Leveraging the power of design and design thinking for public health

By Matthew Trowbridge

It is increasingly clear that solutions for our most pressing and challenging public health issues will ultimately hinge on designing environments that encourage healthy behavior choices by making them more available, economical, and enjoyable.

Traditional public health approaches are not perfectly suited to this task. For example, epidemiological studies allow us to measure the association between environmental design features such as parks or sidewalks and walking behavior, but these experimental data are generally insufficient to be either actionable by decision-makers or effective in prompting behavior change. As Jeff Speck, urban planner and theorist, observes in his recent book “Walkable City: How Downtown Can Save America, One Step at a Time”:

“The pedestrian is an extremely fragile species, the canary in the coal mine of urban livability. Under the right conditions, this creature thrives and multiplies. But creating   those conditions requires attention to a broad range of criteria, some more easily         satisfied than others.”

Public health must improve its ability to develop multi-dimensional interventions to more successfully provide environments and experiences that encourage positive health outcomes. Put another way, public health must develop its capacity for design thinking.

What is design thinking?

Design thinking refers to the core problem-solving approach utilized across design disciplines from architecture to industrial design. This approach calls for the development of human-centered solutions through direct engagement with end users, in order to best understand their needs, challenges, and desires. Multi-disciplinary teams employ a rapid, iterative prototyping process stemming from insights derived from the people they hope to serve. This systems-based approach offers a flexible approach to a wide range of complex problems and helps teams blend technological, process, and communication strategies to achieve more integrated and effective solutions.

Design thinking has gained prominence through its application in a broad variety of business and social entrepreneurship contexts with great success—helping companies design more successful products, strategies, and customer experiences. In his 2008 essay  “Design Thinking” for the Harvard Business Review, Tim Brown, co-founder of the firm IDEO and a prominent spokesperson for the potential of design thinking beyond traditional design applications, writes:

“During the latter half of the twentieth century design became an increasingly valuable competitive asset in, for example, the consumer electronics, automotive, and consumer packaged goods industries. But in most others it remained a late-stage add-on. Now, however, rather than asking designers to make an already developed idea more attractive to consumers, companies are asking them to create ideas that better meet consumers’ needs and desires. The former role is tactical, and results in limited value creation; the latter is strategic, and leads to dramatic new forms of value.”

Opportunities for design thinking within public health practice

Fortunately, public health is well positioned to expand application of design thinking to include health promotion. The success of design thinking firms such as IDEO, combined with the increasingly visible role of designers in many technology start-ups, has created an expanded view of how design can be applied. Moreover, applying design thinking to broad-scale societal issues such as public health and environmental sustainability is a growing area of interest and activity within the design community.

One illustration is the Design for Good campaign developed by AIGA, the largest professional organization for designers in the United States, specifically focused on “implementation of design thinking for social change.”  As of October 2013, the Design for Good website featured more than 60 case studies describing interdisciplinary application of design thinking approaches to address a wide variety of public health issues.  A poignant example, “Designing the Ideal Home for Wounded Warriors”, submitted by IDEO outlines how design thinking was employed to create maximally accessible and supportive living spaces for veterans with debilitating injuries at Fort Belvoir in Virginia.

Looking abroad, a leading innovator in application of design thinking to address societal issues and goals, including public health, is the United Kingdom Design Council. The Design Council is a Royal Charter Charity headquartered in London that works to “champion great design that improves lives” by providing cutting-edge design resources and expertise to inform projects and issues with a public impact. This includes a wide range of public health priorities including obesity prevention through strategies such as active design to public space design recommendations centered on the needs of blind and limited sight pedestrians. Another notable initiative is the Behavioural Design Lab launched in collaboration with the Warwick Business School to develop “design-led innovation” to address societal issues rooted in behavioral or lifestyle factors.

Looking ahead

In short, there is both a growing need and opportunity to build collaboration between public health and the design community to address the critical public health issues of our time. Public health interventions, particularly to address complex problems such as obesity, must become more human-centered; providing environments and experiences that make healthy behaviors easy, enjoyable, and economical parts of everyday life. Building capacity and competence for design thinking within public health offers an important step in that direction.

Matthew J. Trowbridge MD, MPH, is an assistant professor and associate research director in the Department of Emergency Medicine at the University of Virginia School of Medicine. He is also a U.S. Green Building Council’s 2013-2014 Mark Ginsberg Sustainability Fellow and a contributor to the National Collaborative on Childhood Obesity Research (NCCOR). 
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