Pt 1. Design & Health

I've been reading sections from In The Bubble - Designing In A Complex World for the past couple of weeks and enjoying it a lot. It reminds me a bit of Jane Jacob's The Death and Life of Great American Cities about how poor urban planning decisions create inequality, contribute to unsustainable systems, and foster a general sense malaise and at times hostility among residents. Hasty and irresponsible design decisions have greater consequence than we can imagine at the time of their making.

Back to In The Bubble, author and designer John Thackara essentially has written a design manifesto about how creating more and more products and technological gadgets without intention is actually making our lives harder and less connected. Thackara posits that we are moving away from people-centered world by clouding our surroundings with (largely) useless devices. The book was written in 2006, so some of Thackara's lofty predictions/poetic musings about the future are a bit off, but in large part, I've been impressed by how relevant the book still reads. In Chapter 6, "Conviviality," Thackara sharply criticizes the role of technology in healthcare writing brilliant passages such as this:

Health and care industries are growing because people don't look after each other as much as they used to. We expect governments to provide support services instead. Governments don't like this. The provision of care costs a lot of money - and besides, the customer is never satisfied. Hence the growing interest among policymakers in ideas of social capital and conviviality. The case for conviviality is that if we were to take more responsibility for our own well-being, we might rely less on care as a service delivered to use by third parties - especially the state. Such a shift in emphasis - from delivered care to supported care - would enable governments to focus on the supporting infrastructures, collaboration tools, and social software for better connected communities by enhancing dialogue, encounter, and community in our everyday lives (114).

Wait! Before you start thinking Thackara is some luddite, he goes on to say:

I would be foolish to argue that technology has no place in health care. After all, as I recounted in chapter 5, modern medicine saved my daughter's life.... What I object to is not technology in health, but the over reliance on technology to do things that human beings can and should do better, and the false expectations raised by special-interest groups that should- and do-know better regarding what technology can do and what it can't do in the realm of health care (115).

Later in the chapter, Thackara describes what he sees as the future of health care, and, interestingly enough, a lot of these elements are happening now, 10 years later. He argues for what he calls "decentralized care":

A decentralized health system would connect, but not direct, midwives, alternative home care, birthing centers, the fitness industry, health clubs, health food stores, organic farmers and growers, people who offer inspirational workshops, biofeedback, and massage...

He quotes economist Hazel Henderson who says: 

Even within the traditional matrix of medicine, healthcare will be forced into a more clinic-based and neighborhood-based approach (118).

I love this vision of health care, and I love that it's now happening. Just off the top of my head, I'm thinking of the fact that doctors are now re-instating home visits, that certified health coaches and holistic nutritionists now work alongside doctors, that affordable insurance companies like Oscar now reimburse you for gym memberships, that CSA's are on the rise, that companies like Yabidu promote participation in the health care process by helping caregivers, that design agencies like Mad*Pow host conferences like this... To me, all of these things are part and parcel of our health and well-being and a sign of progress. Most importantly, they are people-centered and foster real human connections. And, at the risk of sounding new-agey, I believe these forms of health care contribute to what has been coined "well-th."

Later this week in part 2, I'll be writing about the intersections of behavioral economics & the ethnographic approach in relation to well-being and health care.

Happy Monday!