Adapting to Change: How the Built Environment Can Guide Healthcare Towards Climate Resilience

In Captain Stubing, we examined the healthcare system's readiness to face the storms of climate change. Then, on deck, we understood some of the potential costs. Before we steer the Love Boat towards solutions, let's explore how the built environment consider the whole rather than the parts.

The disjointed and transactional nature of healthcare makes it challenging to think holoptically. The Futurist Frank W. Spencer IV defines holoptic this way:

• Holoptic describes a “whole-eyed” vision that sees the surrounding environment as one unique “whole” entity instead of separate parts.
• This whole-eyed vision creates a simultaneous, constant feedback loop that allows individual and collective actions to communicate and emerge decentralized as resilient, adaptive, and transformative needs arise.

A holoptic views is mandatory as we approach climate health as a series of complex, concurrent systems: Earth systems, Body systems, and Health systems.

This article focuses on lessons from the "built environment," human-made surroundings that are in the foreground of our lives. The built environment goes beyond buildings, bricks, and bridges to the world's layout. It considers how interrelated elements branch to shape our health, social interactions, and economy, from rooms to cities.

A building is more than its steel, glass, concrete, plastic, and wood.

More than its electrical, heating, cooling, and plumbing systems, it is the minerals mined, ore smelted, and trees felled and milled worldwide. It is the container ships and railroads, the trucks and the truckers, the architects and the construction workers. For example, Design for Freedom considers the entire supply chain, from making to placing the brick, and the forced labor involved along the way.

In this visual from Parson's Healthy Materials Lab, we see:

Health: The well-being of people, ensuring that environments where we live and work don't harm our health. It includes considerations like the emissions of building materials and the quality of indoor environments.

Social: The impacts of the built environment on society. It includes how buildings and spaces relate to our communities, supply chain practices, and worker rights. It emphasizes creating spaces that serve their primary function and contribute positively to the communities around them.

Waste: Minimizing the waste produced by buildings throughout their life cycle, from construction to demolition. This includes setting waste reduction goals, managing waste efficiently, and finding ways to reuse materials.

Water: Water efficiency and management in buildings, ensuring that water is used responsibly and that water systems are designed to reduce consumption and waste.

Circularity: Materials and resources should be reused and recycled to form a closed loop, reducing the need for extracting new materials and minimizing environmental impact. This includes managing resources and designing products with their end-of-life in mind.

Carbon: Greenhouse gas emissions associated with building materials and construction processes. It covers everything from embodied carbon (the emissions associated with materials throughout their life) to the operational emissions of buildings and the goals and reporting related to carbon management.

Lessons that healthcare can apply:

1. Holistic Approach: The built environment considers the interaction between materials, energy use, and human well-being. Environmental, social, and economic factors are decisive influences on healthcare outcomes.

2. Design and Layout: Healthcare spaces can be designed to promote healing, withstand extreme weather events, and allow for flexible use of space during crises.

3. Community Integration: The built environment includes community spaces for social interaction. Healthcare can expand partnerships with local communities to promote long-term health and well-being.

4. Resilience Planning: Built environment strategies focus on durability and adaptability. Healthcare must prioritize robust climate disaster response and recovery plans.

5. Supply Chain Management: The built environment sources materials locally and sustainably. Healthcare can strengthen and diversify supply chains for medical supplies and providers.

6. Technological Integration: Utilize technology for health monitoring and telemedicine services to provide care during climate events. This can reduce dependence on physical infrastructure.

7. Green Spaces: Vegetation provides health and environmental benefits in the built environment. We can incorporate green spaces into healthcare facility design for patient and staff well-being.

8. Transportation: Promote sustainable transportation options for healthcare access, reducing the sector's overall carbon footprint.

9. Education and Training: Architects and builders are trained on green building techniques. We are just starting to educate healthcare professionals on the impacts of climate change on health.

10. Policy Advocacy: The built environment encourages regulations that support green building standards. Advocate for policies that promote public climate health, environmental sustainability, and resilience.

11. Innovation and Research: The built environment continually evolves and adapts. Invest in research and innovation focused on sustainable, resilient healthcare delivery.

Since the future doesn't exist, we can create it however we like.