UCL Health of the Public


Transcript: Episode 5: How can arts and creativity tackle health inequalities?


arts, people, community, organisations, artists, pandemic, ucl, culture, creativity, health, public health, radical, important, museums, recognising, individuals, thinking


Harold Offeh, Xand Van Tulleken, Helen Chatterjee, Rochelle Burgess


Xand Van Tulleken  00:02

Hello and welcome to episode 5 of Public Health Disrupted – the brand new podcast from UCL Health of the Public.  I’m Xand Van Tulleken – a Doctor, writer and TV Presenter and I’m prepared to do pretty much anything to start a conversation on public health. And I do mean anything, whether it’s editing journals on humanitarian healthcare or experimenting on my body for children’s television.


Rochelle Burgess  00:37

And I’m Rochelle Burgess - a community health psychologist, specialising in community-based approaches to health. I’m a Lecturer at the UCL Institute for Global Health and a self-confessed hippy here to talk about the importance of community, solidarity and social change to pretty much anyone who will listen. Part of that involves giving lots of hugs so I'm the resident community hug giver.


Xand Van Tulleken  01:07

I'm here for the hugs and the solidarity.


Rochelle Burgess  01:12

This podcast is about public health… but more importantly, it’s about the systems that need disrupting to make public health better. Join us monthly as we challenge the status quo, and ask what needs to change and why. Each month we’ll be joined by activists, scholars, artists, comedians, industry professionals and anyone else we can think of. We want as many people, from inside UCL and out, to join in our public health conversation.


Xand Van Tulleken  01:37

We’re calling this podcast Public Health Disrupted because that’s exactly what we want to do. We’re going to be breaking down disciplinary, sectoral and geographic boundaries to really understand the diverse and complex issues impacting our health.  So in today's episode, we're going to be exploring how arts and creativity can help to tackle health inequalities. And I have to say this is a massive topic, if we think of how broad the idea of arts and creativity is music, poetry, dance, theatre, painting, sculpture, endless amounts of things that can be put into the world and what that would mean to an individual who's never done it before compared to a professional artist, compared to an academic who's looking at an art based intervention as part of a randomised control trial. So I think our guests are unbelievably well placed to steer us through their experiences and what they think What do you think, Rochelle?


Rochelle Burgess  02:31

All that's running in my head right now is 'last night a DJ saved my life ' and I will not sing anymore, ever again, on any episode, but I will tell you that art has saved me on more occasions than I can count. Another one of my secrets is that I sing so there I just outed myself yet again. But singing and poetry and the lot. You know, I think if in another life, I would have been an artist and I keep coming back to it because I think it's so important for finding and living parts of yourselves that get beaten down by the world around us and, and so the idea that we can and should be channelling those different mechanisms of the self to improve health for everyone is one that I am here for and just so excited to be in such great company to discuss this. So I'll just jump in to introduce our first guest, who is Dr. Harold  Offeh who is an artist who works with a wide range of media including performance video photography, one of my faves, which he uses in combination with learning and social arts practice. Harold's work explores history and how it informs contemporary culture, often employing humour to confront the way we tell and relive the stories of our past. He's exhibited widely in the UK and beyond, including the Tate Britain here in London, the Studio Museum in Harlem in New York, and the kunsthal Charlottenborg in Denmark, and my apologies to any Danish listeners for what just transpired. Today via apologies.


Xand Van Tulleken  04:09

Our second guest is Professor Helen Chatterjee, professor of biology in UCL bio sciences and UCL arts and sciences. Helens research includes evidencing the impact of natural and cultural participation on health. She's an advisor to the all party parliamentary group on arts and health. Her interdisciplinary research has won a range of awards, including a special commendation from Public Health England for sustainable development, and the 2018 AHRC welcome health Humanities Medal and Leadership Award and she received an MBE in 2015 for services to higher education and culture. It is a massive treat to have both of you with us.


Rochelle Burgess  04:50

Yes, thanks so, so much. I'll start off my first question for you actually, Helen, what do art and creativity have to deal with public health?


Helen Chatterjee  04:57

Well, we've been researching this question for the past. 10 years and we've worked with a range of different museums of all shapes and sizes, artists, arts and cultural organisations and different sorts of community connectors to understand how their work benefits the health of the public and that we've collected a range of bio psychosocial data. So biological data, psychological well being data behavioural data from a whole range of different audiences that those organisations are working with. We've mostly focused on working with vulnerable and marginalised groups who are not typical or regular users of arts and culture. That might be for example, refugees or asylum seekers, or the people who are perhaps excluded from accessing, for example, museums, older people with dementia, stroke survivors and mental health service users as well as their caregivers and healthcare professionals who support them. And our research has shown that arts and creative engagement elicits a range of different health as well as social and behavioural outcomes, we see increases in positive social experiences leading to reduce social isolation, increased opportunities for learning and acquiring new skills. And we know that that's important for good cognitive health, we see increased positive emotions, optimism, hope, enjoyment, and a sense of belonging, increased self esteem, or confidence, self identity and sense of identity, increased inspiration and opportunities for meaning making an overall healthier lifestyle changes, for example, increased visits to museums and green spaces, once you've been encouraged to come.


Xand Van Tulleken  06:27

 I think you've done an extraordinary job of sewing together, a method of prizing apart this and looking at how how certain interventions or certain organisations might benefit people, when you have such a range of possibilities to look at. If we move from the academic perspective to Harold, I know you are a doctor, but you're also a practising artist. How do you see arts and creativity tackling health inequalities? Who gets access to these kind of public health programmes?


Harold Offeh  06:59

That's obviously a very huge question. And I think it's important to sort of think about the many different aspects of arts and creativity and how they intersect and impact on public health. But I think for me, a crucial thing is participation, and really thinking about not only the opportunity to engage with the arts and creativity broadly, but the qualitative experience of that, through my experience as an artist, I mean, I work quite a lot in social contexts, where I'm working with people who don't often think about themselves as kind of creative beings or creative individuals. I think in that context, I really begin to see some of the problems that I think we have within the culture, which is this kind of siloing, there's a kind of separation between people's experience everyday experience, and what they view as art, culture, in inverted commas, and creativity. And often people see those things as being very much outside of their everyday experience. And I think for me, that is the problem is that sense in which already there's a sense of things being outside of everyday experience. And I think for me, something that I'm really invested in is that sense in which there isn't that separation is that you know, as, as humans, we explore, and use all the tools that are available to us, including creativity. And I think when you begin to have more of a kind of holistic perspective, I think it begins to kind of counteract some of the damage that comes from people lack of access to certain areas of art and creativity. It's for me, what's very problematic in the UK is how arts and culture is very class based, which creates these hierarchies that I think that mean that, again, often exclude people, or people feel they don't necessarily have access to,


Rochelle Burgess  08:53

I think, Harold, you really hit the nail on the on the head there with this idea that people don't see themselves as being allowed to or as what they do with counting as art or being being able to see yourself in those spaces. And it made me think of. So in the beginning, I said that I was a singer. The thing is that I'm classically trained, I was wanting to be an opera singer, tell me how many black opera singers you've ever like seen, and I just sort of was like, Oh, that's not for me so I will do what my mom says and I will become a doctor instead. So there is something about in trying to think about engaging vulnerable communities, how we think about how arts and culture are portrayed as being part of everyday life or something that's a part of the performance of an ideal, and I guess I just would love to hear some of your ideas or thinking about how we work to bring as many people into the fold in terms of thinking about how they access arts and culture and to show that it is for them.


Harold Offeh  09:51

Yeah, I mean, I think it's, it's a crucial point. Maybe it's a slightly tricky way of viewing it. But I think again, it's this thing about partly compartmentalising things, you know, in the way that that school curriculum separates double science, from art from music history. And again, I'm I'm sort of a real believer in this kind of like holistic approach and also seeing the kind of cross currents of creativity and art in science, the scientific thinking that can be applied to creativity as well. And, and so I think it's interesting. I think in other cultures, there isn't this separation between like art, what we what we view as art, and often I think art is the problem. Whenever I'm doing collaborative community projects or working with people who don't consider themselves artists, I feel like I have to dismantle this whole structure and hierarchy of art, we put art in institutions, which is an important part of kind of preserving and recognising the value of that. So in a way, that pedestal I think, disenfranchises people. I mean, I'm of ghanaian heritage and you know, I really love that idea that you get in Ghana, people living the museum, like it's what they're wearing, it's the Kente cloth that has a history that that is, you know, it's the symbols, it's the instruments, you know, this kind of Sonic culture, talking drums, there's, there's a kind of integration of art and culture into the every day, that it makes it weird for people to think about going to a museum, I don't need to go to a museum, I just need to talk to my grandmother or like, go out into the streets. So I think that, for me, is a kind of central thing.


Helen Chatterjee  11:30

People like Harold and the organisations that he works with, you know, for example, hospital rooms, and many of the organisations we've been working with over the last decade or so they've got such a wealth of experience of understanding communities, what their needs are, how they're more marginalised, what their vulnerabilities are, in many ways, I think much better than healthcare professionals and or people researching that. So people in my situation, and in a way, they understand that they have already this inherently person centred, more holistic, nuanced way of understanding what we would call complex needs. And therefore, in a way, they've got that practical experience of understanding those wider social determinants of health. For example, you might have an individual who's got very specific health issues. So they might have depression, or diabetes, or dementia, or obesity, or maybe all of the above. But often what we see is individuals who are experiencing the worst inequalities and who are often excluded most from society, they're, for example, also for issues. So with debt, they might be unemployed, they might have issues, you know, with be having been in prison, they might have housing problems that may have led to drug or alcohol misuse, they're living in very deprived areas. So again, that idea of collaboration between people and Harold and those organisations, community connectors, you might call them, community organisations that have that really deep understanding, linking that up with health, social care and social services, I think is the best way to tackle issues around vulnerabilities and targeting people. But that's really got to, I think, be at the heart of I totally agree with Harold -  systems change. And there are opportunities, I think, around that we're seeing these new integrated care systems being rolled out in England, which is specifically about partnership. But I think that only works if you place people with complex needs, together with those community, individuals and professionals who really understand their needs, alongside the services that are already being offered, because many of those individuals are not actually as Rochelle I'm sure knows they're not accessing those services, or if they do they access them much later than other individuals. So the situation is, is exacerbated.


Rochelle Burgess  13:27

That's really it, right? Like I love that what you've said there about communities, knowing better themselves, where the needs are, where the tensions are, what the complexities are, and also, what roots there might be to solving that. It's something that seems to have run across a lot of our other episodes is the importance of listening to and anchoring to people's stories and voices and actually enabling support services, to follow them and follow their journeys as a way of improving well being.


Xand Van Tulleken  13:57

What do you both think about the idea, the role that arts and culture might play in this post pandemic recovery or not, not post pandemic, but the recovery and our ability to cope with and process the pandemic as it continues around the world. And potentially as things alter a little bit for the better in the UK, the idea of a sort of build back better agenda, what's the role of arts and culture in that?


Harold Offeh  14:19

I think the arts and culture have a huge role to play. I mean, I think one's got to acknowledge the devastation that arts and culture infrastructure has had under the pandemic, one of the things that we need to do is definitely sort of build up that infrastructure. But I think in this moment of some hopefully coming out of the pandemic, and seeing a post pandemic future, I think there's an opportunity to really start to think about how we might shape the arts and culture infrastructure in slightly different ways. That ways I think I'm definitely more responsive to communities that I think is more Integrated and joined up with other sectors, particularly public health. But I think also other areas of public life. Because I think all too much we see our arts infrastructure, I'm focusing on arts, there are other areas, obviously, but maybe they're the most visible things that we think about galleries and museums. But as we think about youth and community art services, that are really the kind of sort of bedrock of the arts ecology, it's often where young people encounter the different arts at a grassroots level, I think it's really important that we begin to really think about the relationship in this ecology between these different institutions. And think about really embedding them. I mean, I've been as an artist involved with many organisations, Helen mentioned hospital rooms, which commissions artists to work on psychiatric wards, most galleries have schools and community kind of initiatives. And this is where I got involved in learned about social practice and working with people in in different contexts. But still, it's a little bit kind of piecemeal, you know, with the funding and how the funding is kind of allocated. But also, I think, in the reach and scope, and depth of relationships between institutions, I have a utopian vision about the arts being totally integrated into every aspect of life. So seeing artists, dancers, musicians, in hospitals, in clinics, in schools, integrated into kind of social services, not instrumentalized, which often happens, and I just want to say that because there's often a danger of like, oh, get an artist in and they'll do a mural, and that'll sort everything out, I think it's about recognising the knowledges, and practices that artists across the arts have, but also recognising the cultural knowledge that communities have, and bringing those together.


Xand Van Tulleken  16:55

Helen, I can see you're nodding along with that, at the instrumentalisation that Harold mentioned to me so fascinating, because there is a danger with a lot of things that are  joyful and incredibly meaningful that the medical community will take them and go Alright, well, can we turn it into a pill somehow? Can we like prescribe a packet of watercolours? And then you have to show your watercolours to your GP or your insurance company in order to get your sort of mad things like this until you're at the sort of interface of maybe that tension where in demonstrating the value, you're potentially then giving them metrics to recommend things. But Helen, how do you resolve that tension? And how do you see to see the arts and culture getting us post pandemic, that sort of recovery process,


Helen Chatterjee  17:39

I think it's really important - Harold hit the nail on the head really. It's that closer collaboration, or what we've seen specifically from arts and culture, which I think we can all learn a lot from is that it can be really, really agile and dynamic that can respond very, very quickly, when they've got a really deep understanding of those communities needs. We've seen these new and unexpected collaboration. So museums, libraries, artists, working with food banks, or local authority risk registers. So these new ways of working, but what we want to do is move away, like Harold says, from this instrumental, where you're just doing some something one off to try and create a specific outcome for a short period of time into something that's intrinsic to, to all those individuals lives within their community, that they're going to be regular users at that Museum, or the library that creates big shifts in the way that those organisations are funded, the way that they're managed. And I think if we really want to, I guess, harness the sort of collective power of arts and included that nature and other sorts of community assets, we've got to build these sort of creative health partnerships and operationalize them in that sort of systems way. And that create requires big change, you know, a policy level at funding level at management level and strategic levels, requires cross government working, cross funding working, and I think there are opportunities to do that. But really, it's only going to work if again, communities and particularly the most vulnerable members of society, put at the heart of that.


Rochelle Burgess  19:02

It feels like there's this critical moment that we're at right now where we could, we could do all of those things we could completely sort of restructure the way things are financed and structured and where things are embedded. There was this brief window of time in the pandemic, when I felt a lot of hope for the way in which community assets and community power was being recognised in these other echelons of power. But if I put on my devil's advocate hat, I don't know how well that's panned out. And what makes me think about that is particularly how the arts and theatre sectors have been completely left behind in terms of thinking about support during the pandemic. I have lots of friends and colleagues who were parts of mobilizations to get funding given to the arts, which came much later after everything else. It was almost this, this afterthought and the mobilisation you're talking about Helen really is organisations who do this out of deep love for the communities that they're embedded in, not because they have the funding laying around, and it could go in either direction, I just wondered if you would both reflect on what would a post COVID world look like, if we didn't do those things? Because what would a post COVID world look like without art? If we don't get our act together and support these mechanisms and support these changes that we know and have the evidence for that are so important to health and well being?


Helen Chatterjee  20:28

I would say bleak and depressing are the two words I would use, I mean, actually, you're right Rochelle the research has shown that there's been this big uplift in awareness of community assets and people using arts and culture to support them during the pandemic. And and we need to keep that momentum up and continue to provide opportunities, particularly I think, for excluded audiences. And again, it comes down to those systemic shifts in the way that they are funded and the way that they run. And I think there's a lot of enthusiasm from that sector to do that. I mean, yes, we've got our culture, health and wellbeing Alliance annual conference running at the minute, and there are hundreds of people at that all committed exactly to that. So I think, you know, the time is now for a radical change.


Harold Offeh  21:09

Yeah, I mean, it would, it would be awful, sort of post pandemic world without art, although in some ways, I mean, often think about, because it's just a part of humanity, like it's always there. Because I mean, when we were talking about, again, the kind of infrastructure and how people's access to the arts is facilitated. I mean, I'm always really concerned with education. And, you know, often as a kind of sort of incubator for young people really thinking about their relationship to the world. And I think at the moment, what really worries me is this inequality and imbalance across the country. So you see in places, because I often do quite a lot of work with schools, you see some schools that have really amazing provision, they'll have galleries, I'm talking about the state sector here I won't talk about about the division between private schools and states. But in other areas, it's a complete desert, they might do either music, theatre or art once every two weeks for half an hour. And I think for me, that is a real problem infrastructurally moving forward, is that we're building generation leaders inequality, and disenfranchising a huge section of the population moving forward. And I think that's something I'm really thinking about as an arts professional, that has to be counteracted.


Xand Van Tulleken  22:36

Harold, I guess as someone who's creating art, how much do you think that you are beyond beyond entertainment? Beyond diversion beyond engagement beyond an intellectual process, you are putting something into the world that it's disruptive,


Harold Offeh  22:48

I don't necessarily set out to make a kind of radical piece of art because, because I think you know, that that notion of radicality is so contingent on context, something that I consider to be potentially very conservative could be radical in a particular context. For me, I think it's more about curiosity and questioning, and finding ways of kind of communicating effectively, I think, in order to bring to light what for me are social concerns. I mean, I'm some of its invested in social justice, and access and education. So those questions are very kind of live to me. And I often think about how I might create and facilitate spaces for those things to be what for conversations around those things for shared making, for shared learning for collaborative co working models, I don't know whether that's necessarily radical or not, I don't always think we necessarily need things to be labelled as kind of radical, maybe they just need to be efficient, or maybe they need to be streamlined. Sometimes the manifestation can be very slight, or very simple. Often, I think, in reaching for the kind of radical can get lost in the kind of hyperbole or rhetoric of the big gesture that maybe doesn't have as much impact. I mean, I think when I think about radical, I mean, maybe this is a bit sucky up to say because Helen's here, but I think, you know, the work that she's doing and her colleagues are doing, I think it's actually quite radical in terms of that investment, long term investment and co partnerships, the data that's been kind of collected, maybe it's not the kind of very like splashy, sexy stuff that you might see like a big theatre production with like nudity or like splashing quite political headlines during but it's that important conduit, but making those kind of connections that is kind of sort of needed. You know,


Xand Van Tulleken  24:40

I love that although I believe for the next departmental meeting it is planned to be in the nude, isn't it Helen?


Helen Chatterjee  24:47

I'm definitely doing that alread. Thank you to Harold for the lovely words, but I did want to just flag up I think the fact that you've mentioned education, and I think I absolutely agree in integrating these more radical approaches in Co-production and collaboration. That's something we're trying to do in our new Master's programme at UCL in creative health, which I'm really hoping Harold and his colleagues are going to get involved in helping to teach. And it's really about a new way of teaching and learning through community engagement and through partnerships. So it's really about training a new generation of scholars and practitioners, I guess, to meet this, hopefully changing health, social care and voluntary third sector where this notion of personalised care and person centred care and health equity and the patient experience are mainstreamed into public health. And we've got loads of brilliant artists, arts organisations, community organisations collaborating with us to deliver it. So it's gonna be really exciting.


Rochelle Burgess  25:42

I'm so excited about that programme, you will see me hanging out there, even though I probably shouldn't be. Uh, yeah, it was I saw that. And I was like that that is what dreams are made of really, really excited. So I mean, just as we're wrapping up now, it'd be really great to ask one more question, something that we've been doing on the podcast so far this series is that we've been asking our guests to think about an artefact sort of a piece of art or music or something in their life that has disrupted their thinking and shifted the way that you think about it and engage with the world. And I just wondered if you would be able to share something,


Harold Offeh  26:22

I'm maybe it's a slight cop out, but I'm gonna choose something that I've been using as part of a project that I've been working on. So maybe I'll cite this book, if that's okay, is that allowed? So there's a book that I've been reading by Barbara Ehrenreich called dancing in the streets, a history of collective joy, which is, it's a really great work. It's a kind of survey of that sort of maps, social joy, where there are these moments of ritualistic practice or going back into kind of classical culture, bacchanalian, reveries practices of ancient Rome and Greece, but also thinking about how our relationship to collective joy has been inscribed through colonialism, and those encounters of religion with indigenous cultures. And how that's then kind of echoed into our present, but also then thinking about the relationship between dance and protest collectivity in public places, which is, at the moment, quite heavily policed. So yeah, I mean, I would cite that I mean, this has been linked into some research that I've been doing, but yeah, really enlightening. And so because I've been thinking a lot about the communal and collective spaces, just because I think are the things I don't have access to at the moment.


Rochelle Burgess  27:37

Amazing, fantastic. I've written that down.


Xand Van Tulleken  27:41

I've already ordered it


Helen Chatterjee  27:46

It's so hard to choose one. Rochelle, you mentioned last night a DJ. saved my life, Frankie Knuckles saved my life on many occasions - RIP. But I think i have to draw from nature just because I love hiking and just being out and out and about in nature and the black mountains. I spend a lot of time there simply because it's easy to get to from London. I also figure skate. And that I think is Yeah, that's really helped me with my research actually talking about the flow state and being immersed emotionally, physically, cognitively in activities just trying to land a jump without, you know, severely injuring yourself whilst also enjoying yourself and making it look relatively good.


Rochelle Burgess  28:24

Oh my gosh, I don't think I've ever met a figure skater before, even though I grew up in Canada. So now I'm definitely going to come and hang out near your office at UCL


Helen Chatterjee  28:35

I've been asking for years for UCL to get some dry ice


Rochelle Burgess  28:39

Yes an ice rink!


Helen Chatterjee  28:44

I can teach you! I'm not very good, but I've been doing it for about 20 years.


Rochelle Burgess  28:50

That's amazing. Wow.


Xand Van Tulleken  28:52

What a treat having you both on that's so lovely.


Rochelle Burgess  28:58

You've been listening to Public Health Disrupted. This episode was presented by me, Rochelle Burgess and Xand Van Tulleken, produced by UCL Health of the Public, and edited by Cerys Bradley. Our guests today were Professor Helen Chatterjee and Dr Harold Offeh.


Xand Van Tulleken  29:13

If you would like to hear more of these podcasts from UCL Health of the Public, subscribe wherever you download your podcasts or visit https://www.ucl.ac.uk/health-of-public/ This podcast is brought to you by UCL Minds - bringing together UCL knowledge, insights, and expertise through events, digital content, and activities that are open to everyone.