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Feed #4

Design Health

If medical professionals are united and bound by the Oath to ‘first do no harm,’ then what analogous pledge unifies architects and designers? For thousands of years, healers have been aware (to varying degrees) that their efforts can harm as much as they can mend. The designed world of regions, cities, buildings, rooms, furniture, objects would seem by its nature to operate in service of humanity, but the reality is often more complicated. Designs are often developed in the abstract, during meetings that may not include the people who will work, play, eat, rest, and live in these spaces. Due to issues of cost and complexity of design,translations from drawing to building do not always go as planned. The subfield of Design Health accepts that design can harm, and asks how to minimize that harm, as we see in Andrew Ibhrahim’s work on the intersection between hospital ward architecture and health outcomes after surgery. Ibrahim and his team ask which room designs are correlated with the best outcomes and why some of the less favorable designs persist and who benefits from these designs. 

In the 1960s, Selwyn Goldsmith was among the first to point out that architecture itself must accommodate a wide range of human bodies and not the other way around. In Designing for the Disabled: The New Paradigm, Goldsmith described the problems facing people who are ‘architecturally disabled because the architect who designed the building did not anticipate their needs.’ He pushed past the medical model of disability, which sees disability as a diagnosis and a set of impairments, to craft a social theory of disability where the environment is the medium through which some are enabled and some are disabled. The potential for design to be inclusive – enabling access by accommodating for the variety of ways that humans occupy, engage with, and move through the world – continues to be provocative and elusive. As Aimi Hamraie has chronicled in Building Access: Universal Design and the Politics of Disability, architects like Ronald Mace sought to expand the role of design beyond being ‘barrier free’ and toward an enriched view of the human. Through this lens, design has the capacity to contribute to a better world by helping us rethink our assumptions about what the environment should be. At the same time, increasing access will require designers to accept that sometimes design itself can be a problem. 

Big institutional actors and distant clients can have a great influence on architecture, often with little knowledge of (and sometimes even concern for) the humans who will occupy that space. Often, the occupants are treated as a set of “human factors” such as height, distance to reach, lumens, and decibels that reduce them to a mechanical model. And while the situation has improved since Henry Dreyfuss described his ideal Joe and Josephine, these factors are still largely derived from studies of neurotypical, able-bodied, male undergraduates. Measured as such, human factors not only marginalize other physical possibilities, but penalize unanticipated interlopers. These mechanical models alienate the mind from the body, causing yet more problems.

The deeper reasons for this estrangement are political, as is the resistance to these models. Design and health are entangled with questions of politics; since the 1960s, the push for rights to access has learned from the struggles of the Civil Rights Movement and other pushes for  racial justice, as illustrated through the documentary ‘Crip Camp.’ As the gathering at Camp Jened in 1971 transitioned to the 504 Sit-In in 1977, the Black Panthers provided food and other support as the groups worked together for justice. Design Health is not just about ramps and curb cuts, though those are essential, it is a larger commitment to including the full range of bodyminds into physical space as much as in discourse. 

The phrase “nothing about us without us,” launched by the autism and neurodiversity communities, is a vivid reminder of the need to include those most affected by decisions,  and this way of thinking can enrich architecture, as seen in the work of designers like Sean Ahlquist and Yi-Chin Lee. An inclusive practice can be slower, more considered, making time in the design process for beneficiaries of design to have input on their designed environment and perhaps even work on the design as well. Disabled communities are already skilful designers of their environments.  As evidenced in the groundbreaking 504 Sit-In, it was the resilient resourcefulness of the disabled activists that allowed for the successful orchestration of a 24-day occupation of a government building, under increasingly difficult and sometimes dangerous circumstances. That this group not only survived but prevailed is testament to the inherent design re-thinking constantly demanded of many people with disabilities in order to navigate a world that was not designed with them in mind.

Participatory design practices have already taught designers and theorists a lot. These inclusions have shown, chiefly, that people are not a collection of purely physical “human factors” and that instead design should consider the bodymind as one integrated whole. This integrated concept of mental and physical processes is an important one in the study of trauma, affect, and disability as it represents an important theoretical conversation as well as a methodological one. As healers learn more about the way trauma is stored in the body, we as designers should ask how we can heal through designs that elicit or speak to affective responses. As theorists such as Tobin Siebers, Erin Manning, Elaine Scarry, and Brian Massumi illuminate the role of the bodymind, Design Health works in parallel with them to translate that theory into methods that study the environment in a more embodied way. In this Gradient feed, we hear from Rule and Aebersold on their virtual reality work where designs can now be tested in a simulation of embodiment. McMorrough unfolds the persistent, responsive, and ingenious design thinking that propelled key disability activism in the passing of Section 504. Knoblauch, Leonard, Nanda, Del Campo, and Delacroix used new generative AI tools to create visualizations of “quiet” hospital rooms to show patients, asking if they agree that these rooms seem quiet. Nanda reflects on the lessons of healthcare architecture research and practice. Wei highlights the value of listening to the voices of those with disabilities. Our group is concerned about the gaps between quantitative analysis and lived experience, and we think architecture and design have an urgent need to close these gaps.

Health is in a crisis, and we ask how design can help. In 2025, humans around the world are struggling with war, income inequality, the long COVID pandemic, the problems of sedentary lifestyles, food deserts, and addiction to screens, substances, or other life depleting habits. The inherent power of good design is to think and re-think: to imagine, evaluate, and respond, all toward further imagining and a continual refreshing of the process. The contradiction that thoughtless design can endanger while its thoughtful counterpart uplifts is useful to remember. On its best day, when aimed in the appropriate directions, design is the right tool for the job of handling difficult problems, but what’s more important is how that tool is wielded and who benefits from it. Critics of Ronald Mace’s ambition for a Universal Design highlight the impossibility of a singular approach to accessible design, but we can nevertheless appreciate that Mace’s ideas of flexibility, equity, and ease ask that, in the process of design, we take on the responsibility of understanding the diversity of human experience: the reconciling of contradictions makes design not just a solution but an undertaking. Just as contradictory standards in endeavoring to create the ‘most accessible’ website may yield something still imperfect, the questions raised in the process point to ideas that can be more than simply answers. While design can indeed help create a functional operating room for an acute problem, more often and more pervasively, it can help in prevention and in setting folks up for social and physical days,years, and decades that foster a society enriched by human flourishing.

Michelle Aebersold
Matias del Campo
Emerson Delacroix
Natalie Leonard
Upali Nanda
Jonathan Rule

Design Health Editors

Joy Knoblauch
Julia McMorrough
Jono Bentley Sturt
Irene Wei

Feed #3

Infrastructures

Why study infrastructures? What do we talk about when we talk about infrastructures? These questions are timely to ask. As you read, Russia is attacking critical infrastructure in Ukraine, chipping away at the country’s political independence. China has spent the last decade erecting highways, bridges, and buildings at unprecedented rate and scale, much of that in Africa. The US has recently passed major infrastructure and climate bills at a scale that suggests a major shift in public priorities, even worldviews. Within the mainly North American scope of this journal and the college it represents, the latter seems enough of a prompt.

Bryan Boyer
Robert Fishman
Catherine Griffiths
Ersela Kripa
Stephen Mueller
Geoffrey Thün
Kathy Velikov
Lee Vinsel

Infrastructures Editors

Malcolm McCullough
Cyrus Peñarroyo
Vyta Pivo
Jono Bentley Sturt

Feed #2

Inflections

[As members of the Architectural Computational Design + Construction Cluster (ACDCC) converge to look inward, to ‘bend in,’ to reassess our priorities and formulate our collective identity and impact, Gradient: Feed #2 captures these discursive moments of exchange. Gradient will be our way to lean outward, to spark conversations and debate, and highlight our priorities.] 

Mollie Claypool

McLain Clutter

Dana Cupkova

Matias del Campo

Shelby Doyle

Andrew Kudless

Achim Menges

Catie Newell

Tsz Yan Ng

Vyta Pivo

Jose Sanchez

Rebecca Smith

Kathy Velikov

Peter von Bülow


Inflections Editors

Tsz Yan Ng
Jono Bentley Sturt

Feed #1

Other
Assemblies

Consider the 91.5x2.75x2 in. Crown Molding in Unfinished Beech, available for $25 at Home Depot. Upon installation, your dining room is magically charged with allusion to a broadly cast notion of western culture, recalling the neoclassical cornice, and its Renaissance, Roman, and Greek antecedents. Shaped to cast shadow from an absent Mediterranean sun, the sectional figuration reflects the physical constraints of chiseled tufa stone, later translated through those of plaster application, and then the factory wood mill. This piece of off-the-shelf trim constitutes the material sediment of millenia of collective labor practices, and their attendant social and cultural constructions. Today, crown molding is attached via finish nail to gypsum wallboard, nominally dimensioned to 4’×8’ to align with light-frame construction beyond. This 4’×8’ dimension, and subdivisions thereof, regulates scores of additional building products, logistical practices, factory floors, bodily configuration, spatial patterns, and the habits of life within. The material assemblies that constitute architecture encapsulate, enforce, and inflect a rich aggregation of social, historical, cultural, and political concerns. 

Xavi Aguirre
Matthew Au
McLain Clutter
Peggy Deamer
Mira Henry
Irene Hwang
Daniel Jacobs
Perry Kulper
Meredith L. Miller
Steven Lauritano
John McMorrough
Mireille Roddier
Anya Sirota
Rebecca Smith

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Online Journal for Architecture and Urban Design

For further reading see: Too (2) PLUMP
Research
For further reading see: Situation, Disassembled
Essay