Exploring the future of care in urban communities

This is a rendering of a health resource center, a forward looking “library-like” space that provides digital, physical, and human resources to enhance health literacy. (Rendering by KPMB Architects)

New research highlights six important trends — and proposes a concept space that could bring them all together.

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A century of urban planning decisions has resulted in lifestyles where we spend too much time commuting alone in cars and too little time being active, too little time outdoors, and too little time interacting with people face-to-face, in our homes or just serendipitously on the sidewalk.

But the choices made as we design and build urban environments have a profound impact not only on how we live, but on how well we live.

We know good health is a prerequisite for a high quality of life, and our daily environments and lifestyles, including the extent to which we can easily connect with our friends and neighbors, are a major contributor to our health. Having access to excellent health care when ill is critical, but staying well and preventing illness is what most of us do day to day. Planning for health and well-being should be a core part of any neighborhood development.

Understanding this link, governments and health care providers are taking a more active interest in the topic of well-being and pursuing more proactive, preventative approaches to keeping people healthy. Sidewalk Labs — as part of our work re-imagining the future of urban communities — is researching ways to meaningfully embed health and well-being into the urban fabric itself. Exploring care is such a foundational aspect of our work that we have already launched a spinoff company, Cityblock Health, focused on community-based care in underserved urban communities.

Sidewalk Labs recently partnered with a Toronto-based firm, Idea Couture, to learn more about how neighborhoods can truly be drivers of community well-being and, by extension, individual health. You can read the full report here. Idea Couture specializes in human-centric and future-focused strategic design, and they know Toronto — one the most diverse cities in the world — very well.

6 trends driving the future of care

To begin the project, Idea Couture analyzed current trends that could signal where the future of care is headed. This scan was followed by “ethnographic immersions,” where researchers sat down with Toronto residents, health and human service providers, and representatives from community organizations for in-depth interviews. These conversations, with people who came from a mix of age groups and cultural, professional, and political backgrounds, were held across a wide variety of neighborhoods and living, work, and recreation spaces. The organizations visited included a branch library, a community health center, a youth center, an affordable housing provider, and a social service organization supporting the homeless.

Experience design firm Idea Couture compiled a report on the future of community health for Sidewalk Labs. Read the full report.

What was uncovered was a complex picture of a city that recognizes the vital role community cohesion and social connection play in health and wellness.

1. Home Is Health: Individuals wanted the boundaries between traditional care and service settings, community spaces, and their homes to be very fluid—in other words, that care be available in the home and the community and that clinical settings feel more like home or community settings.

2. Preparing for the Inevitable and Unpredictable: Service providers stressed the importance of proactively planning and designing for people suffering from homelessness, substance abuse and mental health issues. Some will have vulnerabilities that are not always easy to see or predict, so working closely with community partners who have earned their trust is paramount.

3. Living Well Across Generations: We heard a strong desire for truly intergenerational spaces and services where young and old can come together.

4. Navigating Diversity: Residents expressed a deep pride in the city’s diversity, but desired more opportunities for connection for people across demographics, incomes, and backgrounds.

5. Low-Fidelity Care: Although technology is necessary and often useful, it should never be allowed to get in the way of bringing people together. Residents expressed the need to accommodate low-fidelity options alongside digital service delivery. A community’s well-being is often a result of spontaneous connections and grass-root initiatives. These informal, face-to-face connections are just as important and should exist alongside technological solutions.

6. Balancing Purpose and Spontaneity: Formal health services and infrastructure will always be required, but caring relationships often emerge spontaneously. Residents felt that we should design neighborhoods to create those opportunities of spontaneity.

Engaging more voices to build on initial research

To further build upon the insights gleaned from the immersions, Idea Couture and Sidewalk Labs convened a co-design charrette — a day-long gathering of people from the public, non-profit, and private sectors, many focused on health and community services, civic engagement, and urban planning. We asked participants to imagine what a community-based space focused on human connection and care would look like in 2028.

Through the course of the day, more than 90 ideas emerged. People frequently returned to the idea of using technology to give them more control over their own well-being and greater say in their care. Many identified the opportunity to better connect people and community programs — such as informal mentorships, volunteering, or peer-to-peer support — via digital tools. Participants imagined a future where care of the mind, body, and spirit happened under one roof and where “third places” facilitated community members to relax or casually interact with each other.

Finally, the group stressed the importance of giving the community a voice in how their services are delivered, and they wanted a governance model that would be nimble and responsive to their input.

One community health idea is to integrate sanctuary spaces — nature-infused places of respite that allow visitors to unplug from their hyperconnected lives — into places of care. (Rendering by KPMB Architects)

The Care Collective: A new type of neighborhood care hub

Synthesizing this feedback, and drawing inspiration from existing community care hubs around the globe, Idea Couture created a concept to pull many of these ideas together: a Care Collective. This new kind of community space would bring together a range of programming and services and be dedicated to health, wellbeing, proactive care, and community connection. It could leverage digital tools to expand the reach of the physical space, allowing people to connect with one another digitally as well as in-person.

Idea Couture imagines the Care Collective could include a health resource center dedicated to enhancing digital health literacy, where people could borrow digital health resources, learn from one another and from health experts, or just come to hang out. Areas dedicated to prototyping new community health solutions were proposed, as were mobile health pop-ups that bring care solutions across a city. Clinic spaces that feel more like home, quiet sanctuary spaces, and a pharmacy in the form of a cafe or lounge, offering access to expertise in a relaxed, informal setting were seen as critical resources.

We worked with architectural firm KPMB to mock up these spaces to help us imagine this future. Check out the full report to see more.

This research and public engagement work has provided Sidewalk Labs with community-driven insight that will shape our thinking as we plan neighborhoods that improve well-being and foster local connection. We’ll share more about our planning work soon as it relates to our Sidewalk Toronto project — in the meantime, we hope cities find the insights derived from this research valuable as they plan for their own healthy neighborhoods of the future.

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January 17, 2019