When we look to the future of healthcare and communities, two themes emerge: One, the term “healthcare” is being pulled apart to its core components “health” and “care”; and two, the world is getting much more interdisciplinary and the lines between industries are blurring. How are these seemingly opposed phenomena helping to shape, in tandem, the future of healthcare delivery and design?
In this spirit of inquiry, Perkins+Will hosted an interdisciplinary think tank event titled, “Building a Culture of Health in North Texas.” The 30-person, half-day discussion focused on how, as we rise up from healthcare to health (“living well”) and care (“communal consideration”), can we shift the culture in our communities and positively affect the social determinants of health. What became clear from our discussion is that doing so goes beyond the health systems and the built environment; it is truly an interdisciplinary, collaborative effort.
The event pulled from a diverse group of speakers across industries. Representatives from health systems in North Texas (Baylor Scott & White, Texas Health Resources, JPS Health Network, UT Southwestern) spoke alongside people from businesses like Hillwood and Capital One. Public entities like the new University of North Texas Health Science Center/TCU Medical School in Fort Worth, the Tarrant County Public Health Department, Fort Worth City Planning, and North Texas Business Council for the Arts had a voice at the think tank as well, speaking alongside strategic healthcare planners, physicians, high-technology consultants, and health insurance brokers. Each participant brought unique and interesting perspectives to the table in discussing the opportunities and challenges with achieving a culture of health.
Beto Lopez, a former IDEO leader and founder of the Design Institute for Health at UT Austin, kicked the day off with an inspirational message on design as a process, not as one purely about outcomes. He reminded us that people are resilient and that there are high expectations of healthcare as all industries evolve around it; people are expecting quality experiences at every scale of health. Every company is now a health company, and we must repurpose and rethink our entrenched roles and venues for delivering care.
The bulk of the event centered around two key topics: fostering cross-sector collaboration and creating healthier, more equitable communities. Key themes emerged from the discussion:
- How do you create a cultural shift towards health? It’s not just education, but individual empowerment for behavior change; responsibility is beyond the doctor – we all have a stake in the culture shift.
- Dave Clark from Capital One spoke of their evolving campus in Plano, Texas, that is offering amenities to employees on-campus, like pharmacy, trails, fitness centers, and many restaurants with healthy options, that aim to improve their access to health requirements and wellness opportunities.
- Stuart Flynn, the Dean of the new Fort Worth Medical School, spoke of training new physicians and the areas they focus on. Collaborative and inter-professional training programs that emphasize communication and empathy are central to the School’s pedagogy so these future doctors learn to connect on a human-level with their patients. He shared a study that concluded physicians on average listen to patients for 21 seconds before interrupting. It found people need only 90 seconds of uninterrupted listening from their physicians to feel heard. He hopes the School helps teach future doctors to bridge that gap. He also shared the challenges of the fee-for-service model of healthcare in relationship to medical students who leave school sinking in debt. Medical students turned future doctors aren’t currently incentivized to spend more time with the patient, and that should change.
- Robert Folzenlogen from Hillwood spoke of how wellness and lifestyle are significantly affecting all decisions related to real estate and development; and environment is a driver of behavior. He gave examples from the master plan he leads in Alliance.
- There was general discussion about the role of transportation in access to health service appointments and how missed appointments cost the system money; policy doesn’t currently support transportation or ride share companies as a health service, but it could.
- Art as a zeitgeist for our communities to elevate pride, empowerment and education was discussed from many perspectives. The Design Institute for Health in Austin, Texas studied specific application of this in their case study: A Taste of Feeling Better Through Food, Art, and Health: Daily Bites Café. And the Dallas Mayor’s Star Council has actively affected the health of Dallas communities with art through the Bus Stop Project.
- Employers affect health behavior change through programs and incentives; Adam Fineberg from USI shared about their 85% compliance in wellness programs and that led to significant overall improvement in several health status measures.
- Food deserts or “health food priority areas” are a significant issue in North Texas. Equity in access to good dietary choices is a key social determinant of health.
- Similarly, healthy food access was a major point of discussion. Activities like hosting farmers markets at major public transportation hubs or expanding bike share programs and sidewalk infrastructure in our cities to improve access via cycling and walkability were potential solutions to inequitable access to healthy foods.
Overall, it became clear that the intersections between the different industries and disciplines foster improvement to health. In North Texas, this discussions only becomes more important over time, as the Metroplex Economic Region is projected to grow 67% by 2050 according to the Texas Demographic Center’s long range projections.
To conclude the day’s discussion, our own Robin Guenther, a Culture of Health leader with the Robert Wood Johnson Foundation (RWJF), closed by giving the history and framework of RWJF’s Culture of Health program, of which much of our conversation related. As she explained, there are varied perspectives on the role of the US government in supporting personal health. Working towards health as a shared value will require conversations like the one we had in that day’s Think Tank.
For North Texas, we believe this is only the beginning of the larger conversation around a culture of health. As an interdisciplinary firm focused on design and the built environment, we have an opportunity to foster these important cross-sector discussions towards action. Stay tuned.