Background and future direction

The quality and character of the designed environment can be a powerful factor for improving and strengthening health processes. In the past century, health care facility design, for example, has focused on supporting functional fitness and accommodating new technologies to achieve maximum economic efficiency. This focus, however, has neglected the critical impact of the environmental quality of health care facilities on health outcomes.

A major reason for this approach was the dominant biomedical perspective in western culture during this period. Patients were considered "clinical material". Rather than regarding the patient holistically as a human being made up of many complex interactions, clinical practice focused on treating each "sick element" of the body separately. Health care environments were viewed as minor medical-technical supports for the physical needs of treatment. Consequently, the psychological, social and spiritual needs of patients were either neglected or viewed as secondary considerations in the design of health care facilities.

Recently, a different perspective has emerged. The modern concept of disease is no longer narrowly pathogenic; instead every disease is seen as complex, originating in a variety of ways, affecting systems at every level from the biochemical to the psychological and social.

The new paradigm of health creation

Health promotion is now a critical consideration in the design of health care facilities. In this paradigm, patients are the focus and not the disease. Consequently, the patient’s psychological and social health needs in addition to their physical health become a major priority in planning care activities and the design of health care environments.

There is a growing international awareness of the need to create a global, multidisciplinary network among researchers and practitioners to systematically disseminate new ideas and cooperatively develop research to improve the quality of care and design for health.

Scientists and researchers around the world have established the International Academy for Design and Health as an international scientific forum in this field. The founding of the academy was fostered by the success of the 1st World Congress in Trondheim, Norway, in 1997 and the 2nd World Congress on Design and Health held by Karolinska Institute, the medical university in Stockholm.

Future work: health promotion in a knowledge-based society

The progress of scientific studies in the area of design and health has resulted in a substantial body of research on how design affects people’s health and well-being. Many of these findings are relevant for and can be applied to areas other than health care, such as education, the justice system, urban planning and the work place.

The design of work environments, in particular, has a demonstrable impact on people’s health, well-being, creativity, satisfaction, enjoyment and performance.

The development of today's knowledge-based society has resulted in the increasing dependence of organizations on employees and their ability to develop and process knowledge. In the industrial era, the processing of raw material into finished goods, was at the centre of the value creation process of the manufacturing firm. In today's knowledge-based companies, the knowledge worker is in the centre, often providing the "raw material" (knowledge) as well as the means of production (the processing of knowledge and information). This shift towards knowledge work has created new challenges for people within organizations and for organizations themselves in successful business planning.

Coupled with other changes in society, social structures and life-styles in the developed world, these developments in our work-based activities have led to changes in our patterns of illnesses. Physical diseases resulting from hard physical work dominated in the agricultural and early industrial era. We now see a shift towards a dominance of psychosomatic illnesses. Stress-related illnesses such as depression and burnout are increasing dramatically, resulting in high costs to society in terms of human suffering, financial disruption to economies and organisations and ever-rising costs of health care.

Although there are some studies confirming a strong connection between human health and the work environment, surprisingly little research has been done to explore the effects of the knowledge-based society on design requirements for work environments.

Political realities: designing for ageing populations and climate change

Additionally, the scope to use public money to promote health through the creation of well-designed therapeutic public spaces is significant culturally and economically. As the rising healthcare costs of ageing populations in the western world combine with the potential economic cost of climate change, governments and public institutions are faced with a new political reality that is demanding investment in sustainable social architecture and the design of healthy public spaces.

Determined to be at the fore of social, economic and cultural change, whilst the core of the academy’s activities will continue to revolve around health care settings, the research focus is rapidly being extended to study the concept and development of “healthy organizations”, and “healthy spaces” in their broadest context.

The academy is also in the early stages of development of an International Journal for Design and Health. This will provide the field of design and health with another important forum for communicating important research findings in the field.