Treat the Town pt. 1

March 2, 2023



These days, if you see a high-rise crane, you can make a very educated guess as to what’s being constructed. Chances are, it’s a medical facility. The US Healthcare industry makes up over 18% of the GDP. Last year, the US Healthcare system achieved an astronomical expenditure level, totaling over $4.3 trillion, which works out to nearly $13,000 per person. So yeah, those high-rise cranes can’t build fast enough. 

The healthcare industry is growing at an astonishing clip, poised to reach a total expenditure output of $6.2 trillion by 2028. As the population continues to grow and age, more people need treatment and this is an industry that only treats one person at a time. Well, what if we considered treating thousands of people at a time? What if instead of trying to make an individual a little bit healthier, we looked at ways of making whole communities healthier? 

This is where design has such an incredibly valuable role to play in our society. Just by rethinking how we go about planning and building our communities, we can improve the health of thousands, tens of thousands, even hundreds of thousands of people at a time. If we only decided to design our cities with the resident’s well-being in mind, we could reduce our dependency on the health care system significantly. 

Because the design of our places is so encompassing and ubiquitous, it tends to go unnoticed. We rarely think about the incredibly large forces that shape our day, instead focusing on the little details we encounter. This is why urban design goes unnoticed, but also why it holds the power to transform our lives. So much of what we do throughout our lives is done unconsciously. We don’t give serious consideration to all the design choices made in our places when it comes to shaping the lives we lead. 

Most people get in their car in the morning and drive to their place of employment- such is life and the routines that make it up. But the necessity to own a car to get to work is anything but haphazard and the furthest thing from happenstance. This was the result of a thousand decisions spanning nearly a century about how as a country and how each community would invest their dollars. Decisions regarding what type of housing would get built, and decisions about transportation funding. Millions upon millions of dollars were spent turning forests and farmlands into subdivisions and strip malls. Another unfathomable sum was spent building highways and all of the ancillary development that accompanies them.

The individual takes it for granted that this is just how life is and how it is supposed to be. That this is how progress operates and someone smart came to the conclusion that building sprawl was the pinnacle of development. We assume that subdivision lifestyles were created because it is good for the economy and that we build this way because it’s what people want. All reasonable assumptions to make, but all dead wrong. 

The individual that is confined to the car doesn’t spend the morning commute thinking about the misery of living in Sprawlandia and why it exists. It just is. And when someone suggests car ownership is bad, well then their lifestyle is being attacked. The idea of not owning a car is unfathomable to a person that can’t get to work or the grocery without a car. They are not at fault for this situation, they are simply subject to the design that is delivered unto them, and unto us all. It’s not one person’s fault for driving a car, it’s a community’s fault for building in a manner that requires someone to own a car just to survive. 

Municipalities that have prioritized auto-centric investments over other forms of mobility have done untold damage to the health of their population. Car places make people sick in so a myriad of ways. We can’t expect to get better if we keep doing the same thing that got us here in the first place. It simply isn’t good enough to keep treating the individual after they have gotten sick, we have to begin to look at more preventive methods to keep the population from getting sick in the first place. The simplest and best place to start is in the design of our communities. 

We must be intentional about designing health into the places we call home. We can no longer afford not to, nor should we shy away from a tremendous opportunity to improve people’s lives. 

This is the first of a 5 part series about the design of our places and the health of the resident. Over the coming weeks, I will address how place affects our mental, physical, social, and fiscal health. Please share in the comments section how your place has affected your health, for better or for worse. 




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