Designing the Debate: Assessing the Role of Design Practices in Safe Injection Sites

A safe injection site is an urban public health intervention that saves lives. While they remain illegal in the United States, safe injection sites (SIS) reduce incidences of death and disease related to injection drug use in the cities where they exist. As in many healthcare facilities, the design of SIS must be considered to ensure their success. This thesis determines to what extent design frameworks for health and healthcare are being applied to urban public health interventions, such as SIS, and how design is used to improve user experiences of SIS. Previously conducted studies suggest that established design frameworks meant to improve physical and psychological patient outcomes are exclusively applied to private, residential healthcare facilities as opposed to public, short term healthcare facilities like SIS. However, an analysis of SIS in Amsterdam, the Netherlands and Vancouver, Canada reveals that these spaces are highly designed to improve user safety, hygiene, and stress levels. Similarly, harm reduction organizations in the U.S. have intentionally used design to the same end in both their own spaces and in proposals for hypothetical SIS. Drawing from the design strategies uncovered in these findings, designs for a SIS in the U.S. have been proposed in consideration of the controversial debate that has caused them to be rejected by politicians. This study counters prevailing wisdom in literature that designing for healthcare occurs exclusively in private, residential facilities. In fact, design is critical to the success of urban public health interventions, including SIS.