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Standpoint: Towards 2020 - An Action Plan for a Healthy Planet

Only bold, innovative thinking can head-off a global healthcare crisis, according to Texas A&M University’s George J Mann.

The future belongs to those who prepare for it. By 2050, our planet will support an extra three billion people, placing an incredible strain on healthcare systems and necessitating new and innovative ways to tackle healthcare delivery. Costs, access, quality of delivery, properly trained health professionals and patient safety are complex issues that threaten to overwhelm systems all over the world.

To provide the best for every human being, we will be forced to think outside the box: imagine what healthcare would be like if it was managed by the telephone companies (excellent communications); the airlines (excellent medical records, accessible anywhere in the world); or the hotel/hospitality industry (excellent, comfortable accommodation)?

We need bold thinking and leadership to solve the crisis in healthcare that exists around the world, beginning with the creation of a healthy environment for its citizens. Issues to be addressed include air and water quality; global warming; waste disposal; developing sustainable communities; and limiting non-renewable energy resources while emphasising renewable resources. We must design healthy cities with green spaces that encourage pedestrians to walk and exercise daily; these cities should be places that are designed to be less dependent on cars, buses and trucks powered by fossil fuels, which are linked by high-speed train transportation.

Often, no one thinks to ask the patient for their thoughts and suggestions, or for what they need. Does the patient have easy access to comprehensive healthcare insurance with prescription coverage? Are there patient advocates to help them gain access to health professionals? Is there a continuum of care from the womb to the tomb? Is quality home-care available?

An informed public with high levels of health education can delay or even prevent the onset of many diseases. Closely related to health education is the concept of prevention through self-examination, regular check ups, vaccinations and screening.

Understanding the ageing process is vital in preparing for an increasing ageing population. A continuum of care (independent living, day-care, group homes, assisted living, skilled nursing care, Alzheimer’s units, and hospices) is the basic component of comprehensive care for the elderly.

Health is not a business but it must be organised as such. Some countries spend enormous amounts on healthcare, yet their health outcomes do not reflect those expenditures: we need to learn why. We should work to increase funding for healthcare around the world.

We also need to plan better for specific diseases, by identifying those (cancer, heart disease, etc) for which we need to develop individual strategies. We must focus our efforts and establish priorities based on statistical evidence. These facts and projections are vital for focusing plans of action.

We also need a comprehensive approach to the planning of networks of health facilities. Modern technology has revolutionised healthcare delivery and the individual, and the home will be the next level of prevention, diagnosis and treatment. Individuals will monitor vital signs and continuous diagnostic tests through online technology.

The most important discussion has been left for last – ie, the promotion of high-quality design in the context of the above issues and trends. Architects must base their work on evidence-based design that focuses on healing environments.

We can – and must – do better, by encouraging innovative approaches to healthcare delivery, and by critically evaluating these varied approaches. Necessity is the mother of invention!

Author bio: Professor George J Mann AIA is The Skaggs Sprague Endowed Chair in Health Facilities Design, College of Architecture, Texas A&M University.

This article was advised and edited by Brian D Briscoe, Master of Architecture Candidate, Texas A&M University, Intern HKS; and Judy Pruitt, administrative assistant, Center for Health Systems & Design, Texas A&M University.









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