Congratulations to the Robert Wood Johnson Foundation and Rutgers University for the ambitious and comprehensive plan to Build a Culture of Health in New Jersey. Collaborative, inclusive, and thoughtful, the plan clearly outlines priorities and policies to improve health, equity and well-being for all New Jersey residents, and will no doubt have a positive impact on health-related decisions for years to come.
The matter of well-being is repeatedly referenced throughout the report in the context of quality healthcare. I regrettably take issue that there is no mention of the powerful and proven role of art and culture to treat and promote health and well-being of the whole person, as well as bolster healthy environments and quality caregiving of health workers. This is despite prevailing thinking on the issue by major national and international health and wellness organizations.
The National Organization for Arts and Health’s comprehensive 2017 paper cites a multitude of examples that illustrate how the arts, humanities, design, and the creative arts therapies support prevention, treatment, and the management of illness and chronic disease by improving the healthcare experience as well as aiding in rehabilitation, recovery, human performance, and end-of-life care.
The World Health Organization, in defining health as “a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity” opens the door to broad holistic approaches that include arts and culture. The Office of Disease Prevention and Health Promotion’s social determinants of health (SDOH) advocates for Health Impact Assessments to help communities, decision makers, and practitioners make choices that improve public health through community design in which art and culture are inherent.
Humanizing healthcare with art
In New Jersey there are numerous examples of how art and culture are being used to enhance and humanize the healthcare environment, including Princeton HealthCare System’s award-winning Art for Healing initiative that involves evidence-based design in selecting health-inducing art throughout the hospital including the Punia Family Healing Garden, the hospital restaurant, the Acute Care for the Elderly Unit, and the Regan Family Center for Pediatric Care. The Healing Arts program at AtlantiCare dedicates 1 percent of construction costs to create a healing environment/experience for patients and families and a supportive environment for staff through art in its Atlantic City and Hammonton facilities.
Thousands of creative art therapists nationwide and scores here in New Jersey in music, dance/movement, drama, and creative writing, use their art forms toward achieving clinical and therapeutic outcomes such as reductions in anxiety, pain, length of stay, and readmission. Art therapy is often used in treating substance abuse and addiction by providing an alternative or supplement to conversational therapy. Matheny’s Arts Access program is renowned for its work integrating the arts into therapies and providing creative expression opportunities for persons with severe disabilities. New Jersey Ballet’s Dancing for Parkinson’s Program held at the Robert Wood Johnson Fitness & Wellness Center in New Brunswick is provided in partnership with the American Parkinson’s Disease Association New Jersey Chapter. It is designed to encourage coordination, musicality, spatial awareness, creativity, and technique.
Something is missing
Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation states in the Call to Collaboration (which precedes the above-cited report) that “Creating a culture of health requires more than expanding access to healthcare…” The report also calls for a shift in the healthcare system’s focus toward delivery of whole-person care, working with other systems to promote overall health, well-being and social needs in the context of community. We fully concur with both calls to action. However, each fails to recognize how the inclusion of art and culture in the plan’s implementation strategies will help meet these goals and that of advancing health equity through collaboration across state agencies.
Two excellent examples exist. One is the collaboration between the New Jersey State Council on the Arts and the New Jersey Historical Commission with the New Jersey Department of Human Services and the New Jersey Department of Health to assure that users of the Families First Discovery Pass program (SNAP and WIC assistance) have access to free or significantly reduced admission at cultural events throughout the state. It recognizes that reducing social isolation and nurturing social and mental well-being are vital to a culture of health. Another is the New Jersey Council on the Humanities program called Humanities at the Heart of Health Care®, a national award-winning reading and discussion program, linking literature to medicine, that helps healthcare professionals across the country improve their communication and interpersonal skills while increasing their cultural awareness, empathy for patients, and job satisfaction. Ten New Jersey hospitals and healthcare facilities currently participate in the program.
It’s clear that arts and culture through practice and policy are already engaged in championing several of the policy recommendations included in the Building a Culture of Health report and plan. However, we strongly urge the Robert Wood Johnson Foundation, Rutgers, and every healthcare facility in the state to include arts and culture as vital elements in their respective strategies to improve health, equity, and well-being for all New Jersey residents.