The Quest for Common Ground in Rural and Urban Development: Key Takeaways from the See Change Sessions

Blog Contribution by NIHD Board Member for Education Elizabeth Johnson, PhD, MS-CRM, RN, Assistant Professor at the Mark and Robyn Jones College of Nursing - Montana State University.

The smell of woodsmoke greeted our group as we arrived at a small ski lodge in rural northwest Vermont. To our left, a red, Shaker-style barn stood juxtaposed to the newfallen snow; to our right, the lodge’s main building was humming with activity and chatter, echoing across the wintery landscape only interrupted by soft whishing of skiers. The scene at breakfast was a cacophony of discussion, energy, and excitement. Astronauts sat with environmental law consultants, next to podcasters and aquaculture advocates. This day of adventure was the warmup in the chilly winter air to the main event, See Change Sessions, hosted at the Hula co-working and innovation campus nestled on the shores of Lake Champlain.

Pictured: Elizabeth Johnson, PhD, MS-CRM, RN at the See Change Sessions in February 2024.

See Change Sessions is the collision of unconventional networking and collaboration by labs (workshops) and in-the-moment speaker topics to facilitate change across six different priority, themed areas – Where We Live; Beyond the Stars; Turning the Tide; Breaking the Buzzword; Cultures in Conversation; and Harmony & Dissonance. The Where We Live lab comprised both rural and urban advocates, investors, and community leaders seeking a collective vision to move responsible development forward. While varying in types of spaces and resources available, both rural and urban

populations share more in common than they differ: both are experiencing change in population gradients as communities seek access to nature, quality living conditions, and job opportunities. Environments must be more pragmatic in the design concepts to be responsive and adapt alongside these communities. These spaces also do not exist in siloes, but rather these built environment visionaries must consider the adjacent businesses, community centers, and local economic drivers which enable a holistic system of change and responsible development.

A core question for many in the group, and that asked by facilitator Adam Davidson: Who is going to pay for this development? For most long-term projects, this question is humbling as community needs change and the volatility in key industries (e.g., agriculture) may give pause. With an increasing focus on mixed-use development and densification of core community spaces, both rural and urban settings are equally challenged to achieve design meaningfulness by reflecting the cultural norms and values in the spaces which residents will congregate. Can achieving meaningful, adaptable design be

part of the value proposition and the return on investment to funding groups (foundation, government, or private equity)? Mistrust and the ‘outsider freeze’ are common hurdles for design teams, making the path to partnership one that is paved at the community’s pace and with great care. The exchange of learnings from active or completed projects in a transparent, commonly accessible system may enable design teams to understand the fit-for-purpose of a space and how it needs to be woven into the existing community fabric without repeating latent error encountered in other projects.

How do we engage communities during the development process and which members? This a critical first step to ensure accurate interpretation of feedback. Led by Mi’kmaw Elder Albert Marshall, See Change attendees were introduced to the concept of two-eyed seeing, which integrates both Indigenous and Western perceptual lenses to the interconnectedness of humans to their environment. Together, these worldviews create a full picture of a community’s essence

that drives and motivates impactful and sustainable change. Particularly with healthcare design, the built environment must reflect the values and behaviors attributed to the cultural concept of health. Lab attendees shared their use of community advisory boards, town halls, and interviews with residents through the guidance of community champions and trusted leaders to begin the process of establishing trust and gaining insight.

Pictured left to right: Stephen Posner, Elder Albert Marshall, Cliff Kapono

We closed with presentations from speakers like Molly Kawahata, who reminded us that, no matter our next steps towards responsible rural and urban development, to lead with hope. The message of hope and inspiring a movement can expand into ever-widening circles of positive, meaningful change. This work may be slow-going, but as many speakers mentioned, that is where the true beauty lies. The environments we shape may be geographically distanced and with different immediate needs, but we share the common human experience of hoping for a better tomorrow and to see our communities thrive in the face of challenge.

What we’re developing are ways to preserve ways of life and to enable the stewards of those traditions to impart their teachings to the next generation. As I took in the vista of the Green Mountains and submitted to the stillness of those bright winter days at See Change, I realized that the change I was seeking was not necessarily just the outside environment but also the one within as a mother of little boys who will grow up in a rural setting, who keeps hope that they will enjoy these same rolling prairie hills and majestic mountains of the place we call home. And that was the key takeaway that this nurse needed.

NIHD collaborates with clinicians, design professionals and industry partners in the healthcare design process to shape the future of healthcare design.