designed to thrive: creating salutogenic environments
Post on 21-Oct-2014
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DESCRIPTION
Tye Farrow's presentation to the Architectural Institute of British Columbia’s (AIBC) annual conference and exhibition in Vancouver. This talk is focused on an approach to raising awareness so that the public will begin to expect their built environment to cause health (salutogenesis) rather than cause “dis-ease" (pathogenesis). The conference, entitled "Sea Change: Architecture on the Crest," was hosted by both the AIBC and the American Institute of Architecture’s Northwest and Pacific Region.TRANSCRIPT
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Tye Farrow B Arch, M Arch UD, LEED AP, FRAIC, AIBC, SAA, OAA, NSAA, NLAA, Assoc. AIA
Creating salutogenic environments Designed to Thrive
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Appalling?
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Appalling?
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How does this environment affect us?
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How will this environment become un-acceptable?
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. . . cause health?
Thunder Bay Health Sciences Centre
Salter Farrow Pilon Architects Inc., of which Farrow Partnership Architects is a successor firm
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Our pathology-centric world Agenda for health How people (really) make decisions A way forward: Five Vital Elements
Kaplan Medical Center Farrow Partnership in collaboration with
Uzi Gordon Ltd. Architects and Town Planners
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Context
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WE LIVE IN PATHOLOGY-CENTRIC
WORLD
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I learned a lot of pathology, & a lot about medicines. We were taught virtually nothing about health.
Richard J. Jackson, MD, MPH Professor and Chair
Dept. of Environmental Health School of Public Health, UCLA
Former Director, U.S. Centers for Disease Control & Prevention
“ ”
We find what we look for :
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Seeing Health?
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Why do we have a commonly-used term that refers to origins of disease:
Pathogenic
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while the similar term meaning origins of health is relatively unknown:
Why do we have a commonly-used term that refers to origins of disease:
Pathogenic
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SALUTOGENIC
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. . . time to look for 8,000 ways to cause health.
SALUTOGENIC
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. . .Cause health
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. . .Cause health abnormalities . . .Cause health problems
. . .Cause health risks . . .Cause ill health
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. . .Cause health abnormalities . . .Cause health problems
. . .Cause health risks . . .Cause ill health
. . .Cause Health?
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1st: Communicable diseases
2nd: Non-communicable disease
3rd: Accelerating optimal health Salutogenesis
Dr. Lester Breslow & Three Eras Public Health
Ray Pentecost
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Communicable disease Mid 19th century to mid 20th century
1st
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Urbanization & industrialization Communicable disease: TB, cholera, malaria, yellow fever
1st
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Example: London chorea outbreak of 1854 & Dr John Snows discovery of the source
1st
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Central park & park movement Urban design set backs Public transportation Departments of sanitation Public health movement Results: longer life expectancy & rise of chronic disease 1st
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Non-communicable disease Mid 19th century to mid 20th century
2st
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Changes in our physical and
cultural environment
have fueled this burden of
chronic disease
2nd
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2nd
Changes in our physical and
cultural environment
have fueled this burden of
chronic disease
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Reduced daily-life physical exertion Marketing & manufacturing of tobacco Changing food quality & distribution Car centric design suburbs Biological ability to avoid adverse health compromised 2nd
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The U.S. consumes $2.7 trillion in ‘disease care’ spending 70% to 75% relates to chronic disease
VALUE?
2nd
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70% all deaths globally from chronic disease 1/3 all deaths before sixty years of age . . . . one’s most productive years
2nd
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. . . tell me your postal code I can tell you how long you will live First time in modern history that your children's life expectancy is shorter than yours
2nd
“
”
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Common source epidemic
2nd
Chronic disease
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Reaction
New Urbanism UN Noncommunicable disease resolution (second health resolution in its history)
NYC Department of Planning Active Design Guidelines
3nd
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The evolution of “livability” criteria
1931 (U.S.A. )
- literacy rate - farm electrification rate - deaths from typhoid fever - number of lynchings - teacher’s salaries
source: The Atlantic Cities
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2013 (U.S.A. )
- public transportation
- affordable housing
- quality of schools
- low crime rate
- air quality
- walkability
- access to hospitals
- access to parks
- infrastructure quality
- social capital
The evolution of “livability” criteria
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DESIGNED to SURVIVE
Best of what we know
Best we
can be
DESIGNED to THRIVE
Generic solution
Replace
Cope
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2013
- public transportation - affordable housing - quality of schools - low crime rate - walkability - access to hospitals - parks - social capital
- integrated mobility? - health-causing housing? - cause health? - citizen engagement? - walk worthy? - cause health? - diversity of uses? - social capital?
2030
The evolution of “livability” criteria
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DESIGNED to SURVIVE
Best of what we know
Best we
can be
DESIGNED to THRIVE
Generic solution
Replace
Cope
literacy farm electrification typhoid fever deaths lynchings
public transportation quality of schools walkability affordable housing
cause health integrated mobility walk worthy diversity of uses
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WELCOME
SALUTOGENESIS to
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Aaron Antonovsky coined salutogenesis
Latin salus = health & Greek genesis = origin.
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Aaron Antonovsky coined salutogenesis
Latin salus = health & Greek genesis = origin.
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Salutogenic Pathogenic Health activation Deterioration
Antonovsky saw a continuum, rather than either / or.
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THE LEAP UPSTREAM
SALUTOGENIC ORIENTATION
- better medical interventions
- cure disease
- paternalism, entitlement
- fixing parts of system
PATHOGENIC ORIENTATION
- better quality of life
- cause health
- self-reliance, public health
- holistic approach
GOAL
FOCUS
NORMS
RELIES ON
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Why do some people remain healthy, while some become ill?
Aaron Antonovsky Father of Salutogenesis
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“Sense of Coherence” regarding life and its challenges - comprehensibility - manageability - meaningfulness
The mind: How you feel
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“Sense of Coherence” regarding life and its challenges - comprehensibility - manageability - meaningfulness
Alan Dilani’s work relating it to the built environment
The mind: How you feel
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Pathogenic: Disease prevention
Salutogenic: Health activation
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Pathogenic: Disease prevention
Salutogenic: Health activation
Cause Health
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Occurrence Agent – Environment – Host Stopping something from happening or treating it after it occurs
Pathogenic
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Continuum: encourage health to occur Filling environment with elements that accelerate health
Salutogenic
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…I had to begin to learn less about disease and a whole lot more about the embedded health in the world around me if I was to make an impact.
Richard J. Jackson, MD, MPH Professor and Chair
Dept. of Environmental Health School of Public Health, UCLA
“ ”
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The function of protecting & developing health must rank even above that of restoring it when it is impaired
Hippocrates
“
”
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In the long run, housing may be more important than hospitals to health
Dr Lester Breslow
“
”
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Ministry of health Ministry of education
Ministry of municipal affairs & housing Ministry of economic development
. . . Intentionally have created silos?
3nd
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Ministry of health Ministry of education
Ministry of municipal affairs & housing Ministry of economic development
Ministry of health, education, municipal affairs,
housing & economic development
. . . Intentionally have created silos?
3nd
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U.S. Centers for Disease Control & Prevention
. . . You find what you look for?
3nd
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U.S. Centers of Health Creation U.S. Centers for Disease Control & Prevention
. . . You find what you look for?
3nd
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Accelerating optimal health: Salutogenesis
Start of 21st century
3rd
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Living longer / greater expectations Life to full potential: designed to THRIVE Sense of Coherence: How environments make you feel . . . perform . . . & prosper 3nd
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People make decisions based on an emotion level.
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Change what people SEE on an emotional level
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dis-ease health
How healthy is this place?
The question:
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Understand: How healthy?
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Five Vital Elements Nature Authenticity Variety Vitality Legacy
Salutogenesis: Designed to Thrive
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Nature Design that is inspired by the natural world 1.
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Credit Valley, Farrow Partnership
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Credit Valley, Farrow Partnership
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Credit Valley, Farrow Partnership
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Give us something that’s alive!
“ - Cancer patient survey response
” Credit Valley, Farrow Partnership
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I am in good hands.
“ ”
Credit Valley, Farrow Partnership
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Credit Valley, Farrow Partnership
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NOC, Port-of-Spain, Trinidad and Tobago Farrow Partnership and associate architects co-rd Limited
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NOC, Port-of-Spain, Trinidad and Tobago Farrow Partnership and associate architects co-rd Limited
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NOC, Port-of-Spain, Trinidad and Tobago Farrow Partnership and associate architects co-rd Limited
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NOC, Port-of-Spain, Trinidad and Tobago Farrow Partnership and associate architects co-rd Limited
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Authenticity Design that draws on meaningful local influences 2.
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St Mary’s Hospital
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St Mary’s
On tack to be LEED Platinum & carbon neutral, completion November 2013 Farrow Partnership Architects in association with Busby Perkins + Will Architects
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Farrow Partnership Architects in association with Busby Perkins + Will Architects
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Farrow Partnership Architects in association with Busby Perkins + Will Architects
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Variety A range of experiences and a sense of discovery 3.
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Kaplan Medical Centre, Israel
Farrow Partnership in collaboration with Uzi Gordon Ltd. Architects and Town Planners
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Kaplan Medical Centre, Israel
Farrow Partnership in collaboration with Uzi Gordon Ltd. Architects and Town Planners
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Kaplan Medical Centre, Israel
Farrow Partnership in collaboration with Uzi Gordon Ltd. Architects and Town Planners
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Farrow Partnership in collaboration with Uzi Gordon Ltd. Architects and Town Planners
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Farrow Partnership in collaboration with Uzi Gordon Ltd. Architects and Town Planners
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Farrow Partnership Architects and KMBR Architects
Mission CRC
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Farrow Partnership Architects and KMBR Architects
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Farrow Partnership Architects and KMBR Architects
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Farrow Partnership Architects & KMBR Architects
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Farrow Partnership Architects and KMBR Architects
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Vitality Regenerative space facilitates flow of people and ideas 4.
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E
w
Thunder Bay Health Sciences Centre
Salter Farrow Pilon Architects Inc., of which Farrow Partnership Architects is a successor firm
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Salter Farrow Pilon Architects Inc., of which Farrow Partnership Architects is a successor firm
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Salter Farrow Pilon Architects Inc., of which Farrow Partnership Architects is a successor firm
Abundance
State of mind - feel
Knowledge era
Optimistic
Engage
Captivate
Overflow
Entrepreneurial
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Salter Farrow Pilon Architects Inc., of which Farrow Partnership Architects is a successor firm
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Salter Farrow Pilon Architects Inc., of which Farrow Partnership Architects is a successor firm
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Salter Farrow Pilon Architects Inc., of which Farrow Partnership Architects is a successor firm
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Colchester East Hants Health Centre, Canada
A
B
C
WHW Architects and Farrow Partnership Architects
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WHW Architects and Farrow Partnership Architects
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WHW Architects and Farrow Partnership Architects
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WHW Architects and Farrow Partnership Architects
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WHW Architects and Farrow Partnership Architects
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Legacy Design that makes a lasting contribution to health 5.
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Protea Health Promoting Lifestyle Centres, South Africa
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Protea Health Promoting Lifestyle Centres, South Africa
Protea Greek god
that was able to change
between many forms
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Farrow Partnership Architects, Clark Nexsen, Ngonyama Okpanum & Associates
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Farrow Partnership Architects, Clark Nexsen, Ngonyama Okpanum & Associates
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Farrow Partnership Architects, Clark Nexsen, Ngonyama Okpanum & Associates
Centre of influence
Versus
Centre of Excellence
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Farrow Partnership Architects, Clark Nexsen, Ngonyama Okpanum & Associates Legacy: Change the way people think about, see health
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E’Terra Samara
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E’Terra Samara
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E’Terra Samara
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E’Terra Samara
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E’Terra Samara
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find shared meaning do their best work
develop their capabilities connect with nature
discover their strengths communicate a sense of abundance
build a legacy
SALUTOGENESIS “Design to Thrive”: environments that:
strengthen social networks
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How will you cause health?
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Tye Farrow B Arch, M Arch UD, LEED AP
FRAIC, AIBC, SAA, OAA, NSAA, NLAA, Assoc. AIA
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END