Arts and Culture Increase Health Service Equity and Access 

Work toward increasing equity, inclusivity, and access is needed in both the health and arts sectors. Collaboration across these sectors can help identify blind spots and develop effective solutions toward achieving more equitable services and systems. And, engagement of community members is critical to this work.    

The safety and sense of connection created in arts and culture activities and spaces can: 

• Increase access and engagement  
• Facilitate dialogue, even about difficult issues and across difference 
• This dialogue can reduce stigma and isolation, and increase access to, and equity within, systems that provide support and care 
• Render the healthcare more culturally responsive 
• Generate new opportunities to sustain local cultures and traditions
• Recognizing that arts and culture reflect a community’s character, deepen social connections, and increase the stability of vulnerable neighborhoods 

And, notably, when health and social services are physically integrated with arts and cultural services, access can be significantly increased. Co-location of arts, health and social services can enhance utilization of all services, resulting in direct and long-term health benefits.    

For example: 

• The Jackson Medical Mall in Jackson, Mississippi, transformed an abandoned shopping mall into a medical, wellness, arts and retail center that holistically promotes health, economic and community development, resiliency, health equity, and youth opportunities. The Mall places arts and culture strategies at the core of its mission and activities. With 5,000+ visitors per day, the Mall features an array of arts and cultural programs that engage community members, celebrate local cultures and traditions, and promote healthy and engaged lifestyles alongside traditional health service providers. 
• The Village of Arts and Humanities in Philadelphia, PA, amplifies the voices and aspirations of its community members by providing arts-based opportunities for self-expression and personal success that engage youth and their families, revitalize physical space, and preserve black heritage. The Village provides health care services as well as jobs, arts education programs, and arts-integrated social services.   

Outcomes associated with increasing health service equity and access: 

Increased racial & social equity 

Logie, C. H., Dias, L. V., Jenkinson, J., Newman, P. A, MacKenzie, R. K., Mothopeng, T., Madau, V., Ranotsi, A., Nhlengethwa, W., & Baral, S. D. (2018). Exploring the potential of participatory theatre to reduce stigma and promote health equity for lesbian, gay, bisexual, and transgender (LGBT) people in Swaziland and Lesotho. Health Education & Behavior, 46(1), 146-56. https://doi.org/10.1177/1090198118760682 

Cain, M., Lakhani, A., & Istvandity, L. (2016). Short and long term outcomes for culturally and linguistically diverse (CALD) and at-risk communities in participatory programs: A systematic review. Arts & Health, 8(2), 105-124. https://doi.org/10.1080/17533015.2015.1027934 

Clive, P, C., & White, M. (2013). Inequalities, the arts and public health: Towards an international conversation. Arts & Health, 2(1), 23-32. https://doi.org/10.1080/17533015.2013.826260 

More welcoming and inclusive spaces 

Daykin, N., Byrne, E., Soteriou, T., & Oconnor, S. (2008). Review: The impact of art, design and environment in mental healthcare: A systematic review of the literature. Journal of the Royal Society for the Promotion of Health,128(2), 85-94. https://doi.org/10.1177/1466424007087806

Smart, E., Edwards, B., Kingsnorth, S., Sheffe, S., Curran, C. J., Pinto, M., Crossman, S., & King, G. (2018). Creating an inclusive leisure space: strategies used to engage children with and without disabilities in the arts-mediated program spiral garden. Disability and Rehabilitation, 40(2), 199-207. https://doi.org/10.1080/09638288.2016.1250122 

Gaminiesfahani, H., Lozanovska, M., & Tucker, R. (2020). A scoping review of the impact on children of the built environment design characteristics of healing spaces. HERD. https://doi.org/10.1177/1937586720903845

Enhanced service utilization (such as via co-location of arts and health services) 

Boyce, M, Bungay, H, Munn‐Giddings, C, & Wilson, C. (2018). The impact of the arts in healthcare on patients and service users: A critical review. Health Soc Care Community, 26, 458-473. https://doi.org/10.1111/hsc.12502

Jersky, M., Titmuss, A., Haswell, M., Freeman, N., Osborne, P., & Callaghan, L. (2016). Improving health service access and wellbeing of young Aboriginal parents in an urban setting: mixed methods evaluation of an arts-based program. Australian and New Zealand Journal of Public Health, 40(1), 115-121. https://doi.org/10.1111/1753-6405.12448 

Nielsen, S. L., Fich, L. B., Roessler, K. K., & Mullins, M. F. (2017). How do patients actually experience and use art in hospitals? The significance of interaction: a user-oriented experimental case study. International journal of qualitative studies on health and well-being, 12(1). https://doi.org/10.1080/17482631.2016.1267343

Morse, N., Thomson, L. J. M., Brown, Z., & Chatterjee, H. J. (2015). Effects of creative museum outreach sessions on measures of confidence, sociability and well-being for mental health and addiction recovery service-users. Arts & Health, 7(3), 231-246. https://doi.org/10.1080/17533015.2015.1061570 

Elevation of underrepresented voices 

Wendel, M. L., Jackson, T., Ingram, C. M., Golden, T., Castle, B. F., Ali, N. M., & Combs, R. (2019). Yet we live, strive, and succeed: Using photovoice to understand community members’ experiences of justice, safety, hope, and racial equity. Collaborations: A Journal of Community-based Research and Practice, 2(1), 9. https://doi.org/10.33596/coll.23

Veroff, S. (2002). Participatory art research: Transcending barriers and creating knowledge and connection with young Inuit adults. American Behavioral Scientist, 45(8), 1273-1287. https://doi.org/10.1177/0002764202045008011

Schillinger, D., & Huey, N. (2018). Messengers of truth and health - Young artists of color raise their voices to prevent diabetes. JAMA, 1-3. https://doi.org/10.1001/jama.2018.0986  

Representation of history and culture in the physical environment 

Rose, K., Daniel, M. H., & Liu, J. (2017). Creating change through arts, culture, and equitable development: A policy and practice primer. PolicyLink. https://www.policylink.org/sites/default/files/report_arts_culture_equitable-development.pdf

Golden, T. & Hand, J. (2018). Arts, Culture and Community Mental Health. Community Development Investment Review, 13(1). Retrieved AUgust 6, 2020, from https://www.frbsf.org/community-development/publications/community-development-investment-review/2018/october/arts-culture-and-community-mental-health/

Duffy, L., Pinckney, H., Benjamin, S., & Mowatt, R. (2019). A critical discourse analysis of racial violence in South Carolina, U.S.A.: implications for traveling while Black. Current Issues in Tourism, 22(19), 2430-2446. https://doi.org/10.1080/13683500.2018.1494143

Recognition and application/integration of local cultural assets 

Golden, T. (2020). Reframing photovoice: Building on the method to develop more equitable and responsive research practices. Qualitative Health Research, 1-13. https://doi.org/10.1177/1049732320905564

Grodach, C. (2011). Art spaces in community and economic development: Connections to neighborhoods, artists, and the cultural economy. Journal of Planning Education and Research, 31(1), 74-85. https://doi.org/10.1177/0739456X10391668 

Parkinson, C., & White, M. (2013). Inequalities, the arts and public health: Towards an international conversation. Arts and Health, 5(3), 177-189. https://doi.org/10.1080/17533015.2013.826260

Acknowledgements: We would like to thank Cris Sanhueza and the UF Center for Arts in Medicine Interdisciplinary Research Lab for their support in curating the articles within this online tool.