Interior Design: Living in Poverty and the Absence of Health, Safety, and Welfare

As the design professions continue the commitment to health, safety, welfare, and the support of social justice, equity, and inclusion, there is a stark reality happening around us. Forty million people live in poverty in the United States, 18.5 million in extreme poverty, and 5.3 million live in third-world conditions of absolute poverty (Human Rights Council, Philip Alston, 2018). Unfortunately, health issues are prominent among the poor as the recent pandemic has solidified the contrast between the vulnerable versus the wealthy in terms of resilience to a health crisis and access to health care. The five key areas identified as social determinants of health are economic stability, education, community and social context, health care system, food, and neighborhood and the physical environment (World Health Organization, 2010; see Figure 1). This puts interior designers in a key position to potentially change the trajectory of persons living in poverty and health issues related to the built environment.

Healthy housing has long been an environmental justice issue. Low access to quality food, chronic illness, and poor housing conditions are endemic to those living in poverty. According to the Department of Housing and Urban Development, 44.7% of low-income residents receiving no assistance and living in the South in rental households experience housing problems with at least 1 of the following: incomplete kitchen and plumbing facilities, more than 1 person per room, and a cost burden greater than 30% for housing expenses. Additionally, 54.1% of very low-income rental households experience at least 1 of 4 severe housing problems, with cost burdens that are greater than 50% for housing expenses (U.S. Department of Housing and Urban Development, 2019). Socioeconomic status is a factor leading to “poor quality and inadequate housing which contributes to health problems such as chronic diseases and injuries, and can have harmful effects on childhood development. Poor indoor air quality, lead paint, and other hazards often coexist in homes, placing children and families at great risk for multiple health problems” (Braveman et al., 2011, para. 2).

These demographics clearly illustrate the numerous issues associated with poverty. Thus, the intent of this perspective is to (1) discuss interior design and social justice through the work of professional organizations and scholarship, (2) examine definitions of the poor to dispel the myth that poverty only concerns issues of income, and (3) provide examples of design solutions that embrace health, safety, and welfare for those experiencing poverty.

Since the 1970s, the interior design profession has emerged from a consumer-driven, style, and wealth industry to a profession that serves to create all-inclusive spaces to support wellness. Design for social justice is front and center in professional organization missions, journals, and is now a component in the Council for Interior Design Accreditation (CIDA) Standard 4 as a required understanding by students (CIDA, 2020).

As the interior design profession continues its pursuit of social justice, equity, and inclusivity, little attention has been given to communities living in poverty and the health issues related to poor housing conditions. This is not a new situation, as the same question was asked more than 30 years ago by scholar Nigel Whiteley who called for shifting the interior design agenda and the consideration of societal notions of “equality and justice”. Whiteley (1993) argued that the design profession or design press had not engaged in the discussion of such values explicitly and challenged the assumption that good design needs to be defined in terms of commercial success. A more recent demand to action “propose[s] that designer[s] can contribute toward design (and associated policies) for disadvantaged individuals in meaningful ways and discuss the potential that environmental psychology holds for the development of low-income housing” (Pable & Waxman, 2014, p. 79). As the profession pursues issues of diversity, more consideration could be given to socioeconomic differences. Interior designers can bring an important perspective to addressing health, safety, and wellness to community members, particularly for those struggling with poverty.

According to the International Interior Design Association's (IIDA) equity council, established in May 2021, “In a profession that is predicated on maximizing and expanding the human experience, it is imperative that as an industry we fully recognize that equity, justice, humanity, and dignity are fundamental and indispensable to the practice of design” (IIDA, 2021, para. 4). Additionally, CIDA requires that interior designers have a global view and consider social, cultural, economic, and ecological contexts in all aspects of their work noting that, “Examples could include human responses to hardship and distress, social impacts of mass migration, increased competition for resources, climate change and natural disasters, etc.” (CIDA, 2020, p. 16). In addition to professional organizations, a recent special issue of the Journal of Interior Design focused on Marginalization and the Constructed Interior (see 45.1). This evidence supports the idea that the profession of interior design is aware of the need to include marginalized populations. In the 2015 study, Changing Student Beliefs about Poverty, Homelessness, and Community Service: Results from Interior Design Project Interventions, Dickinson stated, “Developing empathetic designers who understand that design can make a difference in the lives of the underprivileged is long overdue” (p. 20). The question becomes, have our efforts as practitioners and educators made an impact on this forgotten community? Unfortunately, the statistics provided below and cited previously paint a different picture.

“Who are the poor? There are 8 million more poor Whites than there are poor Blacks. The face of poverty in America is not only Black or Hispanic, but also White, Asian, and many other backgrounds” (Human Rights Council, Philip Alston, 2018, p. 6). The United Nations Development Program's definition of poverty recognizes that poverty cannot be measured by income alone. Instead, it takes a multidimensional approach, accounting for health, education, and standard of living, including access to clean water, sanitation, electricity, and quality of housing because of the foundational role each plays in allowing families to lead a decent life (Habitat for Humanity, 2021).

Desmond and Western (2018) defined poverty by outlining the following three characteristics: “First, poverty is multidimensional, compounding material hardship with human frailty, generational trauma, family and neighborhood violence, and broken institutions. Second, poverty is relational, produced through connections between the truly advantaged and the truly disadvantaged. Third, a component of this framework is transparently normative, applying empirical research to analyze poverty as a matter of justice, not just economics” (p. 305). These characteristics are seldom used to explain and define those living in poverty, as many tend to resort to the single reason of income disparity. Sociology researchers are widening the lens to investigate why the United States continues to have such high poverty rates, especially since it has been over 50 years when the war on poverty began. “For almost five decades the overall policy response has been neglectful at best, but the policies pursued over the past year seem deliberately designed to remove basic protections from the poorest, punish those who are not in employment and make even basic health care into a privilege to be earned rather than a right of citizenship” (Center for Economic and Social Rights, 2018, para. 4).

Nussbaum's (2003) Social Justice and Dignity list has been used to define a minimal conception of social justice and to explain the realities of living in poverty. There are 10 concepts included in this list (life; bodily health; bodily integrity; senses, imagination, and thought; emotions; practical reason; affiliation; other species; play; and control over one's environment (political and material)), and some are detailed below.

Nussbaum's (2003) conceptual list along with the realities of living in poverty illustrate the correlation between the underprivileged and a lack of social justice and dignity. But what does poverty look like through an interior design lens? Recall that incomplete kitchens and bathrooms plague those living in poverty and reasons range from an inability to pay for maintenance, repair or replacement, or an inaccessible landlord to name a few (Ungar & Lucas, 2020). Poverty in the interior environment can range from neat, tidy, clean, although worn and outdated to the extreme of hoarding, trash, unsanitary conditions, leaky roofs, broken stairs and floors, and dangerous conditions (see Figures 3, 4, and 5). Consistent needs of those experiencing poverty are added insulation, filtration replacement, mold remediation, and windows and doors that need weather stripping. Safety concerns are many and include deferred maintenance, the need for accessibility accommodations, loose railings and stair treads, and non-working or absent fire and smoke detectors. These ever-present issues can affect the health, safety, and welfare of the occupant and do not enhance Nussbaum's Social Justice and Dignity list.

Interior design continues to be identified as a “professional and comprehensive practice of creating an interior environment that addresses, protects, and responds to human need(s)… while incorporating process and strategy, a mandate for well-being, safety, and health…” (IIDA, n.d., para. 1). However, many of these aspects have not been addressed as witnessed in Figures 3, 4, and 5. While the interior design profession now has access to tools that further support health, such as WELL Building Standards, Aging in Place, and information in regard to the materials we specify along with how installed products impact the occupant's wellness, more needs to be done for the underprivileged. Research continues to produce quantitative and qualitative outcomes that better inform our design decisions for lighting, daylighting, and the effects on circadian rhythm. And, although health care design has propelled evidence-based design into almost every sector of interior design, deplorable housing conditions still exist.

Perhaps Whiteley's (1993) call for equity and justice are finally being heard by a few notable practitioners. Model of Architecture Serving Society (MASS) Design Group was founded under the belief that “Architecture is an expansive field, but too often it has been narrowly considered, ignoring the social justice inherent in appropriate design” (Ireland, 2011, para. 4). Our mission is to research, build, and advocate for architecture that promotes justice and human dignity (MASS, 2021). The Haven Domestic Violence Shelter is just one example on the MASS website that illustrates an interior space that can enhance emotion, bodily integrity, bodily health, control, and wellness (Nussbaum, 2003). The exhibition By the People: Designing a Better America at the Cooper Hewitt Museum highlighted 60 projects focused on concentrated poverty. One in particular, the Las Abuelitas Kinship Housing and Community Center, consists of 12 low-rent homes designed to meet the needs of two generations with peepholes in exterior doors at eye level for children and people using wheelchairs demonstrating Aging in Place, safety, and security features as a solution to poverty (Abbey-Lambertz, 2016). These examples show that designers can be game changers through creative solutions that confront poverty. As eloquently noted by Pritzker Prize winning architect Alejandro Aravena, “The problems in the world are poverty, inequality, segregation,” and “Architects [interior designers] have the skills to deal with these issues if they listen to all the forces at play” (Strachan, 2017, para. 3). In particular, interior designers are uniquely qualified to work with the marginalized due to their inherent focus on health, safety, and welfare (IIDA, n.d.).