Leaders from Louisville—one of seven winners of the 2016 Culture of Health Prize—share how artists can play a role in creating healthier, more equitable communities.
Our Louisville, Kentucky, neighborhood of Smoketown sits across the street from the largest concentration of health care services in our state. Yet people here live 9 years less than the typical Louisville resident. Poverty, racism, unemployment and other social determinants of health have created this gap between residents of Smoketown and those from more affluent parts of the city.
An artist’s creativity has helped make that disparity concrete. Andrew Cozzens’ Smoketown Life Line Project documents the impact of trauma on many aspects of people’s lives and health, as revealed through interviews with more than 20 local residents.
You see the impact in metal rods of different lengths—each representing the length of one community member’s life. Crimps in the rods marked with bands of color represent adverse experiences—violence (red), addiction (white), incarceration (black), trauma (blue)—showing how lives have, in effect, been shortened.
Cozzens created the project as part of Project HEAL (Health. Equity. Art. Learning.), a three-year framework through which trained artists can help communities identify their health priorities and unearth complex issues through sometimes tough conversations. Ultimately, Project HEAL uses the arts to enable communities to work toward health equity, hand-in-hand with policymakers, health care institutions, nonprofits, and others.
What Artists Can Do
This approach can work anywhere because every community has artists: choir directors, dance instructors, musicians, painters, poets, photographers. In Louisville, Project HEAL has shown how artists are able to do four things:
Create opportunities for a shared vision of a healthier, more connected future.
Artists who are connected to the community can lift up unheard voices and channel them into equitable policymaking. More than that, they can offer hope. And hope heals. Cozzens’ project, for example, was about more than creating a sculpture. Friends and family came together to discuss shared experiences and how trauma impacts their community, with an eye toward a future where violence and lack of opportunities don’t hold residents back. Cozzens is continuing to create rods, and plans to turn the piece into a temporary outdoor art installation. Through this artwork, policymakers and community stakeholders will be able to see how neighborhoods like Smoketown are disproportionately impacted by incarceration and other traumatic experiences. We hope this will spur them into finding more ways to improve conditions within the community.
Bring neighbors together and give them tools for facing and addressing adversity.
Artists Greg Acker and Hamidou Koivogui held weekly drum circles in Smoketown last summer. In August, a shooting happened a few blocks away just 45 minutes before the drum circle started. Whether they knew the victim or not, participants looked to the circle for healing, a release for their anger at another young life being taken, and support from others who were grieving. The presence of art and community spirit in the neighborhood that day offered an outlet for grief, bringing people together in a way that our artists hope to build on for future projects.
Use art to facilitate dialogue with policymakers.
For instance, Project HEAL uses arts and culture as a form of discovery and language—creating a feedback loop between policymakers and those most impacted by policy decisions. Spoken word artist and Smoketown native Hannah Drake will launch a project called One Poem at a Time in April, which is National Poetry Month. Negative billboards and signs advertising, for example, cheap lawyers and predatory fast-cash schemes, will be replaced with positive poetry and images. Evidence shows that in the same way lead puts environmental toxins into the environment, negative advertising puts social toxins into a neighborhood. A series of artist-facilitated community discussions with policy makers is being planned as part of One Poem at a Time. Using images and positive messages created with community members and supported by artists, Project HEAL provides a new way for communities to engage in a discussion to support health in all policies.
Pioneer new relationships between communities and health systems that lead to more culturally responsive health services.
KentuckyOne Health has partnered with us to incorporate a “community health champion” into our framework. The champion works with our Project HEAL artists, participating in arts and cultural events alongside community members to establish trust based on shared experiences and then connecting them to local health resources. With Humana, we’re looking at how artist interventions can be used to increase the number of healthy days (based on the CDC Healthy Days measure) enjoyed by Humana Associates participating in arts and culture experiences. This prototype could create new opportunities in the future for earning incentives, in the same way Humana members currently earn points for going to medical checkups and being physically active.
Measuring Impact
We’re excited about the potential for Project HEAL-trained artists have to become an ingrained part of health promotion across the nation, and we want to bring credibility and evidence so this approach can thrive.
That’s why we’re creating a way to evaluate our work—we call it Cultural ROI. This evidence-informed framework aims to expand imaginative capacity and measure the overall impact on a city’s economy that comes from improving health by engaging artists. To evaluate Project HEAL and establish it as an evidence-based model, we've partnered with University of Louisville’s Commonwealth Institute of Kentucky.
Demonstrating Project HEAL’s effectiveness, we think, will motivate communities to find and train artists who want to step off the stage or outside of the studio and focus on health—using their creative process as a form of social sculpture that exposes a different, more hopeful future. Having an evidence base will also help boost funding for training artists as change agents.
Evaluations of art and music therapy have given us much evidence of the positive impact arts can have on individual lives. What makes our work unique is that we go beyond seeking to enhance individual people’s healthy behaviors; we target change at the organizational, community, and public-policy levels. We believe health and well-being are culturally created, not professionally provided. And artists can work with their communities to lead the way.
Learn more about how Louisville is working to improve health for all of its residents.
About the Authors
Josh Miller is chief operating officer and co-founder of IDEAS xLab. IDEAS xLab, which trains artists to find innovative ways to create equitable places and nurture healthy communities - is the creation of Josh and colleagues Theo Edmonds, Chris Radtke and Ayelet Aldouby. A photographer with a background in art administration, he co-chairs the Louisville Health Advisory Board’s Communications Committee.
Theo Edmonds is CEO and co-founder of IDEAS xLab. An artist and former healthcare executive, he serves on Louisville’s Commission on Public Art and co-chairs the Louisville Health Advisory Board’s Cultural Committee.