Feb 16, 201309:00 AMPoint of View
Healthier Communities Through Design
Health indicators are pointing in the wrong direction. Healthcare costs are rising to unprecedented levels. To address these challenges, it’s become imperative that our municipal policies and initiatives be reconsidered. How can design help? As I see it, design provides a key preventative strategy. Designers can improve public health outcomes and enhance our everyday environments. The lens of design can help us focus and re-conceptualize the public health impacts of our cities and buildings. Healthy communities will help stem our raging epidemic of obesity and the chronic diseases that result from our sedentary lifestyles and bad diets. But when you think of health, you may be thinking of the medical industry and the illnesses it treats. It’s time to turn this idea on its head. Let’s start focusing, instead, on preventative strategies that reduce the incidence of sickness in the first place. A key policy, health by design, can be integrated directly into our cities, and architects can play a central role in designing healthier buildings and communities. Many of the problems we face today can be solved by simply looking at the amenities people already want from their cities: developments close to transit, shopping, restaurants, social services, and community services. These are essential parts of a comprehensive, systems-level solution. Active lifestyles rely, in large part, on expanding the options for when, where, and how people can live, work, and play.
Cities and towns looking to help their people stay healthy, now have access to a helpful document, produced by the American Institute of Architects. Local Leaders: Healthier Communities Through Design is a roadmap to design techniques that encourage residents to increase their physical activity. I see this new publication as a key resource for government officials, design professionals, and other stakeholders collaborating to address America’s public health challenges. Current barometers of health suggest that America is headed in the wrong direction. We are fast becoming a nation of physically inactive, obese people suffering from chronic diseases, especially diabetes and high blood pressure. According to a 2012 report from the Institute of Medicine, only 19 percent of us are meeting the recommended daily levels of physical activity. Furthermore, a third of our adult population and nearly one in five children and adolescents are obese, reports the Centers for Disease Control and Prevention. The CDC also estimates that three quarters of U.S. spending on health care now goes toward treating chronic diseases, those that are the leading cause of death and disability, with 70 percent of all U.S. deaths attributed to chronic disease. And, as healthcare costs rise precipitously – estimated to reach an astounding 20 percent of GDP by 2020 – every sector of the economy faces tough questions about managing a problem that touches every citizen. In this context, the consideration of health through the tactics of design is a critical area to consider. Design interventions can help create healthier communities and make an enormous difference in health outcomes. Public policy decisions matter and our Local Leaders report documents the initiatives and policy choices being made by cities across the country. Look for examples in our cities, from New York to Nashville to Seattle and places in-between. Active design is being integrated into the urban fabric of New York City and innovative policies are activating and promoting healthy living. Nashville is committed to becoming the “Healthiest City in the South” by creating an active culture and committing resources to promote walking, biking, and transit. Seattle is envisioning the future through the creation of the Capitol Hill EcoDistrict with healthier buildings, better mobility, improved access to fresh foods, and more social equity. These policies provide templates for other cities looking for design solutions to create healthier communities.
Capitol Hill EcoDistrict, image courtesy GGLO
At the local level, mayoral leadership and strong civic engagement are effectively creating change from the bottom up. These communities are preparing for America’s rapidly aging population, increasing resource constraints, and people’s growing desire to live in more walkable, livable places. Our public health challenges require a broad set of cost-effective design solutions – and a collaborative, interdisciplinary approach. Architecture can make a difference. Design professionals can serve as creative collaborators with key stakeholders in planning, public health, and other disciplines. Communities where human-centered design is implemented find that one of its greatest benefits is choice. Currently a large number of Americans have only one choice – live in a sprawling, low-density community and drive to every destination. But the suburban sprawl is on the decline. Census data shows that between 2000 and 2010 primary population growth occurred in the densest quintile of American counties, with losses of some two percent in the least dense areas. As development patterns start to self-correct in some parts of the country, other regions still do not have the choice they used to have for most of our country’s history; whether or not they’d like to drive, walk, bike, or take public transit to stay healthy.
Columbus Circle, photo courtesy MTA
In preparing for a better future, design and health is a key initiative at the American Institute of Architects. I can imagine a future where designing for health is just the way design is done. I can imagine a time where we all feel that in the places where we live our children can walk safely or bike to school, parents can ride efficient public transportation to work, people of all abilities can live in well-designed single- and multi-family houses, a quick walk replaces a quick ride to the grocery store, and automobiles become one option among many transit choices. In this future, grandparents will be able to grow old, near their families. And perhaps, we will all lose some weight, not by drastic changes, but by using design to make healthy choices easier.
Brooks Rainwater is the American Institute of Architect’s director of public policy, focused the AIA’s design centered policy that meets at the key intersection of cities, sustainability, and health. A strong advocate for sustainability, Brooks frequently speaks and writes on the subject. He is also the lead author of Local Leaders, a national research study that examines green building policy, health, and design, and the urban policy environment.