April 22, 2015
Lindsey Willke

Health and well-being are the imperative we must all embrace. The World Health Organization boldly states, “Why treat people’s illnesses without changing what makes them sick in the first place?” As population health defines a new era for healthcare, designers and providers alike must embrace this paradigm shift to consider the upstream factors of health in the built environment which influence lifestyles. Health(care) is a broad spectrum — the individual health of a person in one’s lifetime varies across the spectrum, as do the differences of health needs between distinct communities.

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HKS recently presented on this topic at the PDC Conference in San Antonio, in collaboration with MetroHealth System of Cleveland, Ohio, and the Director of Cleveland City Planning. As MetroHealth embarks on the transformation of its campus (link here), it is poised at a once-in-a-lifetime opportunity to capitalize on rebuilding the aging campus, while using this opportunity to transform the campus into a wellness destination. Partnering with the community, MetroHealth and the City of Cleveland aim to tackle health by focusing on revitalizing the local neighborhood as a part of the campus transformation. In 2011, Cleveland launched a citywide campaign (link here) to address health disparities through preventive measures “to improve the quality of life of every resident in Cleveland.” As the two entities look to find collaborative ways to leverage resources, it is in partnerships such as this that communities can successfully address the left end of the health spectrum — healthy individual lifestyles, thinking beyond treatment to prevention.

Architects, urban designers, landscape architects, city planners and all who impact the built environment, must adopt this new imperative to address health. As shapers of buildings, landscapes and communities, we have an uncommon and powerful tool to not only create beautiful places, but also use our projects in service to positively impact health and well-being. Last year, the Robert Wood Johnson Foundation released a nationwide County Health Rankings report. In this study, four overarching factors influencing health are identified (link here). While the “built environment” makes up only 10 percent of these factors, a deeper look reveals that many of the health factors in other categories are influenced by the built environment — community safety (streets and neighborhoods), diet and exercise (parks and trails) and access to care (transportation and location). Health is not merely the absence of disease (World Health Organization) — it is evident in the triple bottom line! Health is the social, economic and environmental well-being of our communities, and similarly for individuals, the physical, mental and social wellbeing (WHO).  If this gives a new imperative to our projects, it must also give a new imperative to our process.

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A vision for the MetroHealth campus is being developed through an open and transparent process. MetroHealth is collecting ideas through its external project feedback website (link above), as well as through interviews and sessions with both internal and external stakeholders — currently over 30 community based organizations. The local culture, with a largely Hispanic population, is also a key element in the district’s character and identity. Community outreach, as well as community in-reach, will define the new MetroHealth; a place that respects and responds to its local culture, embraces its community and reflects the culture both inside and outside of its walls. In this opportunity, the project team regards the process as equally important to the final outcome. The success of the project will be in its ability to embrace its community, to have its community embrace the project and, ultimately, to positively impact the daily health and well-being of Cleveland residents.

This shift in thinking about health and built environment must also shift the way we direct our project process, to co-create with communities rather than to simply inform. Positive changes in the built environment can be a catalyst to improve community health by working collaboratively across sectors and disciplines.


Posted in Health