September 13, 2019

Designing for Health Equity

I believe we – as innovators, designers, community leaders, and residents – have a leading role in making health more equitable.

In the last 15 years, we’ve experienced several substantial shifts in healthcare. We’ve seen our government playing a more active role by promoting health IT and incentivizing physicians to adopt new care models. At the same time, traditional healthcare organizations have been making sizable investments in community initiatives, like housing, to improve healthy living outside the hospital walls.

While the government and the healthcare industry have become more influential in shaping our communities, their focus has generally been to serve the majority and those with the strongest advocates. In order to build communities where everyone can thrive, I believe we – as innovators, designers, community leaders, and residents – have a leading role in making health more equitable.

What Does Healthy Equity Mean?

According to the World Health Organization, achieving health equity means that “everyone should have a fair opportunity to attain their full health potential.” In order to address everyone, it requires us to stop treating those we serve as patients, and start recognizing them as people. This means we must look beyond medical charts and community needs assessments, and practice empathy to more deeply understand how we can empower people as unique individuals.

The Robert Wood Johnson Foundation has developed a Culture of Health framework, in which health equity sits at its center. They articulately describe this as such:

“To build a Culture of Health, we must first ensure everyone has the basics to be healthy. And when it comes to expanding opportunities for health, thinking the same approach will work universally is like expecting everyone to be able to ride the same bike.”

Designing for Health Equity

Another organization who has thoughtfully facilitated this conversation is Design for America (DFA). Design for America is a network of social innovators who designs solutions that tackle social challenges. They recently hosted a Summit in Chicago that gathered designers and industry leaders from all corners of the health sector, including The Better Lab, Partners in Health, Humana, Kaizen Health, Shirley Ability Lab, Northwestern University, and myself from Exygy.

Innovators gather at this year’s Design for America Summit.

This year, we gathered around answering the question, “How can we use design to create more equitable practices in healthcare?” Throughout the Summit, I saw three themes emerge:

1.Design for Inclusion by Including Design

When we choose who we design and innovate for, we’re also making an equally conscious choice who we are leaving behind. Our role as a design community includes recognizing and advocating for everyone’s right to their full health potential. And our responsibility as a healthcare community is to create opportunities to invite the role of design into the innovation process.

At the DFA Summit, I shared an example of the innovation – or lack thereof – for people living with Alzheimer’s disease or dementia. Currently, existing dementia medications do not stop or slow disease progression, and are often discontinued due to side effects. Recognizing a need to think beyond conventional pharmacological therapies, a leading UCSF researcher teamed up with an innovator from Stanford University’s renowned design school to create Together Senior Health. As a team, they pioneered an in-person program that teaches functional body movements and facilitates social connections – a tailored approach that was a result of rigorous evidence-based practices and design thinking.

DfA Summit attendees in the midst of an exercise around building collaboration within local community programs.

2.  Design for Accessibility, Built on Empathy

Accessibility guidelines have been fairly well adopted as a design standard. While these guidelines typically pertain to the use of a product or innovation itself, we must put equal, if not more, attention towards placing innovations within reach for everyone.

In the case of Together Senior Health, their team had plans to scale their in-person program nationally. Generally, scaling interventions in healthcare means using telehealth technology and mobile apps. However, in order to reach people facing dementia, they needed to be more intentional in their approach – and this is where Exygy helped.

Our teams began by learning about participants’ home and social environments, daily routines, and support networks. Based on the empathy we’ve developed, we scaled the program to allow people to participate from their own homes using their television. We were able to create an experience that fit seamlessly into their lives by leveraging tools they were confident in and involving people that are already within their support system.

3. Design with Respect

While health equity promotes fairness, let’s not confuse this with delivering consistent care. As RWJF noted in the earlier quote, taking a universal approach will not always yield fair results. Especially when working towards health equity for an entire community, we must first respect what has come before. We may recognize what healthy looks like for one community may be different than another – sometimes literally. It’s an art, and that’s why we need design.

Morgan Ramirez, a Design Fellow of Partners in Health, artfully demonstrated this value in our discussion. As an architect, Morgan found her way into building a health clinic in Mexico. When setting up plans to rebuild the clinic, she recognized the importance of incorporating the local architecture in the design. Her approach was to enroll the residents to design a center that was inspired by their vision of health and not hers. Morgan found her role to be less of a designer, and more focused on unleashing the community’s creativity.

Others Leaders in Health Equity

I’ve been inspired not only by the astounding work from members of the Design for America network, but also thought leaders across the healthcare scene who are raising awareness and taking action to improve health equity in all communities. A couple notable ones worth recognizing are:

  • The American Society of Nephrology (ASN) has advocated for new innovations to address kidney diseases. Today, the only alternative to kidney transplantation is dialysis – a treatment that costs $89,000 per patient annually. Under the leadership of Rachel Meyer and Ed Simcox, ASN and the US DHHS started the KidneyX accelerator to draw more innovation towards the prevention, diagnosis, and treatment of kidney diseases.
  • The Children’s Hospital Los Angeles (CHLA) and the Healthcare Information and Management Systems Society (HIMSS) teamed up to raise the conversation about health inequity for Latino youth. Omkar Kulkarni and the CHLA team hosted a series of challenges that incentivized tech innovators to design solutions along with community leaders.

Are you seeing other inspiring acts of health equity? I’d love to learn what you’re seeing and doing to empower everyone in your community! Let us know at

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Eric Lam

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