Given “What if?” was the theme of this year’s meeting, Theo posed the question: “What if we understood health and well-being as culturally created, not professionally prescribed?”
He talked about the need to create flexible vs. prescriptive models – so people do the things they naturally want to do versus the things we need them to do.
“We like to pretend there’s a monolith out there and that we can create change by treating everyone the same, but that’s not the case,” says Edmonds. “People don’t wake up wanting to be healthy as a goal. They want to do the things that are meaningful for them. And that’s different for everyone.”
This is why organizations like IDEAS xLab and Humana have partnered with local communities to address issues that are important to them.
“We know that health happens locally, which is why we are convening physicians, non-profit and government leaders across seven communities, each with their own unique set of chronic conditions and barriers to health,” says Pattie Dale Tye, segment vice president of Humana’s Bold Goal team. “By addressing barriers to health like food insecurity, loneliness, transportation, and access to quality care with our community partners, we are hoping to solve some of today’s toughest health problems.”
Approaching Community Health from a New Angle
Louisville-based IDEAS xLab is exploring problems like these from a new angle. They provide a framework for art and health innovation that brings together corporations, communities and artist innovators. They’ve spent the last four years training and placing artists inside corporations and communities – bringing the creative process into problem solving.
“Our belief is that innovation is not solely a technological or design issue, it also has to factor in human behavior; things that can positively or negatively impact health aren’t always intuitively associated with it,” says Edmonds.
The Robert Wood Johnson Foundation finds that health care access and quality account for just 20% of health outcomes while physical environment and socioeconomic factors contribute half.
Much like Humana’s Bold Goal team, Edmonds and team are exploring culture-based solutions for addressing health inequities – differences in health affected by social, economic, and environmental conditions.
Specific to Louisville, Edmonds and Humana are part of several Health Advisory Boards (HAB) throughout the southeast. Born from a series of Clinical Town Halls Humana convened in 2015 and 2016, the boards are comprised of community stakeholders invited to discuss barriers to health in their respective cities. Louisville’s HAB has been working to address issues like asthma and behavioral health. In November of last year, they convened their first Suicide Summit.
Project HEAL America
Additionally, IDEAS xLab has partnered with the University of Louisville School of Public Health & Information Science’s to establish the Center for Art + Health Innovation (CAHI) and its flagship program: Project HEAL America.
“It’s a 3-year, community-based, participatory action research model using arts and culture as a tool of activation and catalyzation to increase social cohesion and community capacity to effect change,” says Edmonds. “Our theory is that health is culturally created.”
Project Heal responds to 3 trends: health disparities that inhibit economic growth, shifting population demographics and lack of jobs in the arts sector and decreased arts funding.
CAHI plans to deploy the research model in five regions of the U.S. to promote community discussion about health, collect and analyze community data, and facilitate development and implementation of a health action plan.
“We anticipate that making health a shared community value, fostering place-based collaboration, and pioneering new relationships between communities and health systems will result in a new funding model between the arts and health sectors,” said Edmonds. “We’re not creating anything new, just framing it differently; turning aspirational arts programming into operational public health strategies.”
Making Progress in Smoketown
Edmonds referenced the Smoketown community in Louisville – where the life expectancy of residents is 9 years less than the Louisville average (despite bordering the downtown campus’ of all the city’s major health systems) – as an example for where opportunity exists.
The first step though, according to Edmonds is learning about the community from its members; asking where they want to start, what’s important to them.
“People, especially seniors, want to talk about their knowledge, not their health,” says Edmonds. “They know more about the neighborhood than you’ll get from any data set. It’s valuable, qualitative data, if you choose to treat it that way.”
For instance, IDEAS xLab’s Health Equity Strategist, poet Hannah Drake, has been working for the past year with people in Smoketown to understand why many didn’t want to go out and walk more in the neighborhood. What she learned, was that the community was surrounded with billboards and signs for gun shows, cheap attorneys, or how to sell your diabetic testing strips for cash.
“This kind of messaging creates toxic stress in the community,” Edmonds says. “So we started with community beautification and safety. Now, Hannah is creating a program where negative billboards will be replaced by positive messages from local poets, created with members of the Smoketown neighborhood.”
Simultaneously, IDEAS xLab and its partners are working on a policy change initiative that will mitigate the negative health impact of predatory advertising in low income communities.
This is just one example of how artists and cultural workers can help a community prioritize issues related to the social determinants and catalyze a culture of health in neighborhoods.
The success of Project HEAL will be measured by:
· Increased community capacity to address the social determinants of health
· Improved community health through long-term chronic disease reduction resulting in decreased healthcare costs
· Improved, sustainable funding streams for community arts/culture production
· Increased economic resilience of the business sector through improved workforce productivity
“We think that the places where people live, work, worship and learn can be activated as networks that prompt organic change,” says Edmonds. “We want to rally people around causes that they choose and want to work on. IDEAS xLab and our partners provide the evidence, research and tools to support real systems change thinking.”
It’s easy to see the parallels between Project HEAL and Humana’s Bold Goal efforts. In Bold Goal communities, impact is being measured by “Healthy Days” – a tool used by the CDC for decades that looks at a person’s physical and mental health over a 30-day period.
Changing people’s behaviors takes a collective impact and Humana and IDEAS xLab are helping to lead the way,” says Dr. Andrew Renda, director on the Bold Goal team. “Through our work, we know that there is a direct correlation between a person’s physical and mental health and where they live, work, and play. It takes all parts: art, business, government, the community, and the individual to invest in better health outcomes, which is why this work is so exciting and complex.”