H.E.A.L. Community approach. The artist as catalyst for change in Louisville

Context

HEAL (Health. Equity. Arts. Learning.) Community Approach’s urban prototype is located in the Smoketown neighbourhood of Louisville, KY. Founded by formerly enslaved people after the Civic War, at 151 years old, Smoketown is Louisville’s oldest Black community.

Though rich in cultural heritage, many people in Smoketown struggle financially and can’t pay their rent even though they are employed full time. In 2011, the Internal Revenue Service ranked one of Smoketown’s zip codes, 40203, as the 13th poorest in America.

Smoketown’s young people come from schools where they navigate years of both opportunity and danger. As of 2015, the overall crime rate there was very high, with a 1 in 24 chance of becoming the victim of any crime.

Louisville and culture

To begin a long-term transformation process that would create more health protective policies, and to increase access to live, learn and work opportunities, the neighborhood’s largest (and one of the most dangerous) public housing project, Sheppard Square, was demolished in 2011. This began redevelopment to an energy-efficient, mixed-income residential area, using a $100+ million public-private investment.

In 2013, the desire to support better policy making and increase opportunities for Smoketown residents led to a new effort called the Creative Innovation Zone (The Zone), a civic innovation partnership between IDEAS xLab (IDEAS) and YouthBuild Louisville (YBL). The Zone was unique in that it added arts and culture strategies to the traditional core components of community development in order to increase civic engagement, expand educational opportunity and attract new resources to support economic growth in Smoketown.

As the Creative Innovation Zone model was been developed, IDEAS was simultaneously working on placing artists inside health industry corporations including General Electric, XLerateHealth and Humana. Through this work, the IDEAS team began working with the Robert Wood Johnson Foundation’s County Health Model on a Humana project in Natchez, MS. This led to viewing the work of Creative Innovation Zone through a lens of health policy.

HEAL Community Approach is designed to help communities maximize the positive health benefits stemming from equitable development policies, which encompass both public and private efforts, to strengthen economic, physical and social health.

HEAL Community Approach is fundamentally centred on human development and community well-being. It is based on the firm conviction that civic engagement toward better policy is the most efficient way to create large-scale improvement in community health. Its approach combines the people, tools and resources of three different sectors (Arts and Culture, Community Development, Health and Wellness) into one model in order to impact community-wide health. As such, it puts into practice the Principle 10 of the Agenda 21 for culture.

HEAL Community Approach’s urban prototype is located in a neighbourhood where, in 2015, the overall crime rate was 48 % higher than the national average. HEAL Community Approach sees the appropriation of information and its transformation into knowledge by the citizens as a cultural act (Principle 14).

HEAL artists have taken a lead role in collaborating with city authorities to replace predatory billboard advertising with work of arts, joining a sweeping global trend. The U.S. states of Vermont, Maine, Hawaii, and Alaska have banned billboards, and approximately 1,500 cities nationwide have limited public advertising. It’s not just aesthetic— the movement is a part of a larger conversation about culture and human rights and potentially undermines the historic purpose of public spaces, which is to represent the character and achievements of its inhabitants (Principle 16 and Undertaking 27).

HEAL artists are currently working with the University of Louisville Center for Creative Placehealing to establish a credentialed training program for artists and cultural producers as a population health prevention workforce, providing knowledge-sharing opportunities, including training and development programs and networking through opportunities which will bring artists together with leaders from other sectors to advance a transdisciplinary development process for field building at the intersection of arts, culture and health (Undertaking 35).

HEAL community leaders recognize culture as an enabler, one of the main tenets of the international advocacy campaign that let to inclusion of specific targets for culture in the UN 2030 Agenda for Sustainable Development.

HEAL Community Approach is fundamentally centred on human development and community well-being.

Goals and project implementation

Main aim and specific goals

HEAL Community Approach is designed to help communities maximize the positive health benefits stemming from equitable development policies, which encompass both public and private efforts, to strengthen economic, physical, and social health. HEAL Community Approach does this by using arts and culture to drive participation, by a diverse group of community members, in the policy making process. This arts-based approach is rooted in research showing that strong social connections and community engagement improve health. The result is an artist-activated, social-lab process that uses humanities-based approaches, artistic expression, media, and other strategies to (1) explore both symptoms and root causes of local health challenges, (2) identify leverage points, and (3) create actionable policy strategies and sustainable community development strategies that can positively impact wellbeing and health equity.

Development of the project

Features of HEAL Community Approach

• Developed by a team of artists, curators, community activists, social innovators, health professionals and scientists.
• Brings together people, research, tools and resources of three sectors:
  • Arts/Culture
  • Community/Development
  • Health/Information Sciences
• Replicable, scalable, evidence-informed approach.
• Multi-year, arts and culture-activated, population health program that is co-designed with communities.
• Engages businesses, government, organizations, entrepreneurs, and researchers dedicated to a holistic approach to health and wellbeing.
• Uses various types of humanities-based approaches, artistic expression, media, and other cultural strategies, to explore both symptoms and root causes of local challenges, and identify unique leverage points for community health improvement.
• Creates actionable policy change initiatives and sustainable community development strategies that are designed to impact community wellbeing at multiple levels.
• Builds community capacity by cultivating more fully engaged neighbourhoods, with creative civic leaders, who have the necessary skills and resources, to develop policies and programs, that positively impact wellbeing at community-wide level.

Examples of community-based outcomes

• Arts and culture are increasing civic engagement in neighborhood development policy.
• A spoken word artist created a policy initiative to limit predatory advertising. Both Louisville Metro Department of Public Health & Wellness and Humana have supported the initiative with funding and as thought partners. (2017)
• Collaborative programming between artists and YouthBuild Louisville resulted in annual volunteerism in the Smoketown community rising from 350 individuals to over 1500.
• HEAL Community Approach partners advocated for improvements to municipal government notification policies related to new liquor store licenses. The cultural-based action created by artists also has caused the metro Louisville Government to change its policy notification procedures to be more equitable and transparent.

HEAL Community Approach is based on the firm conviction that civic engagement toward better policy is the most efficient way to create large-scale improvement in community health.

Impacts

Direct impacts

Community development sector

IDEAS xLab’s expertise in creative placemaking, social entrepreneurship and community development attracted over one million dollars in national funding to Louisville that directly funded new cultural and health equity programs (2014-2017).

Arts and culture sector

Through IDEAS xLab’s advocacy and leadership, Imagine 2020, Louisville’s new regional arts and cultural master plan, is the first in the nation to include a specific population health research strategy – a key step in the effort to make Louisville the national thought leader in arts and public health.

Americans for the Arts honored the collaborative work of Humana, IDEAS xLab and Fund for the Arts as one of the Top 10 Business-Arts Partnerships in America in 2017. General Electric and IDEAS xLab won the honor for their collaboration in 2015.

Health and Wellness Sector

• For the work being done at the intersection of health equity, data-driven decision-making and social entrepreneurship in arts/culture, Louisville was recognized by the Robert Wood Johnson Foundation with its 2016 Culture of Health Prize. This is the highest honor given by the largest funder of healthcare in the world
• Louisville has a growing team of experts working at the intersection of arts, culture and population health research through the Center for Creatiive Placehealiing (CCP)-- a partnership formed between IDEAS xLab and the University of Louisville School of Public Health & Information Sciences.
• Inspired by this innovative partnership, the University of Louisville Center for Creative Placehealing is now working with the business community to create a “Cultural Wellbeing Index” to become the first city in the US to scientifically measure and begin to manage inclusion in its private sector across 5 dimensions: Creativity; Curiosity; Commerce; Corporate Citizenship; and Cultural Relationships.

Through the support of the National Endowment for the Arts, the Educational Foundation of America and other key regional funders, IDEAS xLab is now working with the University of Louisville -- CCP and the Center for Health Organization Transformation, a National Science Foundation sponsored center -- to understand how the HEAL Community Approach can be adapted for rural Kentucky communities, culturally-responsive approaches to obesity prevention, and emotional wellbeing in marginalized adolescent populations (e.g., LGBTQ+, African American).

By 2030, IDEAS xLab and the University of Louisville’s mutual goal is (1) to establish HEAL Community Approach as an evidence-based, arts and culture population health intervention that increases healthy equity, and (2) to establish a credentialed training program for artists, creatives and cultural producers as a population health prevention workforce.

Evaluation

Released in fall 2017, the Health Impact Assessment (HIA) on HEAL Community Approach (Health. Equity. Art. Learning.) was the first-of-its-kind conducted on an arts and culture focused population health program in the U.S.

HIA was authored by IDEAS xLab and the Louisville Metro Department of Public Health+Wellness, with additional support from the University of Louisville and the Health Impact Project - a collaboration of Robert Wood Johnson Foundation and The Pew Charitable Trusts, with funding from the Kresge Foundation.

Through the HIA, IDEAS xLab and evaluators analyzed how HEAL Community Approach, as a replicable arts and culture model, provides a framework for rigorously and scientifically assessing in what ways (and why) this community-wide approach may:

• Decrease social isolation/ improve social cohesion/civic engagement.
• Create policy changes positively impact health equity.
• Increase opportunities for building inclusive
• Increase opportunities for improving social emotional skills in youth.
• Improve wellbeing of communities experiencing chronic stress.

Through an innovative partnership with Metro Louisville government and the University of Louisville, Ideas xLab model is now being re-imagined to create a "cultural wellbeing index" for Louisville's business community.

Currently, there is an ongoing evaluation to document/standardize a community-based process to train and activate artists to engage in local cultural production targeting culturally-responsive health improvement. HEAL Community Approach’s evaluation team comprised of public health researchers using solid methods from several disciplines to evaluate the results through science.

Continuity

Rising from the initial work of the HEAL model came an important question from the community. HOW MIGHT WE… re-imagine an old liquor store as a "community center" with digitally-connected cultural spaces, sustainable designs and business models, where Smoketown residents can fight poverty and improve health in a way that honors the culture and heritage of place? That's what more than 15 organizations are now working toward with the Smoketown HOPEBOX!

Arising from the work of the HEAL, a newly formed non-profit (2019), The Smoketown Hopebox Corporation (Hopebox), will focus on the collective wellbeing of neighborhood residents and the organizations governing the non-profit. The Hopebox exists to improve the health and wellbeing of people who are born, grow, live, work, learn, and age in the Smoketown neighborhood of Louisville. The neighborhood organizations who founded the Hopebox include YouthBuild of Louisville, Bates Memorial Baptist Church, Bates Community Development Corporation, IDEAS xLab, Smoketown Neighborhood Association, and Coke Memorial Methodist Church. The Hopebox includes a laundromat, a compassion clinic (to provide training to University of Louisville medicine, nursing, and dental students), arts and culture program to celebrate Black heritage, digital learning lab, after school learning support programs and business incubator for multiple employee-owned cooperatives and sole proprietorships.

Further information

Louisville was a candidate for the third "UCLG Mexico City – Culture 21 International Award" (November 2017 – May 2018). The jury for the award drew up its final report in June of 2016, and requested that the Committee on Culture promote this project as one of the good practices to be implemented through Agenda 21 for culture.

This article was written by Theo Edmonds, Chief Imaginator and Co-Founder IDEAS xLab, Louisville, Kentucky, USA.

Contact: theodore.edmonds@louisville.edu
Website: https://louisvilleky.gov/government/mayor-greg-fischer