inside and outside a building
with an appropriate narrative. The WELL certification links building knowledge
with research into people’s health in a perfect marriage focused on holistic well-
being. The aspects considered by the WELL label are as follows: indoor air quality,
water quality, distribution and control, fruit and vegetable growing areas for healthy
eating, optimal lighting for good health, the promotion of physical activity, thermal
comfort and personalised climate control. In addition, the WELL standard seeks the
acoustic comfort of its inhabitants and their cognitive and emotional well-being and
the restriction of toxic and hazardous materials; it promotes healthy spaces that favour
the social interaction of the community.
• The Living Building Challenge is the father of living building, incorporating nature
into the environmental characteristics of construction. It promotes sustainable building
standards with the least impact on the surrounding natural ecosystems, with special
attention to the energy efficiency of buildings and the natural materials used, and
facilitates healthy lifestyles.
A concept associated with sustainable building is the TOD standard (Transit-Oriented
Development) [67] for sustainable cities, which aims to create safe, balanced and vibrant
cities. The eight basic principles of TOD design are walkable neighbourhoods, favouring
non-motorised transport, connecting street networks, high-quality public transport, mixed
land uses, optimising public transport diversity and capacity, compact regions with short
trips and increasing mobility with the use of regulated parking.
Recently, in 2022, nine groups of experts brought together by the organisations CGATE
(Consejo General de la Arquitectura Técnica de España), GBCe (Green Building Council
Spain) and AEICE (Clúster de Hábitat Eficiente) carried out work to contribute their vision
of what a healthy building should be. In Chapter 9 of the book “Buildings and health” [68],
reinventing the habitat with people’s health in mind, they state the following:
“The environment affects people’s brains, emotions and cognitive capacities.... In cities,
issues such as safety, accessibility and the proliferation of green spaces help to encourage
healthy habits in the population... Everything related to the built environment also affects
physical health and well-being. Ensuring thermal comfort, ergonomics, water quality and
enjoyment of sunshine and views impacts on both quality of life and life expectancy”.
Biophilic design is explicitly mentioned in hospital construction.
The Green Building Council Spain (GBCe) has published the first assessment guide,
GREEN Buildings 2022, which includes the Connecting with Nature indicators [69]:
• Biophilia-enhancing landscaping.
• Visual contact with plant elements.
• Nature in the building.
Buildings 2024, 14, 491 10 of 15

• Dog-friendly spaces.
In 2023, Madrid Salud published a guide to performance, housing, home and health [70],
incorporating biophilic indoor design with its benefits and recommendations.
3.5.h. Future research lines
As we become more aware of the importance of biophilic design for people’s health
and the positive impact of these spaces, the perception of space is changing towards a
construction that goes beyond energy efficiency and domotics towards healthy environ-
ments integrated with living nature. The data provided by the different studies agree on
the benefits they offer, although the quantification of the figures varies considerably from
one report to another. Rigorous studies are needed to be able to objectively assess the
improvements in productivity and welfare offered by biophilic designs. Reliable indicators
should be designed for the construction and renovation of buildings with healthy criteria.
Biophilia is multi-scale and offers a wide variety of solutions; tools will be needed to
calculate the real return on investment. We need to improve built spaces by knowing the
local natural environments, identifying the negative aspects that affect our overall health
and creating new designs that integrate them into the natural environment and bring us
well-being.
Table 5 shows a summary of the analyses with the relevant aspects created by the authors.

3.6. Interpretation of the Results

While sustainable buildings in the early 2000s were primarily focused on energy
efficiency, today the concept has evolved to include people’s well-being and the creation of
healthy buildings. In recent years there has been a trend in architecture and public health
to improve living spaces [18,71].
The COVID-19 pandemic has generated considerable interest in healthy biophilic
spaces, suggesting a growing awareness of the need to live in spaces that are in contact
with nature. Nevertheless, some studies have identified weaknesses and threats, such as
biophobia, including negative emotions towards nature, feelings of boredom, socio-political
influences and increased costs [17,72].
The design of healthy buildings includes comfort, energy efficiency and environmental
impact; aesthetics and health are also part of the design process. They therefore seek to
improve indoor air quality, thermal comfort, natural and artificial lighting adjusted to
circadian rhythms, noise damping, natural views and biophilic design.
It should be noted that the lack of indicators for quantifying the direct and indirect
benefits of these spaces makes it difficult to demonstrate their outcomes. However, it has
been possible to identify the main factors of a healthy biophilic space, and it is also possible
to evaluate the quantitative impact of several biophilic factors on people’s well-being.
This current situation presents an opportunity to integrate and coordinate preventive
and therapeutic health efforts in the building field with all the stakeholders involved.

Table 5. Summary of the analyses.

3.5.a. Main articles consulted in the references

Biophilic design is based on three fundamental aspects:
1. Nature in space: natural elements of space.
3.5.b. Common points
2. Natural analogies: designs inspired by nature.
3. Nature in the environment: the spatial configuration of nature, open spaces.
Biophilic design can help reduce stress, improve cognitive functions, increase creativity and
3.5.c. Assumptions
productivity and contribute to well-being and recovery.
A good integration of the building in the natural environment requires the following:
3.5.d. Main gaps An in-depth study of the local climate, flora and fauna.
A biophysical matrix for the use of space and individuals’ behaviour.
 13% well-being
 concentration
Buildings 2024, 14, 491 ADHD
 (attention
1.6% yearly deficit hyperactivity
absenteeism due to illness disorder) 11 of 15

 ADHD
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well-being
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learningwith natural elements disorder)
>15%
 20% learning
1.6%
HOSPITALS yearly absenteeism due to illness
76% of employees feel + energies
HOSPITALS>15%
 22% creative
use of and with
analgesics natural with elements
natural areas nearby
Buildings 2024, 14, 491 78% happier 65% healthier 11 of 15

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22% well-being
use of analgesics with natural areas nearby
Buildings 2024, 14, 491 Hotels76% of employees feel + energies
SHOPPING
11 of 15
SHOPPING 1.6%
78% yearly
happier absenteeism due to illness
Integrating
Would + and
pay nature 23%65% makes
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retail
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view
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Buildings 2024, 14, 491 Schools 
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4%
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learning
house
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values green spaces 11 of 15
22%
 13% usewell-being
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
78%

 1.6% yearly
happier
concentration
4% house absenteeism
values 65% due
healthier to illness
HOSPITALS
SHOPPING 58%13%
1.6% well-being
moreyearlyvalue for areas near
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3.5.g. Current reference models WELL HOSPITALS
Living Building
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
78%
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spaces. According
Biophilic design is incorporated into the concept of sustainable and healthy new
construction and housing renovation, which is the way of life in the near future.
The study examines the applications of biophilic design and its potential benefits, such
as reducing stress, improving cognitive function, increasing creativity and productivity
and contributing to well-being and recovery.
There are as yet scarce data and very few studies that evaluate the quantitative impact
of biophilic design on well-being. The previous research is more of a scientific discussion
of the hypothetic and intuitive effects.
Further research will be needed to measure the positive effects of implementing bio-
philic design using multidimensional expertise in a cost-effective way. This will contribute
to monitoring and understanding the progress of healthy spaces for people.
New lines for future studies are needed to provide real evidence of the effects of bio-
philic design on holistic well-being and quality of life. One recommendation for transparent
and verifiable evidence would be to develop a standard biophilic design taxonomy by
levels and sectors and a unique common vocabulary.
Finally, this study compiles the current relevant bibliography and sources in the SotA
biophilic design and innovation methodology, suitable for exploring emerging new topics.
After COVID-19, the biophilic design of healthy and sustainable spaces has only
just begun.

Author Contributions: Conceptualisation, N.B.-A.; methodology, N.B.-A.; validation, E.A.-T.; formal

analysis, N.B.-A.; investigation, N.B.-A.; resources, E.A.-T.; writing—original draft preparation,
N.B.-A.; writing—review and editing, N.B.-A.; supervision, E.A.-T. All authors have read and agreed
to the published version of the manuscript.
Funding: This research received no external funding.
Conflicts of Interest: The authors declare no conflicts of interest.
Buildings 2024, 14, 491 13 of 15

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