“If your healthcare system is ill, call 000. Press 1 for an engineer, 2 for an architect, 3 for a transport planner …” Could interdisciplinary design focused on wellness disrupt conventional healthcare provision to solve an intensifying global crisis?
The untapped potential for design to revolutionise how we deliver health is boundless. Combined with a shift to preventing ill-health through wellness, design could take healthcare out of the hospital with transformative effects.
Take the built environment. Mediated by design strategies and critical systems, its fabric exerts a powerful influence. It is the stage where almost all human life is played out. It offers shelter, dictates movement, regulates utilities, facilitates action and even elicits delight.
What if that power was extended to the everyday nurturing of wellness in our communities? By prioritizing wellness in the home, on the road, at work and at play, how dramatic would the impact be on population health? Can research into salutogenic design converge for the public good?
In short, will policymakers call on different experts for radically different, exponentially beneficial solutions?
At the heart of this intriguing idea is the old mantra that prevention is better than cure. A major target has been the environmental and behavioural determinants of ill-health. Digging through WHO data, the statistics are overwhelming:
- Air pollution, especially from cooking with solid fuels in the home, accounts for 4 million premature deaths a year
- Climate change is expected to result in direct costs to health services of between $2-4 billion a year by 2030
- Avoidable factors such as social exclusion, loneliness, standards of living, working conditions, and poor physical health contribute to an estimated 350 million people of all ages suffering from depression
- Globally, 19 per cent of all cancers are attributed to the environment, especially in the work setting, resulting in 1.3 million deaths annually
- Work-related health problems result in an economic loss of 4–6 per cent of GDP for most countries
- Almost 1 in 10 people in the world fall ill after eating contaminated food and 420,000 die every year
- Physical inactivity, alcohol misuse, tobacco use, obesity (itself entirely preventable) and unhealthy diets contribute massively to non-communicable diseases, killing 38 million people a year
- Insufficient physical activity is 1 of the 10 leading risk factors for death worldwide
- Road traffic crashes kill about 1.25 million people a year, and are predicted to rise to be-come the seventh leading cause of death by 2030
With numbers like these, even marginal improvements could have enormous impacts. But: With a growing population and changing demographics, simply staving off ill-health is no longer enough. It’s time to turn our attention to wellness. More importantly, we need new ways to actively engender population-wide well-being.
Harness research from the built environment. Visualize communities designed to discourage car use by keeping essential facilities within easy walking distance. Think of food grown locally rather than shipped half way around the world and placed in cold storage for months.
Envision electric vehicles to keep the air quality clean. Picture new cycle paths on ‘left over’ lanes with the advent of capacity – increasing autonomous vehicles. Conceive public spaces that dispel loneliness and encourage community engagement. Conceptualize a city designed with salutogenics, the pursuit of wellness, as its key guiding principle. Just imagine.
There’s no doubt this is a huge challenge. Lone voices from single disciplines by themselves can’t catalyse change. It needs the input of designers of all kinds, to say nothing of healthcare providers, public health administrators, universities and policymakers. The technical needs to be addressed alongside the philosophical, ethical, cultural, economic and political.
Nonetheless, with the rising emergency in healthcare provision around the globe, do we stick with the old or try something new? So go on: who you gonna call?