There has been much talk in the past few years about food deserts — areas where residents have little to no access to healthy food. Not surprisingly, there is another, equally troubling kind of desert that receives far less media coverage: primary care deserts.
Currently, more than sixty-five million Americans are living in areas where access to primary care is limited, and they suffer from higher rates of chronic health problems, disease, and death. In addition to the insufficient supply and poor distribution of care, many of these residents face additional barriers when they do get care, including communication challenges, lack of privacy and comfort in clinics, and inconvenient hours and locations.
The Firehouse Clinics is an innovative step towards bridging that gap. Spearheaded by the County of Alameda and Public Architecture as part of their 1% Solution, “Firehouse Clinics are an innovation in community health care focused on serving vulnerable, low income, and uninsured individuals and families. Leveraging the trust and expertise of emergency medical services (EMS) and local Fire Departments in the pre-hospital care system, Firehouse Clinics are designed to be conveniently located at neighborhood fire stations where there is critical need for access to health care services.” (visit the website for more information).
Public Architecture approached WRNS Studio to provide a clinic prototype, a conceptual design and set of guiding principles for a 1,200 square foot clinic adjacent to a firehouse.
The result is a clinic that is welcoming, easy to access, and dignified. Nothing about it says “low income” or “free clinic.” Located near pubic transit and the neighborhoods it will serve, the clinic is intended to reflect the values and aspirations of its community. With its adaptable and easy-to-execute prototype, Alameda plans to open clinics throughout the county. The hope is that other communities will follow suit.
The design is easy to build, efficient, and materials can be chosen specifically to match the surrounding neighborhood. The entry is visible from the street, inviting patrons in. Patients walk through gardens to check in at a kiosk and wait for their appointment in a waiting room that feels comfortable and “at home.”
GLS Landscape | Architecture designed surrounding wellness gardens that will be visible from within exam rooms, providing a calm, beautiful alternative to fluorescent lights and sterile white rooms. A green roof and gardens increase the welcoming, natural feel of the clinic. The roof’s plantings will be adapted to the neighborhood, making the building of its place — implying holistic wellness to passerby.
So, why co-locate with firehouses? They are are centrally located, accessible, and plentiful (even in neighborhoods that lack other resources). People’s trust in firefighters often outweighs their faith in law enforcement, perhaps because firefighters’ sole purpose is to do good for the community. The hope is that this inherent trust will bleed over into the neighboring clinic, bridging the divide for residents who are suspicious of healthcare providers or unfamiliar with navigating a clinic. Having a group of EMTs next-door also serves a practical purpose in cases of emergency.
Leveraging the neighboring firehouse and people’s generally positive association with it, these clinics will provide a new model for community-based care, one that is appropriate and culturally relevant. The clinics will become a resource hub for health education, wellness, health insurance enrollment, and referrals to specialty care.
Armed with a promotional website and an executable design, Public Architecture and Alameda County Health Care Services Agency are sharing the vision for the firehouse clinics with communities across the nation. The dream that began in Alameda County of providing efficient, culturally relevant care to people who have historically gone without has the potential to really catch fire.