From Healthcare Design to Public Health Discourse – Presenting at APHA 2025

By Vinisha Narenden

This year, CO's Vinisha Narendran and Kimia Erfani participated in the American Public Health Association (APHA) Annual Meeting & Expo, join­ing a broad community of researchers, clinicians, policymakers, educators and advocates shaping how health is understood and improved at a population scale. Below, they share highlights from their experience and key takeaways for healthcare design.

For architecture, and especially healthcare design, APHA is a very useful lens. It is where the built environment is not just a backdrop, but part of the health system itself alongside evidence, policy and lived experience. Our work at APHA focused on aging and quality of life, highlighting our perspective on how the built environment can support daily autonomy, comfort and dignity for older adults. The conversations consistently returned to practical questions that designers recognize immediately, such as – how do spaces reduce friction when mobility changes, increase clarity when environments are stressful, and support care transitions with ease and humanity? We discussed how foundational architectural decisions, such as legibility and wayfinding, sensory conditions, thresholds, rest points and access to daylight and nature, aren't just nice extras, but choices that meaningfully shape daily well-being, especially for people navigating vulnerability.

In that same spirit, we shared a brief look at our research entitled, 'Beyond the Machine', a direction motivated by a clear inflection point – the COVID era. This time period brought vulnerabilities in hospital infrastructure into focus and revealed how many prevailing prototypes prioritize short-term efficiency over long-term adaptability, resilience and human well-being. While the benefits of integrating natural elements are well supported, our research identifies a persistent gap in healthcare architecture – a lack of a clearly articulated design vocabulary and spatial taxonomy that explains how these principles can be organized and applied within complex hospital set­tings. In response, our work develops spatial artifacts-adaptable design components that combine empirical research and spatial logic into a structured framework for the "Hospital of the Future". Our work reframes the hospital as a dynamic ecosystem that can be both operationally effective and actively supportive of health and resilience.

We left APHA with renewed clarity about what it takes to move design conversations forward, and with invaluable connections that expanded how we think about healthcare environments across scales. The feedback we received reinforced that the stron­gest design arguments are those that translate cleanly into outcomes and can be tested in real-world settings. Several conversations pushed us to be even more explicit about the following topics:

• Mechanisms - what a spatial condition changes in stress, orientation, mobility, or social support.
• Measurement - how we might evaluate design effects beyond satisfaction.
• Implementation - what is fea­sible within clinical operations and policy constraints.

We also found meaningful alignment with public health professionals who view healthcare facilities as part of a broader continuum linked to housing, transportation, climate resilience and community-based care. These professionals are eager for design frameworks that can be applied consistently rather than as isolated gestures.

A few takeaways from APHA we're carrying forward:

• Aging is not a niche topic- it is a design driver. Supporting older adults means designing for legibility, pacing, comfort and dignity from day one, not retrofit­ting later.
• Healthcare architecture needs a shared vocabulary across disciplines. The more we can describe space in ways that connect to prevention, equity and access, the more actionable design becomes in multidisciplinary teams.
• Evidence matters, but so does translation. APHA underscored how quickly ideas travel when they're explained in clear, outcome-oriented terms that clinicians, researchers and policymakers can use.
• Frameworks beat one-off features. Interest was highest when strategies were repeatable with components that can scale across projects and adapt over time in complex hospital systems.
• The "future hospital" conversation is already happening outside architecture. Hearing public health perspectives helped situate design decisions within larger systems and strengthened our mission to keep this work both rigorous and practical.