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In this series, Healthcare design Senior healthcare design professionals, companies, and owners are asked to tell us what caught their attention and share some insights on the topic.
MacKenzie Kusler is a designer at Ryan Architecture + Engineering (Minneapolis). Here, she shares her ideas on Design for Health Equity and the importance of understanding site analysis, historical research, and societal context before creating a design.
- Understand the social determinants of health
Health equity is based on the idea that everyone has access to the essentials that support positive health, but the truth is that it is severely limited by social determinants of health, such as access to food and education, economic stability, and the neighborhood environment. If health outcomes are rooted in where you live, designing for health equity must start outside of the health care facility and in the context of the community. To understand and design the conditions that determine patient outcomes before they advance in a healthcare environment, designers need to assess the location, community, and historical context.
- Site evaluation and historical analysis
Traditional architectural site analysis revolves around inquiries at the surface level such as studies of sun, shade and winds. To start thinking and designing for health equity, a site evaluation must also include in-depth site analyzes and historical research, which can shed light on the basic facts of the site and how it is informed or informing its surroundings. The discoveries may include a historical lack of investment or the high use of racially restricted vocabulary in title deeds that deprive people of color of ownership. For example, an in-depth site analysis might reveal an area where there has been a lack of investment in public transportation. As a result, residents of that area cannot easily access care outside of their own area. The proposed solution would be to design a site that is highly accessible and inaccessible to pedestrian traffic.
- Research in community context
After achieving a comprehensive understanding of the site, it becomes essential to understand how it relates to the community as a whole. This includes research into how social determinants of health emerge and influence the health of neighborhood residents. For example, it became apparent how some societies may be more vulnerable to poor health outcomes when mapping COVID-19 mortality rates, with rates twice as high among populations of black, indigenous and people of color. In contrast, it becomes important to think about the social determinants of health that have manifested themselves through systemic causes such as housing and infrastructure policy, how they can be sustained within the built environment, and the corresponding impacts on health and access to resources.[this addition pretty much repeats what she said in sentence above. I’d cut it]]For proper design of health equity, designers must gain a deeper understanding of the individuals affected.
- Reflection of Community Research
Design is often seen as tangible, but it can also be based on relationship and system designs. For example, research may indicate high rates of childhood obesity, and potential solutions could be a healthy food initiative or nutritional education. Not only can this support long-term health and wellness, but it can continue to evolve with the changing society. This research can also guide site selection and development, spatially informed design, and community-related construction.
- Facility design
For health equity, the design should largely reflect what has been learned during site analysis, historical research, and the societal context. If this broader understanding is not achieved before the design is created, opportunities for communication and community support will be missed. Architecture needs to expand outside the physical building and consider the people and society in which they live.
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