P3C179: Physical Determinants of Health; The Impact of the Built Environment on Health Equity

Background: Social determinant of health (SDOH) are conditions in the environment that contribute to health disparities, inequities, and quality of life. A focus of the Healthy People 2030 initiative is the impact of the built environment on improving health and safety in places where people live, work, learn, and play. Hospital and ambulatory spaces where pediatric healthcare is delivered is an underrecognized yet integral component of the built environment. If hospitals are designed with SDOH in mind, these facilities have the potential to influence healthcare outcomes.

Project Description: Healthcare architects that specialize in designing pediatric healthcare spaces participated in a semi-structured interview to obtain insights on how to design hospitals with SDOH in mind. Four, 45-minute interviews were conducted. Questions prompted participants to reflect on how design improves access to healthcare services and community outreach programs, destigmatizes illness, and promotes inclusivity.

Discussion: Hospital based grocery and pharmacies increase access to healthy food options and support medication compliance. Interactive kitchens and fitness areas used for education and wellness promote physical activity. Lobby concierge desks improve access to financial services, social work, and case management. Private bathrooms, gender neutral signage, and removal of gender icons foster inclusivity. All access playgrounds, all-inclusive imagery that demonstrates potential for every child destigmatizes medical conditions. Intuitive wayfinding and icon-based signage considers the varying levels of literacy and cultural backgrounds. Open spaces with access to nature, light, and fresh air reduce stress and anxiety.

Conclusion: “Physical determinants of health” is the impact of a healthcare facilities-built environment on SDOH. When built with SDOH in mind, pediatric hospitals support community outreach programs, promote socialization, de-stigmatize illnesses, foster inclusivity, and reduce stress. Buffering the risk of harm to minimize adverse childhood experiences, particularly during illness, improves children’s health, wellbeing, and quality of life. It is imperative that healthcare providers and hospital administrators better understand how the physical hospital environment influences SDOH. When designing new healthcare facilities, or renovating old ones, there is a unique opportunity for healthcare providers, executives, and architects to build hospitals that support the patients and communities we serve.