What we can learn from the banishment of brothels - redesigning clinics and health behavior
Recently I learned about how design was used in a really powerful way to transform a neighborhood; what's nice about it, was that it did it by empowering residents to make the place 'their own'. It made me think… people get lazy about health, and there’s endless talk about how the public healthcare system is overwhelmed. People should care about their own health, and take responsibility for it; this would be more sustainable. There are many public health initiatives that put people in the backseat, almost reinforcing a reliance on ‘others’. We know from studies that ‘patient autonomy’ leads to better health outcomes. Why do we have to wait until people become sick to think about autonomy? How could design be used to help this systemic change?
The opportunity to redesign healthcare spaces is not just for aesthetic or workflow value. Space design can change essential health behaviors and attitudes.
One of the major challenges in the healthcare industry is ‘patient compliance’, which to me is a terrible term which conjures up thoughts of ‘naughty’ patients escaping through windows, drip feeds and all! In reality, it refers to patients adhering to prescribed medications and following treatment plans. Many articles on the topic also mention ‘patient autonomy,’ which, in simple terms, is about helping patients feel in control. I emphasize "feel" because even when patients aren't genuinely in control, the belief that they are can significantly improve their outcomes.
I’d like to explore this idea - designing for patient autonomy, through clinic street frontages. The goal is to find ways to encourage individuals to take charge of their own health and become proactive. I’ll draw upon two design concepts: sparking curiosity and inviting ownership.
From brothels to boutiques - design was used to encourage a sense of ownership among residents for their neighborhood
Earlier this year, Yokohama hosted its International Art Triennale, and I found myself in Koganecho on an exhibition hunt. After World War II, this area was known for its black market trade and prostitution. By 2005 it housed over 250 small brothels triggering the Kanagawa Prefectural Police to launch "Operation Bye-Bye" - a crackdown that closed down these illegal establishments.
Following the crackdown, the city government initiated efforts to revitalize the area through art and other means. Art was strategically used to engage the community and encourage residents to creatively reimagine their urban environment. Areas beneath the train tracks were transformed into artist studios. However, art doesn’t always feel accessible to everyone, so the city made the windows large and peculiar enough for people passing by to get closer to the artists and their work. Over time, people became more familiar with the space and ventured inside where local projects and workshops addressed neighborhood issues. These windows served as portals - creating connections that inspired residents to take ownership and empowered them with creative tools to solve problems in their own ways.
Transformation was not just physical, perceptions and behaviors were also changed
While cleaning up the area physically was important, what came next was even more significant - a sense of ownership. By involving locals in the revitalization process, they were able to imprint their own personality and culture on the space. If you visit this area, you’ll notice a unique influence from residents that is much more evident than in other parts of the city.
Could we use these urban techniques to foster a sense of ownership over one’s own health?
This urban renewal initiative offers valuable lessons for healthcare design. Just as the art studio windows invited people to engage in the re-imagination of their neighborhood, perhaps we can design clinic frontages to engage residents in their own health. There is an opportunity to shift the way people think about health, wellness, and vitality by fostering a sense of ownership. Ownership evokes responsibility and care - the foundations for ‘patient autonomy’. Compliance aside, in a world where healthcare resources are stretched thin, we need to do more to inspire proactive health behaviors.
Clinic frontage design and windows have so much more potential to provoke thinking about health
I recently came across an architecture firm called KTX in Tokyo. They have done a lot of work in the medical space design area and were telling me about one of their projects where they designed a dental clinic that lets passersby peek into treatment rooms and see state-of-the-art equipment through strategically placed glass panels. Curtains are drawn only when patients are inside, ensuring privacy while still giving outsiders a glimpse of the clinic’s capabilities and cleanliness. This transparency reassures potential clients about hygiene standards and demystifies the experience of visiting a dentist.
This reminded me a lot of the windows at Koganecho. And although their design objective was to build trust and awareness for this new private practice, I couldn’t help but think this clever design could have another positive impact - that people may think about their oral hygiene every time they pass by. Which begs the question: How might we intentionally use clinic frontages in more creative ways to influence public health behavior?
Windows for health
Currently, clinic frontages and windows are mostly practical, but as such, are underutilized canvases for change. Healthcare clinics have largely fallen behind the innovative and inviting designs seen in retail and restaurants. While coffee shops and boutiques draw customers with their aesthetically appealing and experience-driven spaces, many clinics remain visually unremarkable and uninviting.
Here are some potential ways we could better utilize clinic frontages and windows:
Draw attention to screening programs to encourage early detection and treatments when they have the best chance at success.
Give people a glimpse into some interesting parts of the process, like how restaurants show into their kitchens which generates interest, conversations, and puts health more front-of-mind.
Reimagine window real estate like retail shops (they often have window displays with screens behind them so that you can’t actually see behind into the inside - it could be a good balance for privacy.
Use windows to for public health education - similar to museums.
Ask rhetorical questions on the walls, like billboards.
Redesign entrances to intrigue people to enter and explore preventative or holistic health clinics.
There are many psychological elements to consider with regards to health behaviors - fear, awareness, motivation etc. It would be a good exercise to consider public health much like a private practice, and think about possible touchpoints and ways to engage. And of course, have private specialist practices consider how they play a role in public health as well.
Windows are expensive real estate - let’s use them!
