From Healthy Buildings to Salutogenic Architecture

Translating Sense of Coherence into Evidence-Based Design Strategies

Abstract

Growing concern for human health and well-being has expanded architectural discourse beyond the prevention of environmental harm toward the active creation of health-supportive environments. Yet the increasing use of terms such as healthy, restorative, biophilic, therapeutic, and salutogenic has also produced conceptual ambiguity. In particular, architectural features associated with positive health outcomes are frequently described as salutogenic without demonstrating how they relate to the theoretical mechanisms of salutogenesis. This critical integrative review examines recent literature published between 2020 and 2026 to investigate how architectural design can be more rigorously interpreted through the salutogenic concept of Sense of Coherence, comprising comprehensibility, manageability, and meaningfulness. Recent peer-reviewed research concerning salutogenic architecture, indoor environmental quality, biophilic design, spatial legibility, environmental control, social interaction, place attachment, and restorative environments was critically synthesized. The review identifies six recurring environmental resource domains: spatial legibility, environmental comfort, user control and adaptability, contact with nature, social affordances, and identity and place attachment. Rather than treating these domains as universally health-promoting features, the paper maps their potential contribution to the three components of Sense of Coherence. The synthesis demonstrates that salutogenic value depends less on the presence of isolated design features than on the relationship between environmental resources and users' capacities to understand, manage, and find meaning in their surroundings. Evidence is strongest for environmental comfort, nature contact, and aspects of user control, while direct empirical testing of architectural meaningfulness and cross-contextual Sense of Coherence remains comparatively limited. The paper proposes an evidence-based interpretive matrix for salutogenic architectural design and argues for a shift from feature-based prescriptions toward relational and user-centred evaluation.