Center for Active Design’s Joanna Frank Talks Healthy Buildings and Return to Office

Healthy buildings are no passing fad, as Joanna Frank, president and CEO of CfAD, can tell you.


Joanna Frank, president and CEO of the Center for Active Design (CfAD), has never worked harder.

Her nonprofit, dedicated to making buildings healthier, was launched at the end of the Bloomberg administration, almost a decade ago. Partnering with the Centers for Disease Control and Prevention (CDC), CfAD translates public health research into practical design and operational strategies for real estate owners, so they can ensure that their properties are designed and optimized for the health of occupants.

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Money talks in this industry, and there once was a time when she had to pitch the link between healthy buildings and increased return on investment — and pitch it hard.

Then came COVID-19.

The effect that health risks within a building can have on the financial side of the equation are now inarguable and plain to see.

Joanna Frank
Joanna Frank.

As the pandemic rolled in, CfAD was inundated with requests for help, and it quickly assembled a team of academic advisers who were experts in infectious diseases, as well as experts in the mental health and behavioral challenges that come with a pandemic. In addition to Fitwel — CfAD’s healthy building certification system — it launched its Fitwel Viral Response Module, which provides annual, third-party certification of policies and practices informed by the latest research on combating infectious diseases within buildings.

Fitwel registrations in the fourth quarter of 2020 increased by 644 percent over the fourth quarter of 2019. (Yes, you read that right.)

Along the way, Frank’s team partnered with top real estate owners — including BentallGreenOak, Boston Properties (BXP), Brookfield (BN) Properties, Hudson Pacific Properties and Nuveen Real Estate — to make their buildings healthier and safer for an eventual return to the office.

Commercial Observer: Which career were you interested in pursuing as a kid?

Joanna Frank: I loved physical construction. My parents were always doing stuff to the house and I used to love getting involved. The contractors would have their plumb lines and mortars, and what have you, and I’d be fascinated. I loved Lego, and I guess I thought of construction as Lego on a larger scale.

But your folks weren’t in the construction field?

No, just for home renovation purposes. My dad’s a physicist and he can’t even put up a shelf [laughs]. He was actually head of blades at Gillette. Gillette’s research and development is based in London, and their headquarters are in Boston, so we were going back and forth between the two cities at the time.

I remember the tag line, “Gillette: The best a man can get.”

[Laughs] Yes. At one point, 70 percent of the world’s men shaved with a product that was developed under my father’s watch. “Dr. Blade” was his nickname.

What did he think of your passion for building?

Both my parents would have preferred me to be a doctor. I went to a school for young ladies, and took the A-levels I needed to study medicine, but I persuaded my parents to allow me to do one year at art school first. In the U.K., you begin to study medicine at 18, so rather than starting at that young age, I said, ‘Let me just do a year of art.’ So, I did that year, and then, of course, I never went back. I went on to study architecture at The Glasgow School of Art [in Glasgow, Scotland].

How did you end up working in the U.S.?

Because of a boy — my husband of 25 years now. He was an exchange student from the U.S. in the architecture program. So, I followed him back to the States, and I started working for an architect in Manhattan. We were doing small projects, like re-doing Bloomingdale’s retail spaces.

I was an architect for a few years, and then started the first of my own companies, which was doing design/build work. We were designing and building summer houses for folks out in the Hamptons. It was the first tech bubble, and we definitely rode that wave. Our clients were in New York, so I would go back and forth, out to the construction sites, and work with contractors. I enjoyed that, but then I had the first of my children, so it wasn’t possible to go back and forth.

Once my son was a few months old, I started working for Tribeach Holdings as an owner’s rep — in Tribeca, where they were doing a number of renovations. We renovated a warehouse on North Moore Street into beautiful condos and sold one to Christy Turlington. The developers were Irish, and not in the country all the time, but I was on-site every day, overseeing the contractor. One of my bosses, Jimmy Mooney, actually became my guarantor for the first real estate development deal that I did.

How was that experience?

It was good. This was back in the mid-oughts, before the financial crisis. I had co-founded a development business called Bright City Development with a partner, and we were actually the first all-women team to get financed by HSBC in New York at the time. We were building to the highest sustainability standards. LEED was new back then, but we had a green roof and great indoor air quality, as it was all really interesting and important to us. So, we were busy building mixed-use residential projects and then the financial crisis hit.

We were really fortunate, because we only had three apartments left in the building that were on the market at the time, and they only represented the gravy in the deal — just the profit. So, we had already cleared all our underlying debts, everyone was made whole at that point, and we were able to sell those last apartments. Of course, everyone predicted [the crisis] would only last 18 months, but it went on for a long time. We were doing what we could to stay afloat, but then the offer of working for the Bloomberg administration came about.

In my own time, I was doing a lot of work around food systems, and bringing food system professionals together with building professionals. Those two areas of folks don’t really collaborate, but my husband was really involved with the Hungry City and Hungry New York [programs], which were part of a larger movement of time.

So, I was offered the job of running the FRESH [Food Retail Expansion to Support Health] program under the Bloomberg administration [a multi–agency citywide program to increase food access to underserved communities]. We were working with the grocery industry to understand what their profit margin was and what their motivation was, so that we could demonstrate that a project would be viable if they got a certain amount of financial assistance from the city. So I was putting those deals together and we did 12 grocery stores in 15 months.

How did healthy buildings eventually become your focus within the Bloomberg administration?

The FRESH program was part of a larger question around how you ensure that all aspects of New York City were optimized for alleviating chronic disease. During the Bloomberg administration, Linda Gibbs [former deputy mayor for Health and Human Services for New York City] was focusing on the data, and the fact that 75 percent of the population die of chronic disease in a typical year. Now, obviously, that was different last year, but typically that’s the case.

So, we were looking at the causes of chronic disease and how your built environment has a massive impact on those causes. How do you use what you have as a city — which is a built environment — to create a place that’s optimized for the health of the population? That thinking was cultivated during the Bloomberg administration and it all came together as Active Design, which is the program I ran after the FRESH program.

Active Design was launched in 2013. Did the post-GFC recession place a sharper focus on healthy built environments?

Chronic disease has a massive financial impact as well as the health impact, and Michael Bloomberg was looking to position New York City as a world-class city — it was really more about attracting and retaining business and talent to New York City. It was a question of, ‘How do we use the assets of the city to create an environment where people will thrive?’ This was attraction and retention of talent at a global scale, so that New York City could compete on a quality-of-life basis with Paris and London. And it was very successful.

I came into the Active Design program right at the point where the city had put together a set of guidelines. Tom Frieden was the head of the Health Department at the time — and then he moved on to the CDC — and David Burney was the head of the design and construction agency.

Tom and David started looking at how they could have some shared goals and shared metrics of success. Usually, the construction agency is measured [by] ‘on time and on budget,’ but they added a few other metrics in there that were looking at how to measure having a healthier environment. There was a lot of data showing that health outcomes and financial outcomes are intrinsically linked.

I assume that link was a little harder to sell, pre-COVID?

Yes. 10 years ago, Michael Bloomberg launched the Center for Active Design and the press covered it. There were New York Post articles, talking about a nanny state, so, ‘Don’t tell me to take the stairs,’ etc. It was at the same time the smoking ban happened, along with calorie labeling and the attempt to ban very large sodas. So, there was a general pushback, with no demand coming from investors in real estate, and no demand coming from people [laughs].

That must have been frustrating, knowing you’re doing something that has good intentions but receiving no takers.

David and I talked about it a lot, but we could look at the precedent New York City had already set in addressing infectious disease — 100 years prior to us starting Active Design — by using all aspects of its built environment. To combat infectious disease at the end of the 1800s, New York created a sanitation department. It created the subway system to alleviate overcrowding, because that was leading to all sorts of infectious diseases: typhoid, yellow fever, tuberculosis. It created the park system — and it was specifically, at the time, called the “working man’s lung.” The park system was created to alleviate infectious disease, although they didn’t really understand disease theory and got some of the diseases wrong, but the overall intention was good.

So, we were looking at this movement of 100 years previously, and how effective it had been. The mortality rate for infectious diseases was in the mid-50 percentage at the beginning of all of this, and it went down to 11 percent, and that was before the widespread use of antibiotics. So, we looked at that precedent, and we were like, ‘We can do this.’ But we wanted complete market transformation — we weren’t interested in having one or two fancy, healthy buildings.

Pre-COVID, how was the demand for healthy buildings?

This pandemic is life-changing for everybody, and has had a huge impact on the industry.  I think, pre-COVID, building owners were aware of the fact that health was part of what they were doing, because we’ve been around long enough that an understanding was beginning to solidify. Tenants and their employees were demanding healthy environments of their building owners, and the millennial generation was absolutely demanding it of their employers.

One of the big reasons we were seeing an uptick in Fitwel registrations pre-COVID was because employers were learning that, in order to attract and retain talent, they had to provide spaces that were overtly health-promoting and [were] being forced to think about this beyond just an ergonomic chair.

How would you describe the evolution of getting building owners onboard the healthy building train?

During the first five years, we were training architects and developers, and working to solidify the return on investment argument. But it was all case studies and individual projects. The reason that our work started expanding is because the evidence base around how the built environment was impacting health was increasing and broadening to look at all aspects of health, and we were constantly translating it for the real estate industry.

By the time we launched Fitwel four years ago, we were able to package a massive evidence base — we have more than 5,600 peer-reviewed research studies — and put it through an algorithm to create a really tangible, actionable set of strategies for each building. It’s quite sophisticated. Being able to handle that amount of data and bring it together was the turning point for the industry, because it was packaged in a way that was really actionable and very easy to apply. And, you didn’t have to have a Ph.D. in public health in order to understand and navigate it, and see the value.

Creating a standard in Fitwel, and using it to define what a healthy building is, was crucial, because until you’ve defined what a healthy building is, you can’t start to say, ‘My building is healthier than your building,’ or, ‘We are the leading company when it comes to this aspect of health.’ So, you have to define a clear standard first, and that’s what a certification is — a standard with verified data. It isn’t about giving out plaques, as far as we’re concerned; it’s about having a standard that people can meet.

What went through your mind when you first heard a pandemic was headed our way?

We work globally, and we already have a lot of partners in Asia-Pacific, generally. So, we had a heads-up that it was coming.  But, we were aware of SARS, too, and that never really materialized. We had a best-in-building health event this time last year — which is where we celebrate the highest achievements of the previous year — in San Francisco. While we were there, the city declared a state of emergency and started to shut stuff down. And that was the ‘Uh oh, this is a big deal’ moment. 

Then, we started hearing from the industry, just so loudly. People were getting bombarded with information around new products. So, ‘You need to have a fever-screening device and put it at the entrance of every one of your buildings. You need to have this purification system. You need to have … ’ Tenants were also demanding everything and playing landlords off each other, saying, ‘Well, I can get this with this building owner,’ because nobody was setting a standard. 

I guess, at that time, research around COVID-19 was still evolving and nobody was completely sure how it was being transmitted.

Right, and because of the demand, owners were coming to us saying, ‘We need you, we trust you, and you’re the people we go to when we have questions about health. So, you need to help us.’ At first, we pushed back and said: ‘Look, our team aren’t experts in infectious disease. Infectious disease is a subset of public health, and it’s not our particular area of expertise.’ But they were just like, ‘Yeah, whatever.’ [Laughs]

So, we put together an advisory committee of world experts on infectious disease and the behavior around how to both mitigate infectious disease and the mental health consequences of a pandemic — because 40 percent of people who’d been in the areas of SARS were reporting [post-traumatic stress disorder] after SARS. We looked at all respiratory infectious diseases — not just COVID-19 — and we were able to chart a pretty steady course, because we also broadened the evidence base to all flu research, SARS research and the research on other coronaviruses.

How helpful was it to look at previous pandemics?

It was essential. Especially at the beginning. By looking at other respiratory diseases that were similar in their form, you could start to come up with sensible, practical solutions. The mental health piece is the mental health piece; we didn’t need to see the outcome of COVID-19 and these lockdowns to have been able to predict mental health issues around it, the fear and anxiety.

Then, there’s a really substantial public health evidence base around how to communicate to restore trust. To the building industry, the trust piece always feels like magic — how can you measure trust?

Because if a building owner is executing all of these strategies around the physical environment, we can’t see them as individuals, right? We don’t know you upgraded your filtration system, and we don’t know how many air changes you have an hour. We have to trust you. So, you have to communicate that, and there are ways to communicate it that are evidence-based that will build more trust.

What is the most common call you’re getting today?

Questions about scale. Up until COVID, it was about the return on investment argument. Now, everybody needs a healthy building and they need it now. Everyone with a property needs to be able to demonstrate that they are addressing the health needs of their tenants — they need to do that for their investors, and they need to do that for their occupants. So, we’ve gone from, ‘I’ll do a little bit, I’m going to test the water,’ to suddenly whole portfolios. Rapid scaling is the moment that we find ourselves in. Hence that Q4 growth.

You work with a lot of the top owners. How have they adapted to the new health standards?

I’ve been amazed at how agile the industry has been. Folks have completely redone their policies and reprioritized staffing in addressing how to mitigate infectious disease. And they’ve changed so much so quickly. The industry has really met the moment. The fear is that if you don’t respond, that you’re going to have difficulty competing for tenants in [the] future. So, there’s real motivation around responding. We had an advisory committee, the Scientific Advisory Committee, providing research and guidance, and the CDC is our research adviser as well.

And, then, on the other hand, we had our industry advisers. There was an incredible amount of collegial behavior, and sharing of information was happening from the industry, and the big folks that we are working with were sharing their plans — which isn’t always the way that the industry works. But, there was a lot of support around how we addressed this pandemic as an industry. It was really impressive to me. We were getting as much input from the industry about what was needed as we were from the scientific community. From our perspective, the industry has embraced big changes within months that normally take 10 years to complete.

The whole of last year was unexpected, but anything that threw you for a loop?

I think the remote working aspect has been really interesting for me, as someone who runs a company. That’s been the big lesson, in terms of how to run a business and further grow a business that’s already growing rapidly. I like learning, and this is a real learning process for everybody. But, if I thought I worked hard before COVID-19, that was nothing!