Arts and Culture Support Social, Cultural, and Policy Change
In recent decades, public health has increasingly focused on the social determinants of health and upstream causes of poor health and health disparities. In the process, it's become clear that individual-level interventions and outcomes cannot (by themselves) change the outer levels of the social ecological model: communities, policy, culture.
Fortunately, arts and cultural practices can contribute to upstream solutions, because:
- they have a history of bringing people together around shared interests, which is useful for advocacy, civic engagement, and community organizing;
- they can elevate underrepresented voices and concerns, such as when a film, song, or celebrity generates a platform for stigmatized or unaddressed issues;
- artists are also known historically for speaking truth to power, which can help increase public awareness and engagement regarding policies and institutional actions; and
- arts and artists can shift cultural norms and collective behaviors.
For example, the TV program Will & Grace positively influenced viewer attitudes toward gay men, and East Los High helped promote conversations and positive behaviors related to sexual health. More recently, artists have used video and streaming platforms to discuss COVID-19, helping to explain and normalize health behaviors such as handwashing and social distancing.
Outcomes associated with supporting social, cultural, and policy change:
- Enable dialogue within and across groups
Balls-Berry, J. E., Sinicrope, P. S., Soto, M. A. V., Albertie, M. L., Lafflam, R., Major-Elechi, B. T., Juhn, Y. J., Brockman, T. A., Bock, M. J., & Patten, C. A. (2018). Using Garden Cafes to engage community stakeholders in health research. PloS one, 13(8). https://doi.org/10.1371/journal.pone.0200483
Bruneau, E. G., & Saxe, R. (2012). The power of being heard: The benefits of “perspective-giving” in the context of intergroup conflict. Journal of Experimental Social Psychology, 48(4), 855-866. https://doi.org/10.1016/j.jesp.2012.02.017
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. (2019). 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), 146-156. https://doi.org/10.1177/1090198118760682
- Elevate underrepresented voices
Travis, R., Rodwin, A. H., & Allcorn, A. (2019). Hip hop, empowerment, and clinical practice for homeless adults with severe mental illness. Social Work with Groups, 42(2), 83-100. https://doi.org/10.1080/01609513.2018.1486776
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. http://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, 319(11), 1076-1078. https://doi.org/10.1001/jama.2018.0986
- Organize and mobilize communities
Brownett, T. (2018). Social capital and participation: The role of community arts festivals for generating well-being. Journal of Applied Arts & Health, 9(1), 71-84. https://doi.org/10.1386/jaah.9.1.71_1.
Chung, B., Jones, L., Jones, A., Corbett, C. E., Booker, T., Wells, K. B., & Collins, B. (2009). Using community arts events to enhance collective efficacy and community engagement to address depression in an African American community. American Journal of Public Health, 99(2), 237-244. https://doi.org/10.2105/AJPH.2008.141408
Duncombe, S., Perlov, G., Lamber, S., & Halford, S. J. (2017). Assessing the impact of artistic activism. The Center for Artistic Activism. https://c4aa.org/wp-content/uploads/2018/03/Assessing-the-Impact-of-Artistic-Activism.pdf
Mayfield-Johnson, S., & Butler, J. (2017). Moving from pictures to social action: An introduction to photovoice as a participatory action tool. New Directions for Adult and Continuing Education, 154, 49-59. https://doi.org/10.1002/ace.20230
- Increase social cohesion
- Support greater adoption of collective behaviors
Chung, B., Jones, L., Jones, A., Corbett, C. E., Booker, T., Wells, K. B., & Collins, B. (2009). Using community arts events to enhance collective efficacy and community engagement to address depression in an African American community. American Journal of Public Health, 99(2), 237-244. https://doi.org/10.2105/AJPH.2008.141408
Cuypers, K., Krokstad, S., Holmen, T. L., Knudtsen, M. S., Bygren, L. O., & Holmen, J. (2012). Patterns of receptive and creative cultural activities and their association with perceived health, anxiety, depression and satisfaction with life among adults: the HUNT study, Norway. Journal of Epidemiology & Community Health, 66, 698-703. https://doi.org/10.1136/jech.2010.113571
- Increase community capacity and resilience
All-Party Parliamentary Group on Arts, Health and Wellbeing. (2017). Creative health: The arts for health and wellbeing. https://www.culturehealthandwellbeing.org.uk/appg-inquiry/
Muirhead, A., & De Leeuw, S. (2012). Emerging priorities: Art and wellness: the importance of art for Aboriginal peoples’ health and healing. National Collaborating Centre for Indigenous Health. https://artshealthnetwork.ca/ahnc/art_wellness_en_web.pdf
Lewis, F., & Sommer, E. K. (2017). Art and community capacity-building: A case study. In L. N. Hersey & B. Bobick (Eds.), Handbook of Research on the Facilitation of Civic Engagement through Community Art (pp. 499-523). IGI Global. https://doi.org/http://doi:10.4018/978-1-5225-1727-6.ch023
Straits, K. J. E., deMaría, J., & Tafoya, N. (2019). Place of strength: Indigenous artists and indigenous knowledge is prevention science. Am J Community Psychol, 64(1-2), 96-106. https://doi.org/10.1002/ajcp.12376
- Increase civic engagement
Duncombe, S., Perlov, G., Lamber, S., & Halford, S. J. (2017). Assessing the Impact of Artistic Activism. The Center for Artistic Activism. https://c4aa.org/wp-content/uploads/2018/03/Assessing-the-Impact-of-Artistic-Activism.pdf
Stern, M. J., & Seifert, S. C. (2009). Civic engagement and the arts: Issues of conceptualization and measurement. University of Pennsylvania. https://repository.upenn.edu/siap_civic_engagement/1/
- Reduce stigma
Hankir, A., Zaman, R., Geers, B., Rosie, G., Breslin, G., Barr, L., Carrick, F., & Anderson, S. (2017). The Wounded Healer film: a London College of Communication event to challenge mental health stigma through the power of motion picture. Psychiatr Danub, 29(3), 307-312. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28953783/
Twardzicki, M. (2008). Challenging stigma around mental illness and promoting social inclusion using the performing arts. Journal of the Royal Society for the Promotion of Health, 128(2), 68-72. https://doi.org/10.1177/1466424007087804
Teti, M., Rolbiecki , A., Zhang, N., Hampton, D., Binson, D. (2016). Photo-stories of stigma among gay-identified men with HIV in small-town America: a qualitative exploration of voiced and visual accounts and intervention implications. Arts & Health, 8(1), 50-64. https://doi.org/10.1080/17533015.2014.971830
- Enable community-led and -sustained health practices
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
Kilroy, A., Garner, C., Parkinson, C., Kagan, C., & Senior, P. (2007). Towards transformation: Exploring the impact of culture, creativity and the arts on health and wellbeing. Arts for Health, Manchester Metropolitan University. http://www.compsy.org.uk/Critical%20friends%20report%20final%20amendments.pdf
Byrne, E., Elliott, E., Saltus, R., & Angharad, J. (2018). The creative turn in evidence for public health: community and arts-based methodologies. J Public Health, 40(1), i24-i30. https://doi.org/10.1093/pubmed/fdx151
- Honor indigenous cultural traditions and practices
Flicker, S., Yee Danforth, J., Wilson, C., Oliver, V., Larkin, J., Restoule, J., Mitchell, C., Konsmo, E., Jackson, R., & Prentice, T. (2014). “Because we have really unique art”: Decolonizing research with Indigenous youth using the arts. International Journal of Indigenous Health, 10(1), 16-34. http://dx.doi.org/10.18357/ ijih.101201513271
Fanian, S., Young, S. K., Mantla, M., Daniels, A., & Chatwood, S. (2015). Evaluation of the Kòts’iìhtła (“We Light the Fire”) project: building resiliency and connections through strengths-based creative arts programming for Indigenous youth. Int J Circumpolar Health, 74(1). https://doi.org/10.3402/ijch.v74.27672
- Support policy and advocacy efforts
Madden, C., & Bloom, T. (2004). Creativity, health and arts advocacy. International Journal of Cultural Policy, 10(2), 133-156. https://doi.org/10.1080/1028663042000255772.
Goldbard, A. (2018). Art & wellbeing: Toward a culture of health. U.S. Deparmtent of Arts & Culture. https://usdac.us/cultureofhealth/
Shimshon-Santo, A. (2018). "Do our lives matter?' Music, poetry, and Freedom School. Education Citizenship and Social Justice,13(3), 256-267. https://doi.org/10.1177/1746197918793057
- Empower collective health behavior change
Lewis, F., & Sommer, E. K. (2017). Art and community capacity-building: A case study. In L. N. Hersey & B. Bobick (Eds.), Handbook of research on the facilitation of civic engagement through community art (pp. 499-523). IGI Global. https://doi.org/http://doi:10.4018/978-1-5225-1727-6.ch023
Balfour, B., W-P Fortunato, M., & Alter, T. R. (2018). The creative fire: An interactional framework for rural arts-based development. Journal of Rural Studies, 63, 229-239. https://doi.org/10.1016/j.jrurstud.2016.11.002
Chung, B., Jones, L., Jones, A., Corbett, C. E., Booker, T., Wells, K. B., & Collins, B. (2009). Using community arts events to enhance collective efficacy and community engagement to address depression in an African American community. American Journal of Public Health, 99(2), 237-244. https://doi.org/10.2105/AJPH.2008.141408
Cuypers, K., Krokstad, S., Holmen, T. L., Knudtsen, M. S., Bygren, L. O., & Holmen, J. (2012). Patterns of receptive and creative cultural activities and their association with perceived health, anxiety, depression and satisfaction with life among adults: the HUNT study, Norway. Journal of Epidemiology & Community Health, 66, 698-703. https://doi.org/10.1136/jech.2010.113571
- Illuminate community health issues and priorities
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
Gómez, S., & Castañeda, H. (2019). “Recognize Our Humanity”: Immigrant youth voices on health care in Arizona’s restrictive political environment. Qualitative Health Research, 29(4), 498-509. https://doi.org/10.1177/1049732318755580
Durden, E. & Tomaselli, K. (2012). Theory meets theatre practice: Making a difference to public health programmes in Southern Africa. Professor Lynn Dalrymple: South African scholar, activist, educator. Curriculum Inquiry, 42(1), 80-102. https://doi.org/10.1111/j.1467-873X.2011.00575.x
Balfour, B., W-P Fortunato, M., & Alter, T. R. (2018). The creative fire: An interactional framework for rural arts-based development. Journal of Rural Studies, 63, 229-239. https://doi.org/10.1016/j.jrurstud.2016.11.002
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.