comm unity [health] center
How might we reimagine a healthcare environment which better supports the treatment and prevention of chronic illness?�
My research semester began by looking at the prevalence of chronic disease in the United States (60% of adults in the U.S. have at least one & 40% have two or more, according to the CDC), and how the current healthcare model handles them. Typically this is a single point model in which the patient receives a diagnosis and some form of care plan from their primary provider and are left largely on their own to enact this care plan which usually entails big lifestyle changes. There needs to be an additional, ongoing care point which supports patients throughout their sometimes confusing health journey. Through my research, I found that a very promising way to implement this form of care is by bringing healthcare to where people already are - not requiring them to go out of their way and through the sterility of a hospital or clinical visit - and by involving the community, which allows for the dual benefit of raising the overall level of community health and preventing the further spread of chronic illness.
“This project, for me, in the state that the world is in right now, is rife with mental hurdles. How is it that just over a month ago I was asked in a critique incredulously how medical procedures could be done in a place which was so exposed to the elements, to which I had to assure them that of course the sick would continue to be treated in the safe environment of a sterile hospital. Now there are tents pitched in Central Park which hold people who are intubated because a pandemic level spread virus renders them unable to breathe easily on their own, still others who were not fortunate enough to fight that virus and now lie in a morgue, somehow also in a tent in Central Park. How do you wrap your head around that? How do you look at that and maintain that anything else in this present moment holds importance?..�
kit of parts These pieces come together at various scales and in multiple different configurations to create bubbles of program which will be placed together as a modular community center. Program elements include a kitchen & gathering area, a fitness center, greenhouses & garden plots, private consulting spaces, and locker room facilities. The idea being that these can be placed anywhere that there is open space and a need in a community. The members of that community also have the ability to dictate which pieces of the program they want and in what quantity they want them within their center in order to reap the greatest benefit. A translucent tensile membrane allows for the blurring of interior and exterior, letting in as much natural light as possible and immersing people in their surroundings while keeping them mostly enclosed from the elements. Center pivot doors can be propped open, removing another vertical barrier and truly allowing the outdoors in. For added privacy in some bubbles, a living wall gives a solid, opaque barrier, but maintains the use of natural materials, as does the wood flooring underneath.
“...The state of healthcare, the state of disease, has regressed to something the modern era has not seen on this scale, at least not in the U.S., in decades. There are moments, as I really sit and think and watch this turn of events unfolding, that I panic , thinking that all of this rips away all validity of my project, and at first glance, with the situation at hand, it does seem that way...�
PTFE tensile roof membrane
center pivot doors tensile framework
living wall
wood deck flooring ADA ramp into space
cross braced support base
kitchen & gathe
“...A kitchen meant for meals to feed many, a gym with equipment spaced two feet apart, a consulting space with four chairs crowded around a single table - that is not healthcare right now, that is a coronavirus playground...�
ering
communal kitchen in which healthy cooking demos or community dinners can be cooked with indoor and outdoor gathering areas surrounding, allowing for a packed dining room or lecture style seating for demos or educational health seminars.
indoor/outdoor space includes cardio and weightlifting machines as well as storage for yoga mats and other small fitness equipment, allowing for both individual and class oriented fitness programs.
fitness center
“...But then I remember that even my initial arguments present that hospitals are still critically important to health and recovery, and especially in a health emergency such as this. Trauma and critical care are always going to be important parts of the healthcare system; people will continue to fall ill and break bones at variable rates. The rates that we’re seeing right now, the literal pandemic level rates, are not normal. These times are not normal...�
consulting private spaces in which individuals with questions or concerns about their care or health can meet with a professional for advice. also serves as meditation space for mental health practices.
“...And one thing to remember is that in normal and abnormal times, chronic illness does not go away. Just because the focus is on this virus does not mean that there is a hold on people having diabetes or high blood pressure or other conditions...�
locker room
shower & restroom facilities for those using the fitness center and other center programming, or simply in need of access to a restroom while in the area.
“...In fact, if chronic illness did not occur at the rates that it does, the death rate from this infectious disease could be significantly reduced, as those with existing conditions seem to be at a greater risk of severe symptoms and fatality...�
greenhouse
along with garden boxes placed in any available pockets of space between bubbles, the greenhouse enables community members to grow fresh fruits and vegetables either for use in the center’s kitchen for demos or large meals, or to give out to those in need of fresh food in the greater community.
“...I of course concede that my project is not ideal for the current state of disease, but in actuality, how can there be such as thing as ideal health care when the need for healthcare inherently suggests that there is something wrong with a person’s wellbeing? The Central Park field hospital is also not ideal for the current state of disease, and yet people are being treated there successfully. And if they can put a morgue in a tent then I can invite a community into a space with the goal to support them on a road to better health...”
1405 walnut • located in the heart of Cincinnati’s OTR • conveniently near a bus stop and several public parking lots • large vacant space allows for growth of the center as the community sees fit
proposed program configuration on site: • 1 kitchen/gathering bubble • 1 locker room bubble • 2 consulting bubbles • 1 fitness bubble • 2 greenhouse bubbles • 24 garden boxes throughout
“...Despite the circumstances, my project maintains validity - it just won’t hold as much relevance until people are once again allowed to gather and share meals across households and around a single table - when the state of healthcare can once again shift from a repair center to one of supported, ongoing care and prevention.� -personal journal entry april 8th, 2020
A Capstone Design Project Presented to the Faculty of the School of Architecture and Interior Design College of Design, Architecture, Art, & Planning In partial fulfillment of the requirement for the degree of the Bachelor of Science by Samantha Kelly University of Cincinnati Class of 2020