Tag: AC4D

art & designenvironmentpublic health

Design Space in Public Health

EmabarcaderoFountainIf design is everywhere humans are and shapes our interactions in the built environment, which dictates how we interact with the world around us should it not be considered important enough to be a part of public health?

I recently picked up a copy of the architecturally-inspired Arcade Magazine because of its theme on Science, Art and Inquiry. Inside was a piece by Andrew Dannenberg, Howard Frumpkin and Daniel Friedman. The first two are MD’s and the last author an architect and all are from the University of Washington . In that article, they outline a case for why design and public health should go together. The audience for the piece are those interested in architecture.

Indeed, Arcade’s purpose is to “incite dialogue about design and the built environment”. It makes me wonder why we don’t have something that “incites dialogue about design and public health?”.

Yet, I couldn’t help but think that same piece should be published in a public health space. In the article, the authors outline a few of the key areas where design can contribute to public health.

Among the first of these areas is promoting physical activity and the role that design can play in building and planning for spaces that encourage people to move in healthy ways:

Working together with public health professionals and planners, designers can help remedy what urban theorist Nan Ellin calls “place-deficit disorder,” starting with the basics – stairways, sidewalks, landscapes and contiguous urban spaces – which they can compose to attract greater pedestrian use.

Designing for resiliency is another of the areas where good design can benefit the public by creating a solid urban infrastructure to literally weather the storms that come upon us:

Evidence-based design can help reduce vulnerability and enhance the resilience of buildings and infrastructure, but most importantly, the communities who depend on them.

They also look at the role of design in enhancing sustainability and as a means for assisting environmental health while shaping the demand for sustainable products:

Designers possess the unique skills, knowledge and practices to specify the use of benign materials across scales based on life cycle analysis, energy conservation, carbon management, and environmental and health impacts. As designers expand these practices, they educate their clients, inform the public and shift the market.\

Lastly, they focus on how design can contribute to reducing social inequities by drawing on evidence looking at the connections between space and wellbeing for those in low-income neighbourhoods:

Recent studies demonstrate that links between greater access to green space and lower mortality are more pronounced among the poor than the wealthy. Housing initiatives that offer better homes for low-income persons, workplace design that protects workers, and universal design that improves access for activities by persons with disabilities—these practices benefit vulnerable populations and offer designers unlimited opportunities to help foster fuller, healthier lives.

Expanding the discourse of design and public health

It was refreshing to read a ‘conversation’ between public health and design and some taking the issue of space and health seriously from a design point of view. Some, like Emily Pilloton and her Project H design others have sought to use design as a bridge to social wellbeing by looking at space as being about communities and economics. Her video below explains how she has taken a design-driven approach to her work in promoting new sustainable ways to engage her adopted community of Bertie county.

Both of these examples of design in public health take a place-based approach, however there is much that can be done with designing the experience of health beyond place. Jon Kolko’s group at AC4D looked at design and homeless in their book Wicked Problems.  Andrew Shea has looked at the link between graphic design and social good in his book, which is explained further in his TEDX talk below. The design firm IDEO has been working on social good projects now for a few years through its IDEO.org platform and program.

  Bringing public health in

What seems to be missing and that the article in Arcade did and that was bring public health in. Emily Pilloton, Jon Kolko, Andrew Shea and many other terrific socially-minded designers are changing the way the public thinks about public health. Public health needs to be doing this too. It is striking that we have so few public health professionals — Drs Andrew Dannenberg and Howard Frumpkin as exceptions — doing the kind of design-oriented research and publishing in this area. It is ripe and public health and design both need it.

I don’t expect a lot of public health folks read Arcade, but maybe they should. And maybe we should be reading more about design in public health publications too.

design thinking

The Hyberbole and Exaggerated Demise of Design Thinking

Designing better design thinking

Design thinking is hot and under fire. Just as its miracle properties are misleading, so too are the claims that it is dead or dying.

If design thinking didn’t have something going for it no one would talk about it.

In a well-laid out essay on design thinking (and its timely death) William Storage points to the concept’s origins and proceeds from there to point to how it no longer serves a purpose given the panoply of voices arguing its merits.

He writes:

Design Thinking has lost its focus – and perhaps its mind. The term has been redefined to the point of absurdity. And its overworked referent has drifted from an attitude and guiding principle to yet another hackneyed process in a long line of bankrupt business improvement initiatives, passionately embraced by amnesic devotees for a few months until the next one comes along. This might be the inevitable fate of brands that no one owns, spawned by innovators, put into the public domain, and consumed by consultancies who prey on business managers seeking that infusion of quick-transformation magic.

A related discussion on the LinkedIn group devoted to design thinking on this very topic prompted a lively debate. The impetus from that discussion came from the topic of a panel discussion at next week’s DMI conference in Portland entitled: Is Design Thinking Dead?

Bruce Nussbaum’s oft-cited assertion that design thinking is a failed experiment was one of the higher profile critiques. He asserts that the experiment of design thinking has failed, whereas I argue that we haven’t even begun our research in the first place to make that claim.

Returning to Storage’s essay, he concludes:

Design Thinking is hopelessly contaminated. There’s too much sleaze in the field. Let’s bury it and get back to basics like good design. Everyone already knows that solution-focus is as essential as problem-focus. Stop arguing the point. If good design doesn’t convince the world that design should be fully integrated into business and society, another over-caffeinated Design Thinking book isn’t likely to do so either.

To the first part of this argument, I agree wholeheartedly. Any concept that catches fire as broadly as design thinking that lacks a definitive intellectual home is bound to be tied to the hype cycle (discussed here and here in past posts). I would suggest to anyone interested in design thinking that they follow anyone’s claim about the idea with a question: what do you mean by that term?

Where I have problems with Storage’s argument is in its implication that good design is its own merit and that its benefits are obvious. To this point, I disagree wholeheartedly. The same foolishness is applied to healthcare around use of good evidence: high quality evidence that is “self-evident” is rarely so and even then inconsistently translates into practice with ease. Were that the case, the field of knowledge translation in health wouldn’t exist and evidence-based practice would be a pointless term.

If the benefits of good design were that obvious, every intelligent manager, strategist, executive and front-line staffer would be working towards it. They don’t.

There is little indication that design thinking in a form that would resemble common practice exists in any of the sectors I work in (and no, use of sticky notes and a white board does not equate to design thinking by itself). There simply is not enough reflective and documented practice in design thinking to provide the kind of wisdom to separate out the “sleaze in the field”, yet that isn’t reason to throw the baby out with the bathwater. We do not have good research to either venerate or denigrate design thinking based on anything other than the popular use of the term and rhetoric.

Einstein, as he often does, provides words to consider:

The attempt to combine wisdom and power has only rarely been successful and then only for a short while. – Albert Einstein

The ideas that lay behind design thinking are powerful, yet the wisdom of the field has not yet flourished enough for us to abandon the idea on anything other than the immature notion that it is popular and therefore can’t possibly be serious. In an age where wicked problems are more commonplace, new ways of thinking, seeing and acting are being required of organizations seeking to survive and thrive and design thinking offers some prospects for how to navigate through this. Not all designers deal with wicked problems.

Which leads to my disagreement with Storage’s assertion that design thinking equals design. Designer’s regularly apply the kind of problem exploration and applied creativity that is central to design thinking, but they alone are not design thinkers. Were that the case, then the concept would have found little purchase outside of that discipline. His argument also implies that good design is evident, another point that I contest (and will save argument for another day). Good design is contextual and thus the standards that make it so must therefore be negotiable. It therefore cannot be claimed outright.

A “good” chair is dependent upon who is sitting in it, where it is placed, and the resources required to produce it and sustain it. By that argument, “good” design thinking may fall into the same lines. But unlike design, which has wisdom and experience broadly dispersed in society and different fields of practice, design thinking has no such equivalent. What is the evidence that it produces more useful or effective outcomes? What are its central theories? How is it linked to other fields of creative thought and action? Are there fields better suited to applying design thinking? What do effective practitioners look like? These questions remain either unexplored or poorly done so. The process of design thinking has received the treatment it deserves and it is that which has garnered the attention, admiration and scorn of the blogosphere and beyond — the space where the “over-caffeinated” books might sell.

Scholars such as Nigel Cross have done much to advance our understanding of what designerly ways of knowing might look like as practiced by leading designers. But few systematic examples exist outside of design contexts alone. This is changing and books like Wicked Problems by the group at AC4D provide one such example.

It is time to pull design thinking from the embers of hyperbole and placed under the microscope and macroscope of reflective practice and research. Once there, we might better comment on what this idea means for business, social innovation, human services and our overall wellbeing by pointing to something other than an exclamation mark to make our point.

behaviour changecomplexitydesign thinkinginnovationsystems science

The Wicked Problem of Wicked Problems

All Knotted Up...Like a Wicked Problem

Wicked problems are receiving a lot of attention these days giving much excitement to systems thinkers and designers alike. Yet what these problems mean for planning and understanding social programs and policies is not clear and may be even more wicked that it first appears. 

I was excited to learn that Jon Kolko and his creative band of learners at the Austin Center for Design (AC4D) are coming out with a book on wicked problems. As one who studies and helps others to intervene in addressing such problems, this was like being a Star Trek fan learning that Leonard Nimoy was coming to speak at the Trekkie convention in my hometown. It is refreshing to see that the concept of the wicked problem is gaining traction beyond the small band of scholars and practitioners working at the intersection of complexity, systems and design thinking (which, admittedly is where many AC4D folk inhabit, but hopefully their audience will not).

But it’s not just one book. We are seeing transformations in education and science — with calls for a ‘new breed of scientist’ being created at places like Massey University in New Zealand — or spread through the news or business stories in various forms.

The concept of the wicked problem was originally posed by management science scholar and systems thinker C. West Churchman with planners Horst Rittel and Melvin Webber. The Wikipedia entry on wicked problems provides some examples of what these things are:

Classic examples of wicked problems include economicenvironmental, and political issues. A problem whose solution requires a great number of people to change their mindsets and behavior is likely to be a wicked problem. Therefore, many standard examples of wicked problems come from the areas of public planning and policy. These include global climate change[4]natural hazardshealthcare, the AIDS epidemic, pandemic influenza, international drug traffickinghomeland securitynuclear weapons, and nuclear energy and waste.

In recent years, problems in many areas have been identified as exhibiting elements of wickedness – examples range from aspects of design decision making and knowledge management[5] to business strategy.[6]

As our social lives become more interconnected through the Internet, globalization, and mass migration, the complexity of the situations we find ourselves in grows. More of anything in diverse forms interacting together is likely to create complexity as new properties emerge and those properties change the trajectory of actions and reactions of the parts dynamically.

As one who is interested in wicked problems and works with people to address them, I should be thrilled to see the term used so widely. I am, but cautiously so. There is a risk that in the enthusiasm to embrace the lexicon of complexity that the meaning gets lost, which is what one gets from the hype cycle (See below).

The Hype Cycle: Coming to a Wicked Problem Near You?

The hype cycle is described as phenomonena initiated by a technology (or idea) and, once caught on, spikes the expectations beyond reason leading to discouragement, mass abandonment of the idea, and then — hopefully — a return to a level of reasonable return.

While the “cycle” (it is not a cycle) has limitations, the analogy here is well suited to fads of various types and the rapid ascension of the concept “wicked problem” in past years is indicative of a trend. Below are two representations of the amount of citations of the work “wicked problem” and “wicked problems” from Google’s Ngram service:

Wicked Problem Citations: 1950-2008

Wicked Problem(s) Citations: 1973-2008

It appears that wicked problems (plural) are increasing and reference to a single problem is staying the same.

Regardless, an upward trend is evident. What it means is another matter…

If wicked problems are becoming talked about more often and by more people, it is appropriate to ask what kind of impact that this new thinking will have on not only the way the problems are posed, but how people seek to address them.

To that end, it is worth envisioning the future with caution. One of the reasons for this is that wicked problems are often not wholly wicked in their composition or the strategy required to address the problem — which ironically makes these types of problems even more wicked.

This has to do with the interconnected, multidimensional, and embedded nature of the problems themselves which contain within them many interconnected non-wicked problems. I’ve started to see difficulties with organizations developing strategy that fails to consider this. It is, as I’ve discussed before, an artefact of either-or thinking. Tackling the kind of wicked problems like poverty, chronic disease, and global finance require a meta-level strategy that recognizes, shapes and adapts to complexity, while accounting for micro-level issues that are indeed, very linear and simple.

Finding, training and retaining the right talent to work with diverse communities on problems that are poorly supported or funded from many sources is wicked. The human resource needs for payroll, supply management, and field support might be much less so. Yet, both are joined-up and require strategies that can extend beyond traditional management and strategy, but also embrace some of the very ‘best practices’ that seem at the outset to be antithetical to complexity.

Just as I shake my head in frustration at seeing complexity dealt with using amplified linear strategies that ‘do the wrong things righter‘, I have surprised myself by how much I’ve been twitching at hearing recent converts to systems thinking rail against the traditional ways of planning as if anything other than seeing problems as complex would be wrong.

At issue is that wicked problems are made more so by having both complex and non-complex elements working together, requiring a level of strategy development that is far more sophisticated than many first thought. Even a review of the better management texts using complexity give short shrift to the relationship between the complex, the simple and the complicated working simultaneously in environments and how we plan for that. The Cynefin Framework provides a start, but just a start.

Until we recognize this complexity — no pun intended — in the way we plan, there is great risk of replicating the hype cycle when our sole use complexity-based models yield poor results of a different nature than the poor results we are seeing from traditional linear, reductionist thinking models applied to many of the problems we deem as wicked today.

Picture credits: A Close Up on Knotted Rope by Sundariel used under Creative Commons License from DeviantArt

Graph: Gartner Hype Cycle by Jeremy Kemp used under licence from Wikipedia.