Universal Design for Wellness in Space

Linking Interprofessional Collaboration and Public Health

By Melanie Concordia and Jescelle Major

Take a moment to reflect on the most recent new place you entered. It could be a public space like a museum or garden, a business, or a home. What did you do when you first approached? What caught your attention?

Naomi Abrams proposed similar questions during her talk at the 2018 American Occupational Therapy Association Annual Conference. She inquired, “What did you do when you entered this room, and how did you know what to do?” The audience hesitated, until someone finally shouted, “I sat down!” “And why did you sit down?” Abrams continued, “Because past experience tells us to sit down when we enter a room full of chairs.”

Universal Design

Like the conference attendees who immediately sat down upon entering the room, how we approach our surroundings is influenced by our experiences in the world, our abilities, and our individuality, and it is important to remember that no two people are going to interact with a space in the same way. According to the National Disability Authority, the term universal design is used to describe spaces that “can be accessed, understood, and used to the greatest extent possible by all people regardless of their age, size, ability, or disability.” At best, when approached with universal use in mind, environmental design can address health disparities and ensure that no one is left behind. At their worst, our designed environments can create barriers, often invisible, to access. Because of this, advocating for universal design is an environmental justice movement. Good space design should matter to all of us, since a universally designed public space serves everyone equally and fosters better health.

For example, the World Health Organization’s 2011 report Global Health and Aging emphasizes the need for seniors to “age-in-place”—to be able to live in their homes and communities safely and independently as long as possible.

Aging-in-place is necessary for individual well-being and reduces the physical and financial impacts on health-care systems and communities. Pertaining specifically to how aging-in-place relates to public designed spaces, the report states that the economic strain and health impacts associated with disability “can be reinforced or alleviated by environmental characteristics that can determine whether an older person can remain independent despite physical limitations.” Though the report does not mention universal design explicitly, design for aging-in-place comfortably falls under this distinction.

Interprofessional and Creative Problem Solving

When people enter a space, what do they do, and why? These are questions occupational therapists (OTs) and landscape architects (LAs) ask themselves every day, and though this professional pairing may not seem obvious, OTs and LAs are well suited to work together towards a goal of universally designed spaces. Among other benefits, LAs bring environmental design skills to the table, while OTs offer medical knowledge regarding the abilities of a broad range of users. Currently, few OTs and LAs have bridged this professional gap, but the healing gardens at the VA Puget Sound Fisher House is one successful example of such a collaboration (for details on this interesting project, see the OT Practice article “Universal Design for a Lifetime: Interprofessional Collaboration and the Role of Occupational Therapy in Environmental Modifications” by Debra Young, Tracy Van Oss, and Amy Wagenfeld).

In general, interprofessional design teams are ideal for creating public spaces for diverse uses. As described by Professor Katherine Phillips in her comprehensive Scientific American article “How Diversity Makes Us Smarter,” unconventional collaborations inspire creative problem-solving when compared to the work of homogeneous teams. Phillips’s analysis also indicates a strong link between diverse working groups and deeper discourse. This results in improved quality of work, increased open-mindedness and empathy, and a greater ability to resolve disagreements, and all of these factors are precursors to understanding the value of and prioritizing universal space design. Cross-disciplinary and cross-cultural work of this kind can elevate the practice of universal design from a specialty consideration to a normal part of everyday life. The Gehl Institute’s 2018 report Inclusive Healthy Places offers a framework that details powerful ways interprofessional teams can deliberately design universal spaces, including recommendations for collaboration and feedback.

We encourage everyone, regardless of background, to think more holistically about the spaces we occupy and how they serve our collective health needs. The next time you enter a new space, indoors or out, take a moment to consider all the possible uses and users, not just the first one that comes to mind.

Melanie Concordia is an occupational therapist with an interest in universal design, aging-in-place, and environmental modifications. She is currently based out of Denver, Colorado.

Jescelle Major is a landscape and urban designer in Seattle. She moved to the Pacific Northwest after finishing sustainability and landscape architecture studies in Florida and Louisiana.