How the Next Generation of Physicians Are Learning How to Influence Urban Design

Like many Americans, Dr. Bon Ku, grew up without health insurance and lived life hoping not to get sick or injured. It was because of this experience,  that Dr. Ku decided to go into emergency medicine, with the goal of developing a more city-focused view of medicinal practice. As a practitioner, Dr. Ku saw the healthcare system’s failure to adequately serve the low-income patients he treated in the Philadelphia emergency room and thought about what contribution he could make to public health to improve the conditions of this marginalized and vulnerable population. He believed that a physician could impact not just the patients, but the places they lived.

Dr. Ku co-founded and developed JeffDESIGN, a new hybrid university program at Thomas Jefferson University, that combines medical training with design classes. The program focuses on an expansive range of design applications, such as 3D printing to will improve surgery and redesigning the physical spaces of hospitals, to directly impact real people’s health. It prepares students to redesign healthcare systems, services, and spaces. JeffDESIGN explores the ways community, infrastructure, and the built environment directly affect health and healthcare.

“One of our mission statements is, how do we design healthier cities?” Ku says. “And how do we humanize the data around that? Some people argue that’s not the health system’s job, that’s a public sector job. Because if you fix economic disparity and the quality of education and food, that’s going to improve health, totally. How can I, as a physician who deals with the complications of diseases, make an impact on that? I want caring about these disparities and social injustices to be in the DNA of physicians.”

Research shows that the built environment can influence both physical and mental health. Dr. Ku, as well as other built environment researchers, are trying to change the perception of how physical surroundings can impact  health. Medical students often are not trained to deal with the complexities of their patients’ surroundings. However, the way cities are designed is a major public health concern and it is important that medical students recognize this and can take steps to address this in an effort to provide care, particularly for patients from low-income neighborhoods.

One of the projects JeffDESIGN students have been working on is smarterPLAY, which explores how children play in parks, playgrounds and other public spaces. Sensors were used to detect how Philadelphia children use public spaces such as the local playgrounds and libraries, in an effort to determine how these spaces might be redesigned. This data was incredibly helpful because it allowed researchers to determine where people go, how much time they spend at these places and what they do while there. smarterPLAY builds on existing research, which shows that where parks are and how they’re used have a measurable effect on neighborhood well-being.

At JeffDESIGN, Dr. Ku is trying to train the next generation of doctors to continue to deal with individual-patient issues as well as impact their communities by influencing the way cities are built and designed.  Dr. Ku and his students go into the city thinking about the ways in which physicians can look at the built environment and impact these communities.

“These kids are all going to graduate as physicians, and they’re going to have a whole new language that nobody who’s ever graduated from a med school has had before,” Pugliese says. “So that when they’re being tasked to think about how to help to improve this community, they at least know how to have the conversation about the upstream causes of these health outcomes.”

Ultimately, while Dr. Ku and the Jeff DESIGN lab intend on equipping medical students with the tools to redesign the city, one of the long term goals of JeffDESIGN is to determine how to redesign what a doctor does, in terms of the future of medicine.


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