UK Arts and Humanities Research CouncilCommunities, Culture, Health and WellbeingWorkshop, Cardiff Wales, 17 – 19 September 2011Healthy Communities and CultureThink Local ... Think GlobalMargret MeagherExecutive Director, Arts and Health Australia &The Australian Centre for Creative Ageingwww.firstname.lastname@example.org
The Roseto Mystery Malcolm Gladwell ‘Outliers The Story of Success’ 2008The word ‘Outlier’ is defined as “a statistical observation that is markedly different in value from the others of the sample”
The Roseto Mystery Revealed“Virtually no one under 55 had died of heart attack. For men under65, the death rate from heart disease was half (the nationalaverage). The death rate from all causes in Roseto was up to 35%lower than expected.There was no suicide, no alcoholism, no drug addiction, and verylittle crime. They didn’t have any one on welfare. Then we lookedat peptic ulcers. They didn’t have any of those either. Thesepeople were dying of old age. That’s it.”John Bruhn, sociologist and co-investigator withDr Stephen Wolf, researching the Roseto population aged 21+Malcolm Gladwell , Outliers The Story of Success 2008
Roseto Recipe for Health – A Creative and Connected CommunityJohn Bruhn and Dr Stephen Wolf noticed how socially engagedthe people of Roseto were and the extended family relationshipsthat lay at the heart of the town’s social structure. Many homeshad three generations living under the one roof and grandparentswere respected. Attendance at church had a calming and unifyingeffect. There were 22 civic organisations in a town of under 2000people. The community was markedly egalitarian.“The Rosetans were healthy because of where they were from,because of the world they had created for themselves.”The Roseto Mystery, Malcolm Gladwell Outliers The Story of Success
Roseto Mystery Bewilders ScienceWhen John Bruhn and Dr Stephen Wolf presented theirfindings at medical conferences in the 1950s, they weremet with scepticism by their peers.Genetics, diet, exercise, regional location and medical carewere considered the key determinants of health.People did not think about health in terms of ‘community’.The Roseto Mystery, Malcolm Gladwell Outliers The Story of Success
Roseto Case Study: A New Way of ThinkingBruhn and Wolf sought to convince the medical establishment tothink about health beyond an individual’s personal choices oractions in isolation.Malcolm Gladwell concludes that in understanding the health of aperson, it is important to understand the culture that he or she ispart of, including that of their friends and families and to knowwhere they and their families come from.Finally, he says it is critical to understand that the values of theworld we inhabit and the people we surround ourselves with havea profound effect on who we are and, by implication, on ourhealth, wellbeing and connection to community.Malcolm Gladwell, Outliers The Story of Success 2008
THIS IS AN IDEA OF WHO I AM AND WHERE I COME FROM...
My Workplace My Family and Friends My BackyardPort Macquarieand the world My Community Choirs
Arts and Health is taking great strides as an international movement Black Grace Dance Company New Zealand
In 21st Century What is Arts and Health?Arts and Health is an international field of practice and research thatencompasses primary and acute care, aged care, palliative care,community health, health promotion, medical education, architecture anddesign.An Arts and Health program provides participants with access toprofessionally delivered creative activities specifically designed to achievepositive health outcomes – such as singing to improve cardiovascular andlung function or restore voice facility for stroke victims; dance to improvemobility and combat obesity; clay modelling for arthritis; visual art andmusic to support people with dementia or Parkinson’s disease.Art forms range from the visual arts, music, theatre, dance, circus arts,creative and narrative writing, storytelling, film, digital media.
In 21st Century Growing Recognition of the Value of Arts and Health“Arts and health initiatives are integral to health, healthcareprovision and healthcare environments, including supporting staff,and are delivering real and measurable benefits across a wide rangeof priority areas for health, supported by a substantial evidencebase” UK Dept of Health Review 200The arts bring people together and forge essential linkswith the broader community, facilitate intergenerationalexchange and foster social inclusion.
In 21st Century Why is Arts and Health gathering momentum? Major demographic changes as baby boomer generation ages People live longer and likely to experience chronic health conditions eg dementia, depression, cancer, diabetes, cardiovascular disease 21st century expectations of the right to enjoy a high quality of life and high level of accessible information Increased social isolation in the community with family fragmentation Healthcare now focussed on keeping well, prevention and potential rather than illness and burden Increasing scientific research to corroborate benefits of arts for health International exchange of people, programs and ideas Alison Clough Pioneer Projects, Bentham, Yorkshire UK, WA Healthway Residency 2008 working with Aboriginal Communities around diabetes
Arts and Health is developing as a global fraternityKey to the strengthening of the global arts and health movement is theunifying communications and networking role played by peak arts andhealth organisations, together with improved access to information andresources via the internet: Society for the Arts in Healthcare, USA (www.thesah.org) London Arts and Health Forum, UK (www.lahf.org.uk) Centre for Medical Humanities, UK (http://www.dur.ac.uk/cmh/) Arts and Health Australia (www.artsandhealth.org) Arts Health Network Canada (www.artshealthnetworkcanada.com) Arts and health blogs - Arts in Health Manchester Metropolitan University (http://artsforhealthmmu.blogspot.com) Centre Medical Humanities (http://medicalhumanities.wordpress.com/ Arts & Health International Journal of Research, Policy and Practice; Applied Arts and Health Journal; UNESCO Observatory Multi-Disciplinary Research in the Arts E Journal, University of Melbourne (2012 editions)
Arts and Health Australia (AHA) - www.artsandhealth.org National advocacy, networking and consulting agency Expertise in designing and implementing creative communities programs for hospitals, retirement villages, aged care facilities, community services Strong regional, national and international networks provide access to best practice models and current research Partner in training and research projects such as the Art and Dementia program at the National Gallery of Australia in Canberra (pictured). Convenor of an annual international arts and health conference “The Art of Good Health and Wellbeing” Canberra ACT 14 – 17 November 2011 Fremantle WA 13 – 16 November 2012
Defining Health and WellbeingNational Aboriginal Health Strategy (NAHS) defines health as:‘Not just the physical wellbeing of the individual but the social,emotional and cultural wellbeing of the whole community. This is awhole-of-life view.’Sir Michael Marmot, Chair of WHO Commission on SocialDeterminants of Health, 2006 identifies the key determinants ofhealth as -• Social justice and participation• Empowerment as a means – material, psychosocial, political• Creating the conditions for people to take control of their liveswww.who.int/social_determinantsStrategic Review of Health Inequalities in England post 2010www.ucl.ac.uk/gheg/marmotreview
Examples of Health InequalitiesLife expectancy at birth for selected London electoral wards,a few miles apart, 2002-06 (data from London Health Observatory)Kensington & Chelsea Queens Gate ward:Life Expectancy for men: 88 yearsTottenham Green, HaringeyLife Expectancy for men: 71 yearsIndigenous Australians have a life expectancy of 17 years less thannon indigenous Australians
In 21st Century Questions to Ask What does existing research tell us about the efficacy of arts and health programs in maintaining and improving health and wellbeing and nurturing flourishing communities ? Where are the gaps? What questions do we need answered to advance community cultural development, health and wellbeing?“what is the problem to which we think we are the solution?” François Matarasso
Therapeutic Outcomes from Arts and Health Programs in Hospitals and Aged Care Facilities reduced stress and anxiety; elevated mood and self esteem pain management improved communication – patients/family/hospital staff excite the imagination, entertain, educate and inform safe, non threatening environment improved design features - patient rooms, signage, instrumentation, public spaces reduced length of time in hospital reduced reliance on medication, hospital staff enhanced wellbeing of hospital staff, carers, families Royal Melbourne Hospital
Study of the Effect of Visual and Performing Arts in Health Care -Chelsea and Westminster Hospital, London.(www.hospitalarts.co.uk)Landmark research (1999 – 2002) provided evidence thatthe integration of visual and performing arts into thehealth environment induce psychological, physiologicaland biological outcomes with clinical significance.Units of research established in the following clinics:Medical Day Unit, Antenatal Clinic, High-Risk Clinic,Maternity, Post-natal Ward, Day Surgery Unit,Trauma and Orthopaedics Ward, HIV/AIDS ServicesRosalia Lelchuk Staricoff PhD, Director Research Project
Antenatal High Risk Clinic: Live music in waiting area effective in loweringblood pressure of patientsMaternity Unit – music and visual art: Duration of labour 2.1 hours shorterand requests by women in labour for epidural analgesia diminishedTrauma and Orthopaedic Ward – music and visual art: Patients during thepost-operative period required less analgesia per day and stayed 1 dayless in hospital than control groupStaff Evaluation: Two thirds of respondents(clinicians, nursing staff, managers) indicated thehospital environment – architecture, light, colour,visual art, live music – influenced decision to applyfor job in the hospital or remain in current position
The arts can be the best medicine of all .. and it’s fun Health Professionals and the ArtsHealthcare professionals recognize the arts can reduce the stressof a pressured healthcare environment, assist them to maintainmental alertness and providerespite and lifestyle balance.Medical humanities education isvaluable in honing communicationsand observational skills and improveddiagnosis procedures.(www.nga.org.au/artmed) Corpus Medicum, Melbourne, arts+medicine magazine
Arts and Community Health and Wellbeing“Arts in community health is a distinct area of activity outside acutehealthcare settings, characterised by the use of participatory arts topromote health.The development of such work within theinterweaving strands of health, education andsocial policy has evolved through recognition ofthe connection between engagement in culturalactivity and wellbeing and that the arts can havea lasting and transforming effect on manyaspects of people’s lives.” Mike White 2007Mike White, Senior Research and Development Fellow in Arts and Health,Centre for Medical Humanities, University of Durham, UK (www.dur.ac.uk);author of Arts Development in Community Health: A Social Tonic (Radcliffe, Oxford 2009)
In the USA Music in the Community for Health and Wellbeing“There are now more community choirs in the UK than fish and chipshops.” The Independent, January 2010Singing is widely reported to be enjoyable, energising, relaxing, stressrelieving, mood enhancing and cognitive stimulating. Singing enhancesself-confidence, self esteem, gives a sense of purpose and ofachievement. Socially, it provides social support, friendship and asense of community and belonging.Reference: Group Singing, Wellbeing and HealthA systematic mapping of research evidenceProfessor Stephen Clift, Research Director,Sidney de Haan Research Centre for Arts and Health,Canterbury Christ Church University, UK
In the USAQuality of Life Research Informs Value of Arts HealthDr Cheryl Dileo, PhD, MT-BC. Professor of Music Therapy and Coordinator ofthe MMT Program and Director: Arts and Quality of Life Research CenterTemple University, Philadelphia; faculty member University of Melbourne.www.temple.edu/boyer/researchcenter - undertaking7 Cochrane Reviews into arts and health, exploring: Are the arts effective modalities in healthcare? Do the arts make a difference? How do the arts make a difference? Why do the arts make a difference? What is the best evidence? What kind(s) of evidence is(are) needed?
A Logical Connection New Laguna Honda Hospital for Long Term Care San Francisco Designed to create a sense of community among residents 780 bed facility, each patient has a window and fresh air Each floor is a distinctive neighbourhood 60 residents live in 4 x 15 people households, each with living room Households are organised around a central Great Room (Town Square) Every two households share dining room
A Logical Connection New Laguna Honda Hospital for Long Term CareThe Esplanade is the main street, lined with places for residents, carers,volunteers and visitors to meet, including a community theatre, cafe,library, art studios, hairdresser.
A Logical ConnectionThe Esplanade – Laguna Honda’s Main Street Cliff Garten Bronze Handrail
A Logical Connection New Laguna Honda Hospital for Long Term CareBuildings open onto a central park, hometo the animal therapy center and horticulturalprogram; 11 healing gardens include secureareas for dementia patientsArtwork is appropriate for a population diversein its ethnicity, cultural backgrounds, andlevels of physical ability andmental cognition
A Logical Connection New Laguna Honda Hospital for Long Term CareKey Elements of Design Criteria Meet Functional Needs Way Finding and Location Identity Sensory Stimulation Activity Stimulation of Memory Orientation to Time
A Logical Connection New Laguna Honda Hospital for Long Term CareDesign Principals Sense of Place: Geography, History, Language De‐Institutionalization through art Personal Autonomy through activity, interaction and choice
In the UK Arts – Led Community RegenerationArts-led regeneration can have a dynamic effect on the overall health,confidence and prosperity of a community, supporting social integration andlifelong learning.High-quality arts facilities, supported by their localcommunity, can attract significant investment intotheir region.Cultural provision is an important economic indicator.The Angel of the North, Newcastle Gatesheadis a concrete example of the accumulator effect on thelocal economy of a high quality arts project.
In the UK Arts – Led Community RegenerationIn the 1990s Gateshead was a blue collar town in North East England inlong-term recession. The Council won Government funding to host aNational Garden Festival in 1990. The land reclamation required for this ledto a program of commissioning works of public art to establish a new imageand identity for the town, under the project management of Mike White.The most ambitious art work was the 20 metre high Angel of the North byAntony Gormley, installed 1998, which is now the most viewed and mostpublicly recognised contemporary sculpture in Britain.The Times newspaper chose the Angel as its coverimage for 1st January 2000 issue to herald thenew century.
Cost AUS $2million - Generated an estimated AUS $140 million in freetourism promotion and continuing.The Angel became a national icon and helped Gateshead Council makea case for funding from the National Lottery and the private sector tosupport ...
In the UK Arts Led Regeneration – Community BenefitsDevelopment of major art gallery The BALTIC on Gateshead Quays(AUS $80 million) and international concert hall The Sage designed byBritish architect Norman Foster (AUS $160 million)These developments attracted further private sector investment of AUS$250 million for a science park, a tertiary college, new housing and leisuredevelopmentNew Millennium Bridge over the Tyne (AUS $50 million)built to connect Gatesheads flagship arts facilities withsister city Newcastle.A by-product of this success is that the populationhealth profile of the town significantly improved.
Healthy Ageing: Creativity MattersCreative Ageing: Health and wellbeing benefits for older people who engagein creative activitiesA specialised area, at a critical time in healthcare globally, challenged by arapidly increasing ageing population.Office for an Ageing Australia appointedactress Noelene Brown as Ambassador forAgeing in 2008 to promote healthy, positiveand active ageing messages in the Australiancommunity – to minimise or delay disabilityand lead promotional activities to ensurecommunities value and respect older people.
Ageing in 21st Century : Some FactsBy 2041, 1 in 5 Australians will be over 65; 7% will be over 80 (ABS)Older people want to age in place and live independently in a safe, familiarand welcoming environment. Connection to community is important.We are moving to a time when the ageing population of the western worldwill be the best educated and skilled in history, with much to offer Some of the Challenges for SocietyCombating ageist attitudes and discrimination towards older peopleHarnessing and nurturing the true potential of the ageing populationEnsuring that people with dementia and their carers enjoy quality of life
A Potent MixStrategies to Facilitate Positive Change around Ageing Improved marketing communications / health promotion to promote healthy ageing through the arts, emphasising the physical and mental benefits of engaging in creative activities. Promote positive attitudes to ageing by profiling older role models and champions, encouraging increased intergenerational exchange and highlighting the value of wisdom, experience and mentorship in the community. Support the development of creative ageing strategies for older people living in the community independently or for people in aged care facilities, dementia care, hospitals and hospices, along with their carers and families.
A Potent MixStrategies to Facilitate Positive Change around Ageing Increased research into the efficacy of arts and health programs in improving and maintaining health, wellbeing and social inclusion for older people Extrapolating from research data the business case for creative ageing strategies. Increased research into the use of the arts to support older people with depression, anxiety, dementia and other chronic illness, and their carers.
A path to Healthy Ageing Creative Ageing Research in the USA “Art is like chocolate for the brain” Dr Gene Cohen MD PhDGene Cohen was the Director, Center on Aging, Health &Humanities, Professor of Health Care Sciences & Professor ofPsychiatry & Behavioral Sciences, George Washington University(www.gwumc.edu/cahh)Acclaimed author, includingThe Creative Age: AwakeningHuman Potential in the Second Halfof Life (2000)The Mature Mind : The PositivePoswer of the Aging Brain (2006)
Compelling ResultsCreativity and Aging Study: The Impact of Professionally Conducted Cultural Programs on Older Adults Dr Cohen completed this landmark study on the impact of professionally conducted, participatory cultural programs on older adults, 2001 – 2005, across 3 sites in Washington DC, New York City and San Francisco, with 300 people participants. Average age of participants was 80, with age range of 65 – 103 years The intervention group maintained greater independence, higher morale, experienced less loneliness, used less medication than control group, expanded their interests and activities, achieved a greater sense of control and enjoyed higher social engagement Ref: National Centre for Creative Aging, Washington DC www.creativeaging. org
A Universal Language Creative Ageing – Art and DementiaThe Meet Me at MoMA Alzheimer’s Programand the National Gallery of Australia’sArt and Dementia program are outstandingmodels of arts and health programs in thegalleries/museum sector - bringing peoplewith Alzheimer’s and other forms of dementia,along with their carers, to each museum forinteractive tours of masterpieces from theircollections. (www.moma.org/meetme/index)MoMA offers an invaluable online resource(www.moma.org/meetme/index)bottom right: Carrie McGee Educator, MoMA
A Universal Language Creative Ageing – Art and DementiaThe National Gallery of Australia’s Art and Alzheimer’s Outreach Projecthas been established to assist regional communities develop asustainable model of tours for people living with dementia. Alzheimer’sAustralia is a partner in the project.This has been an important programin facilitating social inclusion andproviding support for email@example.com
A Universal Language3rd Annual InternationalArts and Health ConferenceNational Gallery of AustraliaNational Portrait GalleryCanberra ACT14 – 17 November 2011Mental health, creative ageing,social inclusion, intergenerationalprograms and medical education areareas of key focus.Training workshops include the MoMAand NGA Art and Dementia programs
A Potent Mix The Last Word on Arts and Health“It might be the purgative power of watching a great tragedy, thesoothing effect of a fine painting or even the robust exercise of singingin a choir, but the arts are good for your health”Richard Smith, EditorBritish Medical JournalNew Scientist June 2002Margret MeagherArts and Health Australia &The Australian Centre forCreative Ageingwww.firstname.lastname@example.org