By Ashley Krombach (she/her), Senior Program Manager of Social-Emotional Health; and Brean Witmer (she/her), Senior Program Manager of Monitoring & Evaluation and Youth Risk Behavior Prevention

Social Inequalities and Inequities

Social determinants of health are defined by the Centers for Disease Control and Prevention (CDC) as the conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of-life-risks and outcomes [i]. In other words, they are situational factors that influence the quality of and the access to healthcare and education, economic stability, the built environment, and the social aspects of a community. Through policies, practices, and other interventions there are many efforts across local, state, territorial, tribal, and national levels to improve social determinants of health by addressing social inequalities (uneven distribution of health or health resources) and social inequities (unfair and avoidable differences in society and the environment that can shape health) [ii]. These interventions aim to dismantle barriers and redistribute power and resources in a more equal and equitable way.

One such way of doing this is to encourage and promote programs that foster attributes such as social cohesion and inclusion, empathy, conflict resolution, communication, bonding, and critical thinking. These skills can be integral to shining a light on power imbalances and deescalating growing inequities. One type of programming in which these attributes, and many others that play a role in similar prosocial behaviors, are often developed, is programming involving the arts.

Art has a long history of being used as a vehicle to spark change, social impact, and civic engagement. From art installations that shine light on the unhoused community and the refugee crisis, photography projects reflecting the impact and faces of diseases like addiction or depression, community murals encouraging residents to vote, or grassroots programs bringing neighbors together to foster cohesiveness, art is woven in to many threads of our society, yet frequently with the same goal – to elevate voices and lived experiences, and to bridge connection across communities.

The Arts & The Role They Play

What comes to mind when you think of the arts? Maybe it’s…

• Music, dance, theatre or other forms of performance-based art
• Visual art such as paintings, sculpture, photography, and more
• Poetry, novels, and other forms of literature
• Cultural festivals, concerts, community events, or museums
• Digital art such as graphic design, animations, or film making

No matter what came to mind – no answer is wrong. While the arts tend to be understood within these five categories, the concept of the arts is fluid. This means that the many styles, forms, and interpretations of art are the product of imagination and creativity across many cultures. The truth is, the arts tell a story of our world and the people in it – threading our lived experiences together by honoring and celebrating each one.

We know that at the core of health and well-being is our ability to recognize and respond to emotions, build relationships, and make healthy decisions for both ourselves and for how we engage and support others. It’s a process called social-emotional learning – and it’s a part of everything we do.

The arts help us to tell stories and raise awareness, understand perspectives other than our own, and brings us closer to others. From activating the senses to the stimulation of imagination and cognition, the release of emotions and social interaction, and more – the arts combine these health-promoting components in a way that activate psychological (how we think and feel), physiological (how our bodies work), social (how we connect with others), and behavioral (how we act and react) responses that lead to improved outcomes. When we connect the dots – bridging health and vehicles such as the arts – we can discover the many ways art can change our world and inspire a brighter tomorrow.

Connecting the Dots

In order to improve social determinants of health and address social inequities, we must first begin by understanding and recognizing health as social justice. By honoring diverse lived experience, challenging biases, and creating a shared understanding representative of many perspectives, we begin to strengthen relationships and become catalysts for change… the arts can help us do just that.

Research shows that the arts not only activate psychological and social responses such as improved emotional regulation and communication [iii], decreased stress, and increased pro-social behaviors (behaviors intended to benefit others) [iv], they also foster social cohesion and challenge social inequities.

The arts build social and community capital within societies and have been found to:  

• Foster cooperation, self-concept, and a sense of social inclusion in children, adults, families, and communities across different cultures [v]
• Bridge different groups – for example, activities such as dance, art classes, and theatre, have been found to foster greater social inclusion in children and adults [vi]
• Support conflict resolution through social-emotional and cognitive skills development and supporting empathy, transformative learning, and trust [vii]
• Preserve cultural traditions, foster resilience, and promote positive identity development in Indigenous communities [viii]

The arts promote capacity building and skills development and have been found to:

• Reduce anxiety, depression, and emotional alienation while increasing self-esteem, cultural empathy, and confidence in vulnerable student populations [ix]
• Improve self-control and reduce risk behaviors for children exposed to violence [x]
• Support responsible decision-making, enhance well-being, and reduce exposure to violence among adolescents living in urban areas [xi]

The arts support the creation of safe and supportive environments and have been found to:

• Support restoration programs that improve the built environment and decrease levels of violence [xii]
• Support the creation of spaces that serve an extended area of learning for youth – outside of the classroom and home [xiii]

The evidence is clear – the arts play a role in ensuring our communities thrive and our children have the resources, support, and opportunity to reach their fullest potential. From our classrooms to our homes – we can leverage art as a vehicle for social-emotional learning, strengthen nurturing relationships, and foster safe and supportive environments where children (and adults) can dream and grow.

This post is a part of Connecting the Dots: Health as Art. Learn more about how the arts support child development, strengthen health-promoting behaviors, and foster connectedness.

Discover new activities that connect the dots between social-emotional health, physical activity, and nutrition through art at school and at home with the Connecting the Dots: Health as Art Toolkit!

References

[i] https://www.cdc.gov/socialdeterminants/about.html

[ii] Fancourt D, Finn S. What is the evidence on the role of the arts in improving health and well-being? A scoping review [Internet]. Copenhagen: WHO Regional Office for Europe; 2019. (Health Evidence Network synthesis report, No. 67.) 2. RESULTS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553778/

[iii] Fancourt D, Garnett C, Spiro N, West R, Müllensiefen D. How do artistic creative activities regulate our emotions? Validation of the Emotion Regulation Strategies for Artistic Creative Activities Scale (ERS-ACA). PLOS One. 2019;14(2):e0211362. doi: 10.1371/journal.pone.0211362.

[iv] Weinstein D, Launay J, Pearce E, Dunbar RIM, Stewart L. Singing and social bonding: changes in connectivity and pain threshold as a function of group size. Evol Hum Behav. 2016;37(2):152–8. doi: 10.1016/j.evolhumbehav.2015.10.002.

[v] Boer D, Abubakar A. Music listening in families and peer groups: benefits for young people’s social cohesion and emotional well-being across four cultures. Front Psychol. 2014;5:392. doi: 10.3389/fpsyg.2014.00392.

[vi] Anderson S, Fast J, Keating N, Eales J, Chivers S, Barnet D. Translating knowledge: promoting health through intergenerational community arts programming. Health Promot Pract. 2017;18(1):15–25. doi: 10.1177/1524839915625037.

[vii] Bang AH. The restorative and transformative power of the arts in conflict resolution. J Transform Educ. 2016;14(4):355–76. doi: https://doi.org/10.1177/1541344616655886.

[viii] Fanian S, Young SK, Mantla M, Daniels A, Chatwood S. 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. 2015;74(1):27672. doi: 10.3402/ijch.v74.27672.

[ix] Cain M, Lakhani A, Istvandity L. Short and long term outcomes for culturally and linguistically diverse (cald) and at-risk communities in participatory music programs: a systematic review. Arts Health. 2016;8(2):105–24. doi: https://doi.org/10.1080/175330 15.2015.1027934.

[x] Alemán X, Duryea S, Guerra NG, McEwan PJ, Muñoz R, Stampini M et al. The effects of musical training on child development: a randomized trial of El Sistema in Venezuela. Prev Sci. 2017;18(7):865–78. doi: 10.1007/s11121-016-0727-3.

[xi] Chung HL, Monday A, Perry A. Promoting the well-being of urban youth through drama- based peer education. Am J Health Behav. 2017;41(6):728–39. doi: 10.5993/AJHB.41.6.7.

[xii] Coggan C, Saunders C, Grenot D. Art and safe communities: the role of Big hART in the regeneration of an inner city housing estate. Health Promot J Aust. 2008;19(1):4–9. PMID: 18481925.

[xiii] Delgado M. Music, song, dance, and theatre: Broadway meets social justice youth community practice. Oxford: Oxford University Press; 2017.