The annual HIMSS Global Health Conference took place last week in Orlando. Like most large conferences, healthy food at reasonable prices was a rarity. For this reason, I implored a good friend of mine who was foolish smart enough to rent a car to drive us to a nearby Starbucks for breakfast. We intended to eat a quick breakfast in the store and catch up on the current state of healthcare IT, but that was not to be. Why? Because there were no tables or chairs to be found, neither inside nor outside. I don’t mean to imply the seating was full; it simply didn’t exist. One wall had 20 feet of booth seating, indicating that spending time at this Starbucks was once encouraged, but clearly, that time had passed.
Sociologist Ray Oldenburg coined the term third places as somewhere between our homes (first place) and our work (second place). He writes that they are simply informal gathering places. “Americans long enjoyed third places in the form of the inns and ordinaries of colonial society, then as the saloons and general stores springing up with westward expansion. Later came the candy stores, soda fountains, coffee shops, diners, etc. which, along with the local post office, were conveniently located and provided the social anchors of community life.”
Yet, in America, our third places are disappearing. Oldenburg commented on the dearth of meeting places beginning in the late 1980s. Yet it seemed that with the mushrooming of Starbucks and other similar establishments in the 1990s and 2000s, the trend was reversing. Maybe not. Whether it’s concerns about unhoused people, nonspecific safety issues, or just a basic outcome of a global pandemic, our third places aren’t becoming more common. Quite the contrary!
Third places help foster social interaction, community cohesion, and, ultimately, psychological well-being. There is ample research linking human socialization and health. We know that isolation and loneliness can increase the risk of heart disease, depression, and dementia. Candy stores, diners, and coffee shops mitigated these risks by providing venues for social engagement. What happens if we lose these places?
I posit that healthcare systems are uniquely positioned to fill the void left by the diminishing third places. By integrating principles of urban planning and architectural design that encourage community interaction, healthcare facilities can transform into modern hubs of social and wellness activities. This vision must extend beyond traditional care delivery, contemplating healthcare environments as vibrant, welcoming spaces that promote holistic well-being and community cohesion.
Imagine healthcare campuses that incorporate mixed-use developments, blending clinical care with retail, recreational, and educational spaces. These campuses could become bustling community hubs where people not only come for health services but also engage in social, cultural, and wellness activities. This model promotes an integrated approach to health, recognizing social determinants and community engagement as critical components of well-being.
There is no need to use much imagination, though, because this is happening today. All over the country, struggling shopping malls are being converted into clinics. With centralized locations, plenty of parking, and pre-configured areas for congregating, healthcare systems can leverage the medical mall for more than clinic and ancillary space. Keep the coffee shops and cafes open for the early-morning power walkers. Repurpose the Gap and B. Dalton stores as community spaces for lectures, community events, and support groups.
Incorporating healing gardens and green spaces within and around healthcare facilities offers dual benefits: They provide serene environments for patients and staff while also serving as communal gathering spots. These spaces can host wellness activities, such as yoga classes and gardening clubs, inviting community members to engage in health-promoting activities together. The key is giving people a reason to be somewhere besides home or work.
Achieving this vision requires a collaborative effort among healthcare professionals, architects, urban planners, and, most importantly, the communities they serve. Engaging with community members to understand their needs and preferences is crucial in designing spaces that are truly welcoming and beneficial (hello, human-centered design!). This collaborative approach ensures that healthcare facilities can become cherished parts of the community fabric, reflecting and responding to the unique characteristics and needs of the populations they serve.
As our community landscapes change, with traditional third places fading into the background, healthcare systems have a monumental opportunity to step forward. By reimagining their buildings, programs, and workflows to promote community and social interaction, healthcare providers can play a pivotal role in addressing the social isolation epidemic. This is more than an expansion of services; it's a redefinition of healthcare's role in society – as a guardian not only of physical health but of social well-being and community vitality. In doing so, healthcare systems can become beacons of hope and hubs of community life, proving that even in times of change, the human need for connection and support can be met with innovation and compassion.