ASID: Bariatric Design: An Emerging Concern for Healthcare Designers
Ever since height and weight statistics were first compiled in 1960, the average weight of the general population has continually increased. According to the American Obesity Association, 127 million people or over half of the adult population is classified as overweight. Nearly half of those are considered obese. A staggering 9 million are extremely obese.
According to The Obesity Society, overweight people are often the target of bias and stigmas. Biased attitudes including perceptions that overweight patients are unintelligent, unsuccessful, weak-willed, unpleasant, overindulgent, and lazy have been documented among medical staff. As a result of negative experiences, obese patients may avoid seeking medical care and are more likely to cancel or delay appointments and preventative healthcare services.
Healthcare design must accommodate the needs of the bariatric population to create a universally inclusive environment. With patients ranging from 250-300 pounds up to over 1,200 pounds, design needs to affect the patient and public spaces, equipment needs, and staff training. The patient room is beginning to receive much-needed design attention for bariatric needs. Typically, doorways are wider to account for larger equipment, patient beds receive more space for clearances, and furniture accommodates greater weights. The patient bathroom must also increase in size to accommodate assistance from staff. Bathroom elements such as the toilet, lavatory, and grab bars must allow for greater weights and excursion.
Adult obesity may be a problem, but childhood obesity is becoming an epidemic. Over the past four decades, obesity rates among children have jumped as much as 400% particularly among children ages 6 to 11. Children today may be the first generation to have a shorter life expectancy than their parents as a result of childhood obesity and related health complications. In addition to being susceptible to adult diseases including type 2 diabetes and high blood pressure, obese children are more likely to stay overweight as they age. Currently, America’s cost for obesity-related medical expenses and lost productivity is estimated to be $200 billion a year without accounting for today’s obese and overweight children coming of age.
If we keep on the current health path, the obesity rate will continue to increase with bariatric design required as an integrated approach to healthcare design solutions.
Although the current situation seems grim, there is potential for change. The Robert Wood Johnson Foundation has committed $500 million over five years to prevent childhood obesity with goals of achieving permanent results by 2015. Reversing the epidemic would create benefits to individual’s health, healthcare, and finances. In the national spotlight, First Lady Michelle Obama insists that fresh and nutritious foods are a critical component of everyone’s diet and should not only be available to the wealthy. Mrs. Obama spreads the word via interviews with celebrity and parents’ magazines. Hopefully, a shift towards healthier lifestyles from a younger age will begin. If so, the medical facility design will again shift with the societal shift.
“Big challenge: Designing for the needs of bariatric patients,” James W. Harrell, FAIA, FACHA, and Bill Miller, AIA, ACHA
“Obama’s healthcare policy includes focus on schools,” Rochelle Davis, HSC Executive Director
Terese Hudson Thrall
“The burden of childhood obesity,” James S. Marks, RWJF Senior Vice President and Director, Health Group