Design Justice, Social Work, and Who Makes Decisions

Last you heard from me, a little over a year ago, I made the not so bold prediction that COVID-19 would shine the light on disparities and access to care. Not shockingly that came to fruition. From initial access to telemedicine services to the ongoing launch of vaccines, outcomes have demonstrated a lack of equity and equality. From a larger community perspective, COVID-19 has demonstrated what many of us have known. The playing field is not level and it will continue to the case. Unless we do something about it.

As virtual systems of care continue to be built and maintained. Questions still remain about have and have nots. Who gets access harkens back to the origins of their design. Enter in the concept of Design Justice.

Design Justice is a field of theory and practice that is concerned with how the design of objects and systems influences the distribution of risks, harms, and benefits among various groups of people. Design justice focuses on the ways that design reproduces, is reproduced by, and/or challenges the matrix of domination (white supremacy, heteropatriarchy, capitalism, and settler colonialism)”

~ Sasha Costanza-Chock

I just read “Design Justice: Community-Led Practices To Build The Worlds We Need” by Sasha Costanza-Chock. A powerful examination of this topic backed by the philosophical underpinning’s of design theory, how it is different than traditional theory, and examples of one can build more just systems.

It was my assertion several years ago was designers needed social workers. Learning basic design theory embedded in the book, shifted my thinking. Not only does design need social work theory, social workers need to understand design theory. The book takes you on journey of some of the important design theory and where it omits considerations of social justice. What was most striking to me was the difference between participatory design and design justice. Participatory design as it is the idea that end users are active participants are part of design. Being such a democratic process, I was surprised to learn it’s criticism of omitting social justice issues. Design Justice takes this a step further and talking about how users also have continued ownership and accountability in ongoing design. The end user involvement in design is not the only outcome, it yields a completely new system with users playing an active role in it’s continued development.

The author makes it clear that Design Justice was the developed by not just one person but it is a community of practice. The Design Justice Network have developed 10 core principles Design Justice practitioners are guided by:

  1. We use design to sustain, heal, and empower our communities, as well as to seek liberation from exploitative and oppressive systems.
  2. We center the voices of those who are directly impacted by the outcomes of the design process.
  3. We prioritize design’s impact on the community over the intentions of the designer.
  4. We view change as emergent from an accountable, accessible, and collaborative process, rather than as a point at the end of a process.
  5. We see the role of the designer as a facilitator rather than an expert.
  6. We believe that everyone is an expert based on their own lived experience, and that we all have unique and brilliant contributions to bring to a design process.
  7. We share design knowledge and tools with our communities.
  8. We work towards sustainable, community-led and controlled outcomes.
  9. We work towards non-exploitative solutions that reconnect us to the earth and to each other.
  10. Before seeking new design solutions, we look for what is already working at the community level. We honor and uplift traditional, indigenous, and local knowledge and practices.

In reading these principles and watching them come to life I couldn’t help but think how much they align the core values of social work practice. For those of you reading this from the design side of the shop, those core values are service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence. I was also struck by how much these principles could help better operationalize these core values.

These social work core values and Design Justice principles collide in our work; from facilitating community organizing to design of digital health technologies. Examining social work practice from the Design Justice framework can add a lot of value. In our individual work we do well with principles but then as we expand out to more mezzo and macro work, it becomes more challenging. This is especially true of the work we are doing around anti-racist practices. The elevation of decolonization of social work and abolitionist practices has forced us to think differently about systems design. Who holds the power and makes decisions in our systems design directly impacts the outcomes.

For example thinking about design of our mental health services. Where do we “truly center the voices of those directly effected”? Is our systems design more influenced by billing and reimbursement or are they designed with the services for the client? In light of recent news much has been talked about what social work’s role should be with police departments. When thinking about police reform that includes social workers we need to consider the impact this will the community? Who defines “success” and how it is carried out matters.

One of the principles that is in line with social work values is being a facilitator rather than and expert. Treatment modalities such as motivational interviewing, challenge clinicians to mind our “expert stance”. Our ability (our inability) to do this in community level of practice is key.

Much like the author of the book, I am interested in technology design practices. Using these principles, we can question what we have missed and continue to miss when building health information technology design. The work in this space often lacks the above principles. It often ignores what is already working in communities. It often owned by companies disconnected from the communities they serve. Not only that sometimes disconnected from the clinicians that utilize the technology. The author takes us through examples that are easily applied to your area of practice.

Design Justice has been a powerful exploration for me in a lot of ways. If you are interested in a how we can design more just systems of care that align with social work values, I highly recommend this book. As mentioned earlier, Design Justice is not just one person, it is a community of practice. Learn more about this also visit the Design Justice website.

How Will #COVID19 Transform Digital Transformation?

The Coronavirus is having a tremendous impact on the world. World markets and travel were the first industries to feel the it. Two industries that I follow closely follow are being forced to change the way they do business… and fast. Both healthcare and education are being compelled to change how they use technology to scale and conduct their day to day functions.

My gut reaction was to see how quickly technology in healthcare may be adopted….

Providers building telehealth and other remote monitoring to tackle this disease is becoming a common theme. Also preparing the workforce to reduce face to face contact is needed. Healthcare systems will be quick to see how they can adapt to provide treatment, screening, and protect their workforce and those they serve.

It is also changing education as conferences are forced to cancel and look at virtual options. College’s and Universities are developing strategies about how to scale their classes online and in some cases within weeks or days. However this is coming with challenges. Switching to an online pedagogy with a week’s notice while ensuring equal access is a question that is top of mind…

This COVID19 outbreak is quickly changing our relationship to technology. One of the things I can’t get out of my head is what took us so long to ask these questions. With regard to telehealth, I think about how challenging it has been to adapt this technology of mental health and substance use disorders. With regard to conferences, virtual options would greatly increase knowledge translation to those who normally can’t afford to go to a conference…

Of course technology has transformed society. Of course it is making improvements. This COVID19 outbreak has me thinking about how and for whom. More importantly when technology scales “to make lives better”, who decides who gets access to it? When digital transformation happens this quickly, who benefits? And why did it take a pandemic to get us here?

My suspicion is that as this continues to spread, digital transformation will become a social justice issue. Issues of internet access, broadband, cell service, and access to computers will play an ever increasing role.

One thing I can’t ignore is where social work’s place should be in digital transformation. Whenever challenges like this come up, I think of the National Association Of Social Worker Core Values. How service, social justice, dignity and worth of the person importance of human relationships, integrity, and competence; can guide the complexity of current events. Always have to take a moment to give a plug for social work practice to be a part of solving complex problems.

As COVID19 continues to spread we are just in the early stages and these ethical challenges won’t be going away. Technology will continue to enter our lives, reduce human contact, and accelerate digital transformation. Who will be left behind is important? Having voices at the table to ensure access and equity will be imperative. As technology continues to transform our lives, my hope is that these questions will continue to be elevated.