Color in Health Care: How Mindful Design Can Improve Clinical Spaces

Color in Health Care: How Mindful Design Can Improve Clinical Spaces

Color is a key component of any professional branding or design endeavor, and the use of color in health care settings is no exception. Although color psychology has the potential to affect patient experiences and outcomes, it remains relatively underexplored relative to its extensive use in marketing.1 As research consistently demonstrates the profound impact of color on consumer behavior, there is a compelling case for applying these insights to patient floors, waiting rooms, and physician branding.

Decision-making regarding the use of specific colors in health care spaces appears to be largely based on general psychological research and well-established color theory used in art and design. However, the results of several recent studies suggest that the strategic use of color may enhance the patient experience in health care settings.

For example, a study published in 2023 in the Health Environments Research and Design Journal (HERD) examined the utility of strategic color changes to improve wayfinding in the redesign of an emergency department in Sweden.2 In this study, common patient areas were painted solid neutral colors (gray/beige), while patient-restricted areas were painted red or other colors that contrasted with the neutral patient areas and floors were given a darker shade near the walls to highlight the boundaries of rooms. Based on participant responses on self-report questionnaires that were created and validated by the investigators, the new design was associated with an increased perception of awareness, orientation, and safety among patients and family members compared to the previous design.2 

In addition to improving navigation in a hospital setting, a 2022 prospective, randomized controlled trial by Eminovic et al investigated the effect of incorporating a range of lighter colors (as selected by an art theorist) as well as art containing the same colors into hospital rooms of patients recovering from total hip or knee arthroplasty. Relative to patients in the control group who had rooms with no additional color, patients in lighter-colored rooms showed significantly higher scores on assessments of postoperative quality of life.3

Beyond the actual shades of color in health care settings, investigators have also examined how tones and saturation affect clinical settings. Research published in HERD in January 2024 also evaluated the use of color in health care by examining how ambulatory waiting room characteristics affected the emotions of 1114 women aged 18 to 35 years in the United States. Investigators found that patients prefer rooms with neutral color saturation relative to high or low saturation spaces – regardless of color.4

Further, results of a 2020 study of nursing home residents in Spain revealed that individuals exhibit a preference for warm colors (especially yellow) in activity rooms and a preference for cooler colors (especially green) in bedrooms. Using virtual reality and heart rate variability assessment, the researchers also found that warm colors were associated with higher levels of arousal relative to cool colors. The greatest arousal based on heart rate variability was observed in the yellow activity room, and the lowest arousal was observed in the blue activity room.5

Despite its success in commercial environments, the deliberate use of color in health care remains surprisingly limited, offering a unique opportunity to harness these principles for more empathetic and effective medical spaces. Although additional research using rigorous methodology is needed before color strategies in health care spaces can be considered evidence-based, the aesthetic and practical effects of the intentional use of color remain important considerations in these settings. By strategically incorporating color psychology into health care settings, designers can potentially increase patient comfort, reduce anxiety, and improve overall satisfaction.

To further explore this topic, Psychiatry Advisor interviewed Michelle Lewis, a color psychology expert who specializes in design, marketing, and behavioral color research.

How and when did you get into this work, and what has the experience been like so far?

Lewis: My start in color psychology began in my youth, as my parents were in the film industry. The emotional impact of a story presented in a visual medium was a huge focus, and color was a crucial component of the film’s production design. As I moved my work online and worked more in the branding and marketing space, I saw firsthand how injecting color affected an audience’s perception and emotions regarding physical and digital products and services.

However, I didn’t yet have enough of a knowledge base to understand why, so I decided that I needed to study color throughout history, culture, art, religion, medicine, and more to comprehend how it would interact with people physically, mentally, and emotionally today across the world.

In pouring over research materials, books, studies, and experiments for a solid 6 months, I started to see common threads between what I call the primary 8 communication colors: red, orange, yellow, green, blue, purple, pink, and magenta. I ultimately wrote a book,Color Secrets: Learning the One Universal Language We Were Never Taught, that encapsulated all of my research.6 Through experimenting with clients and students, it became clear to me that color was truly a universal language that made a major impact when used intentionally.

This work has led to collaborations with clients who want to blend color psychology with their expertise to clearly communicate with their target audience in a more emotional and supportive way. I’ve also had the honor of working with neurodivergent children as well as adults with chronic fatigue and multiple sclerosis to support them with color, aiding in increased feelings of well-being. It’s been incredibly powerful and rewarding work that branches into so many aspects of life.

What are some ways in which color is used intentionally in the design of certain spaces and in branding in health care settings? 

Lewis: The power of color psychology has been a relatively untapped resource for most health care organizations due to the lack of knowledge of its efficacy in a strictly scientific modality. However, even this year, an increasing number of spaces are becoming aware of and starting to strategically use color in their facilities. The ability to link specific colors – and even the undertones of certain colors – to clearly communicate and influence a patient’s physical and emotional states is hugely significant.

We typically see the most intentional use of color in children’s health care settings with an assortment of rainbow colors. This is to help children feel more comfortable and to elicit emotions of joy, growth, and positivity. Some great examples of this approach are the New Lady Cilento Children’s Hospital and the Bendigo Hospital in Australia.

The biggest issue with the use of color in health care is intentionality. For example, because red may increase heart rate, blood pressure, and pupil dilation, this is a color to avoid in most health care settings, as it may cause higher levels of stress, especially in cases of physical, emotional, or mental trauma.7-9 This is why the color red has been tied to emergency services, especially since red is the color we first recognize and respond to with attention and alertness.10

Color can be the most powerful way to make someone feel something. To not focus on color when creating a space that patients, practitioners, and staff will spend an abundant amount of time in is like leaving a crucial tool on the table unused.

However, the color blue measurably reduces heart rate and blood pressure, so it can be used in many health care spaces to bring feelings of calm and stress reduction.7,8 We also see blue used within most health care logos, hospitals, and treatment facilities.

According to my research, the 8 colors I have listed are the only ones that create a measurable response in the body. White, black, gray, and brown are great to use in support of the eight primary communication colors, but by themselves do not evoke a measurable response.

What is the basis, in terms of research and otherwise, for some of the specific color choices? How do the color choices vary across settings – in pediatric vs general settings, for example, or between mental health and other health care settings?

Lewis: To begin putting the color pieces together for a health care space, the best research study I recommend starting with is Sarah Babin’s “Color Theory: The Effects of Color in Medical Environments.” This paper provides a great foundation to color study in the medical field and how to approach the conversation of color decisions.11

For example, within the study, she discovered that 49.1% of participants preferred cooler colors, while 29.1% favored warmer colors. What’s interesting about this finding is that cooler colors can evoke a much more calming reaction, especially when they are given a gray undertone. Within a health care setting, the use of cool colors could be prioritized before even deciding on the specific colors. Then, it’s possible to niche into the specific medical setting to determine the exact shades to use.

In a mental health space, for example, I would avoid reds and yellows entirely, as they may cause too much of a physiological reaction. Even though many people associate yellow with happiness, this color would have to be given white or gray undertones to dilute the potential effects of stress on the nervous system. I also would also avoid using darker blues, as they could cause patients to retreat too deeply into their own thoughts.

In more general health care settings, there are certain “safe” colors that usually cause a much more predictable, positive reaction. In my experience, these are often cool-toned blues, teals, and greens. Blue is more mentally stimulating while inducing a calming reaction to the heart rate and blood pressure.7,8 Green tends to be stabilizing, encouraging balance of body and mind.

For pediatric health care settings, the undertone of the chosen colors is key. Most children respond positively to white-tinted colors, which means they have a white undertone. Think of pastels – they feel and look brighter, lighter, and happier.

It’s interesting to note that some colors may cause certain reactions that could be helpful to experiment with. For example, it would be interesting to test red in the room of a child struggling with blood circulation, as red is known to increase blood flow, or to utilize orange in a room for a child who struggles with insomnia, as it may help to improve sleep.12 

I think the most important takeaway is to understand that color is participatory. It can change per person and per setting, as its basis is light. Because light is made of frequency, it can permeate the cellular makeup of the body. And, as light can alter from wave to particle with the presence of a person – as proven by the double-slit experiment – we have to respect color’s ability to respond to us.13

What does the consultation and implementation process involve when a provider or health system engages the services of a color psychologist?

Lewis: When consulting with a color psychologist, it starts with a lot of questions that are best answered by the practitioner and potentially some of their top clients who can give real-time feedback while building the visuals of the site.

When creating a medical setting, certain considerations must be taken into account. Here are some questions I like to ask as a color psychologist working in a new space:

  • What feeling do I want to evoke in this space?
  • What emotional state is the client experiencing before they walk through the doors?
  • What cultural ties to color exist in this area?
  • What colors could help trigger the desired emotional state we are creating?
  • Does the color experience need to change from the waiting room to the treatment room, etc?

These considerations are all very helpful when creating a color experience in a physical space.

Once a foundation is laid in terms of color direction, the color psychologist or designer will create mood boards of potential “looks” of color within the space. The practitioner will choose the favorite look, and then more detailed mockups will be created.

The next step is bringing the design to life at the site. Walkthroughs are done by the practitioner, staff, and past clients to see reactions and get feedback. If needed, additions and adjustments are made before the space receives final approval.

Since color psychology is a newer field, [decision makers at health care facilities] may connect with an interior designer and request that they either subcontract a color psychologist or receive color training from one.

What would you recommend to health care providers and systems interested in using color intentionally their facilities?

Lewis: I would say, with the strongest passion possible, to please utilize this underused tool in your facility. Color can be the most powerful way to make someone feel something. To not focus on color when creating a space that patients, practitioners, and staff will spend an abundant amount of time in is like leaving a crucial tool on the table unused.

For example, even including pops of yellow for employees who spend most of the day sitting may provide a needed burst of energy. Or, for certain offices, there could be a “resting room” where employees can reset their vision with the color green and enjoy a well-earned break from fluorescent lighting.

The gray matter in our brain responds incredibly quickly to new knowledge about color, so start digging into the available resources to learn more.14 I recommend that people exercise caution when exploring information about color psychology. Random internet searching will lead down a rabbit hole of opinions that are usually unresearched. Focus on the National Institutes of Health studies, academic papers, and books written on the subject with extensive bibliographies. 

As you explore, you can start imaging the places at your facility that may be positively impacted by color – whether it’s your advertising, website, waiting room, patient room, or even exit space. Pick one and start there!

My honor is simply sharing my research on color in every way possible. One of the biggest needs, as a former ill child myself, is leaning on color’s ability to assist in feeling while healing. We are electromagnetic beings, so the introduction of color in any way throughout a treatment or healing journey can be powerful, as the body always responds. As we inject more color strategically into health care spaces, I believe we will see revolutionary results. 

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