In his 1969 lecture and subsequent essay “Architecture’s Public,” Giancarlo De Carlo challenged this version of standardized architecture as one that subjected itself to the whims of the privileged elite, arguing that “the architect became a representative of the class in power.” 8 In his essay, De Carlo questioned architecture’s credibility and its capacity to maintain a sense of “public,” often to the detriment of ordinary people. He suggested that architecture’s “credibility disappeared when Modern Architecture chose the same public as academic or business architecture; that is when it took an elite position on the side of the client rather than on the side of the user.” 9 Instead, De Carlo argued for a process that required collective participation to introduce a plurality of objectives and actions. He proposed that design be used to identify with the needs of the user, where architecture does not plan “for” them, but rather plans “with” them. To De Carlo, this approach could be liberating and democratic for architects, “stimulating a multiple and continuous participation.” 10

The difficulty in transposing this notion of participatory design towards traditional architectural practice is that existing processes have evolved over time to be inherently technical; architects move along the prescribed path to navigate their available time, budget, and design intent. While an architect’s response to design challenges may be adaptive as it relates to form-making, a framework that is client-centered nonetheless prevents greater consideration of the needs and desires of a community. It is in this sense that De Carlo’s assertion rings true: Architects became preoccupied with “working on ‘how’ without rigorous control of ‘why’ inevitably [excluding] reality from the planning process.” 11 Modern Architecture’s promise of liberation through design neglected to respond to the very same rigid socio-economic systems that provided them with the resources to produce space, thereby limiting their capacity to respond to adaptive problems. In so doing, Modern Architecture presented little change except for its aesthetics.

Today, as social impact design moves towards a more adaptive design paradigm that concerns itself with issues of social justice, there remains a lack of appropriate processes and frameworks to move through on the path towards a substantial resolution of a given design challenge. The basic progression of schematic design, design development, construction documents, and contract administration is not formatted properly to deal with more ambiguous design challenges such as building coalitions, advocating for social equity, and responding to the needs of the community. For this reason, many architects that engage in social impact design as professionals or as part of a firm are often limited in their ability to be effective advocates. Rather than meeting communities where they are, architects often attempt to frame their relationship through standard contracts and agreements, budgeting their time with communities in need of social impact design services as they would with a client. The use of memorandums of understanding (MOUs), in place of standard architect/client contracts amongst architectural design firms engaged in social impact design, suggests that architects are attempting to respond to the need to provide clarity and establish boundaries to their design services. This well-intentioned evolution of an architect’s role and responsibility is still nonetheless limited by a paradigm that is client-centered, and therefore unable to adapt to design challenges where the community is the client, and the design services rendered are for the common good.

In response to the limitations presented by taking a client-centered approach, human-centered design principles have emerged out of the Stanford D-School and IDEO. In their “Human Centered Design Toolkit”, IDEO defines their approach as being focused squarely on the needs of people. Their process asks designers to listen to those needs, co-create proposals that have a positive impact within a community, and then deliver a completed proposal to the community’s stakeholders. By framing their design solutions through the lenses of “desirability,” “feasibility,” and “viability,” IDEO provides social impact designers an alternative model of practice, one that is more suitable to navigating adaptive design challenges. This filter allows for a more flexible approach than the traditional architectural model, where the desire of the community is given primary consideration, while issues such as whether it can be built efficiently help to guide the process towards a final design solution.

A major challenge for conventional architectural firms attempting to be hyper-responsive to the desires of the community is that traditional funding sources rarely budget for sufficient engagement work within communities. The financial incentive to keep projects on time and under budget leads to a reduction in time spent by architects on design challenges that might be otherwise considered as too ambiguous or adaptive in nature. One alternative to this financial incentive structure is found in the "triple-bottom-line" approach, made popular in design circles through the work of Majora Carter, a community design activist. In her TED Talk on triple-bottom-line sustainability, she makes the case for architects to balance the roles that economic, environmental, and social factors play in determining the potential outcomes of a project. 12 This mindset incorporates elements of social and environmental justice, acknowledging that communities of color in the United States are disproportionately at a higher risk for developing chronic diseases from exposure to environmental toxins and a lack of access to essential health services.

In an awareness of the impact that the environment has on all of us, in recent decades architects have begun to align their design processes with the United States Green Building Council (USGBC) and their Leadership in Energy & Environmental Design (LEED) standards. However, while this formal approach goes far in providing design guidance towards resolving technical design problems measured through environmental outcomes, it has little to say in response to social impact outcomes. Furthermore, LEED is framed within the context of client-centered design, where new buildings are developed exclusively for the clients that can afford them. While reducing greenhouse gases and minimizing the carbon impact of new construction can be taken as a positive step towards addressing climate change, it does little to mitigate the alarming impact that polluted ecological systems are having on millions of people today.

By adopting a unifying view of human-centered and triple-bottom-line design principles, it becomes apparent that formal design hierarchies are ill-equipped to provide standardized solutions to these complex problems. More concerning, however, is that, even were architects able to solve these problems through technical processes alone, most individuals in society would nonetheless be unable to afford traditional architectural fees. In attempting to address adaptive design challenges, architects must not only respond to the needs of the community while balancing a project’s social and environmental outcomes, they must also consider that they themselves must practice within a model of architectural practice that is economically sustainable.

One economically sustainable way for architects to align their objectives with that of the common good is in the healthcare setting. Historically, the relationship between health and architecture has typically been played out within hospitals:

A lead architect says [that] the new hospital “embraces the idea that good architecture is an integral part of the healing process,” creating “an environment that is cheerful, inspirational and intimate, despite its large size.” He continues: “We’ve aimed to design an environment for people, not just machines”... Another lead architect says: “somehow the human scale should come in”; he sought to design a sense of “smallness” into the space... This discourse of a humanistic building was in keeping with various inspirational phrases used to describe the new space and the work it facilitated, epitomized by words of one of the hospital’s senior administrators: “Our vision is to heal humankind, one patient at a time, by improving health, alleviating suffering and delivering acts of kindness.” 13

Emerging design firms such as MASS Design Group have been successful in incorporating better health outcomes as a means towards achieving greater social impact through design. While still framed within the client-centered approach, their work extends "beyond the building" to consider local community stakeholders. By inviting communities to be participants in the process of both a building’s design and its construction, their success reflects how projects that improve health can be a viable path forward for architects wishing to integrate social impact design with architectural practice.

The most innovative path forward for social impact design and public health may be in the context of “community health design.” By identifying the common good as an appeal towards greater quality of life for disenfranchised members of a community, architects will find that there exists other organizations, institutions, and foundations that are motivated to find ways to improve health outcomes “upstream.” Enhancing preventive care by redesigning the built environment to improve health outcomes before patients need emergency health services is an inherently adaptive design challenge. By adopting a “social determinants of health” mindset, design skills that improve the built environment, to enhance access to spaces and support greater community health outcomes, become essential. A client-centered approach is anachronistic in this context; the client is replaced with the community, but communities do not act with a single voice. This is where technical design processes most commonly fail architects; they expect to operate within a traditional process that communities are unfamiliar with or unable to operate within. Leading a design process in pursuit of improving community health requires new methodologies for the successful production of collaborative space. By framing these new methodologies as adaptive design tools, architects can begin to make more meaningful progress towards resolving the complex challenges facing communities today (Fig. 2).