Fourteenth International Conference on The Constructed Environment

Abstract

Scholars continue to wrestle with the delineations between healthcare places and healthcare spaces (Reimer-Kirkham et al., 2012; Roxberg et al., 2020). Some conceptualize healthcare places according to ecological forces (Reimer-Kirkham et al., 2012), or the experiences and geographies that define them (Andrews, 2003). Place attachment theory suggests experiences shape our emotional bonds to places (Morgan, 2010; Ratcliffe & Korpela, 2018); thus conferring more complexity to notions of place than of space, which is often considered in more relational and physical terms (Andrews, 2003; Reimer-Kirkham et al., 2012). Understanding U.S.-based medical places or spaces necessitates foreknowledge of the context and contours of the American healthcare system, including those determinants and dichotomies that make some individuals more vulnerable to poor health outcomes. Despite the U.S. incurring the world’s highest medical spending rates, the American medical system is rife with inequalities (Chan et al., 2020). Some benefit from a background steeped in quality care and healthcare environments, while others face a legacy of medical discrimination (Krieger, 2014). These dichotomies are affirmed in the system’s private markets and pluralism (Ridic et al., 2012), with dividing lines largely falling on factors of employment, socioeconomic status, race, ethnicity, and gender, which impact the types of healthcare places and spaces available to patients (Centers for Medicare and Medicaid Services, 2022). Moreover, multiple factors, such as access, affordability, and demographics, complicate efforts to eradicate health disparities (Williams et al., 2016). This paper discusses those factors and their influences on preventative healthcare spaces and places in the U.S.