Familiar residential forms help integrate the Family Health Center on Virginia into the community that surrounds it.
Client North Texas Family Health Foundation
Architect MASS Design Group
Design Assistance SmithGroup, Corgan
Architect of Record, Interior Architect/Designer, and MEP Engineer SmithGroup
Contractor Rogers-O’Brien Construction
Structural Engineer L.A. Fuess Partners
Civil Engineer Cross Engineering
Landscape Architecture Kimley-Horn
In 1966, Martin Luther King Jr. gave a speech to the Medical Committee for Human Rights in which he said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
Health care disparities are part of the legacy of redlining and other urban planning efforts that reinforced economic and racial disparities between neighborhoods. The resulting inequities take many forms, including lower health insurance coverage and lower access to care, all of which contribute to lower overall community health and environmental justice issues.
As MASS Design Group’s inaugural health care facility in North Texas, this 25,000-sf community clinic fulfills a need for expanded primary care, OB/GYN, dental, and counseling services. It provides these important services regardless of the patient’s ability to pay. In addition to the clinic and administrative program, it also provides a pantry with supplies for mothers, infants, and children, along with flexible community learning and training rooms that can spill into an adjacent courtyard to expand their capacity.
The Family Health Center on Virginia is built in East McKinney, where residents’ median income is half that of their western neighbors. According to studies conducted by the Centers for Disease Control, significant disparities exist between health and dental care in East McKinney compared to other areas.
The study showed that 43 percent of adults in East McKinney lack health insurance and more than half have not had dental care in the past year. East McKinney residents are also twice as likely to have diabetes than their neighbors to the west. Because fewer health care facilities exist in North Texas, the center is intended to serve an area within a 60-mile radius.
MASS Design Group, a design collective dedicated to delivering architecture that promotes justice and human dignity, was tapped by Kate Perry, senior vice president and senior director of healthy communities at Independent Financial, a banking group with a footprint in both Texas and Colorado. As the project executive on the client side, she was tasked with leading the efforts to design and build a federally qualified health center in a medically underserved area in Collin County.
When the project began in 2014, her team did not have a specific site, but by 2019 she had assembled a project team with MASS and SmithGroup, who had recently completed the bank’s headquarters.
“We wanted to create a sense of dignity, and for people in the community receiving treatment to feel loved and cared for,” Perry said. “From the banking perspective, we wanted to be good stewards of the investment and build something durable, sustainable, and low maintenance that would wear well over time. We had a great opportunity on the front end to learn from the community to shape the design process, and we are lucky to have a purpose-built facility.”
MASS Co-Founder and Senior Principal David Saladik infused the design team with his experiences working in Rwanda with Dr. Paul Farmer, chair of the Department of Global Health and Social Medicine at Harvard Medical School. Community workshops revealed the need for a transformative approach beyond the traditional small exam rooms connected by narrow hallways: Saladik heard calls for a more active design that included patient-centered waiting and exam rooms with access to daylight; approachable furniture for patients, health care providers, and family members; and accessibility and transparency of medical records.
“I never went to school thinking I would work in health care in Africa,” said Saladik. “But seeing the need for architects in the sector, we realized this was a need we could help fill. Working in Rwanda might seem very different than working in Texas, but we brought the same immersive process to deliver this project.”
Similarly, the building needed to breathe, and to be carefully inserted into the neighborhood fabric without seeming like a soulless institutional building.
SmithGroup’s Dallas office served as architect of record for the two-story facility, which features welcoming gable roofs, a vernacular dogtrot breezeway, light-gauge steel trellises, and brick elevations. The plan also leaves room for future expansion.
Construction for the project began in February 2020. With the arrival of the pandemic, the team adapted to working remotely. This was supported by a 24-hour live-feed camera on the site donated by OxBlue. As an understanding about the airborne contagion was gained, that knowledge was integrated into the design: The existing design already provided varied and dispersed waiting areas that supported social distancing, but the efficient HVAC units were upgraded to MERV-13 filtration.
In the lobby of the clinic hangs a 42-in. x 132-in. mixed media collage entitled “Love Ain’t for Keeping.” Created by local artist Jim Wilson, it incorporates text and artwork submitted by local members of the community that has been abstracted by the artist into a rich and colorful tapestry.
The Family Health Center on Virginia is likewise a physical manifestation of its community’s voice. It is also a reminder that it is possible to deliver an inclusive facility that begins to reconcile many of society’s long-standing health care injustices and inequities.
Florence Tang, Assoc. AIA, is a journalist, designer, and project manager based in Houston.