Building Back Healthier: How Disease and Design Intertwine

At Le Corbusier’s Villa Savoye (l.) just outside of Paris a seemingly misplaced sink may be a precursor to the handwashing society is now obsessed with. And when you consider the evolution of “healthy” buildings, doesn’t it speak to the utility and beauty of today’s Vaask hand sanitizer?

Building Back Healthier: How Disease and Design Intertwine

If you pay a visit to the Villa Savoye, Le Corbusier’s Modernist masterpiece on the outskirts of Paris, you might be surprised to see, just inside the entrance, a fairly standard pedestal sink. It stands out not only because of its round shape, in contrast to the villa’s straight lines, but because it is surrounded by open space. It’s not hidden away within the walls of a “water closet” or powder room. If you are also familiar with Marcel Duchamps’ porcelain “Urinal,” which had made a splash in the art world a decade before the villa was built, you might guess the sink is also intended as an artistic statement, since there is neither soap nor a towel in sight.

It’s been suggested that the sink is equivalent to a font for holy water—Le Corbusier wanted everyone to cleanse themselves in mind and spirit before venturing further. It has also been interpreted as a monument to health-conscious design and the miracle of indoor plumbing. (Le Corbusier had two bathrooms in his Paris apartment at a time when most Parisians had none.)

No matter what the architect was thinking, the sink reminds everyone who enters of the importance of clean hands. Now, as a new generation of designers considers ways to make buildings healthier, this idea from 100 years ago suddenly seems modern again.

Out from the Dark Ages

Architects of the 1920s and ‘30s were well-known for their focus on creating healthy, hygienic spaces for people to live and work together. But building healthier environments has always been the goal of designers, and the most notable efforts have always come after periods of widespread illness. The cliché in design is “form follows function,” but it’s an alliterative adage that many in the field would debate. “Design follows disease” isn’t nearly as catchy, but it is incontrovertible.

Throughout history, practitioners of architecture and urban design have responded to widespread illness and taken steps to try to mitigate it, even when they had little, if any, understanding of its causes. In the 14th century, the source of the bubonic plague that killed 40 percent of Europe’s population was still centuries away from being identified, but people recognized that contact with infected individuals somehow increased transmission, and that crowded towns and cities represented the biggest risk. It was then that the idea of quarantining first gained hold, with ships forced to wait 40 days before unloading crew and cargo—the word quarantine comes from the Latin word quadraginta, meaning 40 days. And in cities, anyone who had the means fled to the countryside, just as they did during Covid.

The plague returned to London in the 1660s, followed almost immediately by a fire that consumed much of the city. When it was rebuilt, streets were wider, open sewers were done away with, and new regulations ensured that buildings were safer, with better air circulation. More changes followed in the 19th century, after repeated cholera epidemics swept through large cities across the globe.

In London, evidence finally convinced the public that the disease came not from “bad air,” or miasma, but from contaminated water, and a vast sewer system was constructed. In Paris, a huge public works program transformed the city and added vast new parks for recreation. And in New York, the notion that city dwellers needed both space to breathe and exposure to nature was at the center of Frederick Law Olmsted’s design for Central Park. Olmsted, a sanitary officer during the Civil War, said the park would become “the lungs of the city.”

In the 1890s came the realization that exposure to sunlight vastly improved the outcomes of tuberculosis patients, and it would have a huge impact on design in the decades to come.

Building in Hygiene

In terms of design, the first half of the 20th century was in many ways the era of fresh air and sunshine. (Only toward the end did it become the era of fresh air and sunscreen.) The public by then understood the two’s importance, first as a treatment for tuberculosis, and by extension, health in general. After the flu pandemic of 1918, which killed as many as 50 million worldwide, the modern movement in architecture took off, driven by the desire to create healthy spaces while taking advantage of advances in engineering and new construction materials. Buildings incorporated large windows and terraces for sunning. White tile became a popular surface on interior walls as it was easy to clean and reflected the sunshine. Closets were promoted as healthier places to store clothes than pieces of heavy furniture, and powder rooms were considered a must.

Besides the Villa Savoye, iconic buildings from that time include the Health House, built in 1929 for a Los Angeles doctor. It was a showcase of clean lines and plate-glass windows, and it included sleeping porches and an outdoor dining area. At the same time in Finland, architect Alvar Aalto designed the Paimio sanatorium and rehabilitation center. “The main purpose of the building is to function as a medical instrument,” he said. Every room featured floor-to-ceiling windows, and an expansive rooftop terrace allowed patients to spend hours outside each day.

What’s Here and What’s Ahead

What changes will result from the latest pandemic? Certainly we can expect more automation, such as hands-free doors and controls, in public spaces and workplaces, as well as improvements to HVAC and other systems. Maybe we’ll actually see the return of windows that open and close in schools and offices. It remains to be seen whether people’s experience working from home has doomed the “open concept” so common in contemporary houses—or whether the days of the open office are numbered. It’s likely, though, that more flexibility—and soundproofing—will be built in. Maybe there’ll even be a return to pocket doors.

Last century’s modernists were all about fresh air and sunshine; this century could well be when touchless technology takes over. Restaurant menus are already becoming a thing of the past. Soon, the idea of pushing a button on an elevator, or turning on a faucet with your hand will seem as out of date as rabbit ears on a black-and-white TV.

And while a pedestal sink is unlikely to appear inside the entrance to public buildings, we can expect to see more built-in touch-free hand-sanitizing stations like those developed by the designers at Vaask, because the message communicated by the sink in the modernist Villa Savoye has never been more timely. All it needed was a few tweaks to the form and functionality to make it the perfect solution for these modern times.