Insights


Improving Healthcare Resilience Through an Equity Focused Framework

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Resilience is an equity issue. It is directly linked to the resources one has when coping with environmental stressors. These resources occur at multiple scales with social, physical, and economic components.

We shared our research on this topic at this year’s AIA/ACSA Intersections Research Conference: Resilient Futures. The work we presented focused on factors that contribute to resilience and a framework we developed to measure effectiveness of applying these factors at the human, building, and infrastructure scales. This framework and the methodology for applying it helps architects and our clients make better decisions about design.

At the macro scale, climate change has wrought havoc on infrastructure. This impacts us all, but vulnerable populations bear the brunt of the health burden. Within the United States, adverse weather events linked to climate change such as flooding, heat waves, extreme cold, and violent storms often occur in areas with poor air, water, and soil quality exacerbating challenges.

Moving to the building scale, health facilities are also under new stresses. Weather events impact aging structures, challenging their ability to operate in an emergency. Structural integrity, access to power, and indoor air quality are among the life safety issues that may arise. As we build new hospitals, it is important to consider these impacts and potential future impacts on what we design. As we renovate existing structures, we need to consider how to build resilience within the existing systems so that future problems do not occur.

The impacts of the pandemic have magnified the need to consider individual resilience. Stress undermines short-term ability to function and make decisions. Chronic stress has been shown to create inflammation in the body. This inflammation contributes to physical and mental disease. Personal resilience is tied to the ability to return to homeostasis after experiencing an adverse event. Our research in salutogenic (health generating) design shows how environmental resources can help activate the parasympathetic nervous system and turn off the stress response.

The healthcare industry is currently experiencing a paradigm shift from providing episodic care for treatment of disease to a holistic focus on maintaining health. Learn more about our equity and resilience research by viewing our full presentation here.

Our white paper on this topic, authored with Shan Jiang, PhD., GBBN’s Director of Research, is available here.


Tiffany Broyles Yost, AIA, LEED AP, BD+C, Fitwel Amb. is an. associate principal at GBBN and the director of sustainability & resilience. She provides strategic leadership for sustainable design across the firm’s portfolio of projects, manages the research of the firm’s Sustainability Action Network, oversees our Sustainability Action Plan, and spearheads related educational initiatives. Her work includes sustainable design on projects at all scales from international supertall mixed-use buildings to single story existing building renovations. Tiffany serves on several non-profit boards and committees including, the Greenbuild Summit Advisory Board, the Fitwel Advisory Council, the Louisville Sustainability Council, and the Green Umbrella/Cincinnati 2030 District Health Strategy Committee.

Greg Coni, AIA, CPHC, is an associate at GBBN.A Certified Passive House Consultant, Greg is passionate about sustainable, resilient design. He loves tackling the complexity of healthcare projects to ensure all the pieces fit efficiently together inside high-performing exteriors. He serves as the Vice Chair, AIA Pittsburgh, Young Architects Forum (YAF) Committee and volunteers as a Student Mentor with the ACE Mentor Program, Western Pennsylvania.

Angela Mazzi, FAIA, FACHA, EDAC, is a medical planner and principal at GBBN. Harnessing studies on human psychology, research on our biological need for nature, a focus on clinical workspaces, and experience with Lean strategies, Angela creates exceptional environments that empower patients and practitioners. She regularly presents and publishes her research in industry and peer reviewed journals and is sought out by Healthcare Design Magazine, the New York Times, and other publications to share her healthcare expertise with their readers.