Seeing the Connections Between Health and the Built Environment

Across the United States wintertime surges in COVID-19 cases and a slow vaccine rollout are two vivid examples of how the pandemic continues to impact daily life. And, because COVID-19 both spreads more easily indoors and has had a major impact on health care facilities, the interconnectedness of physical spaces and human health is top of mind perhaps more than ever before.

Bridging these two themes is the seminar course New Approaches to an Architecture of Health (ARCH739), in which architecture students learn how the built environment impacts health and well-being. This fall, students were also challenged to look beyond the impacts of the current pandemic to see how mindful design can be used to create a healthier future.

The intersection of health and design

The seminar course began as a collaboration between Stuart Weitzman School of Design faculty and PennFIRST, the team involved with designing and constructing the Penn Medicine Pavilion. After connecting with PennFIRST and discussing ideas for the Pavilion, Winka Dubbeldam, chair of the Department of Architecture, and lecturer Mikael Avery recognized that fostering the connections between health care and the built environment would also be fruitful for students and launched the first ARCH739 course three years ago.

“We are more like a think tank,” Dubbeldam says about the Department. “We teach design-research, a design methodology also based on scenario planning and creating strategies. Because we don’t design what happens today, we aim to teach the students to think of future buildings and needs.”

For Avery, ARCH739 is also a place to share ideas around health and wellness that can be applied to other types of buildings beyond health care facilities. “I don’t anticipate that every one of them designs a hospital. It’s really that when they design anything, this thinking has been infused into their process,” says Avery. “The goal for this class is that, as they move forward into their careers, they’re still thinking about these concepts and really start to say that an office or a museum can be designed to support health as much as a contemporary hospital.”

Design with people and patients in mind

For their first project, students were provided a design brief and asked to develop listening kiosks for the Penn Medicine Listening Lab, a storytelling initiative that provides patients, caregivers, and health care workers the opportunity to both record and listen to the stories of others. Working in collaboration with Lab Director Aaron Levy and team members from across Penn Medicine, students developed several designs for a “post-COVID” world.

“Aaron and I worked with them to go through this idea of listening as cathartic, as connection, as healing, and what would that look like for one person,” says Avery. Many of the student’s final projects were oriented around simple, modular units that could be fabricated and installed at low cost, with designs that incorporated engaging and welcoming structures, provided a sense of privacy, and were simple yet striking in their form.

For the final projects, Avery reached out to Paul Ortiz, vice president of business and service line development at Penn Medicine Princeton Health, who provided the opportunity for students to develop designs for a new cancer center. “I provided students with an overview of the growth that we expected by 2030, and we also talked about the patient experience,” Ortiz says. “We don’t want to be like everyone else; we want it to be amazing.”

With Ortiz’s insights on the needs of the building and what the treatment journey looks like for patients, students produced an array of creative and comforting designs for the cancer center.
One student team, Ellie Garside, a Master of Architecture student, Madonna Miranda, a recent Master of Science in Design with a concentration in environmental building design (MSD-EBD) graduate, and Vashvi Shah, an economics senior submatriculating in the Integrated Product Design (IPD) program, created a design that depicted the treatment center as a comforting embrace.

For their first project, students designed recording pods for Listening Lab, a storytelling initiative that provides patients, caregivers, and health care workers the opportunity to record a short personal story or listen to the stories recorded by others.

“A lot of information was given about what a cancer patient experiences and what needs there were,” says Shah, who used her expertise from the IPD program and focused on the needs of the patient to inform the building design. “We started thinking about adjacencies and how those processes and journeys would go about within the physical form.”

Garside, whose focus was on building form, also incorporated insights from lectures on how the natural environment helps patients heal while allowing the building’s embrace to be visible from multiple angles. "It was a balance of trying to get the planning and the adjacencies right with trying to design the form to provide awe,” Garside says. “You get that feeling of an embrace that you’re coming into something that’s not your traditional health care facility.”

Miranda’s experience in the MSD-EBD program led her to focus on how shapes and forms could be arranged to maximize the amount of natural light coming in. The team also used varying heights to engage patients from the start of their journey. “Even when you’re driving into the site, the views that you see are so different. It embraces that calming nature, that you’re entering this different space where you are going to be taken care of,” she says.

Across the final project designs, other common themes include connection, warm colors and materials, and accommodating people of varying ability levels. Ortiz was impressed with how creative the designs were based on the limited set of working principles he provided the class. “It was exciting to see the clinical adjacencies, light coming in, the landscape design, they thought it all out,” says Ortiz. “The creativity they put into it was amazing.”

Connecting health and space in a post-COVID world

“My fear was that this class would become the COVID class,” Avery says about the pandemic’s potential impact on the course. “We talked about the fact that hospitals and health facilities need to be adaptable, but we don’t want to make everything pandemic for life. It’s the ability for something to flip or to accommodate when needed.”

This theme of adaptability and flexibility was something that Garside also took away from the course. “People are still going to want to be together. Contact, communication, physical space—being with people is still so important, so I think flexibility is key,” she says.

For Miranda, the interdisciplinary nature of the course, with perspectives and expertise from a variety of fields, is analogous to how designers and architects will need to address future challenges, such as building ventilation. “The complexities of ventilation are not something that I think a designer can tackle alone,” says Miranda.

Shah took ARCH739 to learn more about architecture but enjoyed learning about other topics related to health. She says that she is now more aware of other existing challenges such as support for elderly communities. “Elderly people lose this sense of social identity,” says Shah. "This was an issue I had thought about before, but I hadn’t realized it had been studied academically until we spent a unit on architecture for the elderly."

For Ortiz and Penn Medicine Princeton Health’s efforts to design a new cancer facility, health and the built environment have been and will continue to be closely connected. “As we create spaces in the future, we have to really do things differently, to create an experience for anyone, both staff and patients, inside that space on a daily basis,” Ortiz says.

Along with developing key skills, such as how to work as part of a team and how to do research and design in parallel, Dubbeldam adds that another important aspect of this course is to provide students with the opportunity to solve real-world problems and to have a forward-looking view of the future. “Architects “like to strategize, and part of the flexibility that we have is that we don’t think for today. We think about what if we have two viruses, for example,” she says. “That flexibility comes in trying to understand what comes next.”