The average size of the American bottom is growing, according to transit agencies who have to consider the problem when ordering new seats and train cars. And the rising rate of overweight or obese children is increasingly a design factor for furniture manufacturers, schools, hospitals, and clothing companies. Should architecture and urban design have a role in improving overall health and well-being? An exhibit at the CCA (Canadian Centre for Architecture) says yes.
Curated by Giovanna Borasi and Mirko Zardini, the Imperfect Health exhibit explores how architecture and urban design acknowledge, incorporate, and affect health. In an accompanying book and photo essay, Borasi and Zardini question what they call the "medicalization" of society, the trend of treating the nonmedical problems of daily life as medical. The pair also criticize the trend of architects and urban designers co-opting medical language.
"Architecture and urban planning have since undergone a parallel process; they rely increasingly on medical rhetoric to describe problems and arrive at solutions defined in the medical milieu. An ever growing number of urban, environmental and architectural problems are treated as medical, and remedies are sought in increasingly specific solutions; tailoring requirements to particular groups of ill or presumably ill individuals leads to conflicting, contradictory solutions, and finally to the even greater segregation of various demographic groups. In this sense, architecture — subject to medicalization — should itself be considered a “sick” body."
The authors trace the historic evolution of urban design attitudes from defensive, protective, "surgical" responses in the 19th and early 20th centuries to the current prescriptive, therapeutic,"medical" approaches. Transplanting green spaces and opening up streets for circulation would fall under surgical urban design methods. Medical strategies include resurfacing existing buildings and using greenwashing as a cultural panacea.
Borasi and Zardini advocate for removing medical analogies from design strategies.
"The demedicalization process, if applied to architecture, might allow the discipline to escape the ambiguity and moralism of contemporary ideas of health by taking both problems and solutions out of the realm of individual commitment and restoring them more appropriately to the larger sphere of social surroundings. In this way, it might be possible to recover one’s capacity to be critical with respect to public health policies; to take part in the debate while renouncing the allegedly rational, scientific solutions prescribed by a medical idea of health. As architects Kersten Geers and David Van Severen observe in their theoretical project for a healthy city, the most significant shift for architecture and urbanism will be from the idea of cure to the idea of care — in the process of taking care of our bodies and our environments."
So what are we missing as designers when it comes to healthy buildings, healthy cities, and healthy lives? Instead of merely healthy buildings that are energy efficient and environmentally friendly, Borasi and Zardini make the case for "fit" buildings. What makes a building fit? A fit building keeps citizens in shape by training us to adopt healthy behaviors, like taking stairs.
Is the idea of a fit building as the authors describe realistic? Personally, I think the most design can --and should-- do is encourage healthier choices by presenting them in an attractive, convenient way. Whether a person decides to sit, stand, walk, or run is ultimately an individual choice and should remain so.
Demedicalize Architecture [Design Observer]