Academic journal article The Journal of the Royal Society for the Promotion of Health

Establishing Common Ground in Community-Based Arts in Health

Academic journal article The Journal of the Royal Society for the Promotion of Health

Establishing Common Ground in Community-Based Arts in Health

Article excerpt

Key words

Community engagement: behavioural change; well-being; self-esteem; participatory


This article originates in current research into community-based arts in health. Arts in health is now a diverse field of practice, and community-based arts in health interventions have extended the work beyond healthcare settings into public health. Examples of this work can now be found internationally in different health systems and cultural contexts. The paper argues that researchers need to understand the processes through which community-based arts in health projects evolve, and how they work holistically in their attempt to produce therapeutic and social benefits for both individuals and communities, and to connect with a cultural base in healthcare services themselves. A development model that might be adapted to assist in analysing this is the World Health Organisation Quality of Life Index (WHOQOL). Issues raised in the paper around community engagement, healthy choice and self-esteem are then illustrated in case examples of community-based arts in health practice in South Africa and England; namely the DramAide and Siyazama projects in KwaZulu-Natal, and Looking Well Healthy Living Centre in North Yorkshire. In South Africa there are arts and media projects attempting to raise awareness about HIV/AIDS through mass messaging, but they also recognize that they lack models of longer-term community engagement. Looking Well by contrast addresses health issues identified by the community itself in ways that are personal, empathic and domesticated. But there are also similarities among these projects in their aims to generate a range of social, educational and economic benefits within a community-health framework, and they are successfully regenerating traditional cultural forms to create public participation in health promotion. Process evaluation may provide a framework in which community-based arts in health projects, especially if they are networked together to share practice and thinking, can assess their ability to address health inequalities and focus better on health outcomes.


In building an evidence base for the value of interventions of arts into health it is important to establish some common ground on which comparative qualitative studies may be developed. This article relates to recent research I have carried out into community-based arts in health through a ß fellowship award from the National Endowment for ' Science, Technology and Arts (NESTA). I am looking at this area of work increasingly in an international context and this is reflected in comparative case studies I have chosen from South Africa and England. They illustrate how developing community engagement in health issues through participatory arts can stimulate self-determined individual lifestyle change and also provide social, educational and economic benefits.

In recent years there has been considerable expansion and diversity in arts in health practice in the UK, and I believe this growth is not solely attributable to effective advocacy from the arts sector, but rather to an improving context for dialogue between the health sector and arts services. Some projects may focus on the therapeutic benefits of the arts, some on environmental improvements to support health staff in delivering their care services, and others look at producing more creative kinds of health information. When doing arts in health work with communities, projects may also celebrate social cohesion and identity around a health theme.1 These are arts projects that start from the point of using creativity to enhance social relationships, reflecting growing evidence that good relationships and social status are major determinants of health.2 Such diversity is also making it possible to identify a wide range of potential benefits.

When Richard Smith's editorial in a December 2002 issue of the British Medical Journal3 called for one half of 1% of the health budget to be diverted to the arts because 'if health is about adaptation, understanding and acceptance, then the arts may be more potent than anything medicine has to offer', this seemed for arts in health practitioners to be the stuff of dreams. …

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